I Love Neuro
We are a couple of neurologic physical therapists on the quest to keep the passion, commitment, and possibilities alive for those who love neuro rehab and wellness like us, without burnout and overwhelm. This show is great for neuro therapists and trainers looking to stay up to date and make a greater impact. Join us in this important movement to elevate healthcare!
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235: Your Neuro Practice Questions Answered By APTA President Roger Herr, PT, MPA
10/14/2024
235: Your Neuro Practice Questions Answered By APTA President Roger Herr, PT, MPA
In today’s episode Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS had the pleasure of interviewing APTA President Roger Herr and asking all of the burning questions about what it’s like to run a neuro practice with Medicare as it is and where we’re going. Roger shared his journey into physical therapy and his extensive experience in key roles that gave him a wide angle perspective of the profession he advocates for now. Alternative Payment Models for PT Practices - Herr emphasized the importance of finding local, regional payment models that best fit each practice's needs, whether that's working with employers, payers, or patient groups. - He discussed strategies like opting out of Medicare, negotiating contracts, and exploring cash-based services to create sustainable business models. Challenges for Micro Practices - Smaller PT practices often struggle with billing, communicating with payers, and navigating the complexities of Medicare coverage. - Could clearer guidelines around medical necessity and skilled care be a helpful short-term goal? Advocacy Efforts for the PT Profession - Herr highlighted the need to shift from volume-based to value-based care, and to advocate for recognizing the downstream costs and impact on patients. - He discussed opportunities in Medicaid, annual wellness visits, and partnering with patient advocacy groups to drive change. Modernizing Medicare Access - Herr explained efforts to update Medicare legislation and allow beneficiaries to directly contract with physical therapists. - This could provide more flexibility and options for patients, though the details around rules and limitations are still being worked out. Leveraging Technology and AI - Herr shared insights on how technology and AI can support population health management, documentation, and reducing administrative burdens for PT practices. - Sign up by logging into APTA account, then go to Online Profile, then Find a PT Instagram X @RAHPT Facebook Roger Herr
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234: Advancing the Understanding and Treatment of Functional Neurological Disorders With Heather Salon, PT, DPT, NCS and Julie Maggio, PT, DPT, NCS
10/07/2024
234: Advancing the Understanding and Treatment of Functional Neurological Disorders With Heather Salon, PT, DPT, NCS and Julie Maggio, PT, DPT, NCS
Feel confused about how to assess and treat someone with Functional Neurological Disorder (FND)? We got your back! In this episode host Erin Gallardo interviews FND experts Heather Salon, PT, DPT, NCS and Julie Maggio, PT, DPT, NCS on this range of neurological symptoms that includes functional movement disorders, seizures, and speech/communication issues. FND is characterized by abnormal brain connectivity and network dysfunction, often presenting with mixed symptoms. A key shift in recent years has been the recognition of FND as a "rule-in" diagnosis, rather than a diagnosis of exclusion. Learn what to expect during the subjective evaluation and how to approach it with best practice. Heather and Julie highlight the importance of identifying specific "rule-in" signs, such as Hoover sign, give-way weakness, and symptom variability, to confidently diagnose FND. They also emphasize the need for a comprehensive assessment, including evaluations of the motor, sensory, and autonomic systems. Also discussed are differential diagnoses like dystonia. The conversation underscored the multidisciplinary nature of FND care, with physical therapists, occupational therapists, psychologists, and neurologists working collaboratively to provide optimal treatment. Sensory-based interventions, such as the use of Kinesio tape, abdominal binders, and visual feedback, were discussed as valuable tools in the PT's toolbox. Importantly, Heather and Julie stress the need to manage patient expectations and set realistic goals, focusing on improving function and reducing symptoms rather than aiming for complete symptom resolution. They also highlighted the importance of ongoing education and resources for clinicians interested in advancing their knowledge and skills in the FND field. Check out these resources mentioned in the episode: FND society education resources Inform the doctor fact sheet
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233: Optimizing Outcomes For Patients with Multiple Sclerosis With Researcher And Clinician, Herb Karpatkin, PT, DSc, NCS, MSCS
09/30/2024
233: Optimizing Outcomes For Patients with Multiple Sclerosis With Researcher And Clinician, Herb Karpatkin, PT, DSc, NCS, MSCS
Have you heard some things about working with people with MS that make you question how to approach their care? Are they old school thoughts or based on science? Who can tell?! You’ll know after listening to this episode! Hosts Erin Gallardo and Claire McLean had the privilege of speaking with Herb Karpatkin, PT, DSc, NCS, MSCS, a leading expert in physical therapy for individuals with multiple sclerosis (MS). Herb shared invaluable insights from his decades of clinical experience and research, providing guidance for physical therapists on how to actually support patients with this complex neurological condition so they improve. A key focus of Herb's research has been exploring ways to help MS patients overcome debilitating fatigue, which often limits their ability to participate in rehabilitation. He has found great success with intermittent training protocols, where patients alternate short bursts of activity with rest periods. Herb shares specific parameters from the research so you can use it now. Next you must recognize that a significant portion of disability in MS patients may be due to deconditioning, rather than the neurological disease process itself. By implementing targeted reconditioning programs, physical therapists can make a substantial impact on improving functional mobility, even in those with advanced disease. Herb's research has also demonstrated the benefits of high-intensity interval training for individuals with MS. Contrary to outdated beliefs, many MS patients are able to tolerate and thrive with aggressive exercise programs when implemented thoughtfully. Herb emphasizes the importance of gradually progressing patients to higher intensities, while closely monitoring for signs of fatigue. To further support the MS community, Herb is actively involved with the Degenerative Disease Special Interest Group of the American Physical Therapy Association. This group has created a Clinician Locator Map to help patients find physical therapists with expertise in treating degenerative conditions like MS. For your patients and clients with MS: Sign up for the clinician locator map: Register for the free webinar on MS interventions you can apply immediately here!
