{"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":25.65,"endTime":26.79,"body":"Oh, hey,"},{"speaker":"Charles Goldfarb","startTime":25.65,"endTime":26.79,"body":"Chris."},{"speaker":"Chris Dy","startTime":27.3,"endTime":28.26,"body":"Hey, Chuck, how are"},{"speaker":"Chris Dy","startTime":27.3,"endTime":28.26,"body":"you?"},{"speaker":"Charles Goldfarb","startTime":28.83,"endTime":30.93,"body":"I'm doing"},{"speaker":"Charles Goldfarb","startTime":28.83,"endTime":30.93,"body":"really well. It's good to see"},{"speaker":"Charles Goldfarb","startTime":30.93,"endTime":32.16,"body":"you. It's been too long."},{"speaker":"Chris Dy","startTime":32.189,"endTime":34.889,"body":"It's been good to."},{"speaker":"Chris Dy","startTime":32.189,"endTime":34.889,"body":"It's good to see you too. It's"},{"speaker":"Chris Dy","startTime":34.889,"endTime":38.039,"body":"been a long time. I know that"},{"speaker":"Chris Dy","startTime":34.889,"endTime":38.039,"body":"last time we teased these cases"},{"speaker":"Chris Dy","startTime":38.039,"endTime":40.319,"body":"that we're going to talk about."},{"speaker":"Chris Dy","startTime":38.039,"endTime":40.319,"body":"So everybody's probably really"},{"speaker":"Chris Dy","startTime":40.319,"endTime":43.829,"body":"excited about that. But we did"},{"speaker":"Chris Dy","startTime":40.319,"endTime":43.829,"body":"want to share some great"},{"speaker":"Chris Dy","startTime":43.829,"endTime":47.069,"body":"feedback. We did comment a"},{"speaker":"Chris Dy","startTime":43.829,"endTime":47.069,"body":"couple episodes ago about how"},{"speaker":"Chris Dy","startTime":47.819,"endTime":53.009,"body":"the the email inbox has been a"},{"speaker":"Chris Dy","startTime":47.819,"endTime":53.009,"body":"little quiet for the for the"},{"speaker":"Chris Dy","startTime":53.009,"endTime":56.849,"body":"podcast. So Ham"},{"speaker":"Chris Dy","startTime":53.009,"endTime":56.849,"body":"podcast@gmail.com Make sure that"},{"speaker":"Chris Dy","startTime":56.849,"endTime":59.639,"body":"email us questions and"},{"speaker":"Chris Dy","startTime":56.849,"endTime":59.639,"body":"everything. But we had some"},{"speaker":"Chris Dy","startTime":59.639,"endTime":62.849,"body":"really great feedback from"},{"speaker":"Chris Dy","startTime":59.639,"endTime":62.849,"body":"listeners. And David Wells is"},{"speaker":"Chris Dy","startTime":62.849,"endTime":65.459,"body":"one of them. He's an orthopedic"},{"speaker":"Chris Dy","startTime":62.849,"endTime":65.459,"body":"NP that previously worked in"},{"speaker":"Chris Dy","startTime":65.459,"endTime":68.309,"body":"foot and ankle and switched over"},{"speaker":"Chris Dy","startTime":65.459,"endTime":68.309,"body":"to hand and has enjoyed"},{"speaker":"Chris Dy","startTime":68.459,"endTime":73.229,"body":"listening to us on the go and"},{"speaker":"Chris Dy","startTime":68.459,"endTime":73.229,"body":"while driving. So thanks, David"},{"speaker":"Chris Dy","startTime":73.229,"endTime":79.709,"body":"for that very kind email. And"},{"speaker":"Chris Dy","startTime":73.229,"endTime":79.709,"body":"see our next one is from a good"},{"speaker":"Chris Dy","startTime":79.709,"endTime":82.829,"body":"old friend, Bob Vandermark. He's"},{"speaker":"Chris Dy","startTime":79.709,"endTime":82.829,"body":"written a couple of times and"},{"speaker":"Chris Dy","startTime":82.829,"endTime":86.879,"body":"thanked us for the podcast and"},{"speaker":"Chris Dy","startTime":82.829,"endTime":86.879,"body":"wish us a happy new year. So he"},{"speaker":"Chris Dy","startTime":86.879,"endTime":90.929,"body":"liked he liked our talk about"},{"speaker":"Chris Dy","startTime":86.879,"endTime":90.929,"body":"carpal tunnel and practice"},{"speaker":"Chris Dy","startTime":90.929,"endTime":94.439,"body":"guidelines. And you know, so"},{"speaker":"Chris Dy","startTime":90.929,"endTime":94.439,"body":"thanks for that. Bob. And"},{"speaker":"Chris