{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":10.769,"endTime":13.349,"body":"Welcome to the"},{"speaker":"Charles Goldfarb","startTime":10.769,"endTime":13.349,"body":"upper hand, where Chuck and"},{"speaker":"Charles Goldfarb","startTime":13.349,"endTime":14.489,"body":"Chris talk hand surgery."},{"speaker":"Chris Dy","startTime":14.72,"endTime":16.58,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":14.72,"endTime":16.58,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":16.58,"endTime":19.67,"body":"University in St. Louis here to"},{"speaker":"Chris Dy","startTime":16.58,"endTime":19.67,"body":"talk about all aspects of hand"},{"speaker":"Chris Dy","startTime":19.67,"endTime":21.5,"body":"surgery from technical to"},{"speaker":"Chris Dy","startTime":19.67,"endTime":21.5,"body":"personal."},{"speaker":"Charles Goldfarb","startTime":22.07,"endTime":24.35,"body":"Thank you for"},{"speaker":"Charles Goldfarb","startTime":22.07,"endTime":24.35,"body":"subscribing wherever you get"},{"speaker":"Charles Goldfarb","startTime":24.35,"endTime":25.25,"body":"your podcasts."},{"speaker":"Chris Dy","startTime":25.46,"endTime":27.68,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":25.46,"endTime":27.68,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":27.68,"endTime":28.22,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":28.97,"endTime":29.93,"body":"Oh, hey,"},{"speaker":"Charles Goldfarb","startTime":28.97,"endTime":29.93,"body":"Chris."},{"speaker":"Chris Dy","startTime":30.26,"endTime":31.52,"body":"Hey, Chuck, how are"},{"speaker":"Chris Dy","startTime":30.26,"endTime":31.52,"body":"ya?"},{"speaker":"Charles Goldfarb","startTime":31.88,"endTime":33.56,"body":"Fantastic. How"},{"speaker":"Charles Goldfarb","startTime":31.88,"endTime":33.56,"body":"are you?"},{"speaker":"Chris Dy","startTime":34.05,"endTime":36.81,"body":"I'm doing well. I'm"},{"speaker":"Chris Dy","startTime":34.05,"endTime":36.81,"body":"doing well coming off of, you"},{"speaker":"Chris Dy","startTime":36.81,"endTime":41.94,"body":"know, high Easter weekend was"},{"speaker":"Chris Dy","startTime":36.81,"endTime":41.94,"body":"super fun for us. I ate a lot of"},{"speaker":"Chris Dy","startTime":41.94,"endTime":44.97,"body":"food, a lot of the things that I"},{"speaker":"Chris Dy","startTime":41.94,"endTime":44.97,"body":"was supposed to give up for"},{"speaker":"Chris Dy","startTime":44.97,"endTime":50.16,"body":"Lent. I gave up my wife and I"},{"speaker":"Chris Dy","startTime":44.97,"endTime":50.16,"body":"typically will give up sweets"},{"speaker":"Chris Dy","startTime":50.16,"endTime":54.69,"body":"for Lent. And that tends to that"},{"speaker":"Chris Dy","startTime":50.16,"endTime":54.69,"body":"strategy, or at least that"},{"speaker":"Chris Dy","startTime":54.69,"endTime":59.34,"body":"sacrifice tends to bend a little"},{"speaker":"Chris Dy","startTime":54.69,"endTime":59.34,"body":"bit towards the end. We went all"},{"speaker":"Chris Dy","startTime":59.34,"endTime":63.15,"body":"in. And then this year, I also"},{"speaker":"Chris Dy","startTime":59.34,"endTime":63.15,"body":"gave up bread, which was a lot"},{"speaker":"Chris Dy","startTime":63.15,"endTime":66.42,"body":"harder than I expected. Because"},{"speaker":"Chris Dy","startTime":63.15,"endTime":66.42,"body":"even though I don't regularly"},{"speaker":"Chris Dy","startTime":66.42,"endTime":69.6,"body":"eat sandwiches, all I wanted"},{"speaker":"Chris Dy","startTime":66.42,"endTime":69.6,"body":"when I gave up bread was a"},{"speaker":"Chris Dy","startTime":69.6,"endTime":70.14,"body":"sandwich."},{"speaker":"Charles Goldfarb","startTime":71.37,"endTime":74.19,"body":"Well, that"},{"speaker":"Charles Goldfarb","startTime":71.37,"endTime":74.19,"body":"resonates. I am not a"},{"speaker":"Charles Goldfarb","startTime":74.22,"endTime":77.46,"body":"particularly religious person,"},{"speaker":"Charles Goldfarb","startTime":74.22,"endTime":77.46,"body":"but I am Jewish. And so we give"},{"speaker":"Charles Goldfarb","startTime":77.46,"endTime":83.55,"body":"up bread for Passover. I'm not"},{"speaker":"Charles Goldfarb","startTime":77.46,"endTime":83.55,"body":"very good at that part of I have"},{"speaker":"Charles Goldfarb","startTime":83.55,"endTime":85.11,"body":"trouble getting by without"},{"speaker":"Charles Goldfarb","startTime":83.55,"endTime":85.11,"body":"bread."},{"speaker":"Chris Dy","startTime":85.63,"endTime":88.48,"body":"Well, it's"},{"speaker":"Chris Dy","startTime":85.63,"endTime":88.48,"body":"interesting. I was talking about"},{"speaker":"Chris Dy","startTime":88.51,"endTime":91.75,"body":"I guess I was lamenting my"},{"speaker":"Chris Dy","startTime":88.51,"endTime":91.75,"body":"Lenten sacrifices during clinic"},{"speaker":"Chris Dy","startTime":91.75,"endTime":95.05,"body":"one day and Jamie Findeiss the"},{"speaker":"Chris Dy","startTime":91.75,"endTime":95.05,"body":"therapist is in clinic with me"},{"speaker":"Chris Dy","startTime":95.05,"endTime":99.07,"body":"on Fridays, she was like, well,"},{"speaker":"Chris Dy","startTime":95.05,"endTime":99.07,"body":"but is giving these things up"},{"speaker":"Chris Dy","startTime":99.07,"endTime":102.04,"body":"actually making you a better"},{"speaker":"Chris Dy","startTime":99.07,"endTime":102.04,"body":"person? And I'm like, No,"},{"speaker":"Chris Dy","startTime":102.13,"endTime":107.26,"body":"clearly not. I'm hangry. Right"},{"speaker":"Chris Dy","startTime":102.13,"endTime":107.26,"body":"now, maybe I need to reconsider"},{"speaker":"Chris Dy","startTime":107.26,"endTime":108.28,"body":"my strategies here."},{"speaker":"Charles Goldfarb","startTime":109.36,"endTime":111.04,"body":"Yeah, it's"},{"speaker":"Charles Goldfarb","startTime":109.36,"endTime":111.04,"body":"funny when you talk about giving"},{"speaker":"Charles Goldfarb","startTime":111.04,"endTime":113.56,"body":"up sweets, I mean, that that's"},{"speaker":"Charles Goldfarb","startTime":111.04,"endTime":113.56,"body":"another one that's very hard for"},{"speaker":"Charles Goldfarb","startTime":113.56,"endTime":116.98,"body":"me essentially, how our family"},{"speaker":"Charles Goldfarb","startTime":113.56,"endTime":116.98,"body":"divides. My wife is really"},{"speaker":"Charles Goldfarb","startTime":116.98,"endTime":120.7,"body":"disciplined. And my two older"},{"speaker":"Charles Goldfarb","startTime":116.98,"endTime":120.7,"body":"kids are really disciplined as"},{"speaker":"Charles Goldfarb","startTime":120.7,"endTime":123.73,"body":"far as eating and and not to"},{"speaker":"Charles Goldfarb","startTime":120.7,"endTime":123.73,"body":"pick on my youngest child, but"},{"speaker":"Charles Goldfarb","startTime":123.73,"endTime":127.15,"body":"my youngest child follows my"},{"speaker":"Charles Goldfarb","startTime":123.73,"endTime":127.15,"body":"path, which is pretty good most"},{"speaker":"Charles Goldfarb","startTime":127.15,"endTime":130.24,"body":"of the time, but that's"},{"speaker":"Charles Goldfarb","startTime":127.15,"endTime":130.24,"body":"unnecessary crunches and seven"},{"speaker":"Charles Goldfarb","startTime":130.72,"endTime":133.03,"body":"m\u0026ms in the cabinet, and they"},{"speaker":"Charles Goldfarb","startTime":130.72,"endTime":133.03,"body":"will not last long."},{"speaker":"Chris Dy","startTime":133.57,"endTime":135.91,"body":"Oh, man. So I had I"},{"speaker":"Chris Dy","startTime":133.57,"endTime":135.91,"body":"had a patient, a grateful"},{"speaker":"Chris Dy","startTime":135.91,"endTime":138.76,"body":"patient who expressed her"},{"speaker":"Chris Dy","startTime":135.91,"endTime":138.76,"body":"gratitude in the best way,"},{"speaker":"Chris Dy","startTime":138.79,"endTime":144.25,"body":"obviously bringing in food. And"},{"speaker":"Chris Dy","startTime":138.79,"endTime":144.25,"body":"she had a family that was trying"},{"speaker":"Chris Dy","startTime":144.25,"endTime":146.56,"body":"to leave it very generic. She"},{"speaker":"Chris Dy","startTime":144.25,"endTime":146.56,"body":"had a family member who works"},{"speaker":"Chris Dy","startTime":146.56,"endTime":151.42,"body":"for a very big candy company."},{"speaker":"Chris Dy","startTime":146.56,"endTime":151.42,"body":"Comes in, just with looks like"},{"speaker":"Chris Dy","startTime":151.42,"endTime":155.86,"body":"she was about to rob a bank with"},{"speaker":"Chris Dy","startTime":151.42,"endTime":155.86,"body":"these two huge sacks of you"},{"speaker":"Chris Dy","startTime":155.86,"endTime":159.4,"body":"know, candy, branded swag. And"},{"speaker":"Chris Dy","startTime":155.86,"endTime":159.4,"body":"of course, inside it is"},{"speaker":"Chris Dy","startTime":159.4,"endTime":161.65,"body":"literally the most candy I've"},{"speaker":"Chris Dy","startTime":159.4,"endTime":161.65,"body":"ever seen."},{"speaker":"Charles Goldfarb","startTime":163.98,"endTime":167.97,"body":"So let me ask"},{"speaker":"Charles Goldfarb","startTime":163.98,"endTime":167.97,"body":"before you tell, did you share"},{"speaker":"Charles Goldfarb","startTime":167.97,"endTime":171.27,"body":"it with everyone in clinic? And"},{"speaker":"Charles Goldfarb","startTime":167.97,"endTime":171.27,"body":"except that you're not taking"},{"speaker":"Charles Goldfarb","startTime":171.27,"endTime":175.44,"body":"any of this home? Did you? Did"},{"speaker":"Charles Goldfarb","startTime":171.27,"endTime":175.44,"body":"you hide it away to take most of"},{"speaker":"Charles Goldfarb","startTime":175.44,"endTime":177.33,"body":"it home? Or do you do a kind of"},{"speaker":"Charles Goldfarb","startTime":175.44,"endTime":177.33,"body":"partial?"},{"speaker":"Chris Dy","startTime":178.14,"endTime":181.83,"body":"I didn't either of"},{"speaker":"Chris Dy","startTime":178.14,"endTime":181.83,"body":"those to chuck. My whole thing."},{"speaker":"Chris Dy","startTime":181.86,"endTime":185.88,"body":"My thing is that if somebody"},{"speaker":"Chris Dy","startTime":181.86,"endTime":185.88,"body":"brings something into clinic to"},{"speaker":"Chris Dy","startTime":185.88,"endTime":189.18,"body":"show how thankful they are, if"},{"speaker":"Chris Dy","startTime":185.88,"endTime":189.18,"body":"there's any possible way to"},{"speaker":"Chris Dy","startTime":189.18,"endTime":192.69,"body":"bring that home to show my"},{"speaker":"Chris Dy","startTime":189.18,"endTime":192.69,"body":"children that I help somebody,"},{"speaker":"Chris Dy","startTime":192.87,"endTime":196.11,"body":"and that they were so thoughtful"},{"speaker":"Chris Dy","startTime":192.87,"endTime":196.11,"body":"and appreciative that they did"},{"speaker":"Chris Dy","startTime":196.11,"endTime":199.68,"body":"something for me, I kind of want"},{"speaker":"Chris Dy","startTime":196.11,"endTime":199.68,"body":"them to see that because I want"},{"speaker":"Chris Dy","startTime":199.68,"endTime":202.11,"body":"them to understand that, you"},{"speaker":"Chris Dy","startTime":199.68,"endTime":202.11,"body":"know, we're not completely"},{"speaker":"Chris Dy","startTime":202.11,"endTime":205.53,"body":"transactional in this world, in"},{"speaker":"Chris Dy","startTime":202.11,"endTime":205.53,"body":"the sense that you know, you pay"},{"speaker":"Chris Dy","startTime":205.53,"endTime":209.64,"body":"x and you get y but people just"},{"speaker":"Chris Dy","startTime":205.53,"endTime":209.64,"body":"think of you and they appreciate"},{"speaker":"Chris Dy","startTime":209.64,"endTime":213.24,"body":"you and they will do something"},{"speaker":"Chris Dy","startTime":209.64,"endTime":213.24,"body":"nice. And then of course I"},{"speaker":"Chris Dy","startTime":213.24,"endTime":218.22,"body":"wanted to bring them to candy,"},{"speaker":"Chris Dy","startTime":213.24,"endTime":218.22,"body":"but the bags are cool. So I"},{"speaker":"Chris Dy","startTime":218.22,"endTime":221.46,"body":"brought home the bags,"},{"speaker":"Chris Dy","startTime":218.22,"endTime":221.46,"body":"immediately showed them the bags"},{"speaker":"Chris Dy","startTime":221.49,"endTime":224.67,"body":"and what was inside of them and"},{"speaker":"Chris Dy","startTime":221.49,"endTime":224.67,"body":"then dumped all of the candy"},{"speaker":"Chris Dy","startTime":224.67,"endTime":229.23,"body":"into a separate bag, which is"},{"speaker":"Chris Dy","startTime":224.67,"endTime":229.23,"body":"stashed in the laundry room may"},{"speaker":"Chris Dy","startTime":229.23,"endTime":232.62,"body":"have gotten into the stash"},{"speaker":"Chris Dy","startTime":229.23,"endTime":232.62,"body":"recently. But I will admit to"},{"speaker":"Chris Dy","startTime":232.62,"endTime":234.93,"body":"one thing that I did I know"},{"speaker":"Chris Dy","startTime":232.62,"endTime":234.93,"body":"there's a whole line of"},{"speaker":"Chris Dy","startTime":234.93,"endTime":238.05,"body":"questioning that's coming my way"},{"speaker":"Chris Dy","startTime":234.93,"endTime":238.05,"body":"on this but I admit to one thing"},{"speaker":"Chris Dy","startTime":238.05,"endTime":242.91,"body":"that I did very weak of me"},{"speaker":"Chris Dy","startTime":238.05,"endTime":242.91,"body":"before it took the bags home and"},{"speaker":"Chris Dy","startTime":242.91,"endTime":246.78,"body":"went and picked up all the"},{"speaker":"Chris Dy","startTime":242.91,"endTime":246.78,"body":"peanut butter m\u0026ms. Put them in"},{"speaker":"Chris Dy","startTime":246.78,"endTime":249.63,"body":"my stash in the clinic knowing"},{"speaker":"Chris Dy","startTime":246.78,"endTime":249.63,"body":"there would be a day where I"},{"speaker":"Chris Dy","startTime":249.63,"endTime":252.63,"body":"would just need a whole lot of"},{"speaker":"Chris Dy","startTime":249.63,"endTime":252.63,"body":"peanut butter m\u0026ms."