{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":3.6,"endTime":5.97,"body":"Welcome to the"},{"speaker":"Charles Goldfarb","startTime":3.6,"endTime":5.97,"body":"upper hand podcast where Chuck"},{"speaker":"Charles Goldfarb","startTime":6.0,"endTime":7.53,"body":"and Chris talk Hand Surgery."},{"speaker":"Chris Dy","startTime":7.89,"endTime":9.69,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":7.89,"endTime":9.69,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":9.69,"endTime":12.33,"body":"University in St. Louis here to"},{"speaker":"Chris Dy","startTime":9.69,"endTime":12.33,"body":"talk about all things hand"},{"speaker":"Chris Dy","startTime":12.33,"endTime":14.64,"body":"surgery related from technical"},{"speaker":"Chris Dy","startTime":12.33,"endTime":14.64,"body":"to personal."},{"speaker":"Charles Goldfarb","startTime":15.33,"endTime":17.43,"body":"Please"},{"speaker":"Charles Goldfarb","startTime":15.33,"endTime":17.43,"body":"subscribe, wherever you get your"},{"speaker":"Charles Goldfarb","startTime":17.43,"endTime":18.0,"body":"podcasts."},{"speaker":"Chris Dy","startTime":18.93,"endTime":21.3,"body":"And thank you in"},{"speaker":"Chris Dy","startTime":18.93,"endTime":21.3,"body":"advance for leaving a review and"},{"speaker":"Chris Dy","startTime":21.3,"endTime":23.58,"body":"leaving a rating wherever you"},{"speaker":"Chris Dy","startTime":21.3,"endTime":23.58,"body":"get your podcast."},{"speaker":"Charles Goldfarb","startTime":24.42,"endTime":25.32,"body":"Oh hey Chris."},{"speaker":"Chris Dy","startTime":25.8,"endTime":26.76,"body":"Hey, Chuck, how are"},{"speaker":"Chris Dy","startTime":25.8,"endTime":26.76,"body":"you?"},{"speaker":"Charles Goldfarb","startTime":27.6,"endTime":29.88,"body":"Fantastic. I"},{"speaker":"Charles Goldfarb","startTime":27.6,"endTime":29.88,"body":"just finished clinic."},{"speaker":"Chris Dy","startTime":30.69,"endTime":32.94,"body":"Nobody ever says that"},{"speaker":"Chris Dy","startTime":30.69,"endTime":32.94,"body":"after finishing clinic. Was it a"},{"speaker":"Chris Dy","startTime":32.94,"endTime":33.6,"body":"good clinic?"},{"speaker":"Charles Goldfarb","startTime":34.02,"endTime":37.11,"body":"No, it was a"},{"speaker":"Charles Goldfarb","startTime":34.02,"endTime":37.11,"body":"good clinic. And it was great,"},{"speaker":"Charles Goldfarb","startTime":37.17,"endTime":40.98,"body":"because there was just you know"},{"speaker":"Charles Goldfarb","startTime":37.17,"endTime":40.98,"body":"how one patient can make your"},{"speaker":"Charles Goldfarb","startTime":40.98,"endTime":44.91,"body":"clinic like one really, really"},{"speaker":"Charles Goldfarb","startTime":40.98,"endTime":44.91,"body":"good interaction"},{"speaker":"Chris Dy","startTime":45.57,"endTime":47.1,"body":"in a good way or in a"},{"speaker":"Chris Dy","startTime":45.57,"endTime":47.1,"body":"bad way?"},{"speaker":"Charles Goldfarb","startTime":47.13,"endTime":50.25,"body":"Well that's"},{"speaker":"Charles Goldfarb","startTime":47.13,"endTime":50.25,"body":"true. Both directions. This was"},{"speaker":"Charles Goldfarb","startTime":50.25,"endTime":53.67,"body":"good. It was just actually a"},{"speaker":"Charles Goldfarb","startTime":50.25,"endTime":53.67,"body":"woman who works at Barnes that"},{"speaker":"Charles Goldfarb","startTime":53.67,"endTime":56.7,"body":"main hospital we work at that"},{"speaker":"Charles Goldfarb","startTime":53.67,"endTime":56.7,"body":"has known me since I was an"},{"speaker":"Charles Goldfarb","startTime":56.7,"endTime":61.11,"body":"intern. And I've seen her"},{"speaker":"Charles Goldfarb","startTime":56.7,"endTime":61.11,"body":"intermittently over the years,"},{"speaker":"Charles Goldfarb","startTime":61.11,"endTime":63.45,"body":"and she's just delightful. It"},{"speaker":"Charles Goldfarb","startTime":61.11,"endTime":63.45,"body":"was really, really"},{"speaker":"Chris Dy","startTime":63.45,"endTime":65.58,"body":"Did you wish her a"},{"speaker":"Chris Dy","startTime":63.45,"endTime":65.58,"body":"happy 100th birthday."},{"speaker":"Charles Goldfarb","startTime":66.81,"endTime":69.69,"body":"What was funny"},{"speaker":"Charles Goldfarb","startTime":66.81,"endTime":69.69,"body":"was we're sitting in the room,"},{"speaker":"Charles Goldfarb","startTime":69.72,"endTime":72.57,"body":"you know, we have the work room"},{"speaker":"Charles Goldfarb","startTime":69.72,"endTime":72.57,"body":"that I kind of fly in and out of"},{"speaker":"Charles Goldfarb","startTime":72.57,"endTime":76.89,"body":"like you, I'm sure. And I sat"},{"speaker":"Charles Goldfarb","startTime":72.57,"endTime":76.89,"body":"down and the resident Dwayne,"},{"speaker":"Charles Goldfarb","startTime":76.89,"endTime":83.25,"body":"who's working with me said, Wait"},{"speaker":"Charles Goldfarb","startTime":76.89,"endTime":83.25,"body":"a second. I wasn't born when you"},{"speaker":"Charles Goldfarb","startTime":83.25,"endTime":85.08,"body":"started working here."},{"speaker":"Chris Dy","startTime":86.01,"endTime":90.3,"body":"Yep. Yeah, sounds"},{"speaker":"Chris Dy","startTime":86.01,"endTime":90.3,"body":"about right. It's crazy. I was"},{"speaker":"Chris Dy","startTime":90.3,"endTime":94.02,"body":"in the ER today. And so what we"},{"speaker":"Chris Dy","startTime":90.3,"endTime":94.02,"body":"started to do for these long"},{"speaker":"Chris Dy","startTime":94.05,"endTime":97.35,"body":"cases, I did a plexus. We"},{"speaker":"Chris Dy","startTime":94.05,"endTime":97.35,"body":"decided to just do a decade's"},{"speaker":"Chris Dy","startTime":97.35,"endTime":100.14,"body":"progression in terms of music."},{"speaker":"Chris Dy","startTime":97.35,"endTime":100.14,"body":"So we start in the 80s. We go to"},{"speaker":"Chris Dy","startTime":100.14,"endTime":103.89,"body":"the 90s. We go to the 2000s and"},{"speaker":"Chris Dy","startTime":100.14,"endTime":103.89,"body":"go to the 2010s. At some point,"},{"speaker":"Chris Dy","startTime":103.89,"endTime":106.02,"body":"I had to ask the resident I was"},{"speaker":"Chris Dy","startTime":103.89,"endTime":106.02,"body":"working. I was like, So what"},{"speaker":"Chris Dy","startTime":106.02,"endTime":109.26,"body":"year were you born? Oh, you were"},{"speaker":"Chris Dy","startTime":106.02,"endTime":109.26,"body":"a toddler when the song came?"},{"speaker":"Charles Goldfarb","startTime":111.39,"endTime":113.16,"body":"It's"},{"speaker":"Charles Goldfarb","startTime":111.39,"endTime":113.16,"body":"perspective building."},{"speaker":"Chris Dy","startTime":114.21,"endTime":118.2,"body":"Yes, indeed. Yes,"},{"speaker":"Chris Dy","startTime":114.21,"endTime":118.2,"body":"indeed. But while I'm glad you"},{"speaker":"Chris Dy","startTime":118.2,"endTime":121.41,"body":"had enjoyable clinic, because I"},{"speaker":"Chris Dy","startTime":118.2,"endTime":121.41,"body":"actually saw somebody the other"},{"speaker":"Chris Dy","startTime":121.41,"endTime":124.29,"body":"day who you had done a surgery"},{"speaker":"Chris Dy","startTime":121.41,"endTime":124.29,"body":"on but they obviously couldn't"},{"speaker":"Chris Dy","startTime":124.29,"endTime":128.94,"body":"get in to see you. Because the"},{"speaker":"Chris Dy","startTime":124.29,"endTime":128.94,"body":"age age issues. So the age, the"},{"speaker":"Chris Dy","startTime":128.94,"endTime":130.08,"body":"age daddy or clinic."},{"speaker":"Charles Goldfarb","startTime":130.77,"endTime":133.77,"body":"It's a classic"},{"speaker":"Charles Goldfarb","startTime":130.77,"endTime":133.77,"body":"example of be a little pushy."},{"speaker":"Charles Goldfarb","startTime":133.77,"endTime":137.64,"body":"And I never say no. But if you"},{"speaker":"Charles Goldfarb","startTime":133.77,"endTime":137.64,"body":"don't have to be pushy, to just"},{"speaker":"Charles Goldfarb","startTime":137.64,"endTime":142.05,"body":"a nice person, sometimes they"},{"speaker":"Charles Goldfarb","startTime":137.64,"endTime":142.05,"body":"don't they it happens like that,"},{"speaker":"Charles Goldfarb","startTime":142.05,"endTime":143.07,"body":"which is unfortunate."},{"speaker":"Chris Dy","startTime":143.58,"endTime":145.65,"body":"Well, then they ended"},{"speaker":"Chris Dy","startTime":143.58,"endTime":145.65,"body":"up with me. And hopefully I can"},{"speaker":"Chris Dy","startTime":145.65,"endTime":146.07,"body":"live up"},{"speaker":"Charles Goldfarb","startTime":146.07,"endTime":148.95,"body":"to their"},{"speaker":"Charles Goldfarb","startTime":146.07,"endTime":148.95,"body":"expectations. low bar low bar"},{"speaker":"Charles Goldfarb","startTime":148.95,"endTime":149.52,"body":"Doctor Dy"},{"speaker":"Chris Dy","startTime":150.66,"endTime":152.52,"body":"So any good cases"},{"speaker":"Chris Dy","startTime":150.66,"endTime":152.52,"body":"recently?"},{"speaker":"Charles Goldfarb","startTime":153.06,"endTime":155.34,"body":"Yeah, I did"},{"speaker":"Charles Goldfarb","startTime":153.06,"endTime":155.34,"body":"have a relatively interesting"},{"speaker":"Charles Goldfarb","startTime":155.34,"endTime":160.35,"body":"case. Just for, you know, this"},{"speaker":"Charles Goldfarb","startTime":155.34,"endTime":160.35,"body":"was an adolescent case, who"},{"speaker":"Charles Goldfarb","startTime":160.35,"endTime":166.38,"body":"traveled a bit to see me patient"},{"speaker":"Charles Goldfarb","startTime":160.35,"endTime":166.38,"body":"had a distal radius fracture"},{"speaker":"Charles Goldfarb","startTime":166.8,"endTime":172.11,"body":"four years ago, not a bad one."},{"speaker":"Charles Goldfarb","startTime":166.8,"endTime":172.11,"body":"It healed on eventually. And"},{"speaker":"Charles Goldfarb","startTime":172.11,"endTime":175.98,"body":"he's noticed this progressive"},{"speaker":"Charles Goldfarb","startTime":172.11,"endTime":175.98,"body":"deformity on the pinky side of"},{"speaker":"Charles Goldfarb","startTime":175.98,"endTime":180.42,"body":"his wrist. And not to belabor"},{"speaker":"Charles Goldfarb","startTime":175.98,"endTime":180.42,"body":"the issue, but he had a growth"},{"speaker":"Charles Goldfarb","startTime":180.42,"endTime":187.74,"body":"arrest, and had about a 25"},{"speaker":"Charles Goldfarb","startTime":180.42,"endTime":187.74,"body":"millimeter difference. And now,"},{"speaker":"Charles Goldfarb","startTime":188.25,"endTime":189.9,"body":"he is skeletally mature."},{"speaker":"Chris Dy","startTime":190.8,"endTime":192.54,"body":"For those in America."},{"speaker":"Chris Dy","startTime":190.8,"endTime":192.54,"body":"That's an inch right."},{"speaker":"Charles Goldfarb","startTime":195.54,"endTime":197.37,"body":"Yeah, so I was"},{"speaker":"Charles Goldfarb","startTime":195.54,"endTime":197.37,"body":"trying to appeal to the"},{"speaker":"Charles Goldfarb","startTime":197.37,"endTime":201.99,"body":"worldwide audience. But yeah,"},{"speaker":"Charles Goldfarb","startTime":197.37,"endTime":201.99,"body":"it's roughly one inch, which is"},{"speaker":"Charles Goldfarb","startTime":201.99,"endTime":206.37,"body":"a huge difference. Right? Right."},{"speaker":"Charles Goldfarb","startTime":201.99,"endTime":206.37,"body":"And so he was having pain. He's"},{"speaker":"Charles Goldfarb","startTime":206.37,"endTime":210.84,"body":"an athlete and wanted just to"},{"speaker":"Charles Goldfarb","startTime":206.37,"endTime":210.84,"body":"get back to sports. But the way"},{"speaker":"Charles Goldfarb","startTime":210.84,"endTime":214.47,"body":"it's interesting to someone like"},{"speaker":"Charles Goldfarb","startTime":210.84,"endTime":214.47,"body":"me is Do you lengthen the"},{"speaker":"Charles Goldfarb","startTime":214.47,"endTime":216.3,"body":"radius? Or do is shorten the"},{"speaker":"Charles Goldfarb","startTime":214.47,"endTime":216.3,"body":"order?"},{"speaker":"Chris Dy","startTime":217.56,"endTime":222.33,"body":"Now is how much is 2.5"},{"speaker":"Chris Dy","startTime":217.56,"endTime":222.33,"body":"centimeters? Is that a lot to"},{"speaker":"Chris Dy","startTime":222.33,"endTime":223.77,"body":"ask if you lengthen?"},{"speaker":"Charles Goldfarb","startTime":225.06,"endTime":228.15,"body":"No. So I would"},{"speaker":"Charles Goldfarb","startTime":225.06,"endTime":228.15,"body":"if I was going to lengthen it"},{"speaker":"Charles Goldfarb","startTime":228.15,"endTime":231.3,"body":"would be a gradual lengthening"},{"speaker":"Charles Goldfarb","startTime":228.15,"endTime":231.3,"body":"with a unilateral External"},{"speaker":"Charles Goldfarb","startTime":231.3,"endTime":235.41,"body":"Fixator and getting two and a"},{"speaker":"Charles Goldfarb","startTime":231.3,"endTime":235.41,"body":"half centimeters would be fine."},{"speaker":"Charles Goldfarb","startTime":235.47,"endTime":238.98,"body":"It's a it's a great bone to"},{"speaker":"Charles Goldfarb","startTime":235.47,"endTime":238.98,"body":"lengthen. It's well tolerated"},{"speaker":"Charles Goldfarb","startTime":238.98,"endTime":240.45,"body":"complications are low."},{"speaker":"Chris Dy","startTime":241.71,"endTime":243.66,"body":"Just like a bone"},{"speaker":"Chris Dy","startTime":241.71,"endTime":243.66,"body":"transport situation you like"},{"speaker":"Chris Dy","startTime":243.66,"endTime":245.34,"body":"crank it a little bit every day"},{"speaker":"Chris Dy","startTime":243.66,"endTime":245.34,"body":"or like,"},{"speaker":"Charles Goldfarb","startTime":245.52,"endTime":250.59,"body":"yeah, you you"},{"speaker":"Charles Goldfarb","startTime":245.52,"endTime":250.59,"body":"first surgery is basically an"},{"speaker":"Charles Goldfarb","startTime":250.59,"endTime":255.45,"body":"incision down to bone, create an"},{"speaker":"Charles Goldfarb","startTime":250.59,"endTime":255.45,"body":"osteotomy then put foot four"},{"speaker":"Charles Goldfarb","startTime":255.45,"endTime":258.9,"body":"pins in to four chance pins in"},{"speaker":"Charles Goldfarb","startTime":255.45,"endTime":258.9,"body":"to proximal to distal, the"},{"speaker":"Charles Goldfarb","startTime":258.9,"endTime":262.47,"body":"osteotomy. Put your frame back"},{"speaker":"Charles Goldfarb","startTime":258.9,"endTime":262.47,"body":"on, like the bar, the bar that's"},{"speaker":"Charles Goldfarb","startTime":262.47,"endTime":265.35,"body":"sitting outside of the skin, you"},{"speaker":"Charles Goldfarb","startTime":262.47,"endTime":265.35,"body":"let it sit for five to seven"},{"speaker":"Charles Goldfarb","startTime":265.35,"endTime":268.23,"body":"days and they come back and you"},{"speaker":"Charles Goldfarb","startTime":265.35,"endTime":268.23,"body":"start turning a quarter of a"},{"speaker":"Charles Goldfarb","startTime":268.23,"endTime":270.9,"body":"millimeter I only do three times"},{"speaker":"Charles Goldfarb","startTime":268.23,"endTime":270.9,"body":"a day for the radiator for the"},{"speaker":"Charles Goldfarb","startTime":270.9,"endTime":275.4,"body":"hand. And you know, doesn't take"},{"speaker":"Charles Goldfarb","startTime":270.9,"endTime":275.4,"body":"long to get 25 millimeters or"},{"speaker":"Charles Goldfarb","startTime":275.4,"endTime":279.99,"body":"one inch. And then you got to"},{"speaker":"Charles Goldfarb","startTime":275.4,"endTime":279.99,"body":"let it consolidate as you recall"},{"speaker":"Charles Goldfarb","startTime":279.99,"endTime":283.89,"body":"from your orthopedic surgery"},{"speaker":"Charles Goldfarb","startTime":279.99,"endTime":283.89,"body":"days, and so you're looking at"},{"speaker":"Charles Goldfarb","startTime":283.89,"endTime":289.59,"body":"probably four months or you"},{"speaker":"Charles Goldfarb","startTime":283.89,"endTime":289.59,"body":"shorten the ulna."},{"speaker":"Chris Dy","startTime":290.7,"endTime":293.19,"body":"Right Well, I guess is"},{"speaker":"Chris Dy","startTime":290.7,"endTime":293.19,"body":"this is this a unit planar"},{"speaker":"Chris Dy","startTime":293.19,"endTime":296.13,"body":"deformity? Or is it say by"},{"speaker":"Chris Dy","startTime":293.19,"endTime":296.13,"body":"planar multi planar kind of"},{"speaker":"Chris Dy","startTime":296.13,"endTime":296.46,"body":"thing?"