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232: Bridging The Gap: Becoming A Clinician, A Researcher, And A Storyteller With Ryan Lovell, PT, DPT, NCS, ATP
09/23/2024
232: Bridging The Gap: Becoming A Clinician, A Researcher, And A Storyteller With Ryan Lovell, PT, DPT, NCS, ATP
In the ever-evolving world of neurorehabilitation, Dr. Ryan Lovell, PT, DPT, NCS, ATP has carved out a unique path that blends his clinical expertise with a passion for research and storytelling simply through curiosity and exploration. As a physical therapist, doctoral student, and podcast host, Ryan's multifaceted career serves as an inspiring example of the diverse opportunities available within the neuro field. Ryan's journey began with a strong foundation in the medical field, influenced by his mother's work as a registered nurse. Drawn to the intersection of sports medicine and neurology, Ryan found his calling in physical therapy, particularly after a fortuitous opportunity to intern at Casa Colina Hospital. This experience ignited his interest in neurorehabilitation and set him on a course to pursue a neuro residency, specialized certifications, and eventually, PhD candidacy in Rehabilitation and Movement Science. As a researcher, Ryan has tackled intriguing questions, from exploring the use of transcranial stimulation devices for stroke and spinal cord injury rehabilitation to investigating clinical biomarkers in post-concussion syndrome. His work has highlighted the importance of bridging the gap between clinicians and product companies, ensuring that new technologies are not only safe but also truly beneficial for patients. Ryan's passion for storytelling has also found expression through his podcast, The Parallax Effect. Recognizing the power of narrative in making complex scientific concepts accessible, Ryan has used this platform to share diverse perspectives and foster meaningful dialogue within the neuro community. His ability to seamlessly blend his scientific expertise with creative flair serves as a testament to the value of interdisciplinary thinking. As Ryan continues to navigate the realms of research, teaching, and podcasting, his story serves as a reminder of the boundless opportunities that await those willing to embrace the intersection of science, technology, and storytelling. By bridging the gap between clinicians, researchers, and the broader community, Ryan Lovell's work exemplifies the transformative power of a multidimensional approach to neurorehabilitation. YouTube: Instagram: X: @parallaxeffects TikTok: RyloKen27 Facebook:
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231: Navigating Concussion In Aging Adults With Jennifer Lazaro, PT, DPT, NCS
09/16/2024
231: Navigating Concussion In Aging Adults With Jennifer Lazaro, PT, DPT, NCS
Did you know there are some unique differences when working with aging adults who experience concussions? In fact, patients may come to your clinic after a fall and not have the diagnosis of concussion but they may actually have one. How would you know? What would you do to screen for it? What would you treat first? Tune in to answer all of these questions and more! - Concussions in the elderly population often result from falls at standing height, rather than high-velocity impacts. - Symptoms like imbalance and dizziness may be overlooked or attributed to other conditions, making diagnosis difficult. Comprehensive Assessment and Treatment - Evaluating neck pain, vestibular function, balance, and autonomic dysfunction is crucial for managing geriatric concussion. - Strengthening neck muscles, improving cervical proprioception, and incorporating vestibular rehabilitation exercises can aid recovery. - Screening for BPPV and addressing visual motion sensitivity are also important treatment considerations. Monitoring Exertion and Symptom Management - Graded exercise testing, such as the Buffalo Concussion Treadmill Test, can help determine safe activity levels. - Educating patients on pacing activities and using the "gas tank" method can prevent overexertion and prolonged symptoms. - Incorporating breathing exercises can help regulate the autonomic system and promote calming. Interdisciplinary Collaboration and Ongoing Support - Referring patients to the appropriate specialists, such as neurologists or physiatrists, is key for comprehensive care. - Participating in mentorship opportunities, like the NeuroSpark office hours, can provide valuable guidance for clinicians. - Continuous monitoring and adjustments to the treatment plan are essential for successful geriatric concussion management. Check out this episode for more information!
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230: Mastering Floor Transfers and Exercises in Neuro Without the Fear With Dr. JJ Mowder-Tinney, PT, PhD, NCS
09/09/2024
230: Mastering Floor Transfers and Exercises in Neuro Without the Fear With Dr. JJ Mowder-Tinney, PT, PhD, NCS
In this episode, hosts Erin Gallardo and Claire McLean are joined by guest Dr. JJ Mowder-Tinney, PT, PhD, NCS, a highly experienced physical therapist specializing in neurological conditions. Are you afraid to get your patients on the floor? Are you nervous it will be too painful for them (or you)? Join us for this engaging discussion on the importance of getting patients down on the floor and practicing floor transfers, as well as strategies to overcome the common fear and hesitation clinicians may have around this. Some of the key takeaways include: - The significance of building patients' self-efficacy and confidence in getting up from the floor, as fear of falling is closely linked to increased fall risk. - The value of strong movement analysis skills that allow therapists to tailor floor activities to each patient's unique presentation and abilities. - Practical tips for breaking down the task into smaller, more manageable parts and adjusting the environment (e.g. using padded mats) to facilitate success. - The collaborative approach of problem-solving with patients to find the best methods for them, rather than prescribing a one-size-fits-all technique. - The importance of regularly assessing floor skills and incorporating floor exercises into treatment, even for higher-functioning patients. - Encouragement for clinicians to reflect on their own comfort level with floor transfers, seek support from colleagues, and continuously expand their skills in this area. We are also excited to announce a free webinar on September 24th titled "Gettin’ Down and Dirty: Mastering Floor Transfers and Exercises in Neuro Without the Fear," which will give you the opportunity to brainstorm live with hundreds of neuro colleagues from around the world, see some helpful videos, and give you specific takeaways you can use the next day. Here is the Claire uses at her clinic (not an affiliate link) Follow
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229: Creating A Neuro Practice That Works For You AND Your Patients With Vanessa Kaczmarek, PT, DPT, NCS
09/02/2024
229: Creating A Neuro Practice That Works For You AND Your Patients With Vanessa Kaczmarek, PT, DPT, NCS