},{"speaker":"Charles Goldfarb","startTime":252.989,"endTime":254.759,"body":"You got to do"},{"speaker":"Charles Goldfarb","startTime":252.989,"endTime":254.759,"body":"what you got to do. But I You"},{"speaker":"Charles Goldfarb","startTime":254.759,"endTime":258.509,"body":"know what? This is a great"},{"speaker":"Charles Goldfarb","startTime":254.759,"endTime":258.509,"body":"topic. I think most of our"},{"speaker":"Charles Goldfarb","startTime":258.509,"endTime":264.299,"body":"listeners can relate. It is"},{"speaker":"Charles Goldfarb","startTime":258.509,"endTime":264.299,"body":"really appreciated when patients"},{"speaker":"Charles Goldfarb","startTime":264.299,"endTime":267.539,"body":"do think of us in a non"},{"speaker":"Charles Goldfarb","startTime":264.299,"endTime":267.539,"body":"transactional way. And it"},{"speaker":"Charles Goldfarb","startTime":267.539,"endTime":271.559,"body":"happens some I'm pretty you know"},{"speaker":"Charles Goldfarb","startTime":267.539,"endTime":271.559,"body":"my clinic style is pretty"},{"speaker":"Charles Goldfarb","startTime":271.559,"endTime":275.909,"body":"direct. I can be warm and fuzzy,"},{"speaker":"Charles Goldfarb","startTime":271.559,"endTime":275.909,"body":"especially with the pediatric"},{"speaker":"Charles Goldfarb","startTime":275.909,"endTime":279.239,"body":"population but I'm not always"},{"speaker":"Charles Goldfarb","startTime":275.909,"endTime":279.239,"body":"the most warm and fuzzy you know"},{"speaker":"Charles Goldfarb","startTime":279.239,"endTime":282.359,"body":"that about me? And I know"},{"speaker":"Charles Goldfarb","startTime":279.239,"endTime":282.359,"body":"patients get that and either you"},{"speaker":"Charles Goldfarb","startTime":282.359,"endTime":286.439,"body":"like that and or you don't."},{"speaker":"Charles Goldfarb","startTime":282.359,"endTime":286.439,"body":"There's benefits running on time"},{"speaker":"Charles Goldfarb","startTime":286.439,"endTime":289.529,"body":"etc. But what patients do"},{"speaker":"Charles Goldfarb","startTime":286.439,"endTime":289.529,"body":"recognize and bring in gifts on"},{"speaker":"Charles Goldfarb","startTime":289.529,"endTime":293.309,"body":"occasion I don't get gifts all"},{"speaker":"Charles Goldfarb","startTime":289.529,"endTime":293.309,"body":"the time, but when I do there,"},{"speaker":"Charles Goldfarb","startTime":293.339,"endTime":296.189,"body":"I'm grateful. I usually share"},{"speaker":"Charles Goldfarb","startTime":293.339,"endTime":296.189,"body":"them with the staff or just give"},{"speaker":"Charles Goldfarb","startTime":296.189,"endTime":299.039,"body":"them to the staff. I do agree"},{"speaker":"Charles Goldfarb","startTime":296.189,"endTime":299.039,"body":"with you though it is important"},{"speaker":"Charles Goldfarb","startTime":299.039,"endTime":302.519,"body":"is important. for our kids and"},{"speaker":"Charles Goldfarb","startTime":299.039,"endTime":302.519,"body":"family to understand these,"},{"speaker":"Charles Goldfarb","startTime":302.639,"endTime":304.079,"body":"these signs of appreciation."},{"speaker":"Chris Dy","startTime":304.87,"endTime":307.39,"body":"Yeah, there are many,"},{"speaker":"Chris Dy","startTime":304.87,"endTime":307.39,"body":"there are many things that I"},{"speaker":"Chris Dy","startTime":307.39,"endTime":309.55,"body":"will share with our team given-"},{"speaker":"Charles Goldfarb","startTime":309.55,"endTime":310.12,"body":"Just not"},{"speaker":"Charles Goldfarb","startTime":309.55,"endTime":310.12,"body":"chocolate."},{"speaker":"Chris Dy","startTime":310.63,"endTime":312.88,"body":"Well, no, no, there"},{"speaker":"Chris Dy","startTime":310.63,"endTime":312.88,"body":"was there was chocolate"},{"speaker":"Chris Dy","startTime":312.88,"endTime":317.2,"body":"distributed. But I really wanted"},{"speaker":"Chris Dy","startTime":312.88,"endTime":317.2,"body":"them to the bags were really"},{"speaker":"Chris Dy","startTime":317.2,"endTime":321.94,"body":"cool. And of course, you can't"},{"speaker":"Chris Dy","startTime":317.2,"endTime":321.94,"body":"just bring on one bag if you"},{"speaker":"Chris Dy","startTime":321.94,"endTime":324.46,"body":"have to. I mean, I guess I"},{"speaker":"Chris Dy","startTime":321.94,"endTime":324.46,"body":"could, I should probably teach"},{"speaker":"Chris Dy","startTime":324.46,"endTime":328.3,"body":"my kids a lesson in sharing. But"},{"speaker":"Chris Dy","startTime":324.46,"endTime":328.3,"body":"clearly, I haven't learned it"},{"speaker":"Chris Dy","startTime":328.33,"endTime":333.22,"body":"either. It's funny one of the so"},{"speaker":"Chris Dy","startTime":328.33,"endTime":333.22,"body":"patients will bring stuff in."},{"speaker":"Chris Dy","startTime":333.79,"endTime":336.52,"body":"And one of our team members who"},{"speaker":"Chris Dy","startTime":333.79,"endTime":336.52,"body":"shall remain nameless has a"},{"speaker":"Chris Dy","startTime":336.52,"endTime":339.58,"body":"total thing about eating stuff"},{"speaker":"Chris Dy","startTime":336.52,"endTime":339.58,"body":"that patients bring in that is"},{"speaker":"Chris Dy","startTime":339.58,"endTime":345.82,"body":"homemade, will not touch it,"},{"speaker":"Chris Dy","startTime":339.58,"endTime":345.82,"body":"which I kind of get. But I'm"},{"speaker":"Chris Dy","startTime":345.82,"endTime":351.01,"body":"also a sucker. I will go for it."},{"speaker":"Chris Dy","startTime":345.82,"endTime":351.01,"body":"Do you have any strong feelings?"},{"speaker":"Charles Goldfarb","startTime":351.99,"endTime":354.09,"body":"Honestly, it"},{"speaker":"Charles Goldfarb","startTime":351.99,"endTime":354.09,"body":"depends a little on the patient."},{"speaker":"Charles Goldfarb","startTime":355.35,"endTime":356.49,"body":"Judging that way."},{"speaker":"Chris Dy","startTime":358.17,"endTime":360.66,"body":"But you know, I think"},{"speaker":"Chris Dy","startTime":358.17,"endTime":360.66,"body":"our therapy colleagues will,"},{"speaker":"Chris Dy","startTime":360.81,"endTime":363.15,"body":"this will resonate with them."},{"speaker":"Chris Dy","startTime":360.81,"endTime":363.15,"body":"Because if your therapy"},{"speaker":"Chris Dy","startTime":363.15,"endTime":366.42,"body":"practices anything, like the"},{"speaker":"Chris Dy","startTime":363.15,"endTime":366.42,"body":"therapy practices that I see in"},{"speaker":"Chris Dy","startTime":366.45,"endTime":369.51,"body":"surrounding my practice, the"},{"speaker":"Chris Dy","startTime":366.45,"endTime":369.51,"body":"therapist get all the good"},{"speaker":"Chris Dy","startTime":369.51,"endTime":372.78,"body":"stuff, the therapists get all"},{"speaker":"Chris Dy","startTime":369.51,"endTime":372.78,"body":"the good stuff, and rightfully"},{"speaker":"Chris Dy","startTime":372.78,"endTime":376.74,"body":"so because you all spend so much"},{"speaker":"Chris Dy","startTime":372.78,"endTime":376.74,"body":"time with patients. But I think"},{"speaker":"Chris Dy","startTime":376.74,"endTime":378.87,"body":"I get you talking about getting"},{"speaker":"Chris Dy","startTime":376.74,"endTime":378.87,"body":"a few things. I'm like you I'm"},{"speaker":"Chris Dy","startTime":378.87,"endTime":382.59,"body":"not that warm and fuzzy. My soft"},{"speaker":"Chris Dy","startTime":378.87,"endTime":382.59,"body":"spot is not peds. But it's the"},{"speaker":"Chris Dy","startTime":382.59,"endTime":385.2,"body":"nerve patients, I spent a lot of"},{"speaker":"Chris Dy","startTime":382.59,"endTime":385.2,"body":"time with them and do all of"},{"speaker":"Chris Dy","startTime":385.2,"endTime":388.62,"body":"that. But I am pretty direct in"},{"speaker":"Chris Dy","startTime":385.2,"endTime":388.62,"body":"clinic as well probably learned"},{"speaker":"Chris Dy","startTime":388.62,"endTime":394.32,"body":"it from you. And I don't get I"},{"speaker":"Chris Dy","startTime":388.62,"endTime":394.32,"body":"get a fraction, little fraction"},{"speaker":"Chris Dy","startTime":394.32,"endTime":399.51,"body":"of the rewards and fun stuff"},{"speaker":"Chris Dy","startTime":394.32,"endTime":399.51,"body":"that our therapy colleagues get,"},{"speaker":"Chris Dy","startTime":399.6,"endTime":400.98,"body":"which is cool, because they"},{"speaker":"Chris Dy","startTime":399.6,"endTime":400.98,"body":"earned it."},{"speaker":"Charles Goldfarb","startTime":401.339,"endTime":404.159,"body":"For sure. And"},{"speaker":"Charles Goldfarb","startTime":401.339,"endTime":404.159,"body":"that you know, that is for the"},{"speaker":"Charles Goldfarb","startTime":404.819,"endTime":408.089,"body":"medical students and residents"},{"speaker":"Charles Goldfarb","startTime":404.819,"endTime":408.089,"body":"who are listening. It's"},{"speaker":"Charles Goldfarb","startTime":408.089,"endTime":412.349,"body":"different when you know hand"},{"speaker":"Charles Goldfarb","startTime":408.089,"endTime":412.349,"body":"surgery is not always life"},{"speaker":"Charles Goldfarb","startTime":412.349,"endTime":416.969,"body":"changing in a way that total"},{"speaker":"Charles Goldfarb","startTime":412.349,"endTime":416.969,"body":"joint arthroplasty, or spine"},{"speaker":"Charles Goldfarb","startTime":416.969,"endTime":421.709,"body":"surgery may be and if you're in"},{"speaker":"Charles Goldfarb","startTime":416.969,"endTime":421.709,"body":"it for the chocolate, maybe you"},{"speaker":"Charles Goldfarb","startTime":421.709,"endTime":423.089,"body":"think about those specialties."},{"speaker":"Chris Dy","startTime":424.649,"endTime":427.979,"body":"I think that spine"},{"speaker":"Chris Dy","startTime":424.649,"endTime":427.979,"body":"patients might not be chocolate,"},{"speaker":"Chris Dy","startTime":428.069,"endTime":430.559,"body":"I think you're looking for spine"},{"speaker":"Chris Dy","startTime":428.069,"endTime":430.559,"body":"surgeons, they may go a little"},{"speaker":"Chris Dy","startTime":430.559,"endTime":433.349,"body":"bit, you know higher tier so to"},{"speaker":"Chris Dy","startTime":430.559,"endTime":433.349,"body":"say, but you never know."},{"speaker":"Charles Goldfarb","startTime":433.6,"endTime":434.68,"body":"Like wine."},{"speaker":"Chris Dy","startTime":436.22,"endTime":444.08,"body":"Exactly. Anyway, so"},{"speaker":"Chris Dy","startTime":436.22,"endTime":444.08,"body":"our topic today is sportsy. It's"},{"speaker":"Chris Dy","startTime":444.08,"endTime":450.77,"body":"a detail episode on ECU tendon"},{"speaker":"Chris Dy","startTime":444.08,"endTime":450.77,"body":"surgery. Now, I don't have a ton"},{"speaker":"Chris Dy","startTime":450.77,"endTime":454.19,"body":"of experience with this because"},{"speaker":"Chris Dy","startTime":450.77,"endTime":454.19,"body":"I have chosen not to make sports"},{"speaker":"Chris Dy","startTime":454.19,"endTime":457.82,"body":"a big part of my practice,"},{"speaker":"Chris Dy","startTime":454.19,"endTime":457.82,"body":"mainly because there's a giant"},{"speaker":"Chris Dy","startTime":457.82,"endTime":460.58,"body":"elephant in the room that"},{"speaker":"Chris Dy","startTime":457.82,"endTime":460.58,"body":"gobbles up all the sports in our"},{"speaker":"Chris Dy","startTime":460.58,"endTime":464.33,"body":"group. But that's totally okay"},{"speaker":"Chris Dy","startTime":460.58,"endTime":464.33,"body":"with me."},{"speaker":"Charles Goldfarb","startTime":465.26,"endTime":468.59,"body":"You know, I"},{"speaker":"Charles Goldfarb","startTime":465.26,"endTime":468.59,"body":"don't know that I gobble it but"},{"speaker":"Charles Goldfarb","startTime":468.59,"endTime":472.61,"body":"I do enjoy it most of the time,"},{"speaker":"Charles Goldfarb","startTime":468.59,"endTime":472.61,"body":"isn't it. What's interesting"},{"speaker":"Charles Goldfarb","startTime":472.61,"endTime":477.02,"body":"about the ECU tendon is it falls"},{"speaker":"Charles Goldfarb","startTime":472.61,"endTime":477.02,"body":"into the black box of the owner"},{"speaker":"Charles Goldfarb","startTime":477.02,"endTime":481.49,"body":"side of the wrist and I'm"},{"speaker":"Charles Goldfarb","startTime":477.02,"endTime":481.49,"body":"actually doing a webinar for the"},{"speaker":"Charles Goldfarb","startTime":481.52,"endTime":486.86,"body":"AAOS and hand society in on in"},{"speaker":"Charles Goldfarb","startTime":481.52,"endTime":486.86,"body":"early early May, about this"},{"speaker":"Charles Goldfarb","startTime":486.86,"endTime":489.65,"body":"topic that is the ulnar side of"},{"speaker":"Charles Goldfarb","startTime":486.86,"endTime":489.65,"body":"the wrist and, and so people"},{"speaker":"Charles Goldfarb","startTime":489.65,"endTime":496.04,"body":"always like to talk about the"},{"speaker":"Charles Goldfarb","startTime":489.65,"endTime":496.04,"body":"TFCC. And that's sort of, you"},{"speaker":"Charles Goldfarb","startTime":496.04,"endTime":500.21,"body":"know, one of my passions, the"},{"speaker":"Charles Goldfarb","startTime":496.04,"endTime":500.21,"body":"ECU gets a little less respect,"},{"speaker":"Charles Goldfarb","startTime":500.3,"endTime":507.71,"body":"but it shouldn't because it can"},{"speaker":"Charles Goldfarb","startTime":500.3,"endTime":507.71,"body":"be the culprit. And it's tricky."},{"speaker":"Charles Goldfarb","startTime":507.74,"endTime":510.47,"body":"There is no doubt it's tricky."},{"speaker":"Charles Goldfarb","startTime":507.74,"endTime":510.47,"body":"And I would say that when I"},{"speaker":"Charles Goldfarb","startTime":510.47,"endTime":516.65,"body":"think about the ECU, I think"},{"speaker":"Charles Goldfarb","startTime":510.47,"endTime":516.65,"body":"about ECU tendonitis and ECU"},{"speaker":"Charles Goldfarb","startTime":516.68,"endTime":522.14,"body":"instability. And while they are,"},{"speaker":"Charles Goldfarb","startTime":516.68,"endTime":522.14,"body":"you know, potentially related,"},{"speaker":"Charles Goldfarb","startTime":522.53,"endTime":525.35,"body":"they are separate diagnoses. At"},{"speaker":"Charles Goldfarb","startTime":522.53,"endTime":525.35,"body":"least that's the way I think"},{"speaker":"Charles Goldfarb","startTime":525.35,"endTime":528.05,"body":"about it in a big picture. Do"},{"speaker":"Charles Goldfarb","startTime":525.35,"endTime":528.05,"body":"you think about it the same way?"},{"speaker":"Chris Dy","startTime":529.03,"endTime":531.91,"body":"Yeah, I think so."