},{"speaker":"Charles Goldfarb","startTime":296.58,"endTime":298.35,"body":"This is Uni-"},{"speaker":"Charles Goldfarb","startTime":296.58,"endTime":298.35,"body":"planar. When they get really"},{"speaker":"Charles Goldfarb","startTime":298.35,"endTime":302.34,"body":"complex, I send them to our ski"},{"speaker":"Charles Goldfarb","startTime":298.35,"endTime":302.34,"body":"old partners who do the circular"},{"speaker":"Charles Goldfarb","startTime":302.34,"endTime":305.49,"body":"frames, but I am quite"},{"speaker":"Charles Goldfarb","startTime":302.34,"endTime":305.49,"body":"comfortable and enjoy the"},{"speaker":"Charles Goldfarb","startTime":305.49,"endTime":306.96,"body":"unilateral frame procedures."},{"speaker":"Chris Dy","startTime":307.26,"endTime":310.35,"body":"So before we get to"},{"speaker":"Chris Dy","startTime":307.26,"endTime":310.35,"body":"the question of lengthen radius"},{"speaker":"Chris Dy","startTime":310.35,"endTime":313.11,"body":"shorten the ulna. Is there"},{"speaker":"Chris Dy","startTime":310.35,"endTime":313.11,"body":"anything that could have been"},{"speaker":"Chris Dy","startTime":313.11,"endTime":316.2,"body":"done differently with his"},{"speaker":"Chris Dy","startTime":313.11,"endTime":316.2,"body":"original injury treatment that"},{"speaker":"Chris Dy","startTime":316.2,"endTime":320.58,"body":"would have minimized the chances"},{"speaker":"Chris Dy","startTime":316.2,"endTime":320.58,"body":"of you know, if I seal arrest?"},{"speaker":"Charles Goldfarb","startTime":321.03,"endTime":323.19,"body":"In this case?"},{"speaker":"Charles Goldfarb","startTime":321.03,"endTime":323.19,"body":"No. And I think it's so"},{"speaker":"Charles Goldfarb","startTime":323.19,"endTime":326.43,"body":"interesting how sometimes the"},{"speaker":"Charles Goldfarb","startTime":323.19,"endTime":326.43,"body":"most innocuous appearing"},{"speaker":"Charles Goldfarb","startTime":326.43,"endTime":328.98,"body":"fractures ended up closing on"},{"speaker":"Charles Goldfarb","startTime":326.43,"endTime":328.98,"body":"the growth plate and some that"},{"speaker":"Charles Goldfarb","startTime":328.98,"endTime":332.31,"body":"are really devastating do not."},{"speaker":"Charles Goldfarb","startTime":328.98,"endTime":332.31,"body":"Now if they had been followed"},{"speaker":"Charles Goldfarb","startTime":332.31,"endTime":334.65,"body":"closely, this would have been"},{"speaker":"Charles Goldfarb","startTime":332.31,"endTime":334.65,"body":"picked up earlier. But then the"},{"speaker":"Charles Goldfarb","startTime":334.65,"endTime":338.61,"body":"question becomes, would you"},{"speaker":"Charles Goldfarb","startTime":334.65,"endTime":338.61,"body":"really stop the growth of the"},{"speaker":"Charles Goldfarb","startTime":338.64,"endTime":343.47,"body":"owner in a 12 year old? To a no,"},{"speaker":"Charles Goldfarb","startTime":338.64,"endTime":343.47,"body":"because then you're, in"},{"speaker":"Charles Goldfarb","startTime":343.47,"endTime":345.63,"body":"retrospect, sure, that would"},{"speaker":"Charles Goldfarb","startTime":343.47,"endTime":345.63,"body":"have been a great thing to have"},{"speaker":"Charles Goldfarb","startTime":345.63,"endTime":349.08,"body":"done. But it's really hard to do"},{"speaker":"Charles Goldfarb","startTime":345.63,"endTime":349.08,"body":"that in a young patient, because"},{"speaker":"Charles Goldfarb","startTime":349.08,"endTime":352.23,"body":"you're just you're dooming them"},{"speaker":"Charles Goldfarb","startTime":349.08,"endTime":352.23,"body":"so to speak, for one inch"},{"speaker":"Charles Goldfarb","startTime":352.23,"endTime":355.29,"body":"differential side to side,"},{"speaker":"Charles Goldfarb","startTime":352.23,"endTime":355.29,"body":"which, honestly, is not a big"},{"speaker":"Charles Goldfarb","startTime":355.29,"endTime":355.62,"body":"deal."},{"speaker":"Chris Dy","startTime":356.16,"endTime":358.92,"body":"Yeah, I think whenever"},{"speaker":"Chris Dy","startTime":356.16,"endTime":358.92,"body":"I get fitted for shirts, I"},{"speaker":"Chris Dy","startTime":358.92,"endTime":361.98,"body":"remember my one side being quite"},{"speaker":"Chris Dy","startTime":358.92,"endTime":361.98,"body":"longer than the other. I think"},{"speaker":"Chris Dy","startTime":361.98,"endTime":363.12,"body":"it was just my poor posture."},{"speaker":"Charles Goldfarb","startTime":363.72,"endTime":366.18,"body":"So your custom"},{"speaker":"Charles Goldfarb","startTime":363.72,"endTime":366.18,"body":"shirts, Dr. Dy, you are you."},{"speaker":"Chris Dy","startTime":367.59,"endTime":370.17,"body":"This was this was back"},{"speaker":"Chris Dy","startTime":367.59,"endTime":370.17,"body":"in a different life when I lived"},{"speaker":"Chris Dy","startTime":370.17,"endTime":373.32,"body":"in the the old New York City,"},{"speaker":"Chris Dy","startTime":370.17,"endTime":373.32,"body":"the old Big Apple? I don't know,"},{"speaker":"Chris Dy","startTime":373.32,"endTime":375.75,"body":"I don't think I've been since"},{"speaker":"Chris Dy","startTime":373.32,"endTime":375.75,"body":"becoming a parent, I don't think"},{"speaker":"Chris Dy","startTime":375.75,"endTime":377.82,"body":"I've taken that much time to"},{"speaker":"Chris Dy","startTime":375.75,"endTime":377.82,"body":"select my clothing."},{"speaker":"Charles Goldfarb","startTime":378.63,"endTime":381.54,"body":"That is fair,"},{"speaker":"Charles Goldfarb","startTime":378.63,"endTime":381.54,"body":"that is fair. So then how do"},{"speaker":"Chris Dy","startTime":381.54,"endTime":383.49,"body":"you decide what to do"},{"speaker":"Chris Dy","startTime":381.54,"endTime":383.49,"body":"here? How do you decide whether"},{"speaker":"Chris Dy","startTime":383.49,"endTime":385.08,"body":"to lengthen the radius or"},{"speaker":"Chris Dy","startTime":383.49,"endTime":385.08,"body":"shorten the older?"},{"speaker":"Charles Goldfarb","startTime":385.89,"endTime":387.78,"body":"This is one of"},{"speaker":"Charles Goldfarb","startTime":385.89,"endTime":387.78,"body":"those situations where I say"},{"speaker":"Charles Goldfarb","startTime":387.78,"endTime":392.67,"body":"that is patient centered care."},{"speaker":"Charles Goldfarb","startTime":387.78,"endTime":392.67,"body":"But in giving my spiel, I, you"},{"speaker":"Charles Goldfarb","startTime":392.67,"endTime":394.83,"body":"know, I think we can take the"},{"speaker":"Charles Goldfarb","startTime":392.67,"endTime":394.83,"body":"patient wherever we want to take"},{"speaker":"Charles Goldfarb","startTime":394.83,"endTime":397.68,"body":"the patient in most situations,"},{"speaker":"Charles Goldfarb","startTime":394.83,"endTime":397.68,"body":"and this kid just wants to play"},{"speaker":"Charles Goldfarb","startTime":397.68,"endTime":402.96,"body":"ball. And so it's certainly a"},{"speaker":"Charles Goldfarb","startTime":397.68,"endTime":402.96,"body":"faster recovery without any"},{"speaker":"Charles Goldfarb","startTime":402.96,"endTime":406.74,"body":"negatives to my view. And so we"},{"speaker":"Charles Goldfarb","startTime":402.96,"endTime":406.74,"body":"shortened the old nine. What's"},{"speaker":"Charles Goldfarb","startTime":406.74,"endTime":411.96,"body":"interesting, though, is it's not"},{"speaker":"Charles Goldfarb","startTime":406.74,"endTime":411.96,"body":"an easy shortening. A big that's"},{"speaker":"Charles Goldfarb","startTime":411.96,"endTime":412.02,"body":"a"},{"speaker":"Chris Dy","startTime":412.02,"endTime":415.05,"body":"lot. A lot. Yeah,"},{"speaker":"Chris Dy","startTime":412.02,"endTime":415.05,"body":"that's approximately 2.5"},{"speaker":"Chris Dy","startTime":415.05,"endTime":415.68,"body":"centimeters"},{"speaker":"Charles Goldfarb","startTime":415.92,"endTime":417.3,"body":"is"},{"speaker":"Charles Goldfarb","startTime":415.92,"endTime":417.3,"body":"approximately 1 inch"},{"speaker":"Chris Dy","startTime":419.28,"endTime":421.86,"body":"So don't put haven't"},{"speaker":"Chris Dy","startTime":419.28,"endTime":421.86,"body":"hasn't technology evolve where"},{"speaker":"Chris Dy","startTime":421.86,"endTime":425.88,"body":"we don't need to do X fixes for"},{"speaker":"Chris Dy","startTime":421.86,"endTime":425.88,"body":"bone transport, haven't the"},{"speaker":"Chris Dy","startTime":425.88,"endTime":429.27,"body":"spine, scaly folks figured out"},{"speaker":"Chris Dy","startTime":425.88,"endTime":429.27,"body":"ways to use magnets to, you"},{"speaker":"Chris Dy","startTime":429.27,"endTime":431.31,"body":"know, to do guided growth, that"},{"speaker":"Chris Dy","startTime":429.27,"endTime":431.31,"body":"kind of thing?"},{"speaker":"Charles Goldfarb","startTime":431.79,"endTime":434.16,"body":"Well, if you"},{"speaker":"Charles Goldfarb","startTime":431.79,"endTime":434.16,"body":"follow the paediatric literature"},{"speaker":"Charles Goldfarb","startTime":434.16,"endTime":438.09,"body":"for radial deficiency, Dr. D,"},{"speaker":"Charles Goldfarb","startTime":434.16,"endTime":438.09,"body":"you would know that they"},{"speaker":"Charles Goldfarb","startTime":438.12,"endTime":443.4,"body":"actually there is a report on"},{"speaker":"Charles Goldfarb","startTime":438.12,"endTime":443.4,"body":"using the magnetic lengthening"},{"speaker":"Charles Goldfarb","startTime":443.4,"endTime":446.61,"body":"devices for the radius in a"},{"speaker":"Charles Goldfarb","startTime":443.4,"endTime":446.61,"body":"setting of radial deficiency to"},{"speaker":"Charles Goldfarb","startTime":446.61,"endTime":447.87,"body":"help balance the corpus."},{"speaker":"Chris Dy","startTime":448.2,"endTime":450.3,"body":"Well, since I no"},{"speaker":"Chris Dy","startTime":448.2,"endTime":450.3,"body":"longer write the What's New in"},{"speaker":"Chris Dy","startTime":450.3,"endTime":455.01,"body":"hand surgery for JBJS I must"},{"speaker":"Chris Dy","startTime":450.3,"endTime":455.01,"body":"have missed that in the Journal"},{"speaker":"Chris Dy","startTime":455.01,"endTime":459.21,"body":"of Pediatric hand surgery slash"},{"speaker":"Chris Dy","startTime":455.01,"endTime":459.21,"body":"Chuck's blog. Yeah."},{"speaker":"Charles Goldfarb","startTime":460.5,"endTime":461.76,"body":"It's"},{"speaker":"Charles Goldfarb","startTime":460.5,"endTime":461.76,"body":"interesting. I don't think"},{"speaker":"Charles Goldfarb","startTime":461.76,"endTime":465.72,"body":"that's ready for primetime. But"},{"speaker":"Charles Goldfarb","startTime":461.76,"endTime":465.72,"body":"it in for two and a half"},{"speaker":"Charles Goldfarb","startTime":465.72,"endTime":468.12,"body":"centimeters, it's probably not"},{"speaker":"Charles Goldfarb","startTime":465.72,"endTime":468.12,"body":"worth it. But it is fair"},{"speaker":"Charles Goldfarb","startTime":468.12,"endTime":471.69,"body":"question. I think that'll"},{"speaker":"Charles Goldfarb","startTime":468.12,"endTime":471.69,"body":"that'll be here for all bones at"},{"speaker":"Charles Goldfarb","startTime":471.69,"endTime":472.17,"body":"some point."},{"speaker":"Chris Dy","startTime":472.62,"endTime":475.05,"body":"Now, if you're doing"},{"speaker":"Chris Dy","startTime":472.62,"endTime":475.05,"body":"guided growth and lengthening"},{"speaker":"Chris Dy","startTime":475.08,"endTime":477.78,"body":"the radius, in general, how do"},{"speaker":"Chris Dy","startTime":475.08,"endTime":477.78,"body":"you think about that with"},{"speaker":"Chris Dy","startTime":477.78,"endTime":480.66,"body":"response it, of course, I want"},{"speaker":"Chris Dy","startTime":477.78,"endTime":480.66,"body":"to know about the nerves."},{"speaker":"Chris Dy","startTime":481.32,"endTime":483.66,"body":"Because I know that there are"},{"speaker":"Chris Dy","startTime":481.32,"endTime":483.66,"body":"case reports of doing you know,"},{"speaker":"Chris Dy","startTime":483.66,"endTime":488.19,"body":"for addressing a big sciatic"},{"speaker":"Chris Dy","startTime":483.66,"endTime":488.19,"body":"nerve defect to actually shorten"},{"speaker":"Chris Dy","startTime":488.22,"endTime":492.21,"body":"do an osteotomy, shorten the"},{"speaker":"Chris Dy","startTime":488.22,"endTime":492.21,"body":"femur, and then do guided growth"},{"speaker":"Chris Dy","startTime":492.21,"endTime":496.35,"body":"or progressive distraction,"},{"speaker":"Chris Dy","startTime":492.21,"endTime":496.35,"body":"lengthening through the femur."},{"speaker":"Chris Dy","startTime":497.19,"endTime":501.15,"body":"So how do you think about like"},{"speaker":"Chris Dy","startTime":497.19,"endTime":501.15,"body":"the pace at which you, you know,"},{"speaker":"Chris Dy","startTime":501.15,"endTime":503.34,"body":"have them grow, and whether"},{"speaker":"Chris Dy","startTime":501.15,"endTime":503.34,"body":"that's going to stretch nerves,"},{"speaker":"Chris Dy","startTime":503.34,"endTime":503.82,"body":"etc."},{"speaker":"Charles Goldfarb","startTime":504.15,"endTime":506.79,"body":"So I've never"},{"speaker":"Charles Goldfarb","startTime":504.15,"endTime":506.79,"body":"seen a nerve problem in"},{"speaker":"Charles Goldfarb","startTime":506.79,"endTime":510.24,"body":"lengthening. And that's because"},{"speaker":"Charles Goldfarb","startTime":506.79,"endTime":510.24,"body":"we don't lengthen at a rapid"},{"speaker":"Charles Goldfarb","startTime":510.24,"endTime":512.88,"body":"rate, you know, quarter"},{"speaker":"Charles Goldfarb","startTime":510.24,"endTime":512.88,"body":"millimeter three times a day or"},{"speaker":"Charles Goldfarb","startTime":512.88,"endTime":515.97,"body":"four times day is just not going"},{"speaker":"Charles Goldfarb","startTime":512.88,"endTime":515.97,"body":"to bother the nerves, unless"},{"speaker":"Charles Goldfarb","startTime":515.97,"endTime":518.31,"body":"there was a situation where"},{"speaker":"Charles Goldfarb","startTime":515.97,"endTime":518.31,"body":"there was significant scarring"},{"speaker":"Charles Goldfarb","startTime":518.31,"endTime":521.61,"body":"or other issues or something"},{"speaker":"Charles Goldfarb","startTime":518.31,"endTime":521.61,"body":"like that. For those who are"},{"speaker":"Charles Goldfarb","startTime":521.61,"endTime":526.62,"body":"truly interested in this, the"},{"speaker":"Charles Goldfarb","startTime":521.61,"endTime":526.62,"body":"only time I slow lengthening"},{"speaker":"Charles Goldfarb","startTime":526.65,"endTime":532.41,"body":"down is with soft tissue"},{"speaker":"Charles Goldfarb","startTime":526.65,"endTime":532.41,"body":"preparation for centralization."},{"speaker":"Charles Goldfarb","startTime":532.8,"endTime":535.41,"body":"And the reason I think that's"},{"speaker":"Charles Goldfarb","startTime":532.8,"endTime":535.41,"body":"interesting, and maybe the only"},{"speaker":"Charles Goldfarb","startTime":535.41,"endTime":537.81,"body":"one who thinks that's"},{"speaker":"Charles Goldfarb","startTime":535.41,"endTime":537.81,"body":"interesting is that if you"},{"speaker":"Charles Goldfarb","startTime":537.81,"endTime":541.29,"body":"rapidly lengthen for soft tissue"},{"speaker":"Charles Goldfarb","startTime":537.81,"endTime":541.29,"body":"to try to bring the hand over"},{"speaker":"Charles Goldfarb","startTime":541.29,"endTime":544.35,"body":"the end of the ulna, you can"},{"speaker":"Charles Goldfarb","startTime":541.29,"endTime":544.35,"body":"injure the growth plate,"},{"speaker":"Charles Goldfarb","startTime":544.47,"endTime":547.77,"body":"ironically. And so in those"},{"speaker":"Charles Goldfarb","startTime":544.47,"endTime":547.77,"body":"cases, there's no race against"},{"speaker":"Charles Goldfarb","startTime":547.77,"endTime":551.58,"body":"time for lengthening bones, it"},{"speaker":"Charles Goldfarb","startTime":547.77,"endTime":551.58,"body":"is a race against time, because"},{"speaker":"Charles Goldfarb","startTime":551.58,"endTime":554.61,"body":"if you go too slowly, the bone"},{"speaker":"Charles Goldfarb","startTime":551.58,"endTime":554.61,"body":"will consolidate too soon. If"},{"speaker":"Charles Goldfarb","startTime":554.61,"endTime":557.52,"body":"you go too quickly, the bone"},{"speaker":"Charles Goldfarb","startTime":554.61,"endTime":557.52,"body":"doesn't consolidate at all. So"},{"speaker":"Charles Goldfarb","startTime":557.52,"endTime":561.6,"body":"it's a balancing act. But for"},{"speaker":"Charles Goldfarb","startTime":557.52,"endTime":561.6,"body":"soft tissue only stretching and"},{"speaker":"Charles Goldfarb","startTime":561.6,"endTime":564.36,"body":"that does stretch the nerves,"},{"speaker":"Charles Goldfarb","startTime":561.6,"endTime":564.36,"body":"then you have to be a little"},{"speaker":"Charles Goldfarb","startTime":564.36,"endTime":564.81,"body":"careful."