In this episode Erin, Claire and Emily Duval Ledger interview Vanessa Kaczmarek, PT, DPT, NCS about her experience starting a private practice focused on neurologic physical therapy. Some of the key takeaways include: Starting a Niche Private Practice - Vanessa saw gaps in care for patients transitioning from inpatient rehab to outpatient, so she launched Neuroactive Therapy to provide high-intensity, research-based therapy. - Her practice is primarily cash-pay, allowing her to offer more frequent, customized treatment sessions. Growing a New Business - Vanessa initially struggled to build her caseload, but has since gained momentum through networking with other therapists and reaching out to referral sources. - Marketing and business tasks don't come naturally, but she's embraced them as necessary to sustain her passion for patient care. Balancing Work and Life - As a mobile PT, Vanessa has had to get creative with scheduling to maintain a healthy work-life balance, especially as a mom of young kids. - She's learned to prioritize patient treatment time while streamlining administrative tasks like documentation. Leveraging Technology - The group discussed using AI and dictation tools to improve the efficiency of documentation, though Vanessa prefers a more hands-on approach for now. - They agreed that finding ways to reduce the administrative burden could be game-changing for private practice PTs. Throughout the conversation, Vanessa's authenticity and dedication to her patients shone through. Her story provides inspiration and practical insights for other therapists considering the leap into private practice. Learn more about Vanessa and her practice here! https://neuroactivetherapywellness.com/ Instagram
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228: How To Use Neuroscience To Help Your Clients (Or Yourself) Improve Intimacy and Pleasure With Dr. Rose Schlaff, PT, DPT
08/26/2024
228: How To Use Neuroscience To Help Your Clients (Or Yourself) Improve Intimacy and Pleasure With Dr. Rose Schlaff, PT, DPT
As rehab professionals, we're often hyper-focused on helping our clients improve their physical function and manage pain. But what about the equally important aspects of emotional and sexual wellbeing? In this episode Erin had the chance to sit down with Dr. Rose Schlaff, a pelvic PT and sex counselor, to discuss how neuroscience-based techniques can unlock greater intimacy, desire, and pleasure. Dr. Rose shared her "Reclaim the Flame" method, which combines neuroscience, somatics, and sex counseling to help clients overcome societal pressures and unrealistic standards around sex and relationships. One key component is working with the cranial nerves through simple 30-second exercises. She explained that by grounding into the nervous system and using cranial nerve exercises and an understanding of polyvagal theory, we can help clients shift out of stuck states like anxiety, lack of focus, or low libido. These quick movements that stimulate the eyes, face, and other cranial nerves can create rapid shifts in our physiology and emotional state. You will learn how eye movements actually release dopamine and how to use these to reset your nervous system or your clients. You will also have the opportunity to follow along with an exercise to make a shift yourself during the episode. Additionally, if you’re nervous or don’t know where to start having these conversations with clients we’ll give you the steps you need to help them without the embarrassment. As we discussed, our relationships, stress levels, and feelings of desire (or lack thereof) can have a profound impact on our nervous system and overall wellbeing. Dr. Rose emphasized the importance of clinicians feeling safe and comfortable to talk about any topic with clients, and using self-regulation techniques, in order to facilitate better co-regulation. She encouraged clinicians to normalize conversations around sex and intimacy, even if it feels outside of our typical scope. By tapping into the power of the nervous system through techniques like eye exercises and visualization, we can help our clients (and ourselves) experience greater ease, excitement, and connection in all areas of life - not just the bedroom. It's an empowering reminder that holistic health encompasses so much more than just the physical body. To learn more from Dr. Rose and explore her free resources use the links below.. And keep an eye out for her upcoming trainings on trauma-informed pelvic and sexual health coaching. Free 15 min call: Free guide: ^ FREE GUIDE: Playing with Power Dynamics: Scripts to Get You Confident and Comfortable Asking For What You Want in Any Setting! This guide will take you through examples of my 3-step strategy to feel more comfortable, confident, and cozy communicating in any setting so you can: ✅ Decrease pain or discomfort during intimacy so you can have more fun and feel more care-free, confident, and connected in and out of the bedroom ✅ Feel calm and confident communicating your wants and needs ✅ Take the pressure off so you can feel energized and excited by intimacy BONUS: navigate medical appointments with more comfort and confidence
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227: What You Should Know About Telerehab To Improve Access And Equity With Dr. Jennifer O’Neil, PT, PhD and Dr. Alan Lee, PT, DPT, PhD
08/19/2024
227: What You Should Know About Telerehab To Improve Access And Equity With Dr. Jennifer O’Neil, PT, PhD and Dr. Alan Lee, PT, DPT, PhD
Have you ever wondered how to effectively use telehealth to provide care? Maybe you’re already using it and want to know how to improve. In this episode of the I Love Neuro Podcast, host Erin Gallardo sat down with two leading experts in the field - Dr. Jennifer O'Neil and Dr. Alan Lee - to learn the latest research about telehealth. Dr. O'Neil, a physiotherapist and professor at the University of Ottawa, shared her passion for using telehealth to improve access to rehabilitation services. She became interested in this area after seeing how much time she spent traveling to see her patients in Canada's vast countryside. Her doctoral research focused on implementing intensive home-based telerehabilitation programs for people living with traumatic brain injuries. She also discussed her work on a telehealth falls prevention program tailored for Francophone communities, highlighting the importance of addressing health equity. Dr. Lee, a physical therapist and professor at Mount Saint Mary's University, provided historical context on the development of telehealth in physical therapy. He talked about the contributions of the international physical therapy community, including the recent publication of a clinical practice guideline (CPG) on telehealth from the American Physical Therapy Association (APTA). This guideline covers everything from video conferencing to remote monitoring and asynchronous visits. The experts shared their insights on key considerations for implementing telehealth, such as safety, patient satisfaction, and the importance of shared decision-making with patients. They emphasized the need for standardized terminology and the inclusion of qualitative research to better understand the nuances of telehealth delivery. Erin asked about the barriers and best practices for clinicians using telehealth, how to use telehealth with people with cognitive difficulties, tips for using telehealth with groups vs individuals and how to overcome some of the common barriers that clinicians face when using telerehab. The speakers highlighted the importance of preparation, digital literacy, and adapting clinical skills for the virtual environment. They also discussed the latest changes in billing and reimbursement, as well as their opinions on whether telehealth visits should cost the same as in-person visits. Download the CPG here: [email protected] @oneil_jenn @alanleedpt (X) (Linkedin) (email)
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226: How To Start And Scale An Outpatient Neuro Practice With Katie Bouchillon, OTR, CBIST, MCMT
08/12/2024
226: How To Start And Scale An Outpatient Neuro Practice With Katie Bouchillon, OTR, CBIST, MCMT