},{"speaker":"Chris Dy","startTime":529.03,"endTime":531.91,"body":"Yeah, I'm curious, you know, for"},{"speaker":"Chris Dy","startTime":531.91,"endTime":537.67,"body":"you of the percentage of young,"},{"speaker":"Chris Dy","startTime":531.91,"endTime":537.67,"body":"healthy active people who have"},{"speaker":"Chris Dy","startTime":537.67,"endTime":541.48,"body":"on their side of wrist pain, so"},{"speaker":"Chris Dy","startTime":537.67,"endTime":541.48,"body":"not on their styloid or TFCC"},{"speaker":"Chris Dy","startTime":541.48,"endTime":544.12,"body":"related pain after distal radius"},{"speaker":"Chris Dy","startTime":541.48,"endTime":544.12,"body":"fracture, but you know, and a"},{"speaker":"Chris Dy","startTime":544.12,"endTime":548.17,"body":"nonfactor setting, what"},{"speaker":"Chris Dy","startTime":544.12,"endTime":548.17,"body":"percentage of that ulnar sided"},{"speaker":"Chris Dy","startTime":548.17,"endTime":553.81,"body":"wrist pain have symptoms that"},{"speaker":"Chris Dy","startTime":548.17,"endTime":553.81,"body":"are largely driven by the ECU."},{"speaker":"Chris Dy","startTime":554.17,"endTime":556.36,"body":"Now, I know there's, you know,"},{"speaker":"Chris Dy","startTime":554.17,"endTime":556.36,"body":"different kinds of ECU"},{"speaker":"Chris Dy","startTime":556.36,"endTime":560.02,"body":"pathology. There's a lot of"},{"speaker":"Chris Dy","startTime":556.36,"endTime":560.02,"body":"overlap between ECU and the"},{"speaker":"Chris Dy","startTime":560.02,"endTime":562.6,"body":"TFCC. And other causes ulnar"},{"speaker":"Chris Dy","startTime":560.02,"endTime":562.6,"body":"sided wrist pain, but what"},{"speaker":"Chris Dy","startTime":562.6,"endTime":564.7,"body":"percentage is really driven by"},{"speaker":"Chris Dy","startTime":562.6,"endTime":564.7,"body":"the ECU?"},{"speaker":"Charles Goldfarb","startTime":565.09,"endTime":570.19,"body":"We're talking"},{"speaker":"Charles Goldfarb","startTime":565.09,"endTime":570.19,"body":"isolated ECU, I would say, five"},{"speaker":"Charles Goldfarb","startTime":570.25,"endTime":575.74,"body":"to Max 10%. There, like you"},{"speaker":"Charles Goldfarb","startTime":570.25,"endTime":575.74,"body":"said, there's overlap, but it's"},{"speaker":"Charles Goldfarb","startTime":575.74,"endTime":580.06,"body":"a small percentage. Now, you"},{"speaker":"Charles Goldfarb","startTime":575.74,"endTime":580.06,"body":"know, I you know, it may see me"},{"speaker":"Charles Goldfarb","startTime":580.06,"endTime":583.3,"body":"but I don't always see it is one"},{"speaker":"Charles Goldfarb","startTime":580.06,"endTime":583.3,"body":"explanation why it's so low. But"},{"speaker":"Charles Goldfarb","startTime":583.33,"endTime":586.63,"body":"I think that's, that's, that's"},{"speaker":"Charles Goldfarb","startTime":583.33,"endTime":586.63,"body":"feels right to me."},{"speaker":"Chris Dy","startTime":587.23,"endTime":591.82,"body":"But, you know, one 5%,"},{"speaker":"Chris Dy","startTime":587.23,"endTime":591.82,"body":"one out of 20. I mean, you know,"},{"speaker":"Chris Dy","startTime":591.82,"endTime":593.68,"body":"you see a fair number of"},{"speaker":"Chris Dy","startTime":591.82,"endTime":593.68,"body":"patients a week that could be"},{"speaker":"Chris Dy","startTime":593.68,"endTime":597.76,"body":"one patient a week that's ECU"},{"speaker":"Chris Dy","startTime":593.68,"endTime":597.76,"body":"related, that maybe, maybe more"},{"speaker":"Chris Dy","startTime":597.79,"endTime":598.69,"body":"maybe more for you."},{"speaker":"Charles Goldfarb","startTime":598.84,"endTime":601.24,"body":"Yeah, one or"},{"speaker":"Charles Goldfarb","startTime":598.84,"endTime":601.24,"body":"two. patients a week in some"},{"speaker":"Charles Goldfarb","startTime":601.24,"endTime":605.56,"body":"form or fashion. And then it's"},{"speaker":"Charles Goldfarb","startTime":601.24,"endTime":605.56,"body":"also complicated by the fact, by"},{"speaker":"Charles Goldfarb","startTime":605.56,"endTime":610.51,"body":"two facts. I would say one. ECU"},{"speaker":"Charles Goldfarb","startTime":605.56,"endTime":610.51,"body":"tendonitis is a weird diagnosis"},{"speaker":"Charles Goldfarb","startTime":610.54,"endTime":614.17,"body":"for me because when I operate"},{"speaker":"Charles Goldfarb","startTime":610.54,"endTime":614.17,"body":"for ECU tendonitis, I'm never"},{"speaker":"Charles Goldfarb","startTime":614.47,"endTime":618.55,"body":"impressed by the tendinitis."},{"speaker":"Charles Goldfarb","startTime":614.47,"endTime":618.55,"body":"Meaning I don't see a ton of"},{"speaker":"Charles Goldfarb","startTime":618.55,"endTime":621.43,"body":"inflammation. And it's just it"},{"speaker":"Charles Goldfarb","startTime":618.55,"endTime":621.43,"body":"can be one of those procedures"},{"speaker":"Charles Goldfarb","startTime":621.43,"endTime":624.22,"body":"that you do that can be helpful."},{"speaker":"Charles Goldfarb","startTime":621.43,"endTime":624.22,"body":"But it's not a procedure I"},{"speaker":"Charles Goldfarb","startTime":624.22,"endTime":629.83,"body":"rushed to do because I don't"},{"speaker":"Charles Goldfarb","startTime":624.22,"endTime":629.83,"body":"always get the satisfaction of"},{"speaker":"Charles Goldfarb","startTime":629.83,"endTime":631.21,"body":"that surgery. Because that's,"},{"speaker":"Chris Dy","startTime":631.78,"endTime":633.67,"body":"You know, I'll be"},{"speaker":"Chris Dy","startTime":631.78,"endTime":633.67,"body":"honest with you. I mean, I don't"},{"speaker":"Chris Dy","startTime":633.67,"endTime":636.67,"body":"do a lot. I think I can count on"},{"speaker":"Chris Dy","startTime":633.67,"endTime":636.67,"body":"one hand, a number of ECU"},{"speaker":"Chris Dy","startTime":636.67,"endTime":639.22,"body":"tendonitis surgeries that I've"},{"speaker":"Chris Dy","startTime":636.67,"endTime":639.22,"body":"done, I spent a lot of time not"},{"speaker":"Chris Dy","startTime":639.22,"endTime":642.97,"body":"trying to do surgery for the"},{"speaker":"Chris Dy","startTime":639.22,"endTime":642.97,"body":"reasons that you stated. Now I"},{"speaker":"Chris Dy","startTime":642.97,"endTime":645.85,"body":"know we're supposed to do a"},{"speaker":"Chris Dy","startTime":642.97,"endTime":645.85,"body":"detail episode, focusing on"},{"speaker":"Chris Dy","startTime":645.85,"endTime":648.1,"body":"technique, but I think it's"},{"speaker":"Chris Dy","startTime":645.85,"endTime":648.1,"body":"worthwhile in for this"},{"speaker":"Chris Dy","startTime":648.1,"endTime":651.34,"body":"particular topic to really"},{"speaker":"Chris Dy","startTime":648.1,"endTime":651.34,"body":"backpedal and talk about, you"},{"speaker":"Chris Dy","startTime":651.34,"endTime":655.75,"body":"know, diagnosis, pearls on"},{"speaker":"Chris Dy","startTime":651.34,"endTime":655.75,"body":"history, physical exam stuff,"},{"speaker":"Chris Dy","startTime":655.75,"endTime":657.91,"body":"and why don't we start with the"},{"speaker":"Chris Dy","startTime":655.75,"endTime":657.91,"body":"ECU tendonitis?"},{"speaker":"Charles Goldfarb","startTime":658.95,"endTime":662.43,"body":"Yeah, so yeah,"},{"speaker":"Charles Goldfarb","startTime":658.95,"endTime":662.43,"body":"we can probably fly through"},{"speaker":"Charles Goldfarb","startTime":662.43,"endTime":665.07,"body":"this, I think with full, you"},{"speaker":"Charles Goldfarb","startTime":662.43,"endTime":665.07,"body":"know, being fully comprehensive."},{"speaker":"Charles Goldfarb","startTime":665.07,"endTime":669.6,"body":"So, you know, dorsal ulnar pain,"},{"speaker":"Charles Goldfarb","startTime":665.07,"endTime":669.6,"body":"I love it. When patients say"},{"speaker":"Charles Goldfarb","startTime":669.6,"endTime":673.5,"body":"that it radiates up the owner"},{"speaker":"Charles Goldfarb","startTime":669.6,"endTime":673.5,"body":"side of the dorsal forearm, that"},{"speaker":"Charles Goldfarb","startTime":673.5,"endTime":681.36,"body":"is a really helpful, subjective"},{"speaker":"Charles Goldfarb","startTime":673.5,"endTime":681.36,"body":"complaint that I like. Other"},{"speaker":"Charles Goldfarb","startTime":681.36,"endTime":684.66,"body":"than that, is that vague area of"},{"speaker":"Charles Goldfarb","startTime":681.36,"endTime":684.66,"body":"pain on the own wrist, which can"},{"speaker":"Charles Goldfarb","startTime":684.66,"endTime":687.84,"body":"be very difficult to"},{"speaker":"Charles Goldfarb","startTime":684.66,"endTime":687.84,"body":"differentiate between other"},{"speaker":"Charles Goldfarb","startTime":687.84,"endTime":691.41,"body":"pathologies. And so the"},{"speaker":"Charles Goldfarb","startTime":687.84,"endTime":691.41,"body":"subjective comment that I like"},{"speaker":"Charles Goldfarb","startTime":691.41,"endTime":694.92,"body":"to hear if it's easy to nice is"},{"speaker":"Charles Goldfarb","startTime":691.41,"endTime":694.92,"body":"radiating up the form. And I"},{"speaker":"Charles Goldfarb","startTime":694.92,"endTime":699.57,"body":"would just say that the"},{"speaker":"Charles Goldfarb","startTime":694.92,"endTime":699.57,"body":"objective feature is the ECU"},{"speaker":"Charles Goldfarb","startTime":699.57,"endTime":703.08,"body":"synergy test. I and we may have"},{"speaker":"Charles Goldfarb","startTime":699.57,"endTime":703.08,"body":"talked about that on the show."},{"speaker":"Charles Goldfarb","startTime":703.08,"endTime":707.52,"body":"But for those of you who haven't"},{"speaker":"Charles Goldfarb","startTime":703.08,"endTime":707.52,"body":"done it, or used it, I should"},{"speaker":"Charles Goldfarb","startTime":707.52,"endTime":713.34,"body":"say, it is based on a paper,"},{"speaker":"Charles Goldfarb","startTime":707.52,"endTime":713.34,"body":"which was written a while back"},{"speaker":"Charles Goldfarb","startTime":713.76,"endTime":718.89,"body":"is from 2008 is from Robert"},{"speaker":"Charles Goldfarb","startTime":713.76,"endTime":718.89,"body":"Ruhland, and Christopher Hogan"},{"speaker":"Charles Goldfarb","startTime":719.43,"endTime":725.73,"body":"in in Virginia. And they"},{"speaker":"Charles Goldfarb","startTime":719.43,"endTime":725.73,"body":"describe this test, which makes"},{"speaker":"Charles Goldfarb","startTime":725.73,"endTime":729.48,"body":"a lot of sense. And so let me"},{"speaker":"Charles Goldfarb","startTime":725.73,"endTime":729.48,"body":"just describe it. It's a"},{"speaker":"Charles Goldfarb","startTime":729.51,"endTime":733.59,"body":"supinated, elbow bent, 90"},{"speaker":"Charles Goldfarb","startTime":729.51,"endTime":733.59,"body":"degrees form fully supinated."},{"speaker":"Charles Goldfarb","startTime":733.83,"endTime":739.29,"body":"And then the idea is you resume"},{"speaker":"Charles Goldfarb","startTime":733.83,"endTime":739.29,"body":"you put your, you apply radially"},{"speaker":"Charles Goldfarb","startTime":739.29,"endTime":744.48,"body":"directed force on the long"},{"speaker":"Charles Goldfarb","startTime":739.29,"endTime":744.48,"body":"finger, and only a directed"},{"speaker":"Charles Goldfarb","startTime":744.48,"endTime":748.17,"body":"force on the thumbs and the"},{"speaker":"Charles Goldfarb","startTime":744.48,"endTime":748.17,"body":"thumb. And so the patient is"},{"speaker":"Charles Goldfarb","startTime":748.17,"endTime":751.08,"body":"trying to bring their middle"},{"speaker":"Charles Goldfarb","startTime":748.17,"endTime":751.08,"body":"finger and an older direction"},{"speaker":"Charles Goldfarb","startTime":751.26,"endTime":756.21,"body":"and their thumb in a radial"},{"speaker":"Charles Goldfarb","startTime":751.26,"endTime":756.21,"body":"direction. And that requires"},{"speaker":"Charles Goldfarb","startTime":756.57,"endTime":765.21,"body":"that you fire ECU. And this"},{"speaker":"Charles Goldfarb","startTime":756.57,"endTime":765.21,"body":"paper used us used EMG to prove"},{"speaker":"Charles Goldfarb","startTime":765.21,"endTime":770.73,"body":"that point. And so when you fire"},{"speaker":"Charles Goldfarb","startTime":765.21,"endTime":770.73,"body":"your ECU that should precipitate"},{"speaker":"Charles Goldfarb","startTime":770.73,"endTime":774.81,"body":"pain related to tendinitis. And"},{"speaker":"Charles Goldfarb","startTime":770.73,"endTime":774.81,"body":"it's a really well done paper"},{"speaker":"Charles Goldfarb","startTime":774.81,"endTime":780.09,"body":"and they looked at three groups"},{"speaker":"Charles Goldfarb","startTime":774.81,"endTime":780.09,"body":"of patients. I believe one was"},{"speaker":"Charles Goldfarb","startTime":780.09,"endTime":783.36,"body":"isolated ECU tendinitis, it got"},{"speaker":"Charles Goldfarb","startTime":780.09,"endTime":783.36,"body":"better with injection. Another"},{"speaker":"Charles Goldfarb","startTime":783.36,"endTime":786.9,"body":"was coexistent ECU tendinitis"},{"speaker":"Charles Goldfarb","startTime":783.36,"endTime":786.9,"body":"and intra articular pathology."},{"speaker":"Charles Goldfarb","startTime":786.9,"endTime":789.96,"body":"And the third was just in"},{"speaker":"Charles Goldfarb","startTime":786.9,"endTime":789.96,"body":"particular pathology and the"},{"speaker":"Charles Goldfarb","startTime":789.96,"endTime":795.63,"body":"test stood stood well, it did"},{"speaker":"Charles Goldfarb","startTime":789.96,"endTime":795.63,"body":"well. So supinated resisted"},{"speaker":"Charles Goldfarb","startTime":795.63,"endTime":799.29,"body":"thumb radial deviation resisted."},{"speaker":"Charles Goldfarb","startTime":795.63,"endTime":799.29,"body":"Middle finger owner deviation"},{"speaker":"Charles Goldfarb","startTime":799.29,"endTime":802.53,"body":"makes you far your ECU, and that"},{"speaker":"Charles Goldfarb","startTime":799.29,"endTime":802.53,"body":"should recreate pain."