},{"speaker":"Chris Dy","startTime":565.17,"endTime":568.95,"body":"Right? Right. So then"},{"speaker":"Chris Dy","startTime":565.17,"endTime":568.95,"body":"I'm assuming you decided to"},{"speaker":"Chris Dy","startTime":568.95,"endTime":571.56,"body":"shorten the ulna based on your"},{"speaker":"Chris Dy","startTime":568.95,"endTime":571.56,"body":"prior statements,"},{"speaker":"Charles Goldfarb","startTime":571.86,"endTime":574.71,"body":"shorten the"},{"speaker":"Charles Goldfarb","startTime":571.86,"endTime":574.71,"body":"ulna took a big chunk of it out,"},{"speaker":"Charles Goldfarb","startTime":574.98,"endTime":578.97,"body":"and then it's a little bit of a"},{"speaker":"Charles Goldfarb","startTime":574.98,"endTime":578.97,"body":"fight to get those bone ends"},{"speaker":"Charles Goldfarb","startTime":578.97,"endTime":583.29,"body":"opposed. We ended up having to"},{"speaker":"Charles Goldfarb","startTime":578.97,"endTime":583.29,"body":"place a screw outside of the"},{"speaker":"Charles Goldfarb","startTime":583.29,"endTime":587.16,"body":"plate. And then we elevated one"},{"speaker":"Charles Goldfarb","startTime":583.29,"endTime":587.16,"body":"of this was that we put three"},{"speaker":"Charles Goldfarb","startTime":587.16,"endTime":592.62,"body":"screws in distally one screw out"},{"speaker":"Charles Goldfarb","startTime":587.16,"endTime":592.62,"body":"of the plate proximally and then"},{"speaker":"Charles Goldfarb","startTime":592.62,"endTime":597.51,"body":"we use a massive bone clamp like"},{"speaker":"Charles Goldfarb","startTime":592.62,"endTime":597.51,"body":"a pointed bone, tenakee alum,"},{"speaker":"Charles Goldfarb","startTime":597.87,"endTime":602.04,"body":"and we're able to get it In, you"},{"speaker":"Charles Goldfarb","startTime":597.87,"endTime":602.04,"body":"know, an unreasonable position"},{"speaker":"Charles Goldfarb","startTime":602.07,"endTime":604.53,"body":"and then compressed and it"},{"speaker":"Charles Goldfarb","startTime":602.07,"endTime":604.53,"body":"looked beautiful, but I don't"},{"speaker":"Charles Goldfarb","startTime":604.53,"endTime":607.2,"body":"think we could have done much"},{"speaker":"Charles Goldfarb","startTime":604.53,"endTime":607.2,"body":"more than that that little over"},{"speaker":"Charles Goldfarb","startTime":607.2,"endTime":608.28,"body":"two centimeters that we did."},{"speaker":"Chris Dy","startTime":608.61,"endTime":612.0,"body":"Now, when you decide"},{"speaker":"Chris Dy","startTime":608.61,"endTime":612.0,"body":"to do that, and that amount of"},{"speaker":"Chris Dy","startTime":612.27,"endTime":618.0,"body":"shortening, do you still use the"},{"speaker":"Chris Dy","startTime":612.27,"endTime":618.0,"body":"standard kind of shortening"},{"speaker":"Chris Dy","startTime":618.0,"endTime":621.69,"body":"plate and Nia that many of us"},{"speaker":"Chris Dy","startTime":618.0,"endTime":621.69,"body":"use? For all the shortening?"},{"speaker":"Chris Dy","startTime":621.69,"endTime":624.78,"body":"osteotomies? Or do you freehand"},{"speaker":"Chris Dy","startTime":621.69,"endTime":624.78,"body":"this osteotomy? And do kind of"},{"speaker":"Chris Dy","startTime":624.81,"endTime":628.77,"body":"ao technique? Because maybe you"},{"speaker":"Chris Dy","startTime":624.81,"endTime":628.77,"body":"have a little more customer?"},{"speaker":"Chris Dy","startTime":628.8,"endTime":630.78,"body":"customizability? With the"},{"speaker":"Chris Dy","startTime":628.8,"endTime":630.78,"body":"latter?"},{"speaker":"Charles Goldfarb","startTime":631.26,"endTime":633.27,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":631.26,"endTime":633.27,"body":"our freehand makes all the sense"},{"speaker":"Charles Goldfarb","startTime":633.27,"endTime":635.46,"body":"in the world, you can certainly"},{"speaker":"Charles Goldfarb","startTime":633.27,"endTime":635.46,"body":"use anyplace you want, but"},{"speaker":"Charles Goldfarb","startTime":635.46,"endTime":638.49,"body":"you're not getting the costly"},{"speaker":"Charles Goldfarb","startTime":635.46,"endTime":638.49,"body":"advantages of the systems."},{"speaker":"Chris Dy","startTime":639.45,"endTime":641.94,"body":"Right, right. Well, do"},{"speaker":"Chris Dy","startTime":639.45,"endTime":641.94,"body":"you think that that if you use"},{"speaker":"Chris Dy","startTime":641.94,"endTime":646.95,"body":"kind of a standard ao kind of"},{"speaker":"Chris Dy","startTime":641.94,"endTime":646.95,"body":"plating technique, that would"},{"speaker":"Chris Dy","startTime":646.95,"endTime":649.92,"body":"not have saved you money"},{"speaker":"Chris Dy","startTime":646.95,"endTime":649.92,"body":"compared to using a older"},{"speaker":"Chris Dy","startTime":649.92,"endTime":651.06,"body":"shortening specific,"},{"speaker":"Charles Goldfarb","startTime":651.48,"endTime":654.9,"body":"it does, the"},{"speaker":"Charles Goldfarb","startTime":651.48,"endTime":654.9,"body":"benefit of the older shortening"},{"speaker":"Charles Goldfarb","startTime":654.9,"endTime":658.89,"body":"systems is you do the oblique"},{"speaker":"Charles Goldfarb","startTime":654.9,"endTime":658.89,"body":"osteotomy, I think, which is a"},{"speaker":"Charles Goldfarb","startTime":658.89,"endTime":661.71,"body":"bigger surface area, and then"},{"speaker":"Charles Goldfarb","startTime":658.89,"endTime":661.71,"body":"you can put that lag screws. So"},{"speaker":"Charles Goldfarb","startTime":661.71,"endTime":663.12,"body":"that is the advantage."},{"speaker":"Chris Dy","startTime":663.39,"endTime":666.93,"body":"I fully believe that"},{"speaker":"Chris Dy","startTime":663.39,"endTime":666.93,"body":"you could do that for you hit I"},{"speaker":"Chris Dy","startTime":666.93,"endTime":670.65,"body":"think you would do just fine."},{"speaker":"Chris Dy","startTime":666.93,"endTime":670.65,"body":"But you know, those systems are"},{"speaker":"Chris Dy","startTime":670.65,"endTime":673.77,"body":"great. And I what I like about"},{"speaker":"Chris Dy","startTime":670.65,"endTime":673.77,"body":"those systems is that they are"},{"speaker":"Chris Dy","startTime":673.77,"endTime":676.59,"body":"designed in a way where it is"},{"speaker":"Chris Dy","startTime":673.77,"endTime":676.59,"body":"easy to get compression through"},{"speaker":"Chris Dy","startTime":676.59,"endTime":679.17,"body":"your various techniques of"},{"speaker":"Chris Dy","startTime":676.59,"endTime":679.17,"body":"compression, it's easy to get"},{"speaker":"Chris Dy","startTime":679.17,"endTime":682.44,"body":"your inner fragmentary screw"},{"speaker":"Chris Dy","startTime":679.17,"endTime":682.44,"body":"through how they've designed it."},{"speaker":"Charles Goldfarb","startTime":683.4,"endTime":685.35,"body":"For sure,"},{"speaker":"Charles Goldfarb","startTime":683.4,"endTime":685.35,"body":"should we talk about our"},{"speaker":"Charles Goldfarb","startTime":685.35,"endTime":686.22,"body":"sponsors?"},{"speaker":"Chris Dy","startTime":688.5,"endTime":691.08,"body":"We should and then we"},{"speaker":"Chris Dy","startTime":688.5,"endTime":691.08,"body":"have a bit of an important"},{"speaker":"Chris Dy","startTime":691.08,"endTime":693.51,"body":"announcement to make as well."},{"speaker":"Chris Dy","startTime":691.08,"endTime":693.51,"body":"But we should talk about our"},{"speaker":"Chris Dy","startTime":693.51,"endTime":695.79,"body":"friends at practice link. The"},{"speaker":"Chris Dy","startTime":693.51,"endTime":695.79,"body":"upper hand is sponsored by"},{"speaker":"Chris Dy","startTime":695.79,"endTime":699.33,"body":"practice link.com, the most"},{"speaker":"Chris Dy","startTime":695.79,"endTime":699.33,"body":"widely used physician job search"},{"speaker":"Chris Dy","startTime":699.33,"endTime":700.92,"body":"and career advancement resource."},{"speaker":"Charles Goldfarb","startTime":701.37,"endTime":704.16,"body":"Becoming a"},{"speaker":"Charles Goldfarb","startTime":701.37,"endTime":704.16,"body":"physician is hard. Finding the"},{"speaker":"Charles Goldfarb","startTime":704.16,"endTime":707.88,"body":"right job doesn't have to be"},{"speaker":"Charles Goldfarb","startTime":704.16,"endTime":707.88,"body":"joined practice link for free"},{"speaker":"Charles Goldfarb","startTime":707.88,"endTime":713.28,"body":"today. That means today Dr. Dee,"},{"speaker":"Charles Goldfarb","startTime":707.88,"endTime":713.28,"body":"at practice"},{"speaker":"Charles Goldfarb","startTime":714.78,"endTime":715.59,"body":"www.practicelink.com/the upper"},{"speaker":"Charles Goldfarb","startTime":714.78,"endTime":715.59,"body":"hand."},{"speaker":"Chris Dy","startTime":716.37,"endTime":719.49,"body":"So I was mentioning to"},{"speaker":"Chris Dy","startTime":716.37,"endTime":719.49,"body":"somebody about the podcast. And"},{"speaker":"Chris Dy","startTime":719.49,"endTime":721.83,"body":"they were asking, we're talking"},{"speaker":"Chris Dy","startTime":719.49,"endTime":721.83,"body":"about how we finally had a"},{"speaker":"Chris Dy","startTime":721.83,"endTime":725.19,"body":"sponsor. And they're like, oh,"},{"speaker":"Chris Dy","startTime":721.83,"endTime":725.19,"body":"yeah, it's like, do you guys"},{"speaker":"Chris Dy","startTime":725.19,"endTime":729.18,"body":"record that every time and like,"},{"speaker":"Chris Dy","startTime":725.19,"endTime":729.18,"body":"I was wondering whether you just"},{"speaker":"Chris Dy","startTime":729.18,"endTime":731.52,"body":"kind of like plugged it in"},{"speaker":"Chris Dy","startTime":729.18,"endTime":731.52,"body":"differently, like, you know,"},{"speaker":"Chris Dy","startTime":731.52,"endTime":734.85,"body":"kind of pasted it in and splice"},{"speaker":"Chris Dy","startTime":731.52,"endTime":734.85,"body":"it in? And I'm like, No, we"},{"speaker":"Chris Dy","startTime":734.85,"endTime":736.11,"body":"actually record it every time."},{"speaker":"Charles Goldfarb","startTime":737.04,"endTime":738.87,"body":"Yeah, because"},{"speaker":"Charles Goldfarb","startTime":737.04,"endTime":738.87,"body":"they're always on our mind,"},{"speaker":"Charles Goldfarb","startTime":738.87,"endTime":742.53,"body":"because it's such a great"},{"speaker":"Charles Goldfarb","startTime":738.87,"endTime":742.53,"body":"service that practice link"},{"speaker":"Charles Goldfarb","startTime":742.53,"endTime":743.13,"body":"offers."},{"speaker":"Chris Dy","startTime":743.43,"endTime":745.29,"body":"Well, yeah, now I"},{"speaker":"Chris Dy","startTime":743.43,"endTime":745.29,"body":"remember who I was talking to us"},{"speaker":"Chris Dy","startTime":745.29,"endTime":749.34,"body":"talking to Holly Power. Holly is"},{"speaker":"Chris Dy","startTime":745.29,"endTime":749.34,"body":"in practice in Alberta. She was"},{"speaker":"Chris Dy","startTime":749.34,"endTime":752.58,"body":"a former fellow in the plastic"},{"speaker":"Chris Dy","startTime":749.34,"endTime":752.58,"body":"surgery service here at hand."},{"speaker":"Chris Dy","startTime":752.76,"endTime":756.12,"body":"She's doing big things in terms"},{"speaker":"Chris Dy","startTime":752.76,"endTime":756.12,"body":"of peripheral nerve. And she's a"},{"speaker":"Chris Dy","startTime":756.12,"endTime":760.41,"body":"big fan of the podcast. And so"},{"speaker":"Chris Dy","startTime":756.12,"endTime":760.41,"body":"in it was great to see her and"},{"speaker":"Chris Dy","startTime":760.41,"endTime":762.9,"body":"Johnny Lou, who I talked about"},{"speaker":"Chris Dy","startTime":760.41,"endTime":762.9,"body":"in the last episode, a bunch of"},{"speaker":"Chris Dy","startTime":762.9,"endTime":767.46,"body":"other podcast friends at the"},{"speaker":"Chris Dy","startTime":762.9,"endTime":767.46,"body":"meeting last week in Miami. I'm"},{"speaker":"Chris Dy","startTime":767.46,"endTime":768.36,"body":"glad to be back."},{"speaker":"Charles Goldfarb","startTime":769.14,"endTime":773.85,"body":"I bet you are."},{"speaker":"Charles Goldfarb","startTime":769.14,"endTime":773.85,"body":"Before we make our important"},{"speaker":"Charles Goldfarb","startTime":773.85,"endTime":776.01,"body":"announcement, the meeting was"},{"speaker":"Charles Goldfarb","startTime":773.85,"endTime":776.01,"body":"good."},{"speaker":"Chris Dy","startTime":777.09,"endTime":779.61,"body":"Meeting was good"},{"speaker":"Chris Dy","startTime":777.09,"endTime":779.61,"body":"learned a lot. You know, there's"},{"speaker":"Chris Dy","startTime":779.61,"endTime":781.86,"body":"a lot of really interesting"},{"speaker":"Chris Dy","startTime":779.61,"endTime":781.86,"body":"stuff going on in the field of"},{"speaker":"Chris Dy","startTime":781.86,"endTime":785.43,"body":"nerve. We're still trying to"},{"speaker":"Chris Dy","startTime":781.86,"endTime":785.43,"body":"figure things out in a number of"},{"speaker":"Chris Dy","startTime":785.43,"endTime":788.4,"body":"ways. But I think some of the"},{"speaker":"Chris Dy","startTime":785.43,"endTime":788.4,"body":"emerging technologies would be"},{"speaker":"Chris Dy","startTime":788.4,"endTime":790.92,"body":"interesting. I think there's a"},{"speaker":"Chris Dy","startTime":788.4,"endTime":790.92,"body":"lot of perspective on how to"},{"speaker":"Chris Dy","startTime":790.92,"endTime":793.62,"body":"measure outcomes, which"},{"speaker":"Chris Dy","startTime":790.92,"endTime":793.62,"body":"obviously is important for our"},{"speaker":"Chris Dy","startTime":793.62,"endTime":799.35,"body":"work. A lot of agreement that we"},{"speaker":"Chris Dy","startTime":793.62,"endTime":799.35,"body":"don't have that part figured out"},{"speaker":"Chris Dy","startTime":799.35,"endTime":801.54,"body":"and a lot of agreement that"},{"speaker":"Chris Dy","startTime":799.35,"endTime":801.54,"body":"that's something that will be"},{"speaker":"Chris Dy","startTime":801.54,"endTime":804.99,"body":"important. So it was good to it"},{"speaker":"Chris Dy","startTime":801.54,"endTime":804.99,"body":"was good to see that that's"},{"speaker":"Chris Dy","startTime":804.99,"endTime":806.1,"body":"still an area of interest."},{"speaker":"Charles Goldfarb","startTime":806.67,"endTime":808.68,"body":"Excellent. And"},{"speaker":"Charles Goldfarb","startTime":806.67,"endTime":808.68,"body":"I'm sure, I'm sure that sunny"},{"speaker":"Charles Goldfarb","startTime":808.68,"endTime":811.38,"body":"southern Florida was pretty nice"},{"speaker":"Charles Goldfarb","startTime":808.68,"endTime":811.38,"body":"this time of year,"},{"speaker":"Chris Dy","startTime":812.01,"endTime":814.5,"body":"they'll coming back to"},{"speaker":"Chris Dy","startTime":812.01,"endTime":814.5,"body":"Snow was a little bit of a rude"},{"speaker":"Chris Dy","startTime":814.5,"endTime":817.32,"body":"awakening. But I do like the"},{"speaker":"Chris Dy","startTime":814.5,"endTime":817.32,"body":"fact that you know, we're"},{"speaker":"Chris Dy","startTime":817.32,"endTime":819.87,"body":"recording right now. It's just"},{"speaker":"Chris Dy","startTime":817.32,"endTime":819.87,"body":"before five o'clock and the sun"},{"speaker":"Chris Dy","startTime":819.87,"endTime":821.37,"body":"is still out. So that's a good"},{"speaker":"Chris Dy","startTime":819.87,"endTime":821.37,"body":"thing."},{"speaker":"Charles Goldfarb","startTime":821.91,"endTime":826.29,"body":"Yeah, we have"},{"speaker":"Charles Goldfarb","startTime":821.91,"endTime":826.29,"body":"past the nadir of short days and"},{"speaker":"Charles Goldfarb","startTime":826.29,"endTime":829.29,"body":"every day is a little bit"},{"speaker":"Charles Goldfarb","startTime":826.29,"endTime":829.29,"body":"longer. And that is beautiful."