In this episode of the I Love Neuro podcast, hosts Erin Gallardo and Claire McLean sat down with Katie Bouchillon, OTR, CBIST, MCMT, owner and CEO of Spero Rehab, a multidisciplinary outpatient clinic with 6 locations across Houston and Austin, Texas. Katie shared her journey into neuro rehabilitation and entrepreneurship, offering valuable insights for other clinicians looking to start or grow their own practices including what NOT to do based on the big mistakes she made along the way. - Katie was motivated to start her own clinic after becoming frustrated with the decreasing length of stays for neuro rehab patients at her previous employer. She saw a need in the community for more effective and sustainable rehabilitation options. - Starting a brick-and-mortar clinic from scratch came with its challenges, including taking out a large loan and making mistakes in the early years. Katies emphasizes the importance of establishing core values and a clear vision before opening a practice. She explains what this looks like in practice. - Building a strong network and community involvement are crucial to Katie’s success. She leveraged relationships with former colleagues, participated in local events, and used social media to attract patients and employees. - Running a neuro-focused practice comes with unique financial and operational challenges. Katie discusses strategies like outsourcing services, partnering with nonprofits, and diversifying service offerings to maintain financial stability. - Hiring the right team and delegating responsibilities were key to Katie’s ability to scale her business. She prioritizes finding passionate, adaptable employees who share her core values. She explains where to find “A players” and how long it could take to find the right people. Overall, Katie’s story highlights the rewards and difficulties of entrepreneurship in the neurorehabilitation field. Her insights offer valuable lessons for clinicians looking to take the leap into private practice.
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225: How To Integrate Nutrition, Regenerative Therapy, and Fitness into a Specialized Geriatric and Parkinson's Physical Therapy Practice With Beth Templin, PT, DPT, GCS
08/05/2024
225: How To Integrate Nutrition, Regenerative Therapy, and Fitness into a Specialized Geriatric and Parkinson's Physical Therapy Practice With Beth Templin, PT, DPT, GCS
In this episode of the I Love Neuro Podcast, hosts Erin Gallardo and Claire McLean sat down with Dr. Beth Templin, PT, DPT, GCS, the founder of House Fit Physical Therapy, to discuss her innovative approach to serving the aging population and those living with Parkinson's disease. Beth shared her journey into geriatric physical therapy, starting a mobile practice and then expanding to a 5,000 square foot facility that offers a range of services beyond one-on-one therapy. Some key highlights from the conversation include: - Navigating Medicare billing as a non-participating provider initially, then transitioning to a participating provider to remove barriers for clients - Offering a diverse range of fitness classes tailored to different ability levels, with physical therapists leading the classes. Classes are with mixed populations of people, which is unique. - Incorporating non-invasive regenerative therapies like electromagnetic transduction therapy and shockwave to provide pain relief - Launching a comprehensive nutrition education and coaching program, including monthly plant-based potlucks - Emphasizing the importance of integrating nutrition, exercise, and lifestyle changes to achieve the best outcomes for their aging adult and Parkinson's clients The discussion provides valuable insights for physical therapists and other healthcare providers looking to expand their services and take a more holistic approach to patient care. By blending traditional therapy, innovative treatments, and lifestyle interventions, House Fit Physical Therapy is setting a new standard for supporting the aging population and those living with neurological conditions.
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224: The Best Approach To Vision Therapy With Dr. Melissa Zarn Urankar, OD, Katy Coleman, OTR/L, and Xenia Andrzejewski, PT
07/29/2024
224: The Best Approach To Vision Therapy With Dr. Melissa Zarn Urankar, OD, Katy Coleman, OTR/L, and Xenia Andrzejewski, PT
In today’s episode we hosted three experts in vision rehabilitation, optometrist Dr. Melissa Zarn Urankar, occupational therapist Katy Coleman, and physical therapist Xenia Andrzejewski to discuss the importance of optimizing care for people with neurologic conditions who have vision dysfunction. The episode will address who sees patients for vision impairment - an optometrist, ophthalmologist, or neuro-ophthalmologist? Plus what are the differences in their roles for clinicians and optometrists. What are some of the things clinicians should look for that would prompt them to assess a patient's vision more closely? What are some key assessments or techniques they can use? What resources and training are available for physical therapists and occupational therapists who want to improve their skills in visual rehabilitation? Are there any certification programs? The guests will share their key insights into having a collaborative relationship with other disciplines and where you can find your team. Key takeaways: - Building relationships with your "weirdos" or like-minded clinicians who are open to sharing perspectives is crucial for problem-solving complex patient cases. - Optometrists, occupational therapists, and physical therapists each bring unique expertise, but must be willing to listen and learn from each other to provide the best care. - Clear communication and avoiding jargon is key when working across disciplines. Clinicians should focus on describing functional observations rather than making assumptions. - Attending continuing education courses like the NORA annual conference can help build interdisciplinary knowledge and networks. - Reaching out to local vision therapy specialists and being open to learning from their perspective can greatly benefit OTs and PTs working with neuro patients. By embracing an interdisciplinary approach and putting the patient's needs first, clinicians can provide more comprehensive and effective neuro vision rehabilitation. Collaboration is key to unlocking the best outcomes for those recovering from neurological injuries or conditions. Helpful links:
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223: Spasticity Management From A Physician With Dr. Cassandra List, MD
07/22/2024
223: Spasticity Management From A Physician With Dr. Cassandra List, MD
On this week’s episode we hosted a specialist in Physical Medicine and Rehabilitation, Dr. List and occupational therapist Briana Elson, MS, OTR/L, BCPR, CBIS to share insights on spasticity management, focusing on the use of neurotoxin injections and collaboration between physicians and therapists. Key discussion points included: When do you recommend medication versus injection for spasticity management? What do you consider when deciding on a treatment plan for someone with spasticity? What does botulinum toxin do versus what does it not do? When is it too early or too late for neurotoxin injections? Is there research showing that earlier treatment with neurotoxins can prevent symptoms from worsening? Are neurotoxins typically covered by insurance for people? How do you differentiate between spasticity and hypertonicity? What's the best way to get a good outcome when injecting for contractures? Do people need neurotoxin injections continuously to manage spasticity, or do some only need it temporarily? When do you decide that intrathecal baclofen might be necessary instead of injections? How do you respond to concerns about weakness from neurotoxin injections? Does neurotoxin treatment help with pain associated with spasticity? What's the best way for therapists to communicate with physicians about patient needs for spasticity management? Who can perform neurotoxin injections, and how can patients find a provider? This session highlighted the complexity of spasticity management and the need for a multidisciplinary approach. By combining medical interventions with therapy and ongoing assessment, we can help our patients achieve their functional goals and improve their quality of life.