},{"speaker":"Chris Dy","startTime":804.21,"endTime":806.25,"body":"Yeah, no, I think"},{"speaker":"Chris Dy","startTime":804.21,"endTime":806.25,"body":"that's an excellent summary of"},{"speaker":"Chris Dy","startTime":806.25,"endTime":808.53,"body":"it. I'll be honest with you, I"},{"speaker":"Chris Dy","startTime":806.25,"endTime":808.53,"body":"don't usually use the middle"},{"speaker":"Chris Dy","startTime":808.53,"endTime":812.22,"body":"finger part of it, I probably"},{"speaker":"Chris Dy","startTime":808.53,"endTime":812.22,"body":"should I have the patient, you"},{"speaker":"Chris Dy","startTime":812.22,"endTime":815.34,"body":"know, face their palm towards"},{"speaker":"Chris Dy","startTime":812.22,"endTime":815.34,"body":"their face. And then I have them"},{"speaker":"Chris Dy","startTime":815.34,"endTime":818.34,"body":"spread their thumb as far away"},{"speaker":"Chris Dy","startTime":815.34,"endTime":818.34,"body":"as they can from their pinky."},{"speaker":"Chris Dy","startTime":818.61,"endTime":821.76,"body":"And I push against them a little"},{"speaker":"Chris Dy","startTime":818.61,"endTime":821.76,"body":"bit. And if it causes pain on"},{"speaker":"Chris Dy","startTime":821.76,"endTime":824.73,"body":"the other side, that is how I"},{"speaker":"Chris Dy","startTime":821.76,"endTime":824.73,"body":"use the test. So I'm not a"},{"speaker":"Chris Dy","startTime":824.73,"endTime":828.6,"body":"purist. But it seems to work for"},{"speaker":"Chris Dy","startTime":824.73,"endTime":828.6,"body":"me. It works in terms of at"},{"speaker":"Chris Dy","startTime":828.6,"endTime":830.97,"body":"least understanding the"},{"speaker":"Chris Dy","startTime":828.6,"endTime":830.97,"body":"involvement of the ECU,"},{"speaker":"Charles Goldfarb","startTime":831.33,"endTime":834.03,"body":"well said, and"},{"speaker":"Charles Goldfarb","startTime":831.33,"endTime":834.03,"body":"I totally agree. And part of it"},{"speaker":"Charles Goldfarb","startTime":834.03,"endTime":838.26,"body":"is, you know, I'm not calling"},{"speaker":"Charles Goldfarb","startTime":834.03,"endTime":838.26,"body":"patients disingenuous, but they"},{"speaker":"Charles Goldfarb","startTime":838.26,"endTime":840.48,"body":"don't think about it, right?"},{"speaker":"Charles Goldfarb","startTime":838.26,"endTime":840.48,"body":"They're messing with their"},{"speaker":"Charles Goldfarb","startTime":840.48,"endTime":843.21,"body":"thumb, not their owner setting"},{"speaker":"Charles Goldfarb","startTime":840.48,"endTime":843.21,"body":"wrist pain. And so that really"},{"speaker":"Charles Goldfarb","startTime":843.21,"endTime":847.14,"body":"precipitates a strong reaction,"},{"speaker":"Charles Goldfarb","startTime":843.21,"endTime":847.14,"body":"then I feel like it's great. And"},{"speaker":"Charles Goldfarb","startTime":847.14,"endTime":851.34,"body":"then the last thing I'll say is,"},{"speaker":"Charles Goldfarb","startTime":847.14,"endTime":851.34,"body":"you have to differentiate"},{"speaker":"Charles Goldfarb","startTime":852.27,"endTime":855.48,"body":"tendinitis from instability,"},{"speaker":"Charles Goldfarb","startTime":852.27,"endTime":855.48,"body":"right. And that's really"},{"speaker":"Charles Goldfarb","startTime":855.48,"endTime":858.9,"body":"important to do. And you can't"},{"speaker":"Charles Goldfarb","startTime":855.48,"endTime":858.9,"body":"effectively treat anyone if you"},{"speaker":"Charles Goldfarb","startTime":858.9,"endTime":859.77,"body":"don't know the difference."},{"speaker":"Chris Dy","startTime":860.22,"endTime":862.95,"body":"So before we dive into"},{"speaker":"Chris Dy","startTime":860.22,"endTime":862.95,"body":"that, are there any you"},{"speaker":"Chris Dy","startTime":862.98,"endTime":866.73,"body":"mentioned that kind of"},{"speaker":"Chris Dy","startTime":862.98,"endTime":866.73,"body":"subjective complaint of pain"},{"speaker":"Chris Dy","startTime":866.73,"endTime":868.89,"body":"along the other side of the"},{"speaker":"Chris Dy","startTime":866.73,"endTime":868.89,"body":"wrist that radiates up the door?"},{"speaker":"Chris Dy","startTime":868.89,"endTime":872.73,"body":"So on their forearm? Are there"},{"speaker":"Chris Dy","startTime":868.89,"endTime":872.73,"body":"any maneuvers or activities that"},{"speaker":"Chris Dy","startTime":872.73,"endTime":876.54,"body":"patients tend to associate or"},{"speaker":"Chris Dy","startTime":872.73,"endTime":876.54,"body":"you know that you've noticed"},{"speaker":"Chris Dy","startTime":876.54,"endTime":880.29,"body":"that they describe a you know is"},{"speaker":"Chris Dy","startTime":876.54,"endTime":880.29,"body":"more likely to show up as ECU"},{"speaker":"Chris Dy","startTime":880.29,"endTime":881.13,"body":"tendinitis?"},{"speaker":"Charles Goldfarb","startTime":882.41,"endTime":886.07,"body":"I think no,"},{"speaker":"Charles Goldfarb","startTime":882.41,"endTime":886.07,"body":"I'm maybe I'm missing something."},{"speaker":"Charles Goldfarb","startTime":886.07,"endTime":889.25,"body":"But I think anything that"},{"speaker":"Charles Goldfarb","startTime":886.07,"endTime":889.25,"body":"requires you fire your wrist"},{"speaker":"Charles Goldfarb","startTime":889.25,"endTime":894.95,"body":"extensors, puts that ECU tenant"},{"speaker":"Charles Goldfarb","startTime":889.25,"endTime":894.95,"body":"on stretch and can cause pain."},{"speaker":"Charles Goldfarb","startTime":894.98,"endTime":898.22,"body":"So either firing or putting on"},{"speaker":"Charles Goldfarb","startTime":894.98,"endTime":898.22,"body":"stretch can cause pain, but"},{"speaker":"Charles Goldfarb","startTime":898.22,"endTime":901.34,"body":"there's not one specific"},{"speaker":"Charles Goldfarb","startTime":898.22,"endTime":901.34,"body":"activity like The Chair pushup"},{"speaker":"Charles Goldfarb","startTime":901.34,"endTime":904.4,"body":"test or you know that nothing"},{"speaker":"Charles Goldfarb","startTime":901.34,"endTime":904.4,"body":"like that really helps me"},{"speaker":"Charles Goldfarb","startTime":905.21,"endTime":909.35,"body":"isolate the ECU tendon versus"},{"speaker":"Charles Goldfarb","startTime":905.21,"endTime":909.35,"body":"ulnar sided risk pathology in"},{"speaker":"Charles Goldfarb","startTime":909.35,"endTime":909.8,"body":"general."},{"speaker":"Chris Dy","startTime":910.49,"endTime":912.62,"body":"So when do your alarm"},{"speaker":"Chris Dy","startTime":910.49,"endTime":912.62,"body":"bells start to go off about"},{"speaker":"Chris Dy","startTime":912.62,"endTime":915.62,"body":"instability? Is that purely"},{"speaker":"Chris Dy","startTime":912.62,"endTime":915.62,"body":"based on your exam? Or is there"},{"speaker":"Chris Dy","startTime":915.62,"endTime":917.72,"body":"anything that comes out of the"},{"speaker":"Chris Dy","startTime":915.62,"endTime":917.72,"body":"patient's mouth that makes you"},{"speaker":"Chris Dy","startTime":917.72,"endTime":919.19,"body":"think of ECU instability?"},{"speaker":"Charles Goldfarb","startTime":920.12,"endTime":924.11,"body":"So first, I"},{"speaker":"Charles Goldfarb","startTime":920.12,"endTime":924.11,"body":"think we should clarify that not"},{"speaker":"Charles Goldfarb","startTime":924.11,"endTime":929.12,"body":"all instability is pathologic or"},{"speaker":"Charles Goldfarb","startTime":924.11,"endTime":929.12,"body":"painful. And so some patients"},{"speaker":"Charles Goldfarb","startTime":929.12,"endTime":932.57,"body":"will come in with instability."},{"speaker":"Charles Goldfarb","startTime":929.12,"endTime":932.57,"body":"And you notice it, as you know,"},{"speaker":"Charles Goldfarb","startTime":932.6,"endTime":937.1,"body":"a kind of happenstance and that"},{"speaker":"Charles Goldfarb","startTime":932.6,"endTime":937.1,"body":"is, should not be overtreated."},{"speaker":"Charles Goldfarb","startTime":937.43,"endTime":939.77,"body":"And I think that's really"},{"speaker":"Charles Goldfarb","startTime":937.43,"endTime":939.77,"body":"important. And I recall David"},{"speaker":"Charles Goldfarb","startTime":939.77,"endTime":944.39,"body":"ring, talking about that went a"},{"speaker":"Charles Goldfarb","startTime":939.77,"endTime":944.39,"body":"long time ago when I thought,"},{"speaker":"Charles Goldfarb","startTime":944.39,"endTime":948.11,"body":"Wow, is that really true, but it"},{"speaker":"Charles Goldfarb","startTime":944.39,"endTime":948.11,"body":"is absolutely true. Of course,"},{"speaker":"Charles Goldfarb","startTime":948.14,"endTime":950.45,"body":"identifying those that are"},{"speaker":"Charles Goldfarb","startTime":948.14,"endTime":950.45,"body":"symptomatic and unstable is"},{"speaker":"Charles Goldfarb","startTime":950.45,"endTime":954.5,"body":"important. So the classic"},{"speaker":"Charles Goldfarb","startTime":950.45,"endTime":954.5,"body":"maneuver is a good one. And it's"},{"speaker":"Charles Goldfarb","startTime":954.5,"endTime":957.05,"body":"an easy one. And it's I don't"},{"speaker":"Charles Goldfarb","startTime":954.5,"endTime":957.05,"body":"know if this is the official"},{"speaker":"Charles Goldfarb","startTime":957.05,"endTime":960.29,"body":"name, but it's the ice cream"},{"speaker":"Charles Goldfarb","startTime":957.05,"endTime":960.29,"body":"scoop maneuver, right, so you"},{"speaker":"Charles Goldfarb","startTime":960.29,"endTime":963.35,"body":"have your pom protonated. And"},{"speaker":"Charles Goldfarb","startTime":960.29,"endTime":963.35,"body":"actually your wrist a little bit"},{"speaker":"Charles Goldfarb","startTime":963.35,"endTime":966.71,"body":"extended, like you're grabbing"},{"speaker":"Charles Goldfarb","startTime":963.35,"endTime":966.71,"body":"an ice cream scooper. And then"},{"speaker":"Charles Goldfarb","startTime":966.71,"endTime":970.88,"body":"you go into older deviation and"},{"speaker":"Charles Goldfarb","startTime":966.71,"endTime":970.88,"body":"supination. And use a little"},{"speaker":"Charles Goldfarb","startTime":970.88,"endTime":974.27,"body":"flexion of the wrist. And if"},{"speaker":"Charles Goldfarb","startTime":970.88,"endTime":974.27,"body":"there's instability that should"},{"speaker":"Charles Goldfarb","startTime":974.27,"endTime":980.12,"body":"cause it. And so often you can"},{"speaker":"Charles Goldfarb","startTime":974.27,"endTime":980.12,"body":"feel or hear that or see that it"},{"speaker":"Charles Goldfarb","startTime":980.12,"endTime":983.84,"body":"can be subtle, for sure. So you"},{"speaker":"Charles Goldfarb","startTime":980.12,"endTime":983.84,"body":"have to look for pain or some"},{"speaker":"Charles Goldfarb","startTime":983.84,"endTime":987.98,"body":"type of participating symptom."},{"speaker":"Charles Goldfarb","startTime":983.84,"endTime":987.98,"body":"It's not a passive positioning."},{"speaker":"Charles Goldfarb","startTime":988.4,"endTime":991.52,"body":"It's the motion of getting"},{"speaker":"Charles Goldfarb","startTime":988.4,"endTime":991.52,"body":"there. And if the patient"},{"speaker":"Charles Goldfarb","startTime":991.52,"endTime":993.74,"body":"doesn't walk in and say this is"},{"speaker":"Charles Goldfarb","startTime":991.52,"endTime":993.74,"body":"what I'm this is what's"},{"speaker":"Charles Goldfarb","startTime":993.74,"endTime":997.79,"body":"happening, this hurts, then you"},{"speaker":"Charles Goldfarb","startTime":993.74,"endTime":997.79,"body":"can sometimes get them to show"},{"speaker":"Charles Goldfarb","startTime":997.79,"endTime":998.6,"body":"you what that maneuver."},{"speaker":"Chris Dy","startTime":999.41,"endTime":1001.93,"body":"So is there any role"},{"speaker":"Chris Dy","startTime":999.41,"endTime":1001.93,"body":"for blotting or, you know,"},{"speaker":"Chris Dy","startTime":1001.93,"endTime":1005.2,"body":"feeling the ECU tendon in"},{"speaker":"Chris Dy","startTime":1001.93,"endTime":1005.2,"body":"different form positions and"},{"speaker":"Chris Dy","startTime":1005.2,"endTime":1009.04,"body":"seeing if you can subluxated? Or"},{"speaker":"Chris Dy","startTime":1005.2,"endTime":1009.04,"body":"is that is it purely like you're"},{"speaker":"Chris Dy","startTime":1009.04,"endTime":1013.12,"body":"saying an active dynamic kind of"},{"speaker":"Chris Dy","startTime":1009.04,"endTime":1013.12,"body":"test that that adds value?"},{"speaker":"Charles Goldfarb","startTime":1013.45,"endTime":1015.61,"body":"Absolutely."},{"speaker":"Charles Goldfarb","startTime":1013.45,"endTime":1015.61,"body":"And I'd certainly do that, I"},{"speaker":"Charles Goldfarb","startTime":1015.61,"endTime":1021.07,"body":"just think it's it's most often"},{"speaker":"Charles Goldfarb","startTime":1015.61,"endTime":1021.07,"body":"less clear cut. And so my"},{"speaker":"Charles Goldfarb","startTime":1021.07,"endTime":1024.73,"body":"shifting the ECU tendon out of"},{"speaker":"Charles Goldfarb","startTime":1021.07,"endTime":1024.73,"body":"its groove, first of all,"},{"speaker":"Charles Goldfarb","startTime":1024.73,"endTime":1026.98,"body":"doesn't always mean anything,"},{"speaker":"Charles Goldfarb","startTime":1024.73,"endTime":1026.98,"body":"because you can get an MRI and"},{"speaker":"Charles Goldfarb","startTime":1026.98,"endTime":1030.64,"body":"see the ECU out of a screw. And"},{"speaker":"Charles Goldfarb","startTime":1026.98,"endTime":1030.64,"body":"that doesn't necessarily mean"},{"speaker":"Charles Goldfarb","startTime":1030.67,"endTime":1034.42,"body":"that's the cause of the"},{"speaker":"Charles Goldfarb","startTime":1030.67,"endTime":1034.42,"body":"symptoms, it certainly can be"},{"speaker":"Charles Goldfarb","startTime":1034.42,"endTime":1037.03,"body":"the cause of the symptom. And"},{"speaker":"Charles Goldfarb","startTime":1034.42,"endTime":1037.03,"body":"you can even get a supinated"},{"speaker":"Charles Goldfarb","startTime":1037.03,"endTime":1040.54,"body":"MRI, you know, most MRIs are"},{"speaker":"Charles Goldfarb","startTime":1037.03,"endTime":1040.54,"body":"done in the Superman position."},{"speaker":"Charles Goldfarb","startTime":1040.72,"endTime":1043.51,"body":"And so you're protonated, which"},{"speaker":"Charles Goldfarb","startTime":1040.72,"endTime":1043.51,"body":"has relevance for older"},{"speaker":"Charles Goldfarb","startTime":1043.51,"endTime":1046.72,"body":"variants, but also has relevance"},{"speaker":"Charles Goldfarb","startTime":1043.51,"endTime":1046.72,"body":"for the ECU tendon is typically"},{"speaker":"Charles Goldfarb","startTime":1046.72,"endTime":1050.95,"body":"a more stable position. But if"},{"speaker":"Charles Goldfarb","startTime":1046.72,"endTime":1050.95,"body":"you supinate the form that can"},{"speaker":"Charles Goldfarb","startTime":1050.95,"endTime":1055.27,"body":"put the ECU in a more risk for"},{"speaker":"Charles Goldfarb","startTime":1050.95,"endTime":1055.27,"body":"subluxation position."