},{"speaker":"Chris Dy","startTime":829.44,"endTime":832.23,"body":"Makes a big"},{"speaker":"Chris Dy","startTime":829.44,"endTime":832.23,"body":"difference. Well, speaking of"},{"speaker":"Chris Dy","startTime":832.5,"endTime":836.19,"body":"changing, we are changing, we"},{"speaker":"Chris Dy","startTime":832.5,"endTime":836.19,"body":"are making a big change for our"},{"speaker":"Chris Dy","startTime":836.19,"endTime":840.54,"body":"podcasts. So our listeners and"},{"speaker":"Chris Dy","startTime":836.19,"endTime":840.54,"body":"we want to tell you that we are"},{"speaker":"Chris Dy","startTime":840.54,"endTime":844.08,"body":"going to switch to releasing"},{"speaker":"Chris Dy","startTime":840.54,"endTime":844.08,"body":"episodes every two weeks."},{"speaker":"Charles Goldfarb","startTime":844.47,"endTime":846.54,"body":"Yeah, I have"},{"speaker":"Charles Goldfarb","startTime":844.47,"endTime":846.54,"body":"to say that we haven't come to"},{"speaker":"Charles Goldfarb","startTime":846.54,"endTime":850.47,"body":"this decision lightly. We want"},{"speaker":"Charles Goldfarb","startTime":846.54,"endTime":850.47,"body":"to make sure that when we get"},{"speaker":"Charles Goldfarb","startTime":850.47,"endTime":855.3,"body":"together we give this everything"},{"speaker":"Charles Goldfarb","startTime":850.47,"endTime":855.3,"body":"we have and we want to make sure"},{"speaker":"Charles Goldfarb","startTime":855.3,"endTime":860.58,"body":"that we are addressing timely"},{"speaker":"Charles Goldfarb","startTime":855.3,"endTime":860.58,"body":"topics with energy and with"},{"speaker":"Charles Goldfarb","startTime":860.58,"endTime":864.63,"body":"gusto and with new ideas and"},{"speaker":"Charles Goldfarb","startTime":860.58,"endTime":864.63,"body":"they're certainly a never ending"},{"speaker":"Charles Goldfarb","startTime":864.63,"endTime":869.73,"body":"source of ideas but we thought"},{"speaker":"Charles Goldfarb","startTime":864.63,"endTime":869.73,"body":"to do our best for you valued"},{"speaker":"Charles Goldfarb","startTime":869.73,"endTime":873.24,"body":"listener that we were going to"},{"speaker":"Charles Goldfarb","startTime":869.73,"endTime":873.24,"body":"change the cadence now. I would"},{"speaker":"Charles Goldfarb","startTime":873.24,"endTime":877.59,"body":"like to put a plug in if this"},{"speaker":"Charles Goldfarb","startTime":873.24,"endTime":877.59,"body":"makes you happy email us if this"},{"speaker":"Charles Goldfarb","startTime":877.59,"endTime":880.83,"body":"makes you sad email us let us"},{"speaker":"Charles Goldfarb","startTime":877.59,"endTime":880.83,"body":"know communicate. There's been a"},{"speaker":"Charles Goldfarb","startTime":880.83,"endTime":884.28,"body":"little bit of some radio silence"},{"speaker":"Charles Goldfarb","startTime":880.83,"endTime":884.28,"body":"from the from the listeners at"},{"speaker":"Charles Goldfarb","startTime":884.28,"endTime":888.09,"body":"least virtually you know by"},{"speaker":"Charles Goldfarb","startTime":884.28,"endTime":888.09,"body":"interaction maybe in person we"},{"speaker":"Charles Goldfarb","startTime":888.09,"endTime":890.85,"body":"see we see people but I'd love"},{"speaker":"Charles Goldfarb","startTime":888.09,"endTime":890.85,"body":"to hear more."},{"speaker":"Chris Dy","startTime":891.18,"endTime":894.24,"body":"So you know, we've had"},{"speaker":"Chris Dy","startTime":891.18,"endTime":894.24,"body":"enough good stuff from the email"},{"speaker":"Chris Dy","startTime":894.24,"endTime":897.63,"body":"account to put together one grab"},{"speaker":"Chris Dy","startTime":894.24,"endTime":897.63,"body":"bag episode, which we'll do"},{"speaker":"Chris Dy","startTime":897.63,"endTime":900.78,"body":"next. But yes, please let us"},{"speaker":"Chris Dy","startTime":897.63,"endTime":900.78,"body":"know What's your thinking?"},{"speaker":"Chris Dy","startTime":900.78,"endTime":902.88,"body":"What's on your mind what topics"},{"speaker":"Chris Dy","startTime":900.78,"endTime":902.88,"body":"you want to cover? I know that a"},{"speaker":"Chris Dy","startTime":902.88,"endTime":906.81,"body":"lot of folks really like the"},{"speaker":"Chris Dy","startTime":902.88,"endTime":906.81,"body":"radial radial nerve series, but"},{"speaker":"Chris Dy","startTime":906.81,"endTime":909.48,"body":"then others are looking forward"},{"speaker":"Chris Dy","startTime":906.81,"endTime":909.48,"body":"to the Sport series coming up."},{"speaker":"Chris Dy","startTime":909.48,"endTime":913.62,"body":"So, yeah, let us know. It's,"},{"speaker":"Chris Dy","startTime":909.48,"endTime":913.62,"body":"it's tough to switch. But I"},{"speaker":"Chris Dy","startTime":913.62,"endTime":916.89,"body":"think is we want to continue"},{"speaker":"Chris Dy","startTime":913.62,"endTime":916.89,"body":"doing things with panache and"},{"speaker":"Chris Dy","startTime":916.92,"endTime":920.88,"body":"alacrity as one of our former"},{"speaker":"Chris Dy","startTime":916.92,"endTime":920.88,"body":"ministers would say, and I think"},{"speaker":"Chris Dy","startTime":920.88,"endTime":925.11,"body":"this will allow us to do that."},{"speaker":"Chris Dy","startTime":920.88,"endTime":925.11,"body":"So that's something that is"},{"speaker":"Chris Dy","startTime":925.11,"endTime":927.78,"body":"coming your way. I think after"},{"speaker":"Chris Dy","startTime":925.11,"endTime":927.78,"body":"this episode drops, I will start"},{"speaker":"Chris Dy","startTime":927.78,"endTime":929.04,"body":"doing every two weeks after"},{"speaker":"Chris Dy","startTime":927.78,"endTime":929.04,"body":"that."},{"speaker":"Charles Goldfarb","startTime":929.64,"endTime":931.92,"body":"We appreciate"},{"speaker":"Charles Goldfarb","startTime":929.64,"endTime":931.92,"body":"your understanding, and we"},{"speaker":"Charles Goldfarb","startTime":931.92,"endTime":935.64,"body":"appreciate your continued"},{"speaker":"Charles Goldfarb","startTime":931.92,"endTime":935.64,"body":"listenership we hope this is is"},{"speaker":"Charles Goldfarb","startTime":935.64,"endTime":938.52,"body":"not a negative in that respect."},{"speaker":"Charles Goldfarb","startTime":935.64,"endTime":938.52,"body":"And hopefully, it may be even a"},{"speaker":"Charles Goldfarb","startTime":938.52,"endTime":942.03,"body":"positive. So thank you. Thank"},{"speaker":"Charles Goldfarb","startTime":938.52,"endTime":942.03,"body":"you. Thank you. Thank you for"},{"speaker":"Charles Goldfarb","startTime":942.03,"endTime":944.64,"body":"listening in. And we appreciate"},{"speaker":"Charles Goldfarb","startTime":942.03,"endTime":944.64,"body":"all the support and love that we"},{"speaker":"Charles Goldfarb","startTime":944.64,"endTime":948.12,"body":"have gotten over the years."},{"speaker":"Charles Goldfarb","startTime":944.64,"endTime":948.12,"body":"Because Dr. Dy, I think this is"},{"speaker":"Charles Goldfarb","startTime":948.12,"endTime":951.36,"body":"our fourth year, is that right?"},{"speaker":"Chris Dy","startTime":951.63,"endTime":954.27,"body":"We are in our fourth"},{"speaker":"Chris Dy","startTime":951.63,"endTime":954.27,"body":"year, I guess it's we've passed"},{"speaker":"Chris Dy","startTime":954.27,"endTime":957.81,"body":"our three anniversary, I left"},{"speaker":"Chris Dy","startTime":954.27,"endTime":957.81,"body":"the gift I got you at home, I"},{"speaker":"Chris Dy","startTime":957.81,"endTime":960.63,"body":"think I have leftover rice"},{"speaker":"Chris Dy","startTime":957.81,"endTime":960.63,"body":"krispie treat and hear from"},{"speaker":"Chris Dy","startTime":961.08,"endTime":965.31,"body":"something that I could give back"},{"speaker":"Chris Dy","startTime":961.08,"endTime":965.31,"body":"and walk over and give you. But"},{"speaker":"Chris Dy","startTime":965.31,"endTime":966.66,"body":"what do you want to talk about"},{"speaker":"Chris Dy","startTime":965.31,"endTime":966.66,"body":"today?"},{"speaker":"Charles Goldfarb","startTime":967.32,"endTime":969.09,"body":"I want to talk"},{"speaker":"Charles Goldfarb","startTime":967.32,"endTime":969.09,"body":"about for years, I didn't think"},{"speaker":"Charles Goldfarb","startTime":969.09,"endTime":970.59,"body":"we'd make four episodes."},{"speaker":"Chris Dy","startTime":971.97,"endTime":973.95,"body":"You know, somebody"},{"speaker":"Chris Dy","startTime":971.97,"endTime":973.95,"body":"asked, like, you know what, how"},{"speaker":"Chris Dy","startTime":973.95,"endTime":977.13,"body":"it started and the story behind"},{"speaker":"Chris Dy","startTime":973.95,"endTime":977.13,"body":"it. And you know, it's crazy,"},{"speaker":"Chris Dy","startTime":977.13,"endTime":980.55,"body":"like we started at the beginning"},{"speaker":"Chris Dy","startTime":977.13,"endTime":980.55,"body":"of a pandemic, or no, before the"},{"speaker":"Chris Dy","startTime":980.55,"endTime":983.13,"body":"pandemic, and I'm sure the"},{"speaker":"Chris Dy","startTime":980.55,"endTime":983.13,"body":"pandemic was already kind of"},{"speaker":"Chris Dy","startTime":983.13,"endTime":988.38,"body":"started. But, and then things"},{"speaker":"Chris Dy","startTime":983.13,"endTime":988.38,"body":"popped off. And we were left to"},{"speaker":"Chris Dy","startTime":988.38,"endTime":992.55,"body":"our zoom existence and just kind"},{"speaker":"Chris Dy","startTime":988.38,"endTime":992.55,"body":"of rolled with it. It's crazy to"},{"speaker":"Chris Dy","startTime":992.55,"endTime":996.03,"body":"think about everything has"},{"speaker":"Chris Dy","startTime":992.55,"endTime":996.03,"body":"changed in the last three plus"},{"speaker":"Chris Dy","startTime":996.03,"endTime":999.18,"body":"years. The resident I'm working"},{"speaker":"Chris Dy","startTime":996.03,"endTime":999.18,"body":"with was still in medical"},{"speaker":"Chris Dy","startTime":999.18,"endTime":1001.52,"body":"school. I realized that today."},{"speaker":"Charles Goldfarb","startTime":1002.42,"endTime":1005.54,"body":"Did you I have"},{"speaker":"Charles Goldfarb","startTime":1002.42,"endTime":1005.54,"body":"to share a couple of things. Did"},{"speaker":"Charles Goldfarb","startTime":1005.54,"endTime":1012.26,"body":"you share? Or did you see the"},{"speaker":"Charles Goldfarb","startTime":1005.54,"endTime":1012.26,"body":"end of the year summary for our"},{"speaker":"Charles Goldfarb","startTime":1012.26,"endTime":1015.23,"body":"podcast? I think we should share"},{"speaker":"Charles Goldfarb","startTime":1012.26,"endTime":1015.23,"body":"some of the stats. I think the"},{"speaker":"Charles Goldfarb","startTime":1015.23,"endTime":1020.06,"body":"listeners who are you know, to"},{"speaker":"Charles Goldfarb","startTime":1015.23,"endTime":1020.06,"body":"whom we are imminently grateful"},{"speaker":"Charles Goldfarb","startTime":1020.09,"endTime":1021.23,"body":"would find this interesting."},{"speaker":"Chris Dy","startTime":1021.95,"endTime":1024.65,"body":"I think they would"},{"speaker":"Chris Dy","startTime":1021.95,"endTime":1024.65,"body":"too. I would love to pull it up"},{"speaker":"Chris Dy","startTime":1024.65,"endTime":1026.84,"body":"here and see if they can come up"},{"speaker":"Chris Dy","startTime":1024.65,"endTime":1026.84,"body":"for me. Do you have it pulled up"},{"speaker":"Chris Dy","startTime":1026.84,"endTime":1027.29,"body":"already?"},{"speaker":"Charles Goldfarb","startTime":1027.5,"endTime":1031.37,"body":"I do. Or some"},{"speaker":"Charles Goldfarb","startTime":1027.5,"endTime":1031.37,"body":"of them I've memorized. The"},{"speaker":"Charles Goldfarb","startTime":1031.37,"endTime":1032.12,"body":"first is that"},{"speaker":"Chris Dy","startTime":1032.12,"endTime":1033.47,"body":"Lana that says that"},{"speaker":"Chris Dy","startTime":1032.12,"endTime":1033.47,"body":"you've ever"},{"speaker":"Charles Goldfarb","startTime":1034.49,"endTime":1038.06,"body":"it just stuck"},{"speaker":"Charles Goldfarb","startTime":1034.49,"endTime":1038.06,"body":"in my head. We have 125,000"},{"speaker":"Charles Goldfarb","startTime":1038.06,"endTime":1039.92,"body":"reasons to be proud."},{"speaker":"Chris Dy","startTime":1040.88,"endTime":1043.7,"body":"That's really cool."},{"speaker":"Chris Dy","startTime":1040.88,"endTime":1043.7,"body":"I'm sure that is a number of"},{"speaker":"Chris Dy","startTime":1043.7,"endTime":1044.78,"body":"total downloads."},{"speaker":"Charles Goldfarb","startTime":1044.99,"endTime":1048.71,"body":"Yeah, so we"},{"speaker":"Charles Goldfarb","startTime":1044.99,"endTime":1048.71,"body":"had 50 episodes last year. We"},{"speaker":"Charles Goldfarb","startTime":1048.71,"endTime":1057.98,"body":"had 125,000 downloads. We our"},{"speaker":"Charles Goldfarb","startTime":1048.71,"endTime":1057.98,"body":"most popular cities, St. Louis"},{"speaker":"Charles Goldfarb","startTime":1057.98,"endTime":1059.63,"body":"somehow it's never"},{"speaker":"Chris Dy","startTime":1060.11,"endTime":1062.6,"body":"that's all it's all of"},{"speaker":"Chris Dy","startTime":1060.11,"endTime":1062.6,"body":"us all the residents working"},{"speaker":"Chris Dy","startTime":1062.6,"endTime":1065.06,"body":"with you that just clicked and"},{"speaker":"Chris Dy","startTime":1062.6,"endTime":1065.06,"body":"downloaded the entire time."},{"speaker":"Charles Goldfarb","startTime":1065.15,"endTime":1069.59,"body":"Number two,"},{"speaker":"Charles Goldfarb","startTime":1065.15,"endTime":1069.59,"body":"Chicago number three, Sydney,"},{"speaker":"Charles Goldfarb","startTime":1069.59,"endTime":1070.22,"body":"Australia."},{"speaker":"Chris Dy","startTime":1070.85,"endTime":1074.15,"body":"That's really cool. I"},{"speaker":"Chris Dy","startTime":1070.85,"endTime":1074.15,"body":"think that's a that's, that's"},{"speaker":"Chris Dy","startTime":1074.15,"endTime":1076.37,"body":"exciting. I think they're all"},{"speaker":"Chris Dy","startTime":1074.15,"endTime":1076.37,"body":"just listening for more of your"},{"speaker":"Chris Dy","startTime":1076.37,"endTime":1078.92,"body":"stories from your Australian and"},{"speaker":"Chris Dy","startTime":1076.37,"endTime":1078.92,"body":"surgery friends,"},{"speaker":"Charles Goldfarb","startTime":1079.43,"endTime":1084.68,"body":"maybe and then"},{"speaker":"Charles Goldfarb","startTime":1079.43,"endTime":1084.68,"body":"114 countries. And really cool."},{"speaker":"Charles Goldfarb","startTime":1084.95,"endTime":1088.64,"body":"That's very cool. And then do"},{"speaker":"Charles Goldfarb","startTime":1084.95,"endTime":1088.64,"body":"you know what the most popular"},{"speaker":"Charles Goldfarb","startTime":1088.64,"endTime":1091.31,"body":"episode I hate to give you"},{"speaker":"Charles Goldfarb","startTime":1088.64,"endTime":1091.31,"body":"kudos? Do you know what the most"},{"speaker":"Charles Goldfarb","startTime":1091.31,"endTime":1092.72,"body":"popular episode was?"},{"speaker":"Chris Dy","startTime":1094.1,"endTime":1095.84,"body":"You know what? I'm not"},{"speaker":"Chris Dy","startTime":1094.1,"endTime":1095.84,"body":"sure I'm sure it was a"},{"speaker":"Chris Dy","startTime":1095.84,"endTime":1098.96,"body":"discussion about peds or sports"},{"speaker":"Chris Dy","startTime":1095.84,"endTime":1098.96,"body":"or something like that."},{"speaker":"Charles Goldfarb","startTime":1099.29,"endTime":1102.11,"body":"It was the"},{"speaker":"Charles Goldfarb","startTime":1099.29,"endTime":1102.11,"body":"jbjs hand and wrist surgery"},{"speaker":"Charles Goldfarb","startTime":1102.2,"endTime":1104.09,"body":"update episode."},{"speaker":"Chris Dy","startTime":1104.12,"endTime":1106.04,"body":"That's not I mean,"},{"speaker":"Chris Dy","startTime":1104.12,"endTime":1106.04,"body":"it's if you think of it, it's a"},{"speaker":"Chris Dy","startTime":1106.04,"endTime":1108.53,"body":"great way to get your literature"},{"speaker":"Chris Dy","startTime":1106.04,"endTime":1108.53,"body":"update clearly with a ton of"},{"speaker":"Chris Dy","startTime":1108.53,"endTime":1112.46,"body":"bias. We should do that again."},{"speaker":"Chris Dy","startTime":1108.53,"endTime":1112.46,"body":"When that after when that"},{"speaker":"Chris Dy","startTime":1112.64,"endTime":1116.42,"body":"article comes out this year. We"},{"speaker":"Chris Dy","startTime":1112.64,"endTime":1116.42,"body":"definitely should that I have"},{"speaker":"Chris Dy","startTime":1116.42,"endTime":1118.31,"body":"here that I think was"},{"speaker":"Chris Dy","startTime":1116.42,"endTime":1118.31,"body":"interesting is that if you"},{"speaker":"Chris Dy","startTime":1118.31,"endTime":1123.32,"body":"listen to all the episodes in"},{"speaker":"Chris Dy","startTime":1118.31,"endTime":1123.32,"body":"2022, you listen to us talk for"},{"speaker":"Chris Dy","startTime":1123.32,"endTime":1131.09,"body":"1727 bits, which I'm sure was on"},{"speaker":"Chris Dy","startTime":1123.32,"endTime":1131.09,"body":"at least at 1.5x speed."