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222: How You Can Be Tenaciously Optimistic In Business To Be Successful
07/15/2024
222: How You Can Be Tenaciously Optimistic In Business To Be Successful
In this episode Emily Duval Ledger, Erin Gallardo, and Claire McLean explore how maintaining an optimistic mindset can drive success in both clinical practice and business operations. Often it’s not as easy to do this in business, but we’ve got some strategies to share with you today. Key points included: - The power of positive language and beliefs in shaping business outcomes - Viewing challenges as opportunities for growth and innovation - Applying clinical confidence and problem-solving skills to business situations - The importance of perseverance and maintaining perspective during difficult times - Building a supportive community of like-minded professionals The hosts emphasized that while running a business can be challenging, especially in healthcare, maintaining a tenaciously optimistic outlook can lead to creative solutions and ultimate success. They encouraged listeners to reframe obstacles, stay committed to their goals, and remember that "success is inevitable" with persistence.
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221: How To Start A Wellness Program For People With Neurologic Conditions: All Your Questions Answered!
07/08/2024
221: How To Start A Wellness Program For People With Neurologic Conditions: All Your Questions Answered!
In this enlightening discussion, we have an open conversation with physical therapist Lauren Young, PT, DPT, CSRS, NCS, who reached out to Claire with a number of questions. She was willing to come on the podcast so everyone can benefit from the information. Lauren started a mobile neuro practice in February 2024 and is looking to develop group wellness classes to increase access to specialty services. Claire answers the following questions: 1. How do you make exercise classes accessible for all levels of abilities in a group setting? 2. How did you start your wellness program, particularly regarding staffing and class structure? 3. How do you structure her membership model and pricing? 4. Looking back, is there anything Claire wishes she had done differently when first starting? Key takeaways include: 1. Renting space from existing gyms or studios is a smart way to start without heavy upfront costs. 2. Structuring classes for different ability levels is crucial for safety and effectiveness. 3. A monthly membership model provides consistent revenue and commitment from clients. 4. Pricing should reflect the premium nature of specialized services, even if it feels uncomfortable at first. 5. Slow, steady growth allows for learning and adaptation as the business evolves. This conversation offers a wealth of practical advice for PTs looking to expand into wellness programming for neurological patients, emphasizing the importance of adaptability, client-focused services, and sustainable business practices. Find out more about Lauren Young here: NeuroElite Physical Therapy (Instagram) Have a neuro biz and want a place to ask questions of other biz owners?
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220: Building A Biz Model Mix Of Online And In-Person With Katie Nathan, PT, DPT, NCS
07/01/2024
220: Building A Biz Model Mix Of Online And In-Person With Katie Nathan, PT, DPT, NCS
On today’s show, Dr. Katie Nathan, PT, DPT, NCS joined Erin and Claire to share her journey building a successful physical therapy business to maximize impact and reach as many people as possible with focused Parkinson's disease. Katie received her doctorate from USC in 2016 and is passionate about using exercise and movement to empower those with neurological disorders. This led her to start her own business, Moved by Movement, which offers one-on-one sessions, group classes, and a new online membership program. Discover why Katie decided to start her own business and how she went from in person to now starting an online membership. She shares the details of her transition to working for herself full time, how she manages to keep her energy high, what it’s like owning a business solo especially if she wants to travel and what she’s learned with starting and online membership. Katie relocated to Reno, Nevada and had to start from scratch. She shared some of the networking strategies that helped grow her new practice, like volunteering time, speaking at support groups, and consistently being helpful to build trust in the community. Katie has since transitioned her business from one-on-one sessions to a group model through outdoor bootcamp classes. She also launched an online membership called Movement Matters Membership to serve clients worldwide through weekly live classes, an on-demand video library, and educational meetings. The hosts and Katie discussed tips for work-life balance as business owners, marketing strategies, investing in professional video equipment, and more. Katie's passion for empowering those with neurological conditions through exercise was inspiring. Her story shows how physical therapists can thrive outside the traditional healthcare system. Follow Katie on Instagram: Website:
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219: New Evidence On Brain Changes In PD Inspires Hi-Fi Exercise Class At Rogue
06/24/2024
219: New Evidence On Brain Changes In PD Inspires Hi-Fi Exercise Class At Rogue
We’re back for another episode this week! This one is bringing you practical clinical tools you can start incorporating right now. It’s based on new evidence with intense exercise and its effect on increasing dopamine transporter and neuromelanin concentrations in the substantia nigra in Parkinson’s disease. While Rogue has always been known to implement the research into practice, a transition at the clinic and inspiration from a recent article (small “n” yet still inspiring) results in a new class format that just started at Rogue PT and Wellness, Claire’s gym for people with PD. Claire introduces the new high-intensity class at Rogue called "Hi Fi" for “high intensity” and “functional.” It incorporates cardio, strength and functional exercises into intervals with modifications. The format follows recent research on intense exercise improving neuromelanin in Parkinson's. Find the link below to the full text free article. Hi Fi includes a warm-up before intervals alternating between two high-intensity exercises and five skilled exercises. Exercises target mobility, balance and strength. Visual cues and straps help improve participants' form. Claire discusses adapting the class based on themes like last week's focus on mobility. Exercises included burpees, lunges and power moves using straps and chairs. Check it out and let us know what you learned and what you’re going to try!