},{"speaker":"Chris Dy","startTime":1057.52,"endTime":1059.32,"body":"What else are you"},{"speaker":"Chris Dy","startTime":1057.52,"endTime":1059.32,"body":"looking on on the exam?"},{"speaker":"Charles Goldfarb","startTime":1060.64,"endTime":1064.6,"body":"Well, I'm also"},{"speaker":"Charles Goldfarb","startTime":1060.64,"endTime":1064.6,"body":"looking at the fovea and trying"},{"speaker":"Charles Goldfarb","startTime":1064.6,"endTime":1069.94,"body":"to rule out of coexistent TFCC"},{"speaker":"Charles Goldfarb","startTime":1064.6,"endTime":1069.94,"body":"pathology. I'm looking at the"},{"speaker":"Charles Goldfarb","startTime":1069.94,"endTime":1074.56,"body":"carpus as well. And absolutely,"},{"speaker":"Charles Goldfarb","startTime":1069.94,"endTime":1074.56,"body":"you can have you know, you can"},{"speaker":"Charles Goldfarb","startTime":1074.56,"endTime":1078.07,"body":"have multiple pathologies at"},{"speaker":"Charles Goldfarb","startTime":1074.56,"endTime":1078.07,"body":"once because we know the ECU sub"},{"speaker":"Charles Goldfarb","startTime":1078.07,"endTime":1083.23,"body":"sheath is part of the TFCC"},{"speaker":"Charles Goldfarb","startTime":1078.07,"endTime":1083.23,"body":"complex or TFCC complex. And we"},{"speaker":"Charles Goldfarb","startTime":1083.23,"endTime":1085.87,"body":"also know that there can be a"},{"speaker":"Charles Goldfarb","startTime":1083.23,"endTime":1085.87,"body":"communication between the two."},{"speaker":"Charles Goldfarb","startTime":1085.87,"endTime":1088.48,"body":"And so when I think about"},{"speaker":"Charles Goldfarb","startTime":1085.87,"endTime":1088.48,"body":"diagnostic or therapeutic"},{"speaker":"Charles Goldfarb","startTime":1088.48,"endTime":1091.06,"body":"injections, you know, if you're"},{"speaker":"Charles Goldfarb","startTime":1088.48,"endTime":1091.06,"body":"doing a intra articular"},{"speaker":"Charles Goldfarb","startTime":1091.06,"endTime":1095.32,"body":"injection versus doing an ECU"},{"speaker":"Charles Goldfarb","startTime":1091.06,"endTime":1095.32,"body":"injection, sometimes the"},{"speaker":"Charles Goldfarb","startTime":1095.32,"endTime":1099.13,"body":"medicine crosses and you know"},{"speaker":"Charles Goldfarb","startTime":1095.32,"endTime":1099.13,"body":"ICU injection can affect the"},{"speaker":"Charles Goldfarb","startTime":1099.13,"endTime":1100.0,"body":"wrist joint as well."},{"speaker":"Chris Dy","startTime":1100.99,"endTime":1104.71,"body":"So what's your what's"},{"speaker":"Chris Dy","startTime":1100.99,"endTime":1104.71,"body":"your workout from there? So say"},{"speaker":"Chris Dy","startTime":1104.71,"endTime":1108.16,"body":"it's a tendinitis patient, no"},{"speaker":"Chris Dy","startTime":1104.71,"endTime":1108.16,"body":"instability on your exam or on"},{"speaker":"Chris Dy","startTime":1108.16,"endTime":1111.55,"body":"their complaints. Are you doing"},{"speaker":"Chris Dy","startTime":1108.16,"endTime":1111.55,"body":"any additional? Are you getting"},{"speaker":"Chris Dy","startTime":1111.55,"endTime":1116.14,"body":"any X rays? Are you doing any"},{"speaker":"Chris Dy","startTime":1111.55,"endTime":1116.14,"body":"imaging? And then how would you"},{"speaker":"Chris Dy","startTime":1116.17,"endTime":1119.11,"body":"how does that change for in"},{"speaker":"Chris Dy","startTime":1116.17,"endTime":1119.11,"body":"instability patient?"},{"speaker":"Charles Goldfarb","startTime":1120.67,"endTime":1122.86,"body":"If I'm"},{"speaker":"Charles Goldfarb","startTime":1120.67,"endTime":1122.86,"body":"treating tendinitis, I'll do the"},{"speaker":"Charles Goldfarb","startTime":1122.86,"endTime":1127.48,"body":"typical tendinitis things. wrist"},{"speaker":"Charles Goldfarb","startTime":1122.86,"endTime":1127.48,"body":"splint, resting in the position"},{"speaker":"Charles Goldfarb","startTime":1127.48,"endTime":1130.9,"body":"of comfort, which again should"},{"speaker":"Charles Goldfarb","startTime":1127.48,"endTime":1130.9,"body":"be pronation. I don't if this is"},{"speaker":"Charles Goldfarb","startTime":1130.9,"endTime":1133.93,"body":"an acute onset, I might consider"},{"speaker":"Charles Goldfarb","startTime":1130.9,"endTime":1133.93,"body":"a long arm splint but generally"},{"speaker":"Charles Goldfarb","startTime":1133.93,"endTime":1138.1,"body":"I do not. So short arms. Splunk"},{"speaker":"Charles Goldfarb","startTime":1133.93,"endTime":1138.1,"body":"often custom with a little bit"},{"speaker":"Charles Goldfarb","startTime":1138.1,"endTime":1141.37,"body":"of wrist extension, anti"},{"speaker":"Charles Goldfarb","startTime":1138.1,"endTime":1141.37,"body":"inflammatories, activity"},{"speaker":"Charles Goldfarb","startTime":1141.37,"endTime":1145.93,"body":"modification with the next step"},{"speaker":"Charles Goldfarb","startTime":1141.37,"endTime":1145.93,"body":"being corticosteroid injection."},{"speaker":"Chris Dy","startTime":1147.43,"endTime":1148.27,"body":"So no imaging."},{"speaker":"Charles Goldfarb","startTime":1149.02,"endTime":1150.7,"body":"No, I don't"},{"speaker":"Charles Goldfarb","startTime":1149.02,"endTime":1150.7,"body":"think imaging is helpful. And"},{"speaker":"Charles Goldfarb","startTime":1150.7,"endTime":1154.84,"body":"the reason I don't think imaging"},{"speaker":"Charles Goldfarb","startTime":1150.7,"endTime":1154.84,"body":"is helpful is there can be all"},{"speaker":"Charles Goldfarb","startTime":1154.84,"endTime":1160.36,"body":"types of pathologic appearing"},{"speaker":"Charles Goldfarb","startTime":1154.84,"endTime":1160.36,"body":"things in the ECU, the ECU"},{"speaker":"Charles Goldfarb","startTime":1160.36,"endTime":1163.39,"body":"split, so to speak, is called on"},{"speaker":"Charles Goldfarb","startTime":1160.36,"endTime":1163.39,"body":"MRI all the time. We don't know"},{"speaker":"Charles Goldfarb","startTime":1163.39,"endTime":1165.85,"body":"if that's pathologic or not,"},{"speaker":"Charles Goldfarb","startTime":1163.39,"endTime":1165.85,"body":"it's just gonna be if I'm"},{"speaker":"Charles Goldfarb","startTime":1165.85,"endTime":1168.58,"body":"worried about ECU tendonitis, to"},{"speaker":"Charles Goldfarb","startTime":1165.85,"endTime":1168.58,"body":"me it's a clinical diagnosis"},{"speaker":"Charles Goldfarb","startTime":1168.79,"endTime":1175.18,"body":"with injection as a confirmatory"},{"speaker":"Charles Goldfarb","startTime":1168.79,"endTime":1175.18,"body":"test and treatment unless a have"},{"speaker":"Charles Goldfarb","startTime":1175.18,"endTime":1176.95,"body":"to go the or which I try to"},{"speaker":"Charles Goldfarb","startTime":1175.18,"endTime":1176.95,"body":"avoid doing"},{"speaker":"Chris Dy","startTime":1177.76,"endTime":1181.21,"body":"and then how does how"},{"speaker":"Chris Dy","startTime":1177.76,"endTime":1181.21,"body":"does your treatment change for"},{"speaker":"Chris Dy","startTime":1181.21,"endTime":1181.96,"body":"instability?"},{"speaker":"Charles Goldfarb","startTime":1184.0,"endTime":1190.33,"body":"acute onset in"},{"speaker":"Charles Goldfarb","startTime":1184.0,"endTime":1190.33,"body":"acute onset instability can"},{"speaker":"Charles Goldfarb","startTime":1190.36,"endTime":1195.7,"body":"often be most effectively"},{"speaker":"Charles Goldfarb","startTime":1190.36,"endTime":1195.7,"body":"managed surgically in one"},{"speaker":"Charles Goldfarb","startTime":1195.7,"endTime":1199.48,"body":"population, right in a"},{"speaker":"Charles Goldfarb","startTime":1195.7,"endTime":1199.48,"body":"population that is is high level"},{"speaker":"Charles Goldfarb","startTime":1200.14,"endTime":1205.15,"body":"arm surgery to repair the sub"},{"speaker":"Charles Goldfarb","startTime":1200.14,"endTime":1205.15,"body":"sheath might make sense."},{"speaker":"Charles Goldfarb","startTime":1205.36,"endTime":1210.97,"body":"Although you absolutely can also"},{"speaker":"Charles Goldfarb","startTime":1205.36,"endTime":1210.97,"body":"treat them in pronation long arm"},{"speaker":"Charles Goldfarb","startTime":1210.97,"endTime":1214.66,"body":"Splinter cast, and let the sub"},{"speaker":"Charles Goldfarb","startTime":1210.97,"endTime":1214.66,"body":"sheath try to heal. And so it"},{"speaker":"Charles Goldfarb","startTime":1214.66,"endTime":1218.17,"body":"depends on your patient and how"},{"speaker":"Charles Goldfarb","startTime":1214.66,"endTime":1218.17,"body":"aggressive they want to be. I"},{"speaker":"Charles Goldfarb","startTime":1218.17,"endTime":1221.2,"body":"would say that the vast majority"},{"speaker":"Charles Goldfarb","startTime":1218.17,"endTime":1221.2,"body":"of patients who come in are not"},{"speaker":"Charles Goldfarb","startTime":1221.23,"endTime":1226.18,"body":"acute. And the instability is"},{"speaker":"Charles Goldfarb","startTime":1221.23,"endTime":1226.18,"body":"chronic has failed previous"},{"speaker":"Charles Goldfarb","startTime":1226.18,"endTime":1229.3,"body":"treatment. And then you're"},{"speaker":"Charles Goldfarb","startTime":1226.18,"endTime":1229.3,"body":"looking at treatment. And to me,"},{"speaker":"Charles Goldfarb","startTime":1229.3,"endTime":1234.4,"body":"there's two treatment options,"},{"speaker":"Charles Goldfarb","startTime":1229.3,"endTime":1234.4,"body":"and eyes slash we at this"},{"speaker":"Charles Goldfarb","startTime":1234.4,"endTime":1239.47,"body":"institution favorite one. And"},{"speaker":"Charles Goldfarb","startTime":1234.4,"endTime":1239.47,"body":"certainly, other institutions"},{"speaker":"Charles Goldfarb","startTime":1239.56,"endTime":1242.59,"body":"treat this differently. I'll say"},{"speaker":"Charles Goldfarb","startTime":1239.56,"endTime":1242.59,"body":"that a lot of people like the"},{"speaker":"Charles Goldfarb","startTime":1242.59,"endTime":1246.52,"body":"concept of repairing the sub"},{"speaker":"Charles Goldfarb","startTime":1242.59,"endTime":1246.52,"body":"sheath. And to be very clear,"},{"speaker":"Charles Goldfarb","startTime":1246.52,"endTime":1251.2,"body":"there's two parts of what wraps"},{"speaker":"Charles Goldfarb","startTime":1246.52,"endTime":1251.2,"body":"around the ECU one is the dorsal"},{"speaker":"Charles Goldfarb","startTime":1251.2,"endTime":1254.5,"body":"retinaculum, which comes"},{"speaker":"Charles Goldfarb","startTime":1251.2,"endTime":1254.5,"body":"superficially all the way around"},{"speaker":"Charles Goldfarb","startTime":1254.5,"endTime":1259.0,"body":"bowling alley. And the second"},{"speaker":"Charles Goldfarb","startTime":1254.5,"endTime":1259.0,"body":"part is the what's been termed"},{"speaker":"Charles Goldfarb","startTime":1259.0,"endTime":1262.06,"body":"either the sub sheath or the"},{"speaker":"Charles Goldfarb","startTime":1259.0,"endTime":1262.06,"body":"ligamentum jugatum, which is"},{"speaker":"Charles Goldfarb","startTime":1262.06,"endTime":1265.48,"body":"really what holds the ECU"},{"speaker":"Charles Goldfarb","startTime":1262.06,"endTime":1265.48,"body":"stable. So we're pairing that"},{"speaker":"Charles Goldfarb","startTime":1265.72,"endTime":1269.77,"body":"with or without a deepening of"},{"speaker":"Charles Goldfarb","startTime":1265.72,"endTime":1269.77,"body":"the groove is one option. I"},{"speaker":"Charles Goldfarb","startTime":1269.77,"endTime":1273.01,"body":"don't love the idea of deepening"},{"speaker":"Charles Goldfarb","startTime":1269.77,"endTime":1273.01,"body":"the groove, because to me, it"},{"speaker":"Charles Goldfarb","startTime":1273.01,"endTime":1276.4,"body":"feels like the tenant is just"},{"speaker":"Charles Goldfarb","startTime":1273.01,"endTime":1276.4,"body":"going to scar into place, and"},{"speaker":"Charles Goldfarb","startTime":1276.46,"endTime":1280.78,"body":"lose some of its functionality."},{"speaker":"Charles Goldfarb","startTime":1276.46,"endTime":1280.78,"body":"So what Dr. Gelberman taught me"},{"speaker":"Charles Goldfarb","startTime":1280.78,"endTime":1285.07,"body":"and us is a transposition of the"},{"speaker":"Charles Goldfarb","startTime":1280.78,"endTime":1285.07,"body":"ECU where you take it out of his"},{"speaker":"Charles Goldfarb","startTime":1285.07,"endTime":1288.76,"body":"groove shifted dorsally, it's"},{"speaker":"Charles Goldfarb","startTime":1285.07,"endTime":1288.76,"body":"free to glide, it's sitting in a"},{"speaker":"Charles Goldfarb","startTime":1288.76,"endTime":1292.6,"body":"beautiful bed over the fifth"},{"speaker":"Charles Goldfarb","startTime":1288.76,"endTime":1292.6,"body":"compartment. And I've been super"},{"speaker":"Charles Goldfarb","startTime":1292.6,"endTime":1295.93,"body":"happy with that procedure. I've"},{"speaker":"Charles Goldfarb","startTime":1292.6,"endTime":1295.93,"body":"written up that procedure with"},{"speaker":"Charles Goldfarb","startTime":1295.93,"endTime":1300.04,"body":"our experience with it. And I"},{"speaker":"Charles Goldfarb","startTime":1295.93,"endTime":1300.04,"body":"think it's a great option, which"},{"speaker":"Charles Goldfarb","startTime":1300.04,"endTime":1302.77,"body":"gives me greater confidence that"},{"speaker":"Charles Goldfarb","startTime":1300.04,"endTime":1302.77,"body":"the ECU will maintain its"},{"speaker":"Charles Goldfarb","startTime":1302.77,"endTime":1303.22,"body":"function."},{"speaker":"Chris Dy","startTime":1304.54,"endTime":1307.63,"body":"It's a lot to unpack"},{"speaker":"Chris Dy","startTime":1304.54,"endTime":1307.63,"body":"there. I can go on for that."},{"speaker":"Chris Dy","startTime":1307.69,"endTime":1312.19,"body":"That was great. Before we dive"},{"speaker":"Chris Dy","startTime":1307.69,"endTime":1312.19,"body":"into the technique, parts of"},{"speaker":"Chris Dy","startTime":1312.19,"endTime":1314.71,"body":"that, how long? How many"},{"speaker":"Chris Dy","startTime":1312.19,"endTime":1314.71,"body":"injections? Will you give a"},{"speaker":"Chris Dy","startTime":1314.71,"endTime":1318.7,"body":"patient with tendinitis and no"},{"speaker":"Chris Dy","startTime":1314.71,"endTime":1318.7,"body":"instability? And then is there a"},{"speaker":"Chris Dy","startTime":1318.7,"endTime":1321.01,"body":"role for an injection in a"},{"speaker":"Chris Dy","startTime":1318.7,"endTime":1321.01,"body":"patient with instability?"