},{"speaker":"Charles Goldfarb","startTime":1131.9,"endTime":1134.21,"body":"I wonder how"},{"speaker":"Charles Goldfarb","startTime":1131.9,"endTime":1134.21,"body":"many days of life you wasted."},{"speaker":"Chris Dy","startTime":1135.56,"endTime":1137.96,"body":"I think that you you"},{"speaker":"Chris Dy","startTime":1135.56,"endTime":1137.96,"body":"probably were a great commute,"},{"speaker":"Chris Dy","startTime":1137.96,"endTime":1139.91,"body":"buddy. For a lot of people,"},{"speaker":"Chris Dy","startTime":1137.96,"endTime":1139.91,"body":"Chuck. I'm sure they really"},{"speaker":"Chris Dy","startTime":1139.91,"endTime":1140.78,"body":"appreciated that."},{"speaker":"Charles Goldfarb","startTime":1142.37,"endTime":1145.55,"body":"Oh, that's so"},{"speaker":"Charles Goldfarb","startTime":1142.37,"endTime":1145.55,"body":"good. I have a good idea for our"},{"speaker":"Charles Goldfarb","startTime":1145.55,"endTime":1147.89,"body":"discussion today, which you have"},{"speaker":"Charles Goldfarb","startTime":1145.55,"endTime":1147.89,"body":"already heard because I know you"},{"speaker":"Charles Goldfarb","startTime":1147.89,"endTime":1153.2,"body":"prepared. Let's speaking of time"},{"speaker":"Charles Goldfarb","startTime":1147.89,"endTime":1153.2,"body":"and how things change over time."},{"speaker":"Charles Goldfarb","startTime":1153.35,"endTime":1157.49,"body":"Let's talk about things we do"},{"speaker":"Charles Goldfarb","startTime":1153.35,"endTime":1157.49,"body":"different operatively today,"},{"speaker":"Charles Goldfarb","startTime":1158.03,"endTime":1161.81,"body":"compared to in the past now your"},{"speaker":"Charles Goldfarb","startTime":1158.03,"endTime":1161.81,"body":"past is not as long as my past."},{"speaker":"Charles Goldfarb","startTime":1162.38,"endTime":1163.13,"body":"But let's talk"},{"speaker":"Chris Dy","startTime":1163.43,"endTime":1165.5,"body":"you said five or 10"},{"speaker":"Chris Dy","startTime":1163.43,"endTime":1165.5,"body":"years ago, I was like I was"},{"speaker":"Chris Dy","startTime":1165.5,"endTime":1167.96,"body":"barely in practice five years"},{"speaker":"Chris Dy","startTime":1165.5,"endTime":1167.96,"body":"ago and 10 years ago, I was"},{"speaker":"Chris Dy","startTime":1167.96,"endTime":1171.92,"body":"stuffing it with your fellow"},{"speaker":"Chris Dy","startTime":1167.96,"endTime":1171.92,"body":"that's the biggest difference I"},{"speaker":"Chris Dy","startTime":1171.92,"endTime":1176.48,"body":"think for me. But ya know, I"},{"speaker":"Chris Dy","startTime":1171.92,"endTime":1176.48,"body":"think that you know, the biggest"},{"speaker":"Chris Dy","startTime":1176.48,"endTime":1179.39,"body":"change and one that immediately"},{"speaker":"Chris Dy","startTime":1176.48,"endTime":1179.39,"body":"came to mind was just the"},{"speaker":"Chris Dy","startTime":1180.59,"endTime":1183.56,"body":"bringing in what launch so wide"},{"speaker":"Chris Dy","startTime":1180.59,"endTime":1183.56,"body":"awake local anesthesia, no"},{"speaker":"Chris Dy","startTime":1183.56,"endTime":1187.55,"body":"tourniquet surgery into into our"},{"speaker":"Chris Dy","startTime":1183.56,"endTime":1187.55,"body":"practices."},{"speaker":"Charles Goldfarb","startTime":1188.63,"endTime":1191.69,"body":"I think that"},{"speaker":"Charles Goldfarb","startTime":1188.63,"endTime":1191.69,"body":"is a really really good one and"},{"speaker":"Charles Goldfarb","startTime":1191.69,"endTime":1194.96,"body":"it's changed the way my day"},{"speaker":"Charles Goldfarb","startTime":1191.69,"endTime":1194.96,"body":"works. So the instead of having"},{"speaker":"Charles Goldfarb","startTime":1194.96,"endTime":1198.56,"body":"all these little, little cases"},{"speaker":"Charles Goldfarb","startTime":1194.96,"endTime":1198.56,"body":"carpal tunnels triggers whatever"},{"speaker":"Charles Goldfarb","startTime":1198.92,"endTime":1200.99,"body":"first thing in the morning where"},{"speaker":"Charles Goldfarb","startTime":1198.92,"endTime":1200.99,"body":"I bounced and get a bunch of"},{"speaker":"Charles Goldfarb","startTime":1200.99,"endTime":1204.71,"body":"done there. Now at the end of"},{"speaker":"Charles Goldfarb","startTime":1200.99,"endTime":1204.71,"body":"the day, it changes my whole day"},{"speaker":"Charles Goldfarb","startTime":1204.71,"endTime":1209.27,"body":"just how the cadence works. But"},{"speaker":"Charles Goldfarb","startTime":1204.71,"endTime":1209.27,"body":"I would say universally,"},{"speaker":"Charles Goldfarb","startTime":1209.27,"endTime":1212.69,"body":"patients have been really happy"},{"speaker":"Charles Goldfarb","startTime":1209.27,"endTime":1212.69,"body":"with that option. And I was"},{"speaker":"Charles Goldfarb","startTime":1212.69,"endTime":1215.99,"body":"worried about anesthesia. And I"},{"speaker":"Charles Goldfarb","startTime":1212.69,"endTime":1215.99,"body":"was worried about kind of those"},{"speaker":"Charles Goldfarb","startTime":1215.99,"endTime":1219.71,"body":"relationships. No one cares,"},{"speaker":"Charles Goldfarb","startTime":1215.99,"endTime":1219.71,"body":"it's a great thing for patients"},{"speaker":"Charles Goldfarb","startTime":1219.71,"endTime":1221.51,"body":"is a great thing systemically"},{"speaker":"Chris Dy","startTime":1223.07,"endTime":1225.38,"body":"love it. Yeah. I mean,"},{"speaker":"Chris Dy","startTime":1223.07,"endTime":1225.38,"body":"I think that, you know, I think"},{"speaker":"Chris Dy","startTime":1225.92,"endTime":1230.03,"body":"it, it can be threatening to"},{"speaker":"Chris Dy","startTime":1225.92,"endTime":1230.03,"body":"some anesthesia partners. And"},{"speaker":"Chris Dy","startTime":1230.18,"endTime":1232.28,"body":"I've heard this, you know, when"},{"speaker":"Chris Dy","startTime":1230.18,"endTime":1232.28,"body":"people talk about, you know,"},{"speaker":"Chris Dy","startTime":1232.31,"endTime":1235.64,"body":"incorporating Volant into their"},{"speaker":"Chris Dy","startTime":1232.31,"endTime":1235.64,"body":"practice, and getting blocked"},{"speaker":"Chris Dy","startTime":1235.64,"endTime":1238.22,"body":"from doing so, you know, I think"},{"speaker":"Chris Dy","startTime":1235.64,"endTime":1238.22,"body":"at the end of the day, if you"},{"speaker":"Chris Dy","startTime":1238.22,"endTime":1240.2,"body":"were to have one of these"},{"speaker":"Chris Dy","startTime":1238.22,"endTime":1240.2,"body":"surgeries, you probably would"},{"speaker":"Chris Dy","startTime":1240.2,"endTime":1243.08,"body":"want it done this way too. And I"},{"speaker":"Chris Dy","startTime":1240.2,"endTime":1243.08,"body":"think people remember that,"},{"speaker":"Chris Dy","startTime":1243.08,"endTime":1245.12,"body":"because, you know, you hear"},{"speaker":"Chris Dy","startTime":1243.08,"endTime":1245.12,"body":"about, you know, some kind of"},{"speaker":"Chris Dy","startTime":1245.12,"endTime":1248.24,"body":"like, freak issues with"},{"speaker":"Chris Dy","startTime":1245.12,"endTime":1248.24,"body":"anesthesia every now and then,"},{"speaker":"Chris Dy","startTime":1248.6,"endTime":1252.56,"body":"which you know, are not related"},{"speaker":"Chris Dy","startTime":1248.6,"endTime":1252.56,"body":"to the surgery. That stuff can"},{"speaker":"Chris Dy","startTime":1252.56,"endTime":1256.4,"body":"happen. And you know, honestly,"},{"speaker":"Chris Dy","startTime":1252.56,"endTime":1256.4,"body":"most people, you know, want to"},{"speaker":"Chris Dy","startTime":1256.4,"endTime":1258.98,"body":"get back to the, you know,"},{"speaker":"Chris Dy","startTime":1256.4,"endTime":1258.98,"body":"getting back to doing what they"},{"speaker":"Chris Dy","startTime":1258.98,"endTime":1262.31,"body":"love without that, you know,"},{"speaker":"Chris Dy","startTime":1258.98,"endTime":1262.31,"body":"hangover from anesthesia. Yeah,"},{"speaker":"Chris Dy","startTime":1262.31,"endTime":1262.34,"body":"I"},{"speaker":"Charles Goldfarb","startTime":1262.34,"endTime":1263.99,"body":"call it a"},{"speaker":"Charles Goldfarb","startTime":1262.34,"endTime":1263.99,"body":"brain fog when I talk to my"},{"speaker":"Charles Goldfarb","startTime":1263.99,"endTime":1264.98,"body":"patients, but I think"},{"speaker":"Chris Dy","startTime":1267.44,"endTime":1270.41,"body":"maybe maybe yours just"},{"speaker":"Chris Dy","startTime":1267.44,"endTime":1270.41,"body":"just you're just slightly more"},{"speaker":"Chris Dy","startTime":1270.41,"endTime":1271.88,"body":"elegant with your conversations."},{"speaker":"Charles Goldfarb","startTime":1271.88,"endTime":1274.666,"body":"Sure, brain"},{"speaker":"Charles Goldfarb","startTime":1271.88,"endTime":1274.666,"body":"fog sounds very sophisticated."},{"speaker":"Charles Goldfarb","startTime":1274.732,"endTime":1278.713,"body":"Alright, here's mine, that you"},{"speaker":"Charles Goldfarb","startTime":1274.732,"endTime":1278.713,"body":"will very much appreciate. My"},{"speaker":"Charles Goldfarb","startTime":1278.779,"endTime":1282.56,"body":"treatment of cubital tunnel"},{"speaker":"Charles Goldfarb","startTime":1278.779,"endTime":1282.56,"body":"syndrome has changed, I guess"},{"speaker":"Charles Goldfarb","startTime":1282.627,"endTime":1286.408,"body":"it's changed sort of in two"},{"speaker":"Charles Goldfarb","startTime":1282.627,"endTime":1286.408,"body":"ways. If you look back 10- 12"},{"speaker":"Charles Goldfarb","startTime":1286.474,"endTime":1290.256,"body":"years ago, I was doing a lot"},{"speaker":"Charles Goldfarb","startTime":1286.474,"endTime":1290.256,"body":"more decompressions that I'm"},{"speaker":"Charles Goldfarb","startTime":1290.322,"endTime":1294.104,"body":"doing today. And it's not as if"},{"speaker":"Charles Goldfarb","startTime":1290.322,"endTime":1294.104,"body":"I'm, you know, my patient"},{"speaker":"Charles Goldfarb","startTime":1294.17,"endTime":1297.951,"body":"population has changed so much."},{"speaker":"Charles Goldfarb","startTime":1294.17,"endTime":1297.951,"body":"But I think I'm just more"},{"speaker":"Charles Goldfarb","startTime":1298.018,"endTime":1301.733,"body":"selective. Given that we"},{"speaker":"Charles Goldfarb","startTime":1298.018,"endTime":1301.733,"body":"understand that a decompression"},{"speaker":"Charles Goldfarb","startTime":1301.799,"endTime":1305.978,"body":"that doesn't go well can affect"},{"speaker":"Charles Goldfarb","startTime":1301.799,"endTime":1305.978,"body":"long term success rates for the"},{"speaker":"Charles Goldfarb","startTime":1306.045,"endTime":1309.694,"body":"treatment. And so I do have a"},{"speaker":"Charles Goldfarb","startTime":1306.045,"endTime":1309.694,"body":"lot of patients that have"},{"speaker":"Charles Goldfarb","startTime":1309.76,"endTime":1313.674,"body":"instability, I do have a lot of"},{"speaker":"Charles Goldfarb","startTime":1309.76,"endTime":1313.674,"body":"patients with could be with"},{"speaker":"Charles Goldfarb","startTime":1313.74,"endTime":1317.389,"body":"other surgeries at the same"},{"speaker":"Charles Goldfarb","startTime":1313.74,"endTime":1317.389,"body":"time. And I do look for the"},{"speaker":"Charles Goldfarb","startTime":1317.455,"endTime":1321.568,"body":"option of decompression, but I"},{"speaker":"Charles Goldfarb","startTime":1317.455,"endTime":1321.568,"body":"would say 75 to 80% of my cases"},{"speaker":"Charles Goldfarb","startTime":1321.635,"endTime":1325.549,"body":"are transpositions generally,"},{"speaker":"Charles Goldfarb","startTime":1321.635,"endTime":1325.549,"body":"subcutaneous and I can talk a"},{"speaker":"Charles Goldfarb","startTime":1325.615,"endTime":1329.728,"body":"little bit more about technique,"},{"speaker":"Charles Goldfarb","startTime":1325.615,"endTime":1329.728,"body":"but I would like to hear your"},{"speaker":"Charles Goldfarb","startTime":1329.795,"endTime":1331.52,"body":"reaction to my statements."},{"speaker":"Chris Dy","startTime":1332.63,"endTime":1334.55,"body":"Yeah, I think that's"},{"speaker":"Chris Dy","startTime":1332.63,"endTime":1334.55,"body":"about right. I mean, my approach"},{"speaker":"Chris Dy","startTime":1334.55,"endTime":1338.84,"body":"to cubital tunnel treatment has"},{"speaker":"Chris Dy","startTime":1334.55,"endTime":1338.84,"body":"changed to I'm not I came out of"},{"speaker":"Chris Dy","startTime":1338.84,"endTime":1340.73,"body":"training. And for the first"},{"speaker":"Chris Dy","startTime":1338.84,"endTime":1340.73,"body":"couple of years, I was very"},{"speaker":"Chris Dy","startTime":1340.73,"endTime":1343.07,"body":"much, you know, no,"},{"speaker":"Chris Dy","startTime":1340.73,"endTime":1343.07,"body":"decompression is only some"},{"speaker":"Chris Dy","startTime":1343.07,"endTime":1346.22,"body":"muscular transpositions. And you"},{"speaker":"Chris Dy","startTime":1343.07,"endTime":1346.22,"body":"know, upon visiting others and"},{"speaker":"Chris Dy","startTime":1346.22,"endTime":1349.13,"body":"some reflection, I've"},{"speaker":"Chris Dy","startTime":1346.22,"endTime":1349.13,"body":"incorporated decompressions into"},{"speaker":"Chris Dy","startTime":1349.13,"endTime":1352.01,"body":"my practice, but it's not a"},{"speaker":"Chris Dy","startTime":1349.13,"endTime":1352.01,"body":"common thing, I think because I,"},{"speaker":"Chris Dy","startTime":1352.43,"endTime":1355.91,"body":"I become algorithmic with my"},{"speaker":"Chris Dy","startTime":1352.43,"endTime":1355.91,"body":"treatment of cubital tunnel, for"},{"speaker":"Chris Dy","startTime":1355.91,"endTime":1360.05,"body":"better or worse, but it seems to"},{"speaker":"Chris Dy","startTime":1355.91,"endTime":1360.05,"body":"have worked out for me. You"},{"speaker":"Chris Dy","startTime":1360.05,"endTime":1362.3,"body":"know, I think that there is a"},{"speaker":"Chris Dy","startTime":1360.05,"endTime":1362.3,"body":"definite role for decompression,"},{"speaker":"Chris Dy","startTime":1362.3,"endTime":1366.23,"body":"but it is limited. I'd be"},{"speaker":"Chris Dy","startTime":1362.3,"endTime":1366.23,"body":"curious to know what your what"},{"speaker":"Chris Dy","startTime":1366.23,"endTime":1370.34,"body":"you think the revision rate is"},{"speaker":"Chris Dy","startTime":1366.23,"endTime":1370.34,"body":"on a decompression say, within"},{"speaker":"Chris Dy","startTime":1370.34,"endTime":1374.12,"body":"five years of the first surgery."},{"speaker":"Chris Dy","startTime":1370.34,"endTime":1374.12,"body":"What do you think the revision"},{"speaker":"Chris Dy","startTime":1374.12,"endTime":1377.36,"body":"rate is because I know that way"},{"speaker":"Chris Dy","startTime":1374.12,"endTime":1377.36,"body":"back in the day, when I was I"},{"speaker":"Chris Dy","startTime":1377.36,"endTime":1380.06,"body":"think maybe like in grade"},{"speaker":"Chris Dy","startTime":1377.36,"endTime":1380.06,"body":"school, you and Dr. Mansky"},{"speaker":"Chris Dy","startTime":1380.06,"endTime":1383.51,"body":"published his original results"},{"speaker":"Chris Dy","startTime":1380.06,"endTime":1383.51,"body":"and your revision rate was was"},{"speaker":"Chris Dy","startTime":1383.54,"endTime":1387.68,"body":"like 7%, or something like that"},{"speaker":"Chris Dy","startTime":1383.54,"endTime":1387.68,"body":"7% that a recent series from"},{"speaker":"Chris Dy","startTime":1387.68,"endTime":1391.25,"body":"here, which was kind of an all"},{"speaker":"Chris Dy","startTime":1387.68,"endTime":1391.25,"body":"comers and not apples to apples,"},{"speaker":"Chris Dy","startTime":1392.09,"endTime":1394.67,"body":"you know, showed a 20% rate,"},{"speaker":"Chris Dy","startTime":1392.09,"endTime":1394.67,"body":"which I also think is a little"},{"speaker":"Chris Dy","startTime":1394.67,"endTime":1397.04,"body":"high. So where do you think that"},{"speaker":"Chris Dy","startTime":1394.67,"endTime":1397.04,"body":"real revision rate lies?"