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218: Advocating for Accessible Healthcare for People with Disabilities With Chanda Hinton
06/17/2024
218: Advocating for Accessible Healthcare for People with Disabilities With Chanda Hinton
Our recent guest on the I Love Neuro podcast, Chanda Hinton, is doing impactful work to improve healthcare access and quality of care for individuals with disabilities. As the Executive Director of the Chanda Center for Health & Wellness in Denver, Colorado, Chanda leads efforts in both direct service provision and systemic advocacy. Chanda shared her personal story of living with a spinal cord injury since 1991. She discussed the secondary conditions that often arise and how the medical model can fall short in long-term support. Chanda's experience with chronic pain and reliance on opioids inspired her vision for the Chanda Center - providing holistic, collaborative care through integrative therapies like physical therapy, acupuncture and massage. For 19 years, the Chanda Center has evolved its approach. It now offers on-site services under one roof, including physical therapy, chiropractic, behavioral health and more. Chanda advocates for Medicaid coverage of these therapies based on her success with them. She works to reduce red tape around physical therapy access through Medicaid as well. Chanda highlighted the need for improved disability competence among healthcare providers. Biases that disability equals sickness must be challenged. Providers need education and autonomy to respectfully serve individuals. Chanda also emphasized the importance of visibility - on social media and in mainstream representation. This helps normalize the reality that one in four people will experience disability. Through direct service, advocacy and legislative change, Chanda empowers people with disabilities. She trains providers and works to redefine narratives around both disability and aging. Chanda's courageous and collaborative approach is uniquely improving lives and transforming healthcare systems. To learn more about supporting the Chanda Center's mission, visit their website at LinkedIn: Facebook: Instagram:
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217: How To Plan A Transformative PD Retreat With Joy Cochran, PT, DPT
06/10/2024
217: How To Plan A Transformative PD Retreat With Joy Cochran, PT, DPT
On this episode of the I Love Neuro podcast, host Erin Gallardo sits down with guest Joy Cochran to discuss her business Joy Explorations and an upcoming Parkinson's disease retreat. Joy started Joy Explorations in 2018 with a goal of empowering older adults and those with neurological conditions through adaptive outdoor activities and movement. She found many of her physical therapy clients were not continuing the activities they enjoyed after discharge. Joy wanted to help people live life to the fullest outside of the clinic setting. Joy Explorations now offers group classes, one-on-one sessions, and "exploration days" where clients can try kayaking, biking on adaptive trikes, and more. Joy assesses each client's needs and works with them to problem solve challenges in a personalized way. In September, Joy will host a four-day Parkinson's disease retreat focused on exercise, education, and immersion in healthy lifestyle strategies. The retreat will incorporate kayaking, biking, hiking, and other outdoor activities alongside workshops on managing non-motor symptoms. Joy's goal is to help participants realize they can do more than they think and leave with new skills and friendships. The podcast provides valuable insights into Joy's process of planning the retreat budget, contracts, and activities. Overall, the episode offers inspiration and practical tips for anyone interested in hosting health and wellness retreats. Learn more about Joy and the retreat here: on Instagram and FB
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216: How To Shed Your Shoulds So You Can Live And Work Happier With Emily Duval Ledger
06/03/2024
216: How To Shed Your Shoulds So You Can Live And Work Happier With Emily Duval Ledger
Ever feel stuck between what you want to do and what you feel like you should do? Uh, yes, all the time! How does it feel when you have these ingrained expectations making decisions for you? Usually not so great. And it happens to everyone. So in this episode we talk about why that happens, how to recognize when you're operating in external “shoulds” instead of internal “shoulds”, what to do about it. Plus we’ll give you permission to be happier AND reach your goals in the way that works best for you. Get resources, examples and experience to draw from and help propel you forward to a life and business led in the exact best way for you.
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215: Learn How To Help Clients Fall WELL With Naomi Casiro
05/27/2024
215: Learn How To Help Clients Fall WELL With Naomi Casiro
Okay, so let’s address this head on: No one wants to fall. But falls do happen. Especially for people who have trouble with their balance. So wouldn’t it be great if when someone did fall, they knew how to roll or land in a way that minimized injury? That’s what we’re talking about today with physiotherapist Naomi Casiro of NeuroFit BC. She runs one on one and group therapy sessions for people with PD teaching them the fundamentals of controlling their movement and momentum in order to minimize risk. In the show we’ll address: The actual format and progression of classes/sessions focused on fall training The method Naomi uses to hone in on what type of falling to treat What the MOST important factor is when teaching someone how to fall well What the contraindications are for this type of training What equipment is needed and how to get started How to get your clients on board to try this training with you You can reach out to Naomi and learn more about the fall training courses she teaches for healthcare professionals here: Free exercise videos:
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214: What To Know About Being Non-Participating With Medicare With Tyler Horton, PT, DPT, NCS
05/20/2024
214: What To Know About Being Non-Participating With Medicare With Tyler Horton, PT, DPT, NCS