},{"speaker":"Charles Goldfarb","startTime":1324.1,"endTime":1327.22,"body":"I typically"},{"speaker":"Charles Goldfarb","startTime":1324.1,"endTime":1327.22,"body":"only give one injection, and it"},{"speaker":"Charles Goldfarb","startTime":1327.22,"endTime":1332.71,"body":"is a reflection of a couple of"},{"speaker":"Charles Goldfarb","startTime":1327.22,"endTime":1332.71,"body":"patients that I've seen,"},{"speaker":"Charles Goldfarb","startTime":1332.71,"endTime":1335.17,"body":"thankfully not necessarily been"},{"speaker":"Charles Goldfarb","startTime":1332.71,"endTime":1335.17,"body":"a party to their treatment,"},{"speaker":"Charles Goldfarb","startTime":1335.38,"endTime":1337.69,"body":"where they have received"},{"speaker":"Charles Goldfarb","startTime":1335.38,"endTime":1337.69,"body":"multiple injections in this"},{"speaker":"Charles Goldfarb","startTime":1337.69,"endTime":1343.51,"body":"location, subcutaneous fat"},{"speaker":"Charles Goldfarb","startTime":1337.69,"endTime":1343.51,"body":"atrophy, more pain. And you can"},{"speaker":"Charles Goldfarb","startTime":1343.51,"endTime":1346.69,"body":"also create instability. If you"},{"speaker":"Charles Goldfarb","startTime":1343.51,"endTime":1346.69,"body":"inject too many times. And so-"},{"speaker":"Chris Dy","startTime":1346.69,"endTime":1347.47,"body":"Any ruptures?"},{"speaker":"Charles Goldfarb","startTime":1347.74,"endTime":1349.33,"body":"I have not"},{"speaker":"Charles Goldfarb","startTime":1347.74,"endTime":1349.33,"body":"seen a rupture, have you?"},{"speaker":"Chris Dy","startTime":1350.02,"endTime":1353.29,"body":"I have not well, not"},{"speaker":"Chris Dy","startTime":1350.02,"endTime":1353.29,"body":"for ECU. I've seen one for fcr."},{"speaker":"Charles Goldfarb","startTime":1354.82,"endTime":1359.29,"body":"Wow, yeah,"},{"speaker":"Charles Goldfarb","startTime":1354.82,"endTime":1359.29,"body":"that's tough. So I usually only"},{"speaker":"Charles Goldfarb","startTime":1359.29,"endTime":1364.15,"body":"do one. And and I guess I will"},{"speaker":"Charles Goldfarb","startTime":1359.29,"endTime":1364.15,"body":"say if patients pushed me hard"},{"speaker":"Charles Goldfarb","startTime":1364.15,"endTime":1367.81,"body":"because of a great result from a"},{"speaker":"Charles Goldfarb","startTime":1364.15,"endTime":1367.81,"body":"first injection on Mike, is"},{"speaker":"Charles Goldfarb","startTime":1367.81,"endTime":1370.33,"body":"there a second? Do you have a"},{"speaker":"Charles Goldfarb","startTime":1367.81,"endTime":1370.33,"body":"limit?"},{"speaker":"Chris Dy","startTime":1372.19,"endTime":1375.1,"body":"Yeah, I usually won't"},{"speaker":"Chris Dy","startTime":1372.19,"endTime":1375.1,"body":"do more than one based on what I"},{"speaker":"Chris Dy","startTime":1375.1,"endTime":1378.13,"body":"saw at the fcr. And clearly, the"},{"speaker":"Chris Dy","startTime":1375.1,"endTime":1378.13,"body":"ECU is a much more important"},{"speaker":"Chris Dy","startTime":1378.13,"endTime":1379.93,"body":"tendon than the fcr."},{"speaker":"Charles Goldfarb","startTime":1381.01,"endTime":1386.86,"body":"Yeah. I don't"},{"speaker":"Charles Goldfarb","startTime":1381.01,"endTime":1386.86,"body":"know that injection of the ECU"},{"speaker":"Charles Goldfarb","startTime":1386.86,"endTime":1391.36,"body":"for instability is wrong. And I"},{"speaker":"Charles Goldfarb","startTime":1386.86,"endTime":1391.36,"body":"guess if someone was pushing to"},{"speaker":"Charles Goldfarb","startTime":1391.36,"endTime":1395.53,"body":"try it, but because of a time"},{"speaker":"Charles Goldfarb","startTime":1391.36,"endTime":1395.53,"body":"issue, I might consider it but"},{"speaker":"Charles Goldfarb","startTime":1395.53,"endTime":1398.53,"body":"it doesn't make sense to me. So"},{"speaker":"Charles Goldfarb","startTime":1395.53,"endTime":1398.53,"body":"I would not certainly not be"},{"speaker":"Charles Goldfarb","startTime":1398.53,"endTime":1399.37,"body":"eager to do that."},{"speaker":"Chris Dy","startTime":1400.0,"endTime":1404.14,"body":"So let's let's get to"},{"speaker":"Chris Dy","startTime":1400.0,"endTime":1404.14,"body":"the or say you've decided for a"},{"speaker":"Chris Dy","startTime":1404.14,"endTime":1407.56,"body":"tendinitis patient, not"},{"speaker":"Chris Dy","startTime":1404.14,"endTime":1407.56,"body":"instability, you're going to do"},{"speaker":"Chris Dy","startTime":1407.56,"endTime":1413.08,"body":"some kind of debris bent? Or"},{"speaker":"Chris Dy","startTime":1407.56,"endTime":1413.08,"body":"whatever it is that you do for"},{"speaker":"Chris Dy","startTime":1413.08,"endTime":1415.33,"body":"that? What do you do?"},{"speaker":"Charles Goldfarb","startTime":1415.6,"endTime":1418.24,"body":"So there are"},{"speaker":"Charles Goldfarb","startTime":1415.6,"endTime":1418.24,"body":"reports that you cut the"},{"speaker":"Charles Goldfarb","startTime":1418.24,"endTime":1421.27,"body":"retinaculum, cut the sub sheath"},{"speaker":"Charles Goldfarb","startTime":1418.24,"endTime":1421.27,"body":"and everything will be fine."},{"speaker":"Charles Goldfarb","startTime":1422.02,"endTime":1424.69,"body":"That's some of the early reports"},{"speaker":"Charles Goldfarb","startTime":1422.02,"endTime":1424.69,"body":"in the general orthopedic"},{"speaker":"Charles Goldfarb","startTime":1424.69,"endTime":1427.54,"body":"literature. I don't believe in"},{"speaker":"Charles Goldfarb","startTime":1424.69,"endTime":1427.54,"body":"that. And so what I took a"},{"speaker":"Chris Dy","startTime":1427.54,"endTime":1429.46,"body":"AKA how to create"},{"speaker":"Chris Dy","startTime":1427.54,"endTime":1429.46,"body":"instability?"},{"speaker":"Charles Goldfarb","startTime":1430.21,"endTime":1433.09,"body":"It's crazy."},{"speaker":"Charles Goldfarb","startTime":1430.21,"endTime":1433.09,"body":"They the reports say instability"},{"speaker":"Charles Goldfarb","startTime":1433.09,"endTime":1435.94,"body":"was not created, but I don't"},{"speaker":"Charles Goldfarb","startTime":1433.09,"endTime":1435.94,"body":"think in good conscience I can,"},{"speaker":"Charles Goldfarb","startTime":1436.45,"endTime":1445.42,"body":"I could do that. What I tend to"},{"speaker":"Charles Goldfarb","startTime":1436.45,"endTime":1445.42,"body":"do is essentially, take a small"},{"speaker":"Charles Goldfarb","startTime":1445.45,"endTime":1449.65,"body":"area, which would include this"},{"speaker":"Charles Goldfarb","startTime":1445.45,"endTime":1449.65,"body":"the deep ligament or the"},{"speaker":"Charles Goldfarb","startTime":1449.68,"endTime":1453.73,"body":"ligamentum jugatum and work"},{"speaker":"Charles Goldfarb","startTime":1449.68,"endTime":1453.73,"body":"proximal and distal to that. And"},{"speaker":"Charles Goldfarb","startTime":1453.73,"endTime":1458.05,"body":"so I may release the sheath,"},{"speaker":"Charles Goldfarb","startTime":1453.73,"endTime":1458.05,"body":"let's say two centimeters"},{"speaker":"Charles Goldfarb","startTime":1458.05,"endTime":1463.36,"body":"proximal to the to the tip of"},{"speaker":"Charles Goldfarb","startTime":1458.05,"endTime":1463.36,"body":"the styloid and then preserve"},{"speaker":"Charles Goldfarb","startTime":1463.36,"endTime":1465.67,"body":"the sheath over that two"},{"speaker":"Charles Goldfarb","startTime":1463.36,"endTime":1465.67,"body":"centimeters to the tip of the"},{"speaker":"Charles Goldfarb","startTime":1465.67,"endTime":1468.31,"body":"stylet and probably another two"},{"speaker":"Charles Goldfarb","startTime":1465.67,"endTime":1468.31,"body":"centimeters, so maybe preserve"},{"speaker":"Charles Goldfarb","startTime":1468.31,"endTime":1471.61,"body":"three or four centimeters of for"},{"speaker":"Charles Goldfarb","startTime":1468.31,"endTime":1471.61,"body":"stability, where proximal is"},{"speaker":"Charles Goldfarb","startTime":1471.61,"endTime":1475.12,"body":"that area, open things up or"},{"speaker":"Charles Goldfarb","startTime":1471.61,"endTime":1475.12,"body":"distal to that area, position"},{"speaker":"Charles Goldfarb","startTime":1475.12,"endTime":1479.53,"body":"the wrist in different extension"},{"speaker":"Charles Goldfarb","startTime":1475.12,"endTime":1479.53,"body":"or flexion postures and examine"},{"speaker":"Charles Goldfarb","startTime":1479.53,"endTime":1482.23,"body":"the tendon and abraded as"},{"speaker":"Charles Goldfarb","startTime":1479.53,"endTime":1482.23,"body":"necessary. That may be"},{"speaker":"Charles Goldfarb","startTime":1482.23,"endTime":1485.98,"body":"conservative. But when I've done"},{"speaker":"Charles Goldfarb","startTime":1482.23,"endTime":1485.98,"body":"this, I have found that"},{"speaker":"Charles Goldfarb","startTime":1485.98,"endTime":1488.95,"body":"technique to be effective and I"},{"speaker":"Charles Goldfarb","startTime":1485.98,"endTime":1488.95,"body":"hope listeners will weigh in if"},{"speaker":"Charles Goldfarb","startTime":1488.95,"endTime":1490.51,"body":"they see it differently or"},{"speaker":"Charles Goldfarb","startTime":1488.95,"endTime":1490.51,"body":"treated differently."},{"speaker":"Chris Dy","startTime":1491.43,"endTime":1493.29,"body":"What is considered"},{"speaker":"Chris Dy","startTime":1491.43,"endTime":1493.29,"body":"diseased tendon?"},{"speaker":"Charles Goldfarb","startTime":1495.26,"endTime":1498.77,"body":"Well, I mean"},{"speaker":"Charles Goldfarb","startTime":1495.26,"endTime":1498.77,"body":"by MRI, it's often intrinsic to"},{"speaker":"Charles Goldfarb","startTime":1498.77,"endTime":1502.85,"body":"the tendon, which again as"},{"speaker":"Charles Goldfarb","startTime":1498.77,"endTime":1502.85,"body":"confusing to me, I think we're"},{"speaker":"Charles Goldfarb","startTime":1502.85,"endTime":1507.23,"body":"looking for essentially"},{"speaker":"Charles Goldfarb","startTime":1502.85,"endTime":1507.23,"body":"synovitis around the tendon. I"},{"speaker":"Charles Goldfarb","startTime":1507.23,"endTime":1508.97,"body":"think that's diseased, like any"},{"speaker":"Charles Goldfarb","startTime":1507.23,"endTime":1508.97,"body":"other tendon."},{"speaker":"Chris Dy","startTime":1510.05,"endTime":1514.91,"body":"Got it? And then after"},{"speaker":"Chris Dy","startTime":1510.05,"endTime":1514.91,"body":"that's done, close, and that's"},{"speaker":"Chris Dy","startTime":1514.91,"endTime":1515.15,"body":"it?"},{"speaker":"Charles Goldfarb","startTime":1515.539,"endTime":1517.759,"body":"Well, it gets"},{"speaker":"Charles Goldfarb","startTime":1515.539,"endTime":1517.759,"body":"to the point of a lot of this"},{"speaker":"Charles Goldfarb","startTime":1517.759,"endTime":1522.139,"body":"close and rest them. You know,"},{"speaker":"Charles Goldfarb","startTime":1517.759,"endTime":1522.139,"body":"it's forced rest for six weeks,"},{"speaker":"Charles Goldfarb","startTime":1522.139,"endTime":1526.459,"body":"which may be a maybe that's a"},{"speaker":"Charles Goldfarb","startTime":1522.139,"endTime":1526.459,"body":"little punitive. But I think"},{"speaker":"Charles Goldfarb","startTime":1526.459,"endTime":1529.999,"body":"that may provide as much good as"},{"speaker":"Charles Goldfarb","startTime":1526.459,"endTime":1529.999,"body":"the surgical intervention"},{"speaker":"Charles Goldfarb","startTime":1529.999,"endTime":1530.449,"body":"itself."},{"speaker":"Chris Dy","startTime":1531.139,"endTime":1532.579,"body":"Cast or custom"},{"speaker":"Chris Dy","startTime":1531.139,"endTime":1532.579,"body":"orthosis."},{"speaker":"Charles Goldfarb","startTime":1533.179,"endTime":1535.369,"body":"I totally fed,"},{"speaker":"Charles Goldfarb","startTime":1533.179,"endTime":1535.369,"body":"I tend to cast."},{"speaker":"Chris Dy","startTime":1536.93,"endTime":1539.57,"body":"So they have a lot of"},{"speaker":"Chris Dy","startTime":1536.93,"endTime":1539.57,"body":"they've invested a lot of their"},{"speaker":"Chris Dy","startTime":1539.78,"endTime":1544.58,"body":"energy and time into it. They"},{"speaker":"Chris Dy","startTime":1539.78,"endTime":1544.58,"body":"want to get better, and you're"},{"speaker":"Chris Dy","startTime":1544.58,"endTime":1546.65,"body":"arresting them. Sounds like"},{"speaker":"Chris Dy","startTime":1544.58,"endTime":1546.65,"body":"sports."},{"speaker":"Charles Goldfarb","startTime":1548.84,"endTime":1552.29,"body":"Yeah. It's"},{"speaker":"Charles Goldfarb","startTime":1548.84,"endTime":1552.29,"body":"kind of like tennis elbow. I"},{"speaker":"Charles Goldfarb","startTime":1552.29,"endTime":1554.66,"body":"don't love treating tennis"},{"speaker":"Charles Goldfarb","startTime":1552.29,"endTime":1554.66,"body":"elbow, I kind of put it in that"},{"speaker":"Charles Goldfarb","startTime":1554.66,"endTime":1555.17,"body":"category."},{"speaker":"Chris Dy","startTime":1556.04,"endTime":1558.02,"body":"So then talk to me"},{"speaker":"Chris Dy","startTime":1556.04,"endTime":1558.02,"body":"about how you address"},{"speaker":"Chris Dy","startTime":1558.05,"endTime":1562.04,"body":"instability. You know, is this"},{"speaker":"Chris Dy","startTime":1558.05,"endTime":1562.04,"body":"You mentioned a little bit about"},{"speaker":"Chris Dy","startTime":1562.04,"endTime":1566.33,"body":"your philosophy. You don't like"},{"speaker":"Chris Dy","startTime":1562.04,"endTime":1566.33,"body":"to deep in the groove? I mean, I"},{"speaker":"Chris Dy","startTime":1566.33,"endTime":1569.3,"body":"guess if you're looking for a"},{"speaker":"Chris Dy","startTime":1566.33,"endTime":1569.3,"body":"disk or in and not be unstable,"},{"speaker":"Chris Dy","startTime":1569.3,"endTime":1572.87,"body":"then maybe that's a solution."