},{"speaker":"Charles Goldfarb","startTime":1397.67,"endTime":1400.55,"body":"I have not"},{"speaker":"Charles Goldfarb","startTime":1397.67,"endTime":1400.55,"body":"recently done a revision for a"},{"speaker":"Charles Goldfarb","startTime":1400.55,"endTime":1404.75,"body":"decompression, but my guess is"},{"speaker":"Charles Goldfarb","startTime":1400.55,"endTime":1404.75,"body":"seven to 10% is accurate in a"},{"speaker":"Charles Goldfarb","startTime":1404.87,"endTime":1406.55,"body":"carefully selected population."},{"speaker":"Chris Dy","startTime":1407.75,"endTime":1410.42,"body":"And then, you know,"},{"speaker":"Chris Dy","startTime":1407.75,"endTime":1410.42,"body":"what do you think the true"},{"speaker":"Chris Dy","startTime":1410.45,"endTime":1413.84,"body":"advantages of a decompression in"},{"speaker":"Chris Dy","startTime":1410.45,"endTime":1413.84,"body":"2023?"},{"speaker":"Charles Goldfarb","startTime":1414.86,"endTime":1417.83,"body":"Oh, I think"},{"speaker":"Charles Goldfarb","startTime":1414.86,"endTime":1417.83,"body":"it's I think it's so nice to get"},{"speaker":"Charles Goldfarb","startTime":1417.83,"endTime":1421.04,"body":"away with doing that. A you can"},{"speaker":"Charles Goldfarb","startTime":1417.83,"endTime":1421.04,"body":"do an under local only if you're"},{"speaker":"Charles Goldfarb","startTime":1421.04,"endTime":1425.09,"body":"really ambitious, but but it's"},{"speaker":"Charles Goldfarb","startTime":1421.04,"endTime":1425.09,"body":"just a simplicity, and bulky"},{"speaker":"Charles Goldfarb","startTime":1425.09,"endTime":1430.22,"body":"soft dressing, immediate gentle"},{"speaker":"Charles Goldfarb","startTime":1425.09,"endTime":1430.22,"body":"motion, get back to activities"},{"speaker":"Charles Goldfarb","startTime":1430.22,"endTime":1433.76,"body":"faster, get in the shower"},{"speaker":"Charles Goldfarb","startTime":1430.22,"endTime":1433.76,"body":"faster. It's just the recovery"},{"speaker":"Charles Goldfarb","startTime":1433.76,"endTime":1436.79,"body":"time, even though you still have"},{"speaker":"Charles Goldfarb","startTime":1433.76,"endTime":1436.79,"body":"to be careful and aware so that"},{"speaker":"Charles Goldfarb","startTime":1436.79,"endTime":1440.57,"body":"you don't stress them or too"},{"speaker":"Charles Goldfarb","startTime":1436.79,"endTime":1440.57,"body":"much. It's a game changer if"},{"speaker":"Charles Goldfarb","startTime":1440.57,"endTime":1441.41,"body":"you're able to do it."},{"speaker":"Chris Dy","startTime":1442.04,"endTime":1444.41,"body":"They are completely"},{"speaker":"Chris Dy","startTime":1442.04,"endTime":1444.41,"body":"different surgeries to get over"},{"speaker":"Chris Dy","startTime":1444.41,"endTime":1446.99,"body":"even a revision or a"},{"speaker":"Chris Dy","startTime":1444.41,"endTime":1446.99,"body":"decompression versus a"},{"speaker":"Chris Dy","startTime":1446.99,"endTime":1450.29,"body":"subcutaneous, let alone a sub"},{"speaker":"Chris Dy","startTime":1446.99,"endTime":1450.29,"body":"muscular, but I mean, they're"},{"speaker":"Chris Dy","startTime":1450.29,"endTime":1452.78,"body":"very different surgeries to get"},{"speaker":"Chris Dy","startTime":1450.29,"endTime":1452.78,"body":"over it. I use it when I can I"},{"speaker":"Chris Dy","startTime":1452.78,"endTime":1457.49,"body":"think there's definitely a role"},{"speaker":"Chris Dy","startTime":1452.78,"endTime":1457.49,"body":"for it. Have you done any of"},{"speaker":"Chris Dy","startTime":1457.49,"endTime":1459.17,"body":"these? Awake?"},{"speaker":"Charles Goldfarb","startTime":1460.16,"endTime":1461.96,"body":"I have not. I"},{"speaker":"Charles Goldfarb","startTime":1460.16,"endTime":1461.96,"body":"mean, I think if I had the"},{"speaker":"Charles Goldfarb","startTime":1461.96,"endTime":1465.35,"body":"perfect candidate I would offer"},{"speaker":"Charles Goldfarb","startTime":1461.96,"endTime":1465.35,"body":"by the perfect candidate. I mean"},{"speaker":"Charles Goldfarb","startTime":1465.35,"endTime":1471.8,"body":"someone who is not too heavy."},{"speaker":"Charles Goldfarb","startTime":1465.35,"endTime":1471.8,"body":"And where I was really 99%"},{"speaker":"Charles Goldfarb","startTime":1471.8,"endTime":1475.28,"body":"confident I was doing a"},{"speaker":"Charles Goldfarb","startTime":1471.8,"endTime":1475.28,"body":"decompression only because as"},{"speaker":"Charles Goldfarb","startTime":1475.28,"endTime":1478.55,"body":"you know when we commit to the"},{"speaker":"Charles Goldfarb","startTime":1475.28,"endTime":1478.55,"body":"local only we sort of lose"},{"speaker":"Charles Goldfarb","startTime":1478.55,"endTime":1481.13,"body":"anesthesia is involvement."},{"speaker":"Charles Goldfarb","startTime":1478.55,"endTime":1481.13,"body":"There's no pre screening."},{"speaker":"Chris Dy","startTime":1481.55,"endTime":1483.5,"body":"Right, right, right."},{"speaker":"Chris Dy","startTime":1481.55,"endTime":1483.5,"body":"Well, I think the ultrasound is"},{"speaker":"Chris Dy","startTime":1483.5,"endTime":1486.2,"body":"helpful for that. I've only seen"},{"speaker":"Chris Dy","startTime":1483.5,"endTime":1486.2,"body":"the ultrasound be wrong once."},{"speaker":"Chris Dy","startTime":1487.73,"endTime":1490.43,"body":"And, you know, it wasn't one"},{"speaker":"Chris Dy","startTime":1487.73,"endTime":1490.43,"body":"that I was doing under local,"},{"speaker":"Chris Dy","startTime":1490.43,"endTime":1493.82,"body":"I've done a handful under local"},{"speaker":"Chris Dy","startTime":1490.43,"endTime":1493.82,"body":"and, you know, the shoulder is"},{"speaker":"Chris Dy","startTime":1493.82,"endTime":1497.12,"body":"gotta be real flexible to make"},{"speaker":"Chris Dy","startTime":1493.82,"endTime":1497.12,"body":"that happen. It's going to work"},{"speaker":"Chris Dy","startTime":1497.12,"endTime":1499.97,"body":"you have to really check that"},{"speaker":"Chris Dy","startTime":1497.12,"endTime":1499.97,"body":"ahead of time and I've learned"},{"speaker":"Chris Dy","startTime":1500.0,"endTime":1503.21,"body":"To any clinic just be like,"},{"speaker":"Chris Dy","startTime":1500.0,"endTime":1503.21,"body":"okay, so if you had to lay like"},{"speaker":"Chris Dy","startTime":1503.24,"endTime":1506.36,"body":"this for like a solid 15"},{"speaker":"Chris Dy","startTime":1503.24,"endTime":1506.36,"body":"minutes, could you do that?"},{"speaker":"Charles Goldfarb","startTime":1507.23,"endTime":1509.03,"body":"That is"},{"speaker":"Charles Goldfarb","startTime":1507.23,"endTime":1509.03,"body":"interesting. That is a really"},{"speaker":"Charles Goldfarb","startTime":1509.03,"endTime":1510.74,"body":"good point. Well, there"},{"speaker":"Chris Dy","startTime":1510.74,"endTime":1513.14,"body":"there are some people"},{"speaker":"Chris Dy","startTime":1510.74,"endTime":1513.14,"body":"who do it under local in the"},{"speaker":"Chris Dy","startTime":1513.14,"endTime":1517.31,"body":"office and do it prone. Just to"},{"speaker":"Chris Dy","startTime":1513.14,"endTime":1517.31,"body":"minimize that, you know, the"},{"speaker":"Chris Dy","startTime":1517.31,"endTime":1518.15,"body":"movement and stuff."},{"speaker":"Charles Goldfarb","startTime":1518.57,"endTime":1521.12,"body":"I would think"},{"speaker":"Charles Goldfarb","startTime":1518.57,"endTime":1521.12,"body":"that's not a bad idea."},{"speaker":"Chris Dy","startTime":1521.57,"endTime":1523.79,"body":"And lying prone for 15"},{"speaker":"Chris Dy","startTime":1521.57,"endTime":1523.79,"body":"minutes while you're having"},{"speaker":"Chris Dy","startTime":1523.79,"endTime":1525.26,"body":"surgery is not also not easy."},{"speaker":"Charles Goldfarb","startTime":1526.61,"endTime":1530.66,"body":"No, let's talk"},{"speaker":"Charles Goldfarb","startTime":1526.61,"endTime":1530.66,"body":"technical because I think I say"},{"speaker":"Charles Goldfarb","startTime":1530.66,"endTime":1536.45,"body":"this regularly to the trainees."},{"speaker":"Charles Goldfarb","startTime":1530.66,"endTime":1536.45,"body":"I, how I used to do a"},{"speaker":"Charles Goldfarb","startTime":1536.45,"endTime":1539.33,"body":"subcutaneous with a standard"},{"speaker":"Charles Goldfarb","startTime":1536.45,"endTime":1539.33,"body":"eatin flap. And for those who"},{"speaker":"Charles Goldfarb","startTime":1539.33,"endTime":1542.42,"body":"don't know the terminology,"},{"speaker":"Charles Goldfarb","startTime":1539.33,"endTime":1542.42,"body":"tick, eat and describe taking a"},{"speaker":"Charles Goldfarb","startTime":1542.42,"endTime":1547.28,"body":"strip of fascia from the flexor"},{"speaker":"Charles Goldfarb","startTime":1542.42,"endTime":1547.28,"body":"parameter mass, and elevating"},{"speaker":"Charles Goldfarb","startTime":1547.28,"endTime":1551.36,"body":"it, and suturing it into the"},{"speaker":"Charles Goldfarb","startTime":1547.28,"endTime":1551.36,"body":"anterior scan to prevent the"},{"speaker":"Charles Goldfarb","startTime":1551.36,"endTime":1555.23,"body":"nerve from succeeding posted"},{"speaker":"Charles Goldfarb","startTime":1551.36,"endTime":1555.23,"body":"early, it's easy, it's somewhat"},{"speaker":"Charles Goldfarb","startTime":1555.23,"endTime":1560.9,"body":"elegant. And it works to prevent"},{"speaker":"Charles Goldfarb","startTime":1555.23,"endTime":1560.9,"body":"the nerve from sub luxating. I"},{"speaker":"Charles Goldfarb","startTime":1560.9,"endTime":1566.69,"body":"don't do that anymore. Almost"},{"speaker":"Charles Goldfarb","startTime":1560.9,"endTime":1566.69,"body":"ever. But this fasciocutaneous"},{"speaker":"Charles Goldfarb","startTime":1566.69,"endTime":1572.78,"body":"Flap is awesome. And for those"},{"speaker":"Charles Goldfarb","startTime":1566.69,"endTime":1572.78,"body":"of you who haven't tried it, try"},{"speaker":"Charles Goldfarb","startTime":1572.78,"endTime":1579.68,"body":"it. It is really slick. You"},{"speaker":"Charles Goldfarb","startTime":1572.78,"endTime":1579.68,"body":"elevate all the fat and and at"},{"speaker":"Charles Goldfarb","startTime":1579.68,"endTime":1584.48,"body":"you know fascial tissue off the"},{"speaker":"Charles Goldfarb","startTime":1579.68,"endTime":1584.48,"body":"flexor pronator mass, excise"},{"speaker":"Charles Goldfarb","startTime":1584.48,"endTime":1587.6,"body":"your muscular system as you"},{"speaker":"Charles Goldfarb","startTime":1584.48,"endTime":1587.6,"body":"usually do. And then you have"},{"speaker":"Charles Goldfarb","startTime":1587.63,"endTime":1592.58,"body":"hopefully a nice reasonable size"},{"speaker":"Charles Goldfarb","startTime":1587.63,"endTime":1592.58,"body":"padding to cover the nerve and"},{"speaker":"Charles Goldfarb","startTime":1592.58,"endTime":1596.09,"body":"also to suture into the middle"},{"speaker":"Charles Goldfarb","startTime":1592.58,"endTime":1596.09,"body":"of a condyle to prevent them"},{"speaker":"Charles Goldfarb","startTime":1596.09,"endTime":1600.38,"body":"there from succeeding posterior"},{"speaker":"Charles Goldfarb","startTime":1596.09,"endTime":1600.38,"body":"Lee. And I think it's fantastic."},{"speaker":"Charles Goldfarb","startTime":1600.38,"endTime":1604.46,"body":"I haven't had a single revision"},{"speaker":"Charles Goldfarb","startTime":1600.38,"endTime":1604.46,"body":"after using that technique. And"},{"speaker":"Charles Goldfarb","startTime":1604.46,"endTime":1608.9,"body":"I have revised several others"},{"speaker":"Charles Goldfarb","startTime":1604.46,"endTime":1608.9,"body":"that have used the eatin flap"},{"speaker":"Charles Goldfarb","startTime":1608.9,"endTime":1611.87,"body":"that weren't mine. And you just"},{"speaker":"Charles Goldfarb","startTime":1608.9,"endTime":1611.87,"body":"see what happens sometimes with"},{"speaker":"Charles Goldfarb","startTime":1611.87,"endTime":1613.64,"body":"that flap. It's not always"},{"speaker":"Charles Goldfarb","startTime":1611.87,"endTime":1613.64,"body":"great."},{"speaker":"Chris Dy","startTime":1614.45,"endTime":1617.66,"body":"Yeah, I think there's"},{"speaker":"Chris Dy","startTime":1614.45,"endTime":1617.66,"body":"a real risk for some tricky"},{"speaker":"Chris Dy","startTime":1617.66,"endTime":1621.08,"body":"adhesions, especially if"},{"speaker":"Chris Dy","startTime":1617.66,"endTime":1621.08,"body":"patients don't get started early"},{"speaker":"Chris Dy","startTime":1621.11,"endTime":1624.59,"body":"with the Eaton flap or the V"},{"speaker":"Chris Dy","startTime":1621.11,"endTime":1624.59,"body":"sling, which is something that"},{"speaker":"Chris Dy","startTime":1624.59,"endTime":1626.78,"body":"others have described that any"},{"speaker":"Chris Dy","startTime":1624.59,"endTime":1626.78,"body":"kind of sling coming off of"},{"speaker":"Chris Dy","startTime":1626.78,"endTime":1630.2,"body":"fascia. If you're not talking to"},{"speaker":"Chris Dy","startTime":1626.78,"endTime":1630.2,"body":"nerve all the way deep. I know"},{"speaker":"Chris Dy","startTime":1630.2,"endTime":1633.98,"body":"that there's some folks have a"},{"speaker":"Chris Dy","startTime":1630.2,"endTime":1633.98,"body":"role for a sub fascial"},{"speaker":"Chris Dy","startTime":1633.98,"endTime":1636.53,"body":"transposition. I'm not in love"},{"speaker":"Chris Dy","startTime":1633.98,"endTime":1636.53,"body":"with that just because I've had"},{"speaker":"Chris Dy","startTime":1636.53,"endTime":1640.07,"body":"to do the revisions. But I think"},{"speaker":"Chris Dy","startTime":1636.53,"endTime":1640.07,"body":"that you know, do whatever works"},{"speaker":"Chris Dy","startTime":1640.1,"endTime":1643.67,"body":"for you. Obviously making sure"},{"speaker":"Chris Dy","startTime":1640.1,"endTime":1643.67,"body":"that you avoid those extra kinks"},{"speaker":"Chris Dy","startTime":1643.67,"endTime":1646.46,"body":"in the nerve as it takes us"},{"speaker":"Chris Dy","startTime":1643.67,"endTime":1646.46,"body":"downslope, getting rid of the"},{"speaker":"Chris Dy","startTime":1646.46,"endTime":1652.46,"body":"septum where it can come across."},{"speaker":"Chris Dy","startTime":1646.46,"endTime":1652.46,"body":"So a little plug. I've been I'm"},{"speaker":"Chris Dy","startTime":1652.46,"endTime":1656.48,"body":"going to do one of the acsh"},{"speaker":"Chris Dy","startTime":1652.46,"endTime":1656.48,"body":"Fellowship debate webinars I'm"},{"speaker":"Chris Dy","startTime":1656.48,"endTime":1659.9,"body":"going to moderate on I think"},{"speaker":"Chris Dy","startTime":1656.48,"endTime":1659.9,"body":"it's February 9, if you guys"},{"speaker":"Chris Dy","startTime":1659.9,"endTime":1662.78,"body":"want to tune in, but the topic"},{"speaker":"Chris Dy","startTime":1659.9,"endTime":1662.78,"body":"is cubital tunnel syndrome, and"},{"speaker":"Chris Dy","startTime":1662.78,"endTime":1665.81,"body":"one of the topics that's going"},{"speaker":"Chris Dy","startTime":1662.78,"endTime":1665.81,"body":"to be presented is the adipur"},{"speaker":"Chris Dy","startTime":1665.81,"endTime":1669.17,"body":"fascial flap that Chuck adores,"},{"speaker":"Chris Dy","startTime":1665.81,"endTime":1669.17,"body":"and that's going to be presented"},{"speaker":"Chris Dy","startTime":1669.17,"endTime":1672.8,"body":"by one of our colleagues from"},{"speaker":"Chris Dy","startTime":1669.17,"endTime":1672.8,"body":"Duke University so that'll be an"},{"speaker":"Chris Dy","startTime":1672.8,"endTime":1675.44,"body":"interesting if you want to see"},{"speaker":"Chris Dy","startTime":1672.8,"endTime":1675.44,"body":"all the technical details I'm"},{"speaker":"Chris Dy","startTime":1675.44,"endTime":1679.16,"body":"sure that he'll mythologies"},{"speaker":"Chris Dy","startTime":1675.44,"endTime":1679.16,"body":"fella, Wola will have some great"},{"speaker":"Chris Dy","startTime":1679.16,"endTime":1682.55,"body":"slides. So yeah, please listen"},{"speaker":"Chris Dy","startTime":1679.16,"endTime":1682.55,"body":"to that or follower. Watch that"},{"speaker":"Chris Dy","startTime":1682.55,"endTime":1683.21,"body":"if you're interested."},{"speaker":"Charles Goldfarb","startTime":1683.84,"endTime":1686.93,"body":"Love it, love"},{"speaker":"Charles Goldfarb","startTime":1683.84,"endTime":1686.93,"body":"it. All right, I got another"},{"speaker":"Charles Goldfarb","startTime":1686.93,"endTime":1688.43,"body":"unless you got one to share."