There are a lot of reasons you can go into private practice. Most of which have to do with the desire to provide care in a different way than you’ve seen in your community. But the way you set up your practice can be as unique as you are. One challenging question most neuro clinicians face when setting up their private practice is what to do about Medicare? As policies with Medicare continue to change, many opt to enroll in Medicare as a non-participating provider. This means you work with Medicare beneficiaries to deliver covered services but you bill differently. As a non-participating provider with Medicare you’re able to collect up front from patients, submit your claim to Medicare, and Medicare reimburses the patient for the visit (rather than you since you collected your money up front). There are pros and cons about going this route. In this episode we talk to physical therapist Tyler Horton of Synapse Neuro Rehab about his business model and why he decided to become a non-participating provider with Medicare. Tyler has been running his business this way for a few years and helps other neuro business owners who want to become non-participating with Medicare navigate this path. Website: Instagram: Facebook: Join the free slack group, NeuroBiz Besties:
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213: Quick High-Impact, Low-Cost Ideas With Dr. JJ Mowder-Tinney, PT, PhD, NCS
05/13/2024
213: Quick High-Impact, Low-Cost Ideas With Dr. JJ Mowder-Tinney, PT, PhD, NCS
Ever feel discouraged about the care you think you can provide without fancy equipment? Not after you listen to this episode! In today’s show you’ll learn easy ideas to make maximum impact no matter what setting you’re in and what you have available to you. We’ll share actual patient stories to give you real examples of strategies to apply in the clinic tomorrow. Making meaningful change doesn’t require a big budget. Sometimes the best ideas come from using what you have around you and from working on the priorities of your patient. Which ideas are your favorites? To attend the live webinar on High-Impact Low-Cost Ideas for the Posterior Chain, register here: Missed the live webinar but want the replay? Email
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212: How To Safely Get To Heart Rate Peak In Order To Modify Parkinson’s With Dr. Daniel Corcos, PhD
05/06/2024
212: How To Safely Get To Heart Rate Peak In Order To Modify Parkinson’s With Dr. Daniel Corcos, PhD
Have you heard exercise is good for people with Parkinson’s? Duh! As a listener of this podcast you most certainly have! Do you know how much someone should get their heart rate up to make a difference? What about how to test them to ensure you understand their peak HR? The research on exercise and Parkinson’s is booming and we want to give you the best information straight from the source. That’s exactly why we invited prominent researcher Dr. Daniel M Corcos, PhD to the show! He’s been involved in pivotal research that actually shows exercise can modify the disease progression. No drug test has ever been able to show this, but his research team is getting closer and closer to understanding exactly what type of exercise people with Parkinson’s should do and in what dosage to truly modify their signs and symptoms and get back to the activities they love. In the episode we discussed a current study, , which is recruiting and aiming to determine whether high intensity or moderate exercise change PD progression. We discuss the specifics of this study and why the exercise prescription was selected the way that it was, what a cardiopulmonary exercise test is and why it’s helpful, how to really measure HR peak, how to get someone up to their HR peak SAFELY and what NOT to do, and resources you must share with physicians in your area! Reach out to us at if you have anyone you’d like to refer to SPARX3 so we can pass your information along to Dr. Corcos. They are recruiting through August 2025. Journal of PD 2023 “” - give this article to physicians by Kristine Meldrum Chapter 11 Edition 11 for PD
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211: How To Approach Pain Neuroscience Education In Neuro With Dr. Adriaan Louw, PT, PhD
04/29/2024
211: How To Approach Pain Neuroscience Education In Neuro With Dr. Adriaan Louw, PT, PhD
Do you work with people who have pain AND neurologic conditions? In our world it would be rare to find someone who doesn’t have at least a few patients or clients who experience pain either as a result of their diagnosis or even pain that is completely unrelated but persists. In this episode we had the privilege of picking the brain of one of the best pain neuroscience educators around, Dr. Adriaan Louw, PT, PhD, senior faculty, pain science director and vice-president of faculty experience for Evidence in Motion. As a leader in the field of pain neuroscience, Adriaan has authored and co-authored over 100 peer-reviewed articles related to spinal disorders and pain science. If you’ve ever seen him teach at a conference his courses are the ones with the overflowing rooms for a reason: He knows his stuff! And clinicians are hungry for the knowledge and skills that will help people with pain feel better and return to function again. We asked Adriaan the best ways to incorporate pain neuroscience education (PNE) into practice when working with people with complex histories. He discussed the importance of both education and an approach to function as well as how to identify who is ready for change regarding their pain. You’ll learn key outcome assessments you should be using for your patients who have pain and how to create a balance of addressing the pain and progressing function in therapy sessions. Assessments like the Central Sensitization Inventory Scale, Fear Avoidance Belief Questionnaire and Pain Catastrophization Survey can help you identify who will benefit the most from PNE. You’ll also learn how language matters and which words to use and which words to avoid when describing pain and other medical conditions as they can impact the pain someone is experiencing. We discuss how to approach a person who feels like their pain is completely physical as well as how much time or effort to dedicate to incorporating PNE in sessions vs other activities and with which patients. You’ll learn this and so much more in the episode! Resources mentioned in the episode (Note, some require permission from authors. Links will give you the information needed to request) free videos for clinicians and patients Join the to be the first to hear when we open again! Dr. Louw will be a presenter inside NeuroSpark in the upcoming quadrimester Summer 2024!