},{"speaker":"Chris Dy","startTime":1569.3,"endTime":1572.87,"body":"Are there any cases in which you"},{"speaker":"Chris Dy","startTime":1572.87,"endTime":1574.37,"body":"think groove deepening is the"},{"speaker":"Chris Dy","startTime":1572.87,"endTime":1574.37,"body":"answer?"},{"speaker":"Charles Goldfarb","startTime":1576.58,"endTime":1579.43,"body":"Well, I think"},{"speaker":"Charles Goldfarb","startTime":1576.58,"endTime":1579.43,"body":"there are cases where repair of"},{"speaker":"Charles Goldfarb","startTime":1579.43,"endTime":1583.27,"body":"the ligamentum jugatum is the"},{"speaker":"Charles Goldfarb","startTime":1579.43,"endTime":1583.27,"body":"answer in a truly acute injury"},{"speaker":"Charles Goldfarb","startTime":1583.27,"endTime":1587.14,"body":"in one of our orthopedic"},{"speaker":"Charles Goldfarb","startTime":1583.27,"endTime":1587.14,"body":"colleagues, not at Wash U was"},{"speaker":"Charles Goldfarb","startTime":1587.14,"endTime":1591.4,"body":"playing golf, had a pop, had"},{"speaker":"Charles Goldfarb","startTime":1587.14,"endTime":1591.4,"body":"instability and had had a"},{"speaker":"Charles Goldfarb","startTime":1591.4,"endTime":1595.87,"body":"repair. Two days later, he"},{"speaker":"Charles Goldfarb","startTime":1591.4,"endTime":1595.87,"body":"recognized what he had done. And"},{"speaker":"Charles Goldfarb","startTime":1596.32,"endTime":1599.8,"body":"they put two suture anchors in"},{"speaker":"Charles Goldfarb","startTime":1596.32,"endTime":1599.8,"body":"the owner border, and repair"},{"speaker":"Charles Goldfarb","startTime":1599.8,"endTime":1604.06,"body":"that ligament or the subsheath"},{"speaker":"Charles Goldfarb","startTime":1599.8,"endTime":1604.06,"body":"back down. And he was kept in a"},{"speaker":"Charles Goldfarb","startTime":1604.06,"endTime":1607.06,"body":"position of, you know, pronation"},{"speaker":"Charles Goldfarb","startTime":1604.06,"endTime":1607.06,"body":"and slight wrist extension for"},{"speaker":"Charles Goldfarb","startTime":1607.06,"endTime":1609.73,"body":"six weeks. And he did great."},{"speaker":"Charles Goldfarb","startTime":1607.06,"endTime":1609.73,"body":"Totally agree with that I would"},{"speaker":"Charles Goldfarb","startTime":1609.73,"endTime":1611.92,"body":"have done the same, I don't"},{"speaker":"Charles Goldfarb","startTime":1609.73,"endTime":1611.92,"body":"think I would have added a"},{"speaker":"Charles Goldfarb","startTime":1611.92,"endTime":1616.15,"body":"deepening there. I just don't"},{"speaker":"Charles Goldfarb","startTime":1611.92,"endTime":1616.15,"body":"believe in the deepening. I"},{"speaker":"Charles Goldfarb","startTime":1616.15,"endTime":1619.72,"body":"guess if it's an old guy like"},{"speaker":"Charles Goldfarb","startTime":1616.15,"endTime":1619.72,"body":"me, and you wanted to use that"},{"speaker":"Charles Goldfarb","startTime":1619.72,"endTime":1622.6,"body":"approach, you and I probably"},{"speaker":"Charles Goldfarb","startTime":1619.72,"endTime":1622.6,"body":"wouldn't miss my ECU, honestly."},{"speaker":"Charles Goldfarb","startTime":1623.35,"endTime":1625.6,"body":"But I think in an athlete,"},{"speaker":"Charles Goldfarb","startTime":1623.35,"endTime":1625.6,"body":"whether that'd be a teenager,"},{"speaker":"Charles Goldfarb","startTime":1625.6,"endTime":1628.93,"body":"athlete, collegiate or"},{"speaker":"Charles Goldfarb","startTime":1625.6,"endTime":1628.93,"body":"professional, I think for some,"},{"speaker":"Charles Goldfarb","startTime":1628.96,"endTime":1629.68,"body":"they might."},{"speaker":"Chris Dy","startTime":1630.7,"endTime":1632.17,"body":"I just don't"},{"speaker":"Chris Dy","startTime":1630.7,"endTime":1632.17,"body":"understand how you're gonna get"},{"speaker":"Chris Dy","startTime":1632.2,"endTime":1635.2,"body":"attended to collide by a raw"},{"speaker":"Chris Dy","startTime":1632.2,"endTime":1635.2,"body":"bone. You can't sell a surface I"},{"speaker":"Chris Dy","startTime":1635.2,"endTime":1635.5,"body":"just."},{"speaker":"Charles Goldfarb","startTime":1636.01,"endTime":1640.03,"body":"And you"},{"speaker":"Charles Goldfarb","startTime":1636.01,"endTime":1640.03,"body":"immobilize them to boot. Right."},{"speaker":"Charles Goldfarb","startTime":1640.87,"endTime":1645.55,"body":"So, for that reason, I love this"},{"speaker":"Charles Goldfarb","startTime":1640.87,"endTime":1645.55,"body":"transposition procedure."},{"speaker":"Chris Dy","startTime":1646.57,"endTime":1648.73,"body":"To talk me through the"},{"speaker":"Chris Dy","startTime":1646.57,"endTime":1648.73,"body":"transposition."},{"speaker":"Charles Goldfarb","startTime":1649.45,"endTime":1651.34,"body":"I think it's"},{"speaker":"Charles Goldfarb","startTime":1649.45,"endTime":1651.34,"body":"technically very"},{"speaker":"Charles Goldfarb","startTime":1651.34,"endTime":1656.29,"body":"straightforward. So you do need"},{"speaker":"Charles Goldfarb","startTime":1651.34,"endTime":1656.29,"body":"a sizable incision. So I don't"},{"speaker":"Charles Goldfarb","startTime":1656.29,"endTime":1661.3,"body":"know four inches, going from"},{"speaker":"Charles Goldfarb","startTime":1656.29,"endTime":1661.3,"body":"near the base of the fifth"},{"speaker":"Charles Goldfarb","startTime":1661.3,"endTime":1666.73,"body":"metacarpal, proximal, you know a"},{"speaker":"Charles Goldfarb","startTime":1661.3,"endTime":1666.73,"body":"bit and insides through the"},{"speaker":"Charles Goldfarb","startTime":1666.73,"endTime":1670.3,"body":"skin, protecting cutaneous nerve"},{"speaker":"Charles Goldfarb","startTime":1666.73,"endTime":1670.3,"body":"branches, and release the"},{"speaker":"Charles Goldfarb","startTime":1670.3,"endTime":1676.0,"body":"retinaculum as far voli as you"},{"speaker":"Charles Goldfarb","startTime":1670.3,"endTime":1676.0,"body":"can you reflect the retinaculum"},{"speaker":"Charles Goldfarb","startTime":1676.0,"endTime":1680.29,"body":"up you're looking at the sub"},{"speaker":"Charles Goldfarb","startTime":1676.0,"endTime":1680.29,"body":"sheath, which always looks like"},{"speaker":"Charles Goldfarb","startTime":1680.71,"endTime":1685.27,"body":"degenerative tissue. And I"},{"speaker":"Charles Goldfarb","startTime":1680.71,"endTime":1685.27,"body":"released that is far own early"},{"speaker":"Charles Goldfarb","startTime":1685.3,"endTime":1689.05,"body":"as possible, and then examine"},{"speaker":"Charles Goldfarb","startTime":1685.3,"endTime":1689.05,"body":"the tenant examine, you know,"},{"speaker":"Charles Goldfarb","startTime":1689.08,"endTime":1692.74,"body":"just take a look at things try"},{"speaker":"Charles Goldfarb","startTime":1689.08,"endTime":1692.74,"body":"to get a sense of things. And"},{"speaker":"Charles Goldfarb","startTime":1692.74,"endTime":1695.56,"body":"then it's really simple. Once"},{"speaker":"Charles Goldfarb","startTime":1692.74,"endTime":1695.56,"body":"you mobilize the tenant, you"},{"speaker":"Charles Goldfarb","startTime":1695.56,"endTime":1702.34,"body":"simply bring it dorsally on top"},{"speaker":"Charles Goldfarb","startTime":1695.56,"endTime":1702.34,"body":"of the retinaculum. And then you"},{"speaker":"Charles Goldfarb","startTime":1702.34,"endTime":1705.07,"body":"bring the rest of the"},{"speaker":"Charles Goldfarb","startTime":1702.34,"endTime":1705.07,"body":"retinaculum underneath and then"},{"speaker":"Charles Goldfarb","startTime":1705.07,"endTime":1709.9,"body":"back over the top of the ECU and"},{"speaker":"Charles Goldfarb","startTime":1705.07,"endTime":1709.9,"body":"suture it in place. And you're"},{"speaker":"Charles Goldfarb","startTime":1709.9,"endTime":1713.71,"body":"suturing it directly over the"},{"speaker":"Charles Goldfarb","startTime":1709.9,"endTime":1713.71,"body":"fifth compartment. You have to"},{"speaker":"Charles Goldfarb","startTime":1713.71,"endTime":1720.07,"body":"be careful not to grab a the"},{"speaker":"Charles Goldfarb","startTime":1713.71,"endTime":1720.07,"body":"EDM. But it has a nice bed to"},{"speaker":"Charles Goldfarb","startTime":1720.07,"endTime":1723.52,"body":"rest in. It's a smooth gliding"},{"speaker":"Charles Goldfarb","startTime":1720.07,"endTime":1723.52,"body":"bed, the retinaculum heals"},{"speaker":"Charles Goldfarb","startTime":1723.52,"endTime":1730.21,"body":"nicely, I typically put at least"},{"speaker":"Charles Goldfarb","startTime":1723.52,"endTime":1730.21,"body":"6, 7, 8 stitches in there. And"},{"speaker":"Charles Goldfarb","startTime":1730.27,"endTime":1733.39,"body":"again, gotten patients back to"},{"speaker":"Charles Goldfarb","startTime":1730.27,"endTime":1733.39,"body":"full activities. I tend to"},{"speaker":"Charles Goldfarb","startTime":1733.39,"endTime":1735.7,"body":"mobilize them for five to six"},{"speaker":"Charles Goldfarb","startTime":1733.39,"endTime":1735.7,"body":"weeks, and then they ramp up"},{"speaker":"Charles Goldfarb","startTime":1735.7,"endTime":1736.12,"body":"from there."},{"speaker":"Chris Dy","startTime":1736.9,"endTime":1738.82,"body":"What stitches used"},{"speaker":"Chris Dy","startTime":1736.9,"endTime":1738.82,"body":"like three with a bone or"},{"speaker":"Chris Dy","startTime":1738.82,"endTime":1743.62,"body":"something like that, or three"},{"speaker":"Chris Dy","startTime":1738.82,"endTime":1743.62,"body":"other bond, you got it. Yeah, I"},{"speaker":"Chris Dy","startTime":1743.62,"endTime":1747.7,"body":"remember very vividly the"},{"speaker":"Chris Dy","startTime":1743.62,"endTime":1747.7,"body":"description of this procedure in"},{"speaker":"Chris Dy","startTime":1747.7,"endTime":1752.35,"body":"the Masters techniques for risk"},{"speaker":"Chris Dy","startTime":1747.7,"endTime":1752.35,"body":"surgery, obviously, edited by"},{"speaker":"Chris Dy","startTime":1752.35,"endTime":1756.67,"body":"Dr. Gelberman. But I, as an"},{"speaker":"Chris Dy","startTime":1752.35,"endTime":1756.67,"body":"aside, I picked up a copy of"},{"speaker":"Chris Dy","startTime":1756.67,"endTime":1759.67,"body":"this textbook for like 10 bucks"},{"speaker":"Chris Dy","startTime":1756.67,"endTime":1759.67,"body":"on Amazon when I was a fellow"},{"speaker":"Chris Dy","startTime":1759.7,"endTime":1763.09,"body":"just because I was as a fellow I"},{"speaker":"Chris Dy","startTime":1759.7,"endTime":1763.09,"body":"was running around with my head"},{"speaker":"Chris Dy","startTime":1763.09,"endTime":1765.34,"body":"cut off most of the time. And if"},{"speaker":"Chris Dy","startTime":1763.09,"endTime":1765.34,"body":"I needed to read for something,"},{"speaker":"Chris Dy","startTime":1765.34,"endTime":1767.65,"body":"it had to be like a textbook"},{"speaker":"Chris Dy","startTime":1765.34,"endTime":1767.65,"body":"because I couldn't spend any"},{"speaker":"Chris Dy","startTime":1767.65,"endTime":1769.96,"body":"more time looking for articles."},{"speaker":"Chris Dy","startTime":1767.65,"endTime":1769.96,"body":"Unfortunately, most of the"},{"speaker":"Chris Dy","startTime":1769.96,"endTime":1773.71,"body":"textbooks are edited by our"},{"speaker":"Chris Dy","startTime":1769.96,"endTime":1773.71,"body":"faculty. So I picked that one up"},{"speaker":"Chris Dy","startTime":1773.71,"endTime":1776.11,"body":"and I still actually look at"},{"speaker":"Chris Dy","startTime":1773.71,"endTime":1776.11,"body":"that. And it's got a great"},{"speaker":"Chris Dy","startTime":1776.11,"endTime":1777.82,"body":"illustration of this exact"},{"speaker":"Chris Dy","startTime":1776.11,"endTime":1777.82,"body":"procedure."},{"speaker":"Charles Goldfarb","startTime":1778.15,"endTime":1779.8,"body":"Yeah, and"},{"speaker":"Charles Goldfarb","startTime":1778.15,"endTime":1779.8,"body":"that's where I learned it. And"},{"speaker":"Charles Goldfarb","startTime":1779.8,"endTime":1784.18,"body":"certainly Dr. Gelberman was"},{"speaker":"Charles Goldfarb","startTime":1779.8,"endTime":1784.18,"body":"active in the sports field for"},{"speaker":"Charles Goldfarb","startTime":1784.18,"endTime":1788.17,"body":"many years and did a great job"},{"speaker":"Charles Goldfarb","startTime":1784.18,"endTime":1788.17,"body":"and I took his advice and tried"},{"speaker":"Charles Goldfarb","startTime":1788.17,"endTime":1791.95,"body":"it and have liked it. It is"},{"speaker":"Charles Goldfarb","startTime":1788.17,"endTime":1791.95,"body":"funny about what happens to"},{"speaker":"Charles Goldfarb","startTime":1791.95,"endTime":1794.41,"body":"textbook and pricing because"},{"speaker":"Charles Goldfarb","startTime":1791.95,"endTime":1794.41,"body":"most of the procedures we do in"},{"speaker":"Charles Goldfarb","startTime":1794.41,"endTime":1798.37,"body":"hand surgery are changing that"},{"speaker":"Charles Goldfarb","startTime":1794.41,"endTime":1798.37,"body":"frequently. I bet most of that"},{"speaker":"Charles Goldfarb","startTime":1798.37,"endTime":1801.49,"body":"book is maybe with this set If"},{"speaker":"Charles Goldfarb","startTime":1798.37,"endTime":1801.49,"body":"you don't staple in a treatment,"},{"speaker":"Charles Goldfarb","startTime":1801.49,"endTime":1803.65,"body":"most of that books probably spot"},{"speaker":"Charles Goldfarb","startTime":1801.49,"endTime":1803.65,"body":"on today."},{"speaker":"Chris Dy","startTime":1804.13,"endTime":1805.75,"body":"Oh, you know, the"},{"speaker":"Chris Dy","startTime":1804.13,"endTime":1805.75,"body":"scuffle in a treatment doesn't"},{"speaker":"Chris Dy","startTime":1805.75,"endTime":1813.01,"body":"work anyway. So sure. Any other"},{"speaker":"Chris Dy","startTime":1805.75,"endTime":1813.01,"body":"pearls for ECU either"},{"speaker":"Chris Dy","startTime":1813.01,"endTime":1816.79,"body":"tendinitis, surgery or"},{"speaker":"Chris Dy","startTime":1813.01,"endTime":1816.79,"body":"instability, surgery? anything"},{"speaker":"Chris Dy","startTime":1816.79,"endTime":1819.04,"body":"different that you've done? Have"},{"speaker":"Chris Dy","startTime":1816.79,"endTime":1819.04,"body":"you changed your surgery over"},{"speaker":"Chris Dy","startTime":1819.04,"endTime":1819.64,"body":"the years?"