},{"speaker":"Chris Dy","startTime":1689.18,"endTime":1693.74,"body":"I've got one to share."},{"speaker":"Chris Dy","startTime":1689.18,"endTime":1693.74,"body":"I'm, I think I'm maybe 30"},{"speaker":"Chris Dy","startTime":1693.74,"endTime":1696.65,"body":"Something cases into doing"},{"speaker":"Chris Dy","startTime":1693.74,"endTime":1696.65,"body":"ultrasound guided carpal tunnel"},{"speaker":"Chris Dy","startTime":1696.65,"endTime":1701.45,"body":"release. And, you know, I've"},{"speaker":"Chris Dy","startTime":1696.65,"endTime":1701.45,"body":"it's been I think I went and did"},{"speaker":"Chris Dy","startTime":1701.45,"endTime":1707.12,"body":"the training in November of 21,"},{"speaker":"Chris Dy","startTime":1701.45,"endTime":1707.12,"body":"initially, and it took a while"},{"speaker":"Chris Dy","startTime":1707.12,"endTime":1710.6,"body":"to kind of get the process"},{"speaker":"Chris Dy","startTime":1707.12,"endTime":1710.6,"body":"through, so that we could"},{"speaker":"Chris Dy","startTime":1710.6,"endTime":1713.99,"body":"actually start doing cases along"},{"speaker":"Chris Dy","startTime":1710.6,"endTime":1713.99,"body":"while Now obviously, there was a"},{"speaker":"Chris Dy","startTime":1713.99,"endTime":1718.1,"body":"lot of training I did in terms"},{"speaker":"Chris Dy","startTime":1713.99,"endTime":1718.1,"body":"of follow up cadaver workshops,"},{"speaker":"Chris Dy","startTime":1718.4,"endTime":1723.11,"body":"etc. So I believe I started"},{"speaker":"Chris Dy","startTime":1718.4,"endTime":1723.11,"body":"doing that procedure in the fall"},{"speaker":"Chris Dy","startTime":1723.11,"endTime":1727.73,"body":"of 22. Kind of early fall. And"},{"speaker":"Chris Dy","startTime":1723.11,"endTime":1727.73,"body":"you know, 30 Something cases in"},{"speaker":"Chris Dy","startTime":1727.73,"endTime":1731.6,"body":"and it's been really"},{"speaker":"Chris Dy","startTime":1727.73,"endTime":1731.6,"body":"interesting. You know, because"},{"speaker":"Chris Dy","startTime":1731.6,"endTime":1735.23,"body":"of the way that I trained here,"},{"speaker":"Chris Dy","startTime":1731.6,"endTime":1735.23,"body":"I did not do a endoscopic and"},{"speaker":"Chris Dy","startTime":1735.23,"endTime":1739.46,"body":"training. I know a lot of"},{"speaker":"Chris Dy","startTime":1735.23,"endTime":1739.46,"body":"listeners will do endoscopic as"},{"speaker":"Chris Dy","startTime":1739.46,"endTime":1743.48,"body":"opposed to a mini open. And I"},{"speaker":"Chris Dy","startTime":1739.46,"endTime":1743.48,"body":"think it's been refreshing to"},{"speaker":"Chris Dy","startTime":1743.99,"endTime":1747.14,"body":"see how patients do after it."},{"speaker":"Chris Dy","startTime":1743.99,"endTime":1747.14,"body":"I'm not exactly sure where it's"},{"speaker":"Chris Dy","startTime":1747.14,"endTime":1750.26,"body":"going to land in my practice."},{"speaker":"Chris Dy","startTime":1747.14,"endTime":1750.26,"body":"I'm learning a lot about how to"},{"speaker":"Chris Dy","startTime":1750.26,"endTime":1752.96,"body":"counsel patients about it. So I"},{"speaker":"Chris Dy","startTime":1750.26,"endTime":1752.96,"body":"don't want to go into too much"},{"speaker":"Chris Dy","startTime":1752.96,"endTime":1756.35,"body":"detail here yet, because I want"},{"speaker":"Chris Dy","startTime":1752.96,"endTime":1756.35,"body":"to be fair to, to the technique."},{"speaker":"Chris Dy","startTime":1756.59,"endTime":1759.62,"body":"But it's been it's been"},{"speaker":"Chris Dy","startTime":1756.59,"endTime":1759.62,"body":"interesting to have to"},{"speaker":"Chris Dy","startTime":1759.62,"endTime":1762.74,"body":"implement, getting a device"},{"speaker":"Chris Dy","startTime":1759.62,"endTime":1762.74,"body":"through the approval process,"},{"speaker":"Chris Dy","startTime":1762.95,"endTime":1766.79,"body":"trying a new technique in"},{"speaker":"Chris Dy","startTime":1762.95,"endTime":1766.79,"body":"practice, and kind of comparing"},{"speaker":"Chris Dy","startTime":1766.79,"endTime":1769.31,"body":"it to something that I've done"},{"speaker":"Chris Dy","startTime":1766.79,"endTime":1769.31,"body":"many, many, many, many, many"},{"speaker":"Chris Dy","startTime":1769.31,"endTime":1770.0,"body":"more times."},{"speaker":"Charles Goldfarb","startTime":1772.1,"endTime":1774.32,"body":"Yeah, it is"},{"speaker":"Charles Goldfarb","startTime":1772.1,"endTime":1774.32,"body":"interesting. And I guess"},{"speaker":"Charles Goldfarb","startTime":1774.32,"endTime":1776.66,"body":"ultimately, at some point, you"},{"speaker":"Charles Goldfarb","startTime":1774.32,"endTime":1776.66,"body":"have to decide whether it's a"},{"speaker":"Charles Goldfarb","startTime":1776.66,"endTime":1780.5,"body":"value add for your practice and"},{"speaker":"Charles Goldfarb","startTime":1776.66,"endTime":1780.5,"body":"for you, and for your patients,"},{"speaker":"Charles Goldfarb","startTime":1780.5,"endTime":1784.16,"body":"of course, and I ultimately"},{"speaker":"Charles Goldfarb","startTime":1780.5,"endTime":1784.16,"body":"decided that it was not when I"},{"speaker":"Charles Goldfarb","startTime":1784.16,"endTime":1788.81,"body":"went through this process and"},{"speaker":"Charles Goldfarb","startTime":1784.16,"endTime":1788.81,"body":"inch I look forward to your"},{"speaker":"Charles Goldfarb","startTime":1788.81,"endTime":1791.87,"body":"ultimate decision about whether"},{"speaker":"Charles Goldfarb","startTime":1788.81,"endTime":1791.87,"body":"you will continue to do this. I"},{"speaker":"Charles Goldfarb","startTime":1791.87,"endTime":1795.05,"body":"think it's interesting and it's"},{"speaker":"Charles Goldfarb","startTime":1791.87,"endTime":1795.05,"body":"different. Whether it's the"},{"speaker":"Charles Goldfarb","startTime":1795.05,"endTime":1796.67,"body":"right thing for the long term,"},{"speaker":"Charles Goldfarb","startTime":1795.05,"endTime":1796.67,"body":"who knows."},{"speaker":"Chris Dy","startTime":1797.12,"endTime":1799.73,"body":"And what was the this"},{"speaker":"Chris Dy","startTime":1797.12,"endTime":1799.73,"body":"was slightly different with the"},{"speaker":"Chris Dy","startTime":1799.73,"endTime":1802.16,"body":"device. I saw that you were ago"},{"speaker":"Chris Dy","startTime":1799.73,"endTime":1802.16,"body":"that you were using right?"},{"speaker":"Charles Goldfarb","startTime":1802.49,"endTime":1804.65,"body":"Yeah, I use"},{"speaker":"Charles Goldfarb","startTime":1802.49,"endTime":1804.65,"body":"the I don't mind saying it the"},{"speaker":"Charles Goldfarb","startTime":1804.65,"endTime":1808.85,"body":"am surgical, I guess retrograde"},{"speaker":"Charles Goldfarb","startTime":1804.65,"endTime":1808.85,"body":"approach whereas incision in the"},{"speaker":"Charles Goldfarb","startTime":1808.85,"endTime":1812.45,"body":"palm and you work from distal to"},{"speaker":"Charles Goldfarb","startTime":1808.85,"endTime":1812.45,"body":"proximal. And I liked the"},{"speaker":"Charles Goldfarb","startTime":1812.45,"endTime":1815.99,"body":"technique, I liked the"},{"speaker":"Charles Goldfarb","startTime":1812.45,"endTime":1815.99,"body":"technology. But ultimately, I"},{"speaker":"Charles Goldfarb","startTime":1815.99,"endTime":1820.94,"body":"didn't leave the or as happy and"},{"speaker":"Charles Goldfarb","startTime":1815.99,"endTime":1820.94,"body":"Skippy as I do after a regular"},{"speaker":"Charles Goldfarb","startTime":1820.94,"endTime":1824.6,"body":"carpal tunnel, it just added an"},{"speaker":"Charles Goldfarb","startTime":1820.94,"endTime":1824.6,"body":"element of stress that I never"},{"speaker":"Charles Goldfarb","startTime":1824.6,"endTime":1828.38,"body":"got past. And I talked to Dr."},{"speaker":"Charles Goldfarb","startTime":1824.6,"endTime":1828.38,"body":"Government about it. And he"},{"speaker":"Charles Goldfarb","startTime":1828.38,"endTime":1833.15,"body":"said, Why are you taking a"},{"speaker":"Charles Goldfarb","startTime":1828.38,"endTime":1833.15,"body":"simple, safe, effective surgery"},{"speaker":"Charles Goldfarb","startTime":1833.15,"endTime":1836.33,"body":"and adding that to it? Do you"},{"speaker":"Charles Goldfarb","startTime":1833.15,"endTime":1836.33,"body":"really think it's worth it? And"},{"speaker":"Charles Goldfarb","startTime":1836.33,"endTime":1837.77,"body":"ultimately, I decided, for me,"},{"speaker":"Chris Dy","startTime":1837.98,"endTime":1841.82,"body":"it was not never seen"},{"speaker":"Chris Dy","startTime":1837.98,"endTime":1841.82,"body":"you skip. Don't"},{"speaker":"Charles Goldfarb","startTime":1841.88,"endTime":1843.77,"body":"skip"},{"speaker":"Charles Goldfarb","startTime":1841.88,"endTime":1843.77,"body":"regularly, but I have skipped."},{"speaker":"Chris Dy","startTime":1845.21,"endTime":1847.49,"body":"So I want to see if"},{"speaker":"Chris Dy","startTime":1845.21,"endTime":1847.49,"body":"you skip after a carpal tunnel"},{"speaker":"Chris Dy","startTime":1848.84,"endTime":1853.73,"body":"of all the things. That was my"},{"speaker":"Chris Dy","startTime":1848.84,"endTime":1853.73,"body":"recent addition to my practice,"},{"speaker":"Chris Dy","startTime":1854.39,"endTime":1857.51,"body":"anything else that you've"},{"speaker":"Chris Dy","startTime":1854.39,"endTime":1857.51,"body":"changed in the last five years?"},{"speaker":"Charles Goldfarb","startTime":1857.69,"endTime":1859.22,"body":"Well, I don't"},{"speaker":"Charles Goldfarb","startTime":1857.69,"endTime":1859.22,"body":"want to belabor because we've"},{"speaker":"Charles Goldfarb","startTime":1859.22,"endTime":1862.16,"body":"talked about it. But how I"},{"speaker":"Charles Goldfarb","startTime":1859.22,"endTime":1862.16,"body":"approach the TFCC is completely"},{"speaker":"Charles Goldfarb","startTime":1862.16,"endTime":1865.46,"body":"different today than it was"},{"speaker":"Charles Goldfarb","startTime":1862.16,"endTime":1865.46,"body":"five, seven years ago with the"},{"speaker":"Charles Goldfarb","startTime":1865.46,"endTime":1869.03,"body":"understanding of phobias, TFCC"},{"speaker":"Charles Goldfarb","startTime":1865.46,"endTime":1869.03,"body":"tears, and I'm speaking about"},{"speaker":"Charles Goldfarb","startTime":1869.03,"endTime":1873.23,"body":"that tonight for the SSH"},{"speaker":"Charles Goldfarb","startTime":1869.03,"endTime":1873.23,"body":"webinar. But it's just totally"},{"speaker":"Charles Goldfarb","startTime":1873.23,"endTime":1877.28,"body":"different. And I feel as though"},{"speaker":"Charles Goldfarb","startTime":1873.23,"endTime":1877.28,"body":"I didn't understand the TFCC as"},{"speaker":"Charles Goldfarb","startTime":1877.28,"endTime":1880.82,"body":"well as I could have, even"},{"speaker":"Charles Goldfarb","startTime":1877.28,"endTime":1880.82,"body":"though I'm not sure many did."},{"speaker":"Charles Goldfarb","startTime":1881.72,"endTime":1887.03,"body":"But the faux vo insertion of the"},{"speaker":"Charles Goldfarb","startTime":1881.72,"endTime":1887.03,"body":"TFCC matters. And it's"},{"speaker":"Charles Goldfarb","startTime":1887.03,"endTime":1892.76,"body":"remarkable how often I am"},{"speaker":"Charles Goldfarb","startTime":1887.03,"endTime":1892.76,"body":"repairing the TFCC with a phobia"},{"speaker":"Charles Goldfarb","startTime":1892.76,"endTime":1896.48,"body":"in mind. So big deal and totally"},{"speaker":"Charles Goldfarb","startTime":1892.76,"endTime":1896.48,"body":"has changed my practice."},{"speaker":"Chris Dy","startTime":1896.99,"endTime":1899.33,"body":"Yeah, it's changed"},{"speaker":"Chris Dy","startTime":1896.99,"endTime":1899.33,"body":"mine to listening to you. I"},{"speaker":"Chris Dy","startTime":1899.33,"endTime":1903.89,"body":"mean, I, it was scoping a risk"},{"speaker":"Chris Dy","startTime":1899.33,"endTime":1903.89,"body":"recently, and you know, was"},{"speaker":"Chris Dy","startTime":1903.89,"endTime":1908.24,"body":"telling our trainee all about"},{"speaker":"Chris Dy","startTime":1903.89,"endTime":1908.24,"body":"your papers about you know, hook"},{"speaker":"Chris Dy","startTime":1908.24,"endTime":1911.63,"body":"test and everything. And it"},{"speaker":"Chris Dy","startTime":1908.24,"endTime":1911.63,"body":"really has changed kind of how I"},{"speaker":"Chris Dy","startTime":1911.63,"endTime":1916.1,"body":"evaluate stability. And think"},{"speaker":"Chris Dy","startTime":1911.63,"endTime":1916.1,"body":"about it in terms of what what a"},{"speaker":"Chris Dy","startTime":1916.1,"endTime":1918.8,"body":"specific repair technique could"},{"speaker":"Chris Dy","startTime":1916.1,"endTime":1918.8,"body":"do what the role of shortening"},{"speaker":"Chris Dy","startTime":1918.8,"endTime":1922.49,"body":"would be subsequently. Super"},{"speaker":"Chris Dy","startTime":1918.8,"endTime":1922.49,"body":"interesting to hear. And And"},{"speaker":"Chris Dy","startTime":1922.49,"endTime":1926.63,"body":"honestly, like, I think that if"},{"speaker":"Chris Dy","startTime":1922.49,"endTime":1926.63,"body":"people, by the time this episode"},{"speaker":"Chris Dy","startTime":1926.63,"endTime":1930.11,"body":"drops, your webinar will have"},{"speaker":"Chris Dy","startTime":1926.63,"endTime":1930.11,"body":"been done, but it'll be"},{"speaker":"Chris Dy","startTime":1930.41,"endTime":1934.46,"body":"available to view on online for"},{"speaker":"Chris Dy","startTime":1930.41,"endTime":1934.46,"body":"the hands signing, I'm sure it's"},{"speaker":"Chris Dy","startTime":1934.46,"endTime":1938.3,"body":"going to be a great one. So make"},{"speaker":"Chris Dy","startTime":1934.46,"endTime":1938.3,"body":"sure to check that out. I have a"},{"speaker":"Chris Dy","startTime":1938.3,"endTime":1943.73,"body":"question for you, Chuck. Sure."},{"speaker":"Chris Dy","startTime":1938.3,"endTime":1943.73,"body":"So in the last five years, or so"},{"speaker":"Chris Dy","startTime":1943.76,"endTime":1949.1,"body":"2023 versus 2018, do you think"},{"speaker":"Chris Dy","startTime":1943.76,"endTime":1949.1,"body":"you operate more or less on"},{"speaker":"Chris Dy","startTime":1949.13,"endTime":1950.96,"body":"adult distal radius fractures?"},{"speaker":"Charles Goldfarb","startTime":1951.8,"endTime":1955.73,"body":"Is a fair"},{"speaker":"Charles Goldfarb","startTime":1951.8,"endTime":1955.73,"body":"question. I don't think I've"},{"speaker":"Charles Goldfarb","startTime":1955.73,"endTime":1958.4,"body":"changed honestly there. You"},{"speaker":"Charles Goldfarb","startTime":1955.73,"endTime":1958.4,"body":"know, there certainly hasn't"},{"speaker":"Charles Goldfarb","startTime":1958.4,"endTime":1961.91,"body":"been a change. I don't know that"},{"speaker":"Charles Goldfarb","startTime":1958.4,"endTime":1961.91,"body":"my approach has changed. What"},{"speaker":"Charles Goldfarb","startTime":1961.91,"endTime":1962.3,"body":"about you?"},{"speaker":"Chris Dy","startTime":1963.2,"endTime":1965.03,"body":"I feel like my"},{"speaker":"Chris Dy","startTime":1963.2,"endTime":1965.03,"body":"approach hasn't changed a whole"},{"speaker":"Chris Dy","startTime":1965.03,"endTime":1968.15,"body":"lot. But I find myself doing"},{"speaker":"Chris Dy","startTime":1965.03,"endTime":1968.15,"body":"less surgery. And I don't know"},{"speaker":"Chris Dy","startTime":1968.15,"endTime":1971.54,"body":"whether that's because maybe"},{"speaker":"Chris Dy","startTime":1968.15,"endTime":1971.54,"body":"subconsciously or unconsciously,"},{"speaker":"Chris Dy","startTime":1971.54,"endTime":1974.09,"body":"the way that I present the"},{"speaker":"Chris Dy","startTime":1971.54,"endTime":1974.09,"body":"options is different now."},{"speaker":"Chris Dy","startTime":1974.6,"endTime":1977.33,"body":"Although I think the purely"},{"speaker":"Chris Dy","startTime":1974.6,"endTime":1977.33,"body":"radiographically my indications"},{"speaker":"Chris Dy","startTime":1977.33,"endTime":1978.11,"body":"haven't changed,"},{"speaker":"Charles Goldfarb","startTime":1978.2,"endTime":1979.67,"body":"I think you're"},{"speaker":"Charles Goldfarb","startTime":1978.2,"endTime":1979.67,"body":"probably right, I think I"},{"speaker":"Charles Goldfarb","startTime":1979.67,"endTime":1983.69,"body":"probably operate less for that"},{"speaker":"Charles Goldfarb","startTime":1979.67,"endTime":1983.69,"body":"reason I, I don't push surgery"},{"speaker":"Charles Goldfarb","startTime":1983.69,"endTime":1987.62,"body":"as much as maybe I might have"},{"speaker":"Charles Goldfarb","startTime":1983.69,"endTime":1987.62,"body":"subconsciously or consciously in"},{"speaker":"Charles Goldfarb","startTime":1987.62,"endTime":1988.16,"body":"the past."