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210: Running Intensives For Individuals With Spinal Cord Injury With Empower SCI
04/22/2024
210: Running Intensives For Individuals With Spinal Cord Injury With Empower SCI
Do you see a gap in the care of individuals that you work with? Sometimes the work isn’t done after discharge, am I right? The desire to fill a gap for individuals with spinal cord injury (SCI) is what led 2 PTs and an OT to establish Empower SCI in 2012. Empower SCI is a non-profit dedicated to providing intensive rehabilitation experiences for people with SCI by creating immersive, residential experiences with clinical experts, peer mentors, recreational opportunities, and around the clock support. Empower SCI has a unique and innovative model that is volunteer driven and loved by all who encounter it. In this episode we interviewed the co-founders, Carrie Callahan, PT, DPT, ATP, Jessica Goodine, PT, DPT, NCS, and Elizabeth Lima Remillard, MS, OTR/L about everything from how it all started to where it’s all going. They shared the motivation for starting Empower, what “residential program” means, where and how they operate without a brick and mortar, who qualifies and who doesn’t qualify for an intensive, their biggest challenges to running intensives, why they decided to create a nonprofit, their tips for a successful partnership of 3, their new teen program and how you can get involved. Join us for an amazing dive into a life changing program that will inspire you! Please share this episode and information with anyone you know who might be interested in either volunteering or attending! To sign up to be a volunteer or participant use this link: Participants for the upcoming teen program have until June 15, 2024 to apply! IG FB
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209: How To Close the Gap Between Research And Practice With Dr. Carolee Winstein, PhD, PT, FAPTA
04/15/2024
209: How To Close the Gap Between Research And Practice With Dr. Carolee Winstein, PhD, PT, FAPTA
Have you ever felt like there was a disconnect between what the researchers are thinking and what you, as a clinician, are thinking? You’re not the only one! The desire to bridge the gap between research and what really goes on in the clinic has been a topic of discussion for decades. We interviewed Dr. Carolee Winstein, PhD, PT, FAPTA about this very topic and what the possible solutions may be. Dr. Winstein, a pivotal figure in redirecting professional focus towards motor control, motor learning and neuroplasticity, shares her transformational journey. When working with individuals with neurologic conditions in the 1990s (“before neuro rehab was a thing,” as she laughs) she wondered, why do some people get better and some don’t? Her intellectual curiosity propelled her into the sphere of motor learning and control under the tutelage of the esteemed Richard (Dick) Schmidt, PhD, an intellectual leader in motor learning and control and founder and founding editor of the Journal of Motor Behavior. Accumulating over 34,000 citations, Dr. Winstein stands as a luminary in the realm of neuro rehabilitation, boasting an unparalleled expertise in motivation, motor control, and neuroplasticity. She shares why the practice of neuro rehabilitation must be accompanied by an understanding of the behavioral literature. She provides advice and guidance for the clinician struggling to incorporate the research into practice, a warning about Clinical Practice Guidelines (CPGs), and what types of studies you should actually pay attention to in order to implement emerging evidence. Have you ever felt like your patient population doesn’t really match those studied in the research? She addresses that too and provides advice and encouragement about how to shift this disconnect. Articles mentioned in the interview can be found and downloaded here:
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208: “Old Not Weak” How You Should Actually Train Aging Adults With Dustin Jones, PT, DPT, GCS
04/08/2024
208: “Old Not Weak” How You Should Actually Train Aging Adults With Dustin Jones, PT, DPT, GCS
How much are you challenging the older adults you work with What biases do you have about someone when you see their age or comorbidities? Are they limiting how much you push them? Have you ever thought about the consequences of not pushing someone enough?? On today’s show we interviewed Dr. Dustin Jones, PT, DPT, GCS about his approach to working with aging adults and how it challenges the norm. He was working in skilled nursing facilities and seeing nearly everyone with the same exercises and plans of care despite varying abilities. This led to a desire to change the approach to care to be about determining what is really possible for aging adults and questioning why we only reserve more challenging work for those who are younger. In the episode Dustin explores how many therapists make assumptions (often ageist) about what someone is able or not able to do that isn’t backed up by research. He discusses the fear that something could go wrong when you challenge an older adult and challenges you to consider what could go right. If you approach it the right way, honoring their system and giving time to adapt, older adults have so much to gain by doing heavy lifting and strength training. The bigger risk for this population is actually to underdose them. People who are stronger and more fit have an ability to overcome more illnesses and stay independent longer. We discuss how to have conversations and set expectations for hard work outs that could lead to soreness or even orthopedic flare ups and how this is actually less risky as a consequence of pushing someone than the alternative outcomes that can happen is they aren’t as strong as possible, such as illnesses and chronic conditions from being sedentary. Keys to success with a fitness forward approach include ensuring the exercises are aligned with the patient’s primary goal. If they have pain, address that first but still have the conversation about where you’re going. Keep tying the exercise approach back to their independence and functional goals, and help them see the connection. Make sure they know the worst thing they can do is stop. Assure them to keep coming back so you can help them through it. Dustin runs StrongerLife, a gym for people over 55 and teaches Modern Management of the Older Adult as part of the Institute of Clinical Excellence, or PT on ICE. Learn more about Dustin and StrongerLIfe at - PTonICE.com
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207: Intensity Isn’t Just For Therapy Sessions With Han Nguyen, PT, DPT, NCS
04/01/2024
207: Intensity Isn’t Just For Therapy Sessions With Han Nguyen, PT, DPT, NCS
Everyone is on their own timeline. For some the notion to start a business doesn’t happen until well into their career. For others it happens almost immediately. For some, the slow growth method is right. For others it’s full speed ahead. Dr. Han Nguyen, PT, DPT, NCS is a PT who’s constantly seeking growth and opportunity. She asks, “what’s next?” and continues to strive for more and better. In today’s show we had the opportunity to learn about how she set up a multidisciplinary neuro rehab clinic in Saint Petersburg, FL focused on high intensity sessions, creative treatment strategies and team work. Han mentions some very key ways she was able to grow so quickly including being involved in her community. She also discusses the transitions she did from starting out mobile to renting shared space to recently signing a lease of her own. She’s learned lessons with hiring, negotiating, and growing her team. She also discusses her model of care and why she decided to be participating with Medicare. She also highlights the importance of understanding who you’re here to serve (hint: it’s not a diagnosis), getting clear on your messaging and one invaluable investment that has made all the difference. If you’re looking for inspiration to start your own thing or you’re already doing it, you’re sure to take away helpful insights in today’s show! If you’re interested in coaching for your neuro biz, schedule a discovery call with Emily Duval Ledger today! For an invitation to our NeuroBiz Besties free slack group fill out
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206: What To Do When You’re Overwhelmed In Your Business
03/25/2024
206: What To Do When You’re Overwhelmed In Your Business
Busy-ness and fluctuations are pretty normal when running a business but do you have trouble turning your business brain off? Can you go on vacation without working? Do you know the signs in your body when you’ve hit your edge? In the world of hustle culture how do you show up differently so you can love what you do and make it sustainable without wanting to burn it all to the ground? If you’re finding it difficult to step away from your business, this episode is for you. If you’re feeling frustrated because you think you’re doing everything right and it’s just not working, this episode is for you. If you’re snapping at people and cranky and you think it’s everyone else’s fault, this episode is for you. We’ve been there too and will provide you with strategies that work for us when we need grounding and a break. Emily Duval Ledger, NeuroBiz coach is here to coach Erin and Claire and anyone listening. You’re sure to come away with permission, insight and tactics.
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