},{"speaker":"Charles Goldfarb","startTime":1820.12,"endTime":1823.09,"body":"I have not. I"},{"speaker":"Charles Goldfarb","startTime":1820.12,"endTime":1823.09,"body":"have not. I don't think there's"},{"speaker":"Charles Goldfarb","startTime":1823.09,"endTime":1825.49,"body":"any other pearls. I think it's"},{"speaker":"Charles Goldfarb","startTime":1823.09,"endTime":1825.49,"body":"something you have to actively"},{"speaker":"Charles Goldfarb","startTime":1825.49,"endTime":1830.56,"body":"look for. Meaning the tendinitis"},{"speaker":"Charles Goldfarb","startTime":1825.49,"endTime":1830.56,"body":"or subtle instability. And so"},{"speaker":"Charles Goldfarb","startTime":1830.56,"endTime":1835.69,"body":"making the diagnosis is the hard"},{"speaker":"Charles Goldfarb","startTime":1830.56,"endTime":1835.69,"body":"part. Sometimes Sometimes is the"},{"speaker":"Charles Goldfarb","startTime":1835.69,"endTime":1838.27,"body":"easiest part ever. And sometimes"},{"speaker":"Charles Goldfarb","startTime":1835.69,"endTime":1838.27,"body":"it's the hard part. So you have"},{"speaker":"Charles Goldfarb","startTime":1838.27,"endTime":1842.08,"body":"to think about it versus"},{"speaker":"Charles Goldfarb","startTime":1838.27,"endTime":1842.08,"body":"intrinsic pathology of the wrist"},{"speaker":"Charles Goldfarb","startTime":1842.08,"endTime":1844.78,"body":"joint. And I guess you would say"},{"speaker":"Charles Goldfarb","startTime":1842.08,"endTime":1844.78,"body":"lt would be part of the"},{"speaker":"Charles Goldfarb","startTime":1845.14,"endTime":1848.86,"body":"pathologic spectrum. But no,"},{"speaker":"Charles Goldfarb","startTime":1845.14,"endTime":1848.86,"body":"it's it's an interesting"},{"speaker":"Charles Goldfarb","startTime":1848.86,"endTime":1851.29,"body":"diagnosis. It's not an"},{"speaker":"Charles Goldfarb","startTime":1848.86,"endTime":1851.29,"body":"infrequent diagnosis, as we"},{"speaker":"Charles Goldfarb","startTime":1851.29,"endTime":1853.69,"body":"discussed earlier, but I think"},{"speaker":"Charles Goldfarb","startTime":1851.29,"endTime":1853.69,"body":"it's one where we can help"},{"speaker":"Charles Goldfarb","startTime":1853.69,"endTime":1854.23,"body":"patients."},{"speaker":"Chris Dy","startTime":1854.81,"endTime":1857.81,"body":"Does anybody after a"},{"speaker":"Chris Dy","startTime":1854.81,"endTime":1857.81,"body":"transposition of the ECU? Do"},{"speaker":"Chris Dy","startTime":1857.81,"endTime":1861.71,"body":"they ever complain about the"},{"speaker":"Chris Dy","startTime":1857.81,"endTime":1861.71,"body":"appearance of their wrist? Does"},{"speaker":"Chris Dy","startTime":1861.71,"endTime":1866.0,"body":"that lump us in over the more"},{"speaker":"Chris Dy","startTime":1861.71,"endTime":1866.0,"body":"centrally Does that bother them"},{"speaker":"Chris Dy","startTime":1866.0,"endTime":1866.33,"body":"at all?"},{"speaker":"Charles Goldfarb","startTime":1867.11,"endTime":1870.32,"body":"No, I haven't"},{"speaker":"Charles Goldfarb","startTime":1867.11,"endTime":1870.32,"body":"heard that or honestly seen it."},{"speaker":"Charles Goldfarb","startTime":1870.32,"endTime":1873.56,"body":"i It hasn't ever been totally"},{"speaker":"Charles Goldfarb","startTime":1870.32,"endTime":1873.56,"body":"visible to me."},{"speaker":"Chris Dy","startTime":1874.61,"endTime":1875.81,"body":"Just as good of a"},{"speaker":"Chris Dy","startTime":1874.61,"endTime":1875.81,"body":"surgeon."},{"speaker":"Charles Goldfarb","startTime":1877.25,"endTime":1879.83,"body":"The wrists"},{"speaker":"Charles Goldfarb","startTime":1877.25,"endTime":1879.83,"body":"have support and fatty tissue"},{"speaker":"Charles Goldfarb","startTime":1879.83,"endTime":1880.43,"body":"which hides it."},{"speaker":"Chris Dy","startTime":1881.75,"endTime":1882.74,"body":"Or you don't ask."},{"speaker":"Charles Goldfarb","startTime":1883.76,"endTime":1885.29,"body":"Alright, tell"},{"speaker":"Charles Goldfarb","startTime":1883.76,"endTime":1885.29,"body":"me one thing you're grateful"},{"speaker":"Charles Goldfarb","startTime":1885.29,"endTime":1885.65,"body":"for."},{"speaker":"Chris Dy","startTime":1886.79,"endTime":1889.91,"body":"I am grateful for"},{"speaker":"Chris Dy","startTime":1886.79,"endTime":1889.91,"body":"eating bread and sweets again,"},{"speaker":"Chris Dy","startTime":1889.97,"endTime":1895.04,"body":"and not feeling bad about it."},{"speaker":"Chris Dy","startTime":1889.97,"endTime":1895.04,"body":"I'm grateful for the you know,"},{"speaker":"Chris Dy","startTime":1895.04,"endTime":1898.55,"body":"having had the chance to spend"},{"speaker":"Chris Dy","startTime":1895.04,"endTime":1898.55,"body":"some time over the holidays,"},{"speaker":"Chris Dy","startTime":1899.12,"endTime":1902.51,"body":"over the Easter holiday with"},{"speaker":"Chris Dy","startTime":1899.12,"endTime":1902.51,"body":"with friends and family. And,"},{"speaker":"Chris Dy","startTime":1902.84,"endTime":1906.74,"body":"you know, that is always fun,"},{"speaker":"Chris Dy","startTime":1902.84,"endTime":1906.74,"body":"and I think should not be taken"},{"speaker":"Chris Dy","startTime":1906.74,"endTime":1909.35,"body":"for granted as much anymore,"},{"speaker":"Chris Dy","startTime":1906.74,"endTime":1909.35,"body":"given everything we've gone"},{"speaker":"Chris Dy","startTime":1909.35,"endTime":1912.8,"body":"through in the last two and two"},{"speaker":"Chris Dy","startTime":1909.35,"endTime":1912.8,"body":"plus years. How about you?"},{"speaker":"Charles Goldfarb","startTime":1913.07,"endTime":1914.93,"body":"Love that. I"},{"speaker":"Charles Goldfarb","startTime":1913.07,"endTime":1914.93,"body":"am grateful that I went to a"},{"speaker":"Charles Goldfarb","startTime":1914.93,"endTime":1917.93,"body":"meeting, I went to the pediatric"},{"speaker":"Charles Goldfarb","startTime":1914.93,"endTime":1917.93,"body":"hands study group meeting in"},{"speaker":"Charles Goldfarb","startTime":1917.93,"endTime":1922.76,"body":"Salt Lake City, Utah. Last"},{"speaker":"Charles Goldfarb","startTime":1917.93,"endTime":1922.76,"body":"weekend. It was great to see"},{"speaker":"Charles Goldfarb","startTime":1922.76,"endTime":1927.53,"body":"people it's great to socialize."},{"speaker":"Charles Goldfarb","startTime":1922.76,"endTime":1927.53,"body":"It was educational. It was not"},{"speaker":"Charles Goldfarb","startTime":1927.53,"endTime":1931.85,"body":"COVID free. In the end, there"},{"speaker":"Charles Goldfarb","startTime":1927.53,"endTime":1931.85,"body":"was a couple of cases."},{"speaker":"Chris Dy","startTime":1932.69,"endTime":1934.76,"body":"The old super spreader"},{"speaker":"Chris Dy","startTime":1932.69,"endTime":1934.76,"body":"conference nice."},{"speaker":"Charles Goldfarb","startTime":1935.27,"endTime":1937.13,"body":"I don't think"},{"speaker":"Charles Goldfarb","startTime":1935.27,"endTime":1937.13,"body":"it turned into that we did wear"},{"speaker":"Charles Goldfarb","startTime":1937.13,"endTime":1940.25,"body":"masks because of the rules of"},{"speaker":"Charles Goldfarb","startTime":1937.13,"endTime":1940.25,"body":"the university inside but with"},{"speaker":"Charles Goldfarb","startTime":1940.25,"endTime":1944.75,"body":"dinner and stuff we did not but"},{"speaker":"Charles Goldfarb","startTime":1940.25,"endTime":1944.75,"body":"man. I you know I've never been"},{"speaker":"Charles Goldfarb","startTime":1944.75,"endTime":1947.33,"body":"someone to say I love meetings"},{"speaker":"Charles Goldfarb","startTime":1944.75,"endTime":1947.33,"body":"that I still wouldn't say that."},{"speaker":"Charles Goldfarb","startTime":1947.33,"endTime":1949.37,"body":"But it really felt good."},{"speaker":"Chris Dy","startTime":1949.88,"endTime":1951.92,"body":"Was this your first"},{"speaker":"Chris Dy","startTime":1949.88,"endTime":1951.92,"body":"meeting back? I know you've done"},{"speaker":"Chris Dy","startTime":1951.92,"endTime":1954.71,"body":"some like smaller committee"},{"speaker":"Chris Dy","startTime":1951.92,"endTime":1954.71,"body":"meeting and question writing"},{"speaker":"Chris Dy","startTime":1954.71,"endTime":1957.14,"body":"things with those this first"},{"speaker":"Chris Dy","startTime":1954.71,"endTime":1957.14,"body":"like academic meeting."},{"speaker":"Charles Goldfarb","startTime":1957.17,"endTime":1959.27,"body":"First academic"},{"speaker":"Charles Goldfarb","startTime":1957.17,"endTime":1959.27,"body":"meeting. Yep. Loved it."},{"speaker":"Chris Dy","startTime":1960.11,"endTime":1962.09,"body":"How many podcasts high"},{"speaker":"Chris Dy","startTime":1960.11,"endTime":1962.09,"body":"fives that you get?"},{"speaker":"Charles Goldfarb","startTime":1963.41,"endTime":1965.6,"body":"You know, it's"},{"speaker":"Charles Goldfarb","startTime":1963.41,"endTime":1965.6,"body":"funny you asked that question."},{"speaker":"Charles Goldfarb","startTime":1966.05,"endTime":1970.31,"body":"Because I know you have said it"},{"speaker":"Charles Goldfarb","startTime":1966.05,"endTime":1970.31,"body":"was great. I did get some. And I"},{"speaker":"Charles Goldfarb","startTime":1970.31,"endTime":1972.89,"body":"don't really know what to say. I"},{"speaker":"Charles Goldfarb","startTime":1970.31,"endTime":1972.89,"body":"say thank you. I'm so glad"},{"speaker":"Charles Goldfarb","startTime":1972.89,"endTime":1976.73,"body":"you're listening. Do you have"},{"speaker":"Charles Goldfarb","startTime":1972.89,"endTime":1976.73,"body":"ideas for topics but I got a"},{"speaker":"Charles Goldfarb","startTime":1976.73,"endTime":1977.36,"body":"lot."},{"speaker":"Chris Dy","startTime":1977.57,"endTime":1980.18,"body":"I really did. I really"},{"speaker":"Chris Dy","startTime":1977.57,"endTime":1980.18,"body":"did. Then you didn't give away"},{"speaker":"Chris Dy","startTime":1980.18,"endTime":1980.9,"body":"any swag."},{"speaker":"Charles Goldfarb","startTime":1981.41,"endTime":1982.34,"body":"I forgot to."},{"speaker":"Chris Dy","startTime":1984.89,"endTime":1985.88,"body":"I'm sure."},{"speaker":"Charles Goldfarb","startTime":1986.18,"endTime":1988.01,"body":"I have a box"},{"speaker":"Charles Goldfarb","startTime":1986.18,"endTime":1988.01,"body":"on my front door. I need to"},{"speaker":"Charles Goldfarb","startTime":1988.01,"endTime":1988.94,"body":"bring some to your house."},{"speaker":"Chris Dy","startTime":1989.21,"endTime":1991.34,"body":"I'm sure they'll find"},{"speaker":"Chris Dy","startTime":1989.21,"endTime":1991.34,"body":"out I'm sure they're gonna find"},{"speaker":"Chris Dy","startTime":1991.34,"endTime":1994.85,"body":"you in Boston at the hand"},{"speaker":"Chris Dy","startTime":1991.34,"endTime":1994.85,"body":"society or whatever other Oh, we"},{"speaker":"Chris Dy","startTime":1994.85,"endTime":1998.3,"body":"need to bring something to"},{"speaker":"Chris Dy","startTime":1994.85,"endTime":1998.3,"body":"London for the IFSSH, the guys"},{"speaker":"Chris Dy","startTime":1998.3,"endTime":2000.85,"body":"at TSA are going to say what"},{"speaker":"Chris Dy","startTime":1998.3,"endTime":2000.85,"body":"what are you bringing into our"},{"speaker":"Chris Dy","startTime":2000.85,"endTime":2005.62,"body":"country? The British equivalent"},{"speaker":"Chris Dy","startTime":2000.85,"endTime":2005.62,"body":"of the TSA."},{"speaker":"Charles Goldfarb","startTime":2006.13,"endTime":2007.06,"body":"And who would"},{"speaker":"Charles Goldfarb","startTime":2006.13,"endTime":2007.06,"body":"want it?"},{"speaker":"Chris Dy","startTime":2007.9,"endTime":2010.0,"body":"Exactly like are you"},{"speaker":"Chris Dy","startTime":2007.9,"endTime":2010.0,"body":"guys some kind of fake"},{"speaker":"Chris Dy","startTime":2010.0,"endTime":2011.5,"body":"celebrity? I don't understand."},{"speaker":"Charles Goldfarb","startTime":2012.73,"endTime":2014.47,"body":"All right."},{"speaker":"Charles Goldfarb","startTime":2012.73,"endTime":2014.47,"body":"Great to see you."},{"speaker":"Chris Dy","startTime":2014.92,"endTime":2016.33,"body":"Nice seeing you. See"},{"speaker":"Chris Dy","startTime":2014.92,"endTime":2016.33,"body":"you next time."},{"speaker":"Charles Goldfarb","startTime":2018.76,"endTime":2020.74,"body":"Hey, Chris,"},{"speaker":"Charles Goldfarb","startTime":2018.76,"endTime":2020.74,"body":"that was fun. Let's do it again"},{"speaker":"Charles Goldfarb","startTime":2020.74,"endTime":2021.25,"body":"real soon."},{"speaker":"Chris Dy","startTime":2021.52,"endTime":2024.04,"body":"Sounds good. Well, be"},{"speaker":"Chris Dy","startTime":2021.52,"endTime":2024.04,"body":"sure to check us out on Twitter"},{"speaker":"Chris Dy","startTime":2024.19,"endTime":2026.44,"body":"@Handpodcast. Hey, Chuck, what's"},{"speaker":"Chris Dy","startTime":2024.19,"endTime":2026.44,"body":"your Twitter handle?"},{"speaker":"Charles Goldfarb","startTime":2026.8,"endTime":2029.65,"body":"Mine is"},{"speaker":"Charles Goldfarb","startTime":2026.8,"endTime":2029.65,"body":"@congenitalhand. What about you?"},{"speaker":"Chris Dy","startTime":2029.8,"endTime":2033.19,"body":"Mine is @ChrisDyMD"},{"speaker":"Chris Dy","startTime":2029.8,"endTime":2033.19,"body":"spelled d y. And if you'd like"},{"speaker":"Chris Dy","startTime":2033.19,"endTime":2036.67,"body":"to email us, you can reach us at"},{"speaker":"Chris Dy","startTime":2033.19,"endTime":2036.67,"body":"handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2037.6,"endTime":2039.76,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2037.6,"endTime":2039.76,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2039.76,"endTime":2040.84,"body":"get your podcasts"},{"speaker":"Chris Dy","startTime":2040.87,"endTime":2043.09,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":2040.87,"endTime":2043.09,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2043.09,"endTime":2043.51,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":2043.87,"endTime":2046.18,"body":"Special thanks"},{"speaker":"Charles Goldfarb","startTime":2043.87,"endTime":2046.18,"body":"to Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2046.18,"endTime":2050.17,"body":"music. And remember, keep the"},{"speaker":"Charles Goldfarb","startTime":2046.18,"endTime":2050.17,"body":"upper hand. Come back next time"}]}