},{"speaker":"Chris Dy","startTime":1989.51,"endTime":1993.74,"body":"So another big change"},{"speaker":"Chris Dy","startTime":1989.51,"endTime":1993.74,"body":"for me, has been having to rooms"},{"speaker":"Chris Dy","startTime":1993.74,"endTime":1998.03,"body":"regularly. And that I think has"},{"speaker":"Chris Dy","startTime":1993.74,"endTime":1998.03,"body":"brought it's just another"},{"speaker":"Chris Dy","startTime":1998.03,"endTime":2001.87,"body":"element to you know, the day in"},{"speaker":"Chris Dy","startTime":1998.03,"endTime":2001.87,"body":"terms of planning things out,"},{"speaker":"Chris Dy","startTime":2002.68,"endTime":2007.42,"body":"and having to figure out how to"},{"speaker":"Chris Dy","startTime":2002.68,"endTime":2007.42,"body":"how to navigate that. And I"},{"speaker":"Chris Dy","startTime":2007.42,"endTime":2011.08,"body":"think I've gotten pretty good at"},{"speaker":"Chris Dy","startTime":2007.42,"endTime":2011.08,"body":"it for my setup. But you know,"},{"speaker":"Chris Dy","startTime":2011.08,"endTime":2013.72,"body":"as soon as you think you have"},{"speaker":"Chris Dy","startTime":2011.08,"endTime":2013.72,"body":"something set up well, you never"},{"speaker":"Chris Dy","startTime":2013.72,"endTime":2014.77,"body":"know what's going to happen"},{"speaker":"Chris Dy","startTime":2013.72,"endTime":2014.77,"body":"next."},{"speaker":"Charles Goldfarb","startTime":2015.31,"endTime":2017.5,"body":"It is a skill"},{"speaker":"Charles Goldfarb","startTime":2015.31,"endTime":2017.5,"body":"as we've talked about. It's a"},{"speaker":"Charles Goldfarb","startTime":2017.5,"endTime":2022.12,"body":"it's a really a It's not easy to"},{"speaker":"Charles Goldfarb","startTime":2017.5,"endTime":2022.12,"body":"do it right and to do it. Well."},{"speaker":"Charles Goldfarb","startTime":2023.05,"endTime":2026.38,"body":"I think that's that's exactly"},{"speaker":"Charles Goldfarb","startTime":2023.05,"endTime":2026.38,"body":"right. I'll share my last one."},{"speaker":"Charles Goldfarb","startTime":2026.38,"endTime":2028.27,"body":"And if you have another one,"},{"speaker":"Charles Goldfarb","startTime":2026.38,"endTime":2028.27,"body":"please share we'd"},{"speaker":"Chris Dy","startTime":2028.54,"endTime":2030.76,"body":"love for you get to"},{"speaker":"Chris Dy","startTime":2028.54,"endTime":2030.76,"body":"your last one, I just do you"},{"speaker":"Chris Dy","startTime":2030.76,"endTime":2034.66,"body":"have one pearl, you could share"},{"speaker":"Chris Dy","startTime":2030.76,"endTime":2034.66,"body":"with somebody who is in the"},{"speaker":"Chris Dy","startTime":2034.66,"endTime":2037.0,"body":"stage of their practice where"},{"speaker":"Chris Dy","startTime":2034.66,"endTime":2037.0,"body":"they're getting real busy, and"},{"speaker":"Chris Dy","startTime":2037.0,"endTime":2039.25,"body":"they might be trying to run two"},{"speaker":"Chris Dy","startTime":2037.0,"endTime":2039.25,"body":"rooms."},{"speaker":"Charles Goldfarb","startTime":2039.46,"endTime":2042.58,"body":"Yeah, the curl"},{"speaker":"Charles Goldfarb","startTime":2039.46,"endTime":2042.58,"body":"is easy. Do it yourself that is"},{"speaker":"Charles Goldfarb","startTime":2042.58,"endTime":2048.31,"body":"plan out which cases go in which"},{"speaker":"Charles Goldfarb","startTime":2042.58,"endTime":2048.31,"body":"room and what order and how you"},{"speaker":"Charles Goldfarb","startTime":2048.31,"endTime":2051.7,"body":"flip flop. You cannot trust that"},{"speaker":"Charles Goldfarb","startTime":2048.31,"endTime":2051.7,"body":"to anyone else for maximum"},{"speaker":"Charles Goldfarb","startTime":2051.7,"endTime":2055.15,"body":"efficiency. A lot of thought"},{"speaker":"Charles Goldfarb","startTime":2051.7,"endTime":2055.15,"body":"goes into it because you have to"},{"speaker":"Charles Goldfarb","startTime":2055.15,"endTime":2059.5,"body":"think about a multitude of"},{"speaker":"Charles Goldfarb","startTime":2055.15,"endTime":2059.5,"body":"different factors, including"},{"speaker":"Charles Goldfarb","startTime":2059.53,"endTime":2063.91,"body":"equipment, including how much"},{"speaker":"Charles Goldfarb","startTime":2059.53,"endTime":2063.91,"body":"time you can potentially overlap"},{"speaker":"Charles Goldfarb","startTime":2063.97,"endTime":2067.66,"body":"the rooms, not the cases. It's"},{"speaker":"Charles Goldfarb","startTime":2063.97,"endTime":2067.66,"body":"very tricky. And I think that's"},{"speaker":"Charles Goldfarb","startTime":2067.66,"endTime":2069.55,"body":"the that's the secret sauce."},{"speaker":"Charles Goldfarb","startTime":2067.66,"endTime":2069.55,"body":"What about you?"},{"speaker":"Chris Dy","startTime":2070.63,"endTime":2073.54,"body":"I think that's really,"},{"speaker":"Chris Dy","startTime":2070.63,"endTime":2073.54,"body":"the other thing I'd say is to"},{"speaker":"Chris Dy","startTime":2073.99,"endTime":2078.73,"body":"consider who's with you, and how"},{"speaker":"Chris Dy","startTime":2073.99,"endTime":2078.73,"body":"to maximize their education"},{"speaker":"Chris Dy","startTime":2078.76,"endTime":2081.64,"body":"while balancing that against"},{"speaker":"Chris Dy","startTime":2078.76,"endTime":2081.64,"body":"efficiency. Because you know,"},{"speaker":"Chris Dy","startTime":2081.64,"endTime":2084.07,"body":"the reality is, is that you're"},{"speaker":"Chris Dy","startTime":2081.64,"endTime":2084.07,"body":"going to in a place like ours"},{"speaker":"Chris Dy","startTime":2084.07,"endTime":2087.01,"body":"where you have trainees of"},{"speaker":"Chris Dy","startTime":2084.07,"endTime":2087.01,"body":"various levels it is a fellow to"},{"speaker":"Chris Dy","startTime":2087.01,"endTime":2090.25,"body":"room day is very different than"},{"speaker":"Chris Dy","startTime":2087.01,"endTime":2090.25,"body":"a PGY two or three to room day."},{"speaker":"Chris Dy","startTime":2090.49,"endTime":2093.52,"body":"And both have fantastic things"},{"speaker":"Chris Dy","startTime":2090.49,"endTime":2093.52,"body":"that you can get from each of"},{"speaker":"Chris Dy","startTime":2093.52,"endTime":2095.59,"body":"them. And you know, I think that"},{"speaker":"Chris Dy","startTime":2093.52,"endTime":2095.59,"body":"that's an important thing to"},{"speaker":"Chris Dy","startTime":2095.59,"endTime":2096.04,"body":"consider."},{"speaker":"Charles Goldfarb","startTime":2097.0,"endTime":2101.59,"body":"Well said well"},{"speaker":"Charles Goldfarb","startTime":2097.0,"endTime":2101.59,"body":"said my final I change. And"},{"speaker":"Charles Goldfarb","startTime":2101.59,"endTime":2105.85,"body":"again, we've talked about it is"},{"speaker":"Charles Goldfarb","startTime":2101.59,"endTime":2105.85,"body":"the CMC joint. And I had a"},{"speaker":"Charles Goldfarb","startTime":2105.85,"endTime":2110.68,"body":"patient come back today, that"},{"speaker":"Charles Goldfarb","startTime":2105.85,"endTime":2110.68,"body":"was 10 years out from her lrti"},{"speaker":"Charles Goldfarb","startTime":2110.89,"endTime":2114.55,"body":"Happy as a clam, and wanted"},{"speaker":"Charles Goldfarb","startTime":2110.89,"endTime":2114.55,"body":"surgery on the other side. And"},{"speaker":"Charles Goldfarb","startTime":2114.55,"endTime":2117.43,"body":"we talked about the options. And"},{"speaker":"Charles Goldfarb","startTime":2114.55,"endTime":2117.43,"body":"she chose the newer option,"},{"speaker":"Charles Goldfarb","startTime":2117.43,"endTime":2120.07,"body":"which is the suture teacher"},{"speaker":"Charles Goldfarb","startTime":2117.43,"endTime":2120.07,"body":"takes"},{"speaker":"Chris Dy","startTime":2120.07,"endTime":2121.39,"body":"suspension. Yes. And"},{"speaker":"Charles Goldfarb","startTime":2123.58,"endTime":2126.19,"body":"I gave her"},{"speaker":"Charles Goldfarb","startTime":2123.58,"endTime":2126.19,"body":"both options. And it's hard when"},{"speaker":"Charles Goldfarb","startTime":2126.19,"endTime":2128.77,"body":"you're very happy with one side,"},{"speaker":"Charles Goldfarb","startTime":2126.19,"endTime":2128.77,"body":"but she didn't like the"},{"speaker":"Charles Goldfarb","startTime":2128.77,"endTime":2129.37,"body":"recovery."},{"speaker":"Chris Dy","startTime":2129.7,"endTime":2132.31,"body":"You know what I think"},{"speaker":"Chris Dy","startTime":2129.7,"endTime":2132.31,"body":"the that is that brings me to a"},{"speaker":"Chris Dy","startTime":2132.31,"endTime":2134.92,"body":"point that is different. I think"},{"speaker":"Chris Dy","startTime":2132.31,"endTime":2134.92,"body":"I counsel patients differently"},{"speaker":"Chris Dy","startTime":2134.98,"endTime":2139.36,"body":"in for a number of procedures,"},{"speaker":"Chris Dy","startTime":2134.98,"endTime":2139.36,"body":"but mainly for thumb, CMC, about"},{"speaker":"Chris Dy","startTime":2139.36,"endTime":2143.86,"body":"the duration of time. And that"},{"speaker":"Chris Dy","startTime":2139.36,"endTime":2143.86,"body":"ultimately ends up that the time"},{"speaker":"Chris Dy","startTime":2143.86,"endTime":2145.96,"body":"it takes to recover and that"},{"speaker":"Chris Dy","startTime":2143.86,"endTime":2145.96,"body":"ultimately, I think, ends up"},{"speaker":"Chris Dy","startTime":2145.96,"endTime":2148.63,"body":"turning off some patients, but"},{"speaker":"Chris Dy","startTime":2145.96,"endTime":2148.63,"body":"I'd rather err on the side of"},{"speaker":"Chris Dy","startTime":2148.63,"endTime":2151.72,"body":"accuracy of what that recovery"},{"speaker":"Chris Dy","startTime":2148.63,"endTime":2151.72,"body":"is like. And that for me,"},{"speaker":"Chris Dy","startTime":2151.72,"endTime":2154.57,"body":"stemmed from an actual paper"},{"speaker":"Chris Dy","startTime":2151.72,"endTime":2154.57,"body":"that one of our fellows wrote"},{"speaker":"Chris Dy","startTime":2154.57,"endTime":2157.6,"body":"after interviewing my patients"},{"speaker":"Chris Dy","startTime":2154.57,"endTime":2157.6,"body":"after they've recovered from"},{"speaker":"Chris Dy","startTime":2157.9,"endTime":2161.95,"body":"from CMC surgery, and how long"},{"speaker":"Chris Dy","startTime":2157.9,"endTime":2161.95,"body":"it really took mine. And some of"},{"speaker":"Chris Dy","startTime":2162.01,"endTime":2164.35,"body":"you, I think, maybe some of"},{"speaker":"Chris Dy","startTime":2162.01,"endTime":2164.35,"body":"yours and some of our partners."},{"speaker":"Chris Dy","startTime":2164.62,"endTime":2168.34,"body":"So it's not a quick it's not a"},{"speaker":"Chris Dy","startTime":2164.62,"endTime":2168.34,"body":"quick surgery to get over. But"},{"speaker":"Chris Dy","startTime":2168.37,"endTime":2171.19,"body":"you know, using the suture tape,"},{"speaker":"Chris Dy","startTime":2168.37,"endTime":2171.19,"body":"I think does speed that recovery"},{"speaker":"Chris Dy","startTime":2171.19,"endTime":2171.61,"body":"alone."},{"speaker":"Charles Goldfarb","startTime":2172.0,"endTime":2174.64,"body":"I think it"},{"speaker":"Charles Goldfarb","startTime":2172.0,"endTime":2174.64,"body":"does. You want the final word?"},{"speaker":"Chris Dy","startTime":2174.97,"endTime":2176.98,"body":"No, I never want the"},{"speaker":"Chris Dy","startTime":2174.97,"endTime":2176.98,"body":"final word. I'm gonna give it to"},{"speaker":"Chris Dy","startTime":2176.98,"endTime":2177.22,"body":"you."},{"speaker":"Charles Goldfarb","startTime":2178.18,"endTime":2180.55,"body":"I like this."},{"speaker":"Charles Goldfarb","startTime":2178.18,"endTime":2180.55,"body":"This is fine. Here's my here's"},{"speaker":"Charles Goldfarb","startTime":2180.55,"endTime":2183.4,"body":"my plug for another episode,"},{"speaker":"Charles Goldfarb","startTime":2180.55,"endTime":2183.4,"body":"we're gonna do a grab bag. I'd"},{"speaker":"Charles Goldfarb","startTime":2183.4,"endTime":2186.97,"body":"like to I think we should both"},{"speaker":"Charles Goldfarb","startTime":2183.4,"endTime":2186.97,"body":"take stock of what we say in"},{"speaker":"Charles Goldfarb","startTime":2186.97,"endTime":2190.87,"body":"clinic often our little"},{"speaker":"Charles Goldfarb","startTime":2186.97,"endTime":2190.87,"body":"colloquialisms that we use and"},{"speaker":"Charles Goldfarb","startTime":2190.87,"endTime":2192.82,"body":"why we use them. We've sort of"},{"speaker":"Charles Goldfarb","startTime":2190.87,"endTime":2192.82,"body":"done that in the past, but I"},{"speaker":"Charles Goldfarb","startTime":2192.82,"endTime":2194.53,"body":"think we could do a better job"},{"speaker":"Charles Goldfarb","startTime":2192.82,"endTime":2194.53,"body":"of it in the future."},{"speaker":"Chris Dy","startTime":2194.8,"endTime":2196.51,"body":"Yeah, and I've"},{"speaker":"Chris Dy","startTime":2194.8,"endTime":2196.51,"body":"definitely got a couple of"},{"speaker":"Chris Dy","startTime":2196.51,"endTime":2199.36,"body":"analogies. And then a couple of"},{"speaker":"Chris Dy","startTime":2196.51,"endTime":2199.36,"body":"things that I things I use with"},{"speaker":"Chris Dy","startTime":2199.36,"endTime":2202.96,"body":"patients and things I use with"},{"speaker":"Chris Dy","startTime":2199.36,"endTime":2202.96,"body":"our team are very different. But"},{"speaker":"Chris Dy","startTime":2203.68,"endTime":2206.83,"body":"you know, anybody who's been in"},{"speaker":"Chris Dy","startTime":2203.68,"endTime":2206.83,"body":"clinic with me knows what the TI"},{"speaker":"Chris Dy","startTime":2206.83,"endTime":2208.9,"body":"protocol is. And I'll leave the"},{"speaker":"Chris Dy","startTime":2206.83,"endTime":2208.9,"body":"teaser for that."},{"speaker":"Charles Goldfarb","startTime":2209.56,"endTime":2212.26,"body":"Teased. All"},{"speaker":"Charles Goldfarb","startTime":2209.56,"endTime":2212.26,"body":"right, have a good night. All"},{"speaker":"Charles Goldfarb","startTime":2212.26,"endTime":2215.89,"body":"right. Take care. Hey, Chris."},{"speaker":"Charles Goldfarb","startTime":2212.26,"endTime":2215.89,"body":"That was fun. Let's do it again"},{"speaker":"Charles Goldfarb","startTime":2215.89,"endTime":2217.45,"body":"real soon. Sounds good."},{"speaker":"Chris Dy","startTime":2217.06,"endTime":2219.673,"body":"Well, be sure to check"},{"speaker":"Chris Dy","startTime":2217.06,"endTime":2219.673,"body":"us out on Twitter @Handpodcast."},{"speaker":"Chris Dy","startTime":2219.722,"endTime":2221.61,"body":"Hey, Chuck, what's your Twitter handle?"},{"speaker":"Charles Goldfarb","startTime":2221.94,"endTime":2224.8,"body":"Mine is"},{"speaker":"Charles Goldfarb","startTime":2221.94,"endTime":2224.8,"body":"@congenitalhand. What about you?"},{"speaker":"Chris Dy","startTime":2224.94,"endTime":2228.369,"body":"Mine is @ChrisDyMD"},{"speaker":"Chris Dy","startTime":2224.94,"endTime":2228.369,"body":"spelled d- y. And if you'd like"},{"speaker":"Chris Dy","startTime":2228.437,"endTime":2232.21,"body":"to email us, you can reach us at"},{"speaker":"Chris Dy","startTime":2228.437,"endTime":2232.21,"body":"handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2232.75,"endTime":2234.91,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2232.75,"endTime":2234.91,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2234.91,"endTime":2235.99,"body":"get your podcast"},{"speaker":"Chris Dy","startTime":2236.02,"endTime":2238.24,"body":"and be sure to leave a"},{"speaker":"Chris Dy","startTime":2236.02,"endTime":2238.24,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2238.24,"endTime":2238.63,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":2239.02,"endTime":2241.33,"body":"Special thanks"},{"speaker":"Charles Goldfarb","startTime":2239.02,"endTime":2241.33,"body":"to Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2241.33,"endTime":2245.29,"body":"music. And remember, keep the"},{"speaker":"Charles Goldfarb","startTime":2241.33,"endTime":2245.29,"body":"upper hand. Come back next time"}]}