Dy","startTime":94.499,"endTime":97.859,"body":"Clifford Johnson, a surgeon"},{"speaker":"Chris Dy","startTime":94.499,"endTime":97.859,"body":"that's not too far from us. on"},{"speaker":"Chris Dy","startTime":97.859,"endTime":101.339,"body":"the Illinois side, he sent a"},{"speaker":"Chris Dy","startTime":97.859,"endTime":101.339,"body":"very nice email saying that he"},{"speaker":"Chris Dy","startTime":101.339,"endTime":103.919,"body":"understands how we're going to Q"},{"speaker":"Chris Dy","startTime":101.339,"endTime":103.919,"body":"two weeks he surprised it took"},{"speaker":"Chris Dy","startTime":103.919,"endTime":106.469,"body":"us this long. I think Bob"},{"speaker":"Chris Dy","startTime":103.919,"endTime":106.469,"body":"vandermark said about the same"},{"speaker":"Chris Dy","startTime":106.469,"endTime":111.479,"body":"thing too. But yeah, so we"},{"speaker":"Chris Dy","startTime":106.469,"endTime":111.479,"body":"really appreciate everything"},{"speaker":"Chris Dy","startTime":111.479,"endTime":115.829,"body":"that everybody's written in you"},{"speaker":"Chris Dy","startTime":111.479,"endTime":115.829,"body":"know, there was a podcast"},{"speaker":"Chris Dy","startTime":115.829,"endTime":119.969,"body":"listener Nikhil Agra wall, who"},{"speaker":"Chris Dy","startTime":115.829,"endTime":119.969,"body":"was at the, at the Hand"},{"speaker":"Chris Dy","startTime":119.969,"endTime":123.959,"body":"Association meeting and didn't"},{"speaker":"Chris Dy","startTime":119.969,"endTime":123.959,"body":"have the, quote, nerve to say"},{"speaker":"Chris Dy","startTime":123.959,"endTime":127.919,"body":"hi. I wanted to write in and,"},{"speaker":"Chris Dy","startTime":123.959,"endTime":127.919,"body":"and tell us how much he loved"},{"speaker":"Chris Dy","startTime":127.919,"endTime":132.449,"body":"the podcast. So yes, thank you"},{"speaker":"Chris Dy","startTime":127.919,"endTime":132.449,"body":"to all of you for for your kind"},{"speaker":"Chris Dy","startTime":132.449,"endTime":132.989,"body":"comments."},{"speaker":"Charles Goldfarb","startTime":133.56,"endTime":136.95,"body":"So those are"},{"speaker":"Charles Goldfarb","startTime":133.56,"endTime":136.95,"body":"great. I love those. I can share"},{"speaker":"Charles Goldfarb","startTime":136.95,"endTime":142.71,"body":"a few as well. So you know, if"},{"speaker":"Charles Goldfarb","startTime":136.95,"endTime":142.71,"body":"you aren't on our upper hand"},{"speaker":"Charles Goldfarb","startTime":142.71,"endTime":147.21,"body":"podcast, email list, right in"},{"speaker":"Charles Goldfarb","startTime":142.71,"endTime":147.21,"body":"and we'll put you on the list, I"},{"speaker":"Charles Goldfarb","startTime":147.21,"endTime":151.47,"body":"promise. They're not that"},{"speaker":"Charles Goldfarb","startTime":147.21,"endTime":151.47,"body":"frequent. Sometimes there's"},{"speaker":"Charles Goldfarb","startTime":151.47,"endTime":155.13,"body":"information and sometimes it's"},{"speaker":"Charles Goldfarb","startTime":151.47,"endTime":155.13,"body":"an update, but I don't know we"},{"speaker":"Charles Goldfarb","startTime":155.13,"endTime":157.8,"body":"probably over the last year"},{"speaker":"Charles Goldfarb","startTime":155.13,"endTime":157.8,"body":"since we were you two, we"},{"speaker":"Charles Goldfarb","startTime":157.8,"endTime":160.05,"body":"probably sent out one every"},{"speaker":"Charles Goldfarb","startTime":157.8,"endTime":160.05,"body":"three or four months. So"},{"speaker":"Charles Goldfarb","startTime":160.23,"endTime":163.68,"body":"recently, we sent one out"},{"speaker":"Charles Goldfarb","startTime":160.23,"endTime":163.68,"body":"notifying all about the change"},{"speaker":"Charles Goldfarb","startTime":163.68,"endTime":167.04,"body":"in cadence to every other week."},{"speaker":"Charles Goldfarb","startTime":163.68,"endTime":167.04,"body":"And then we've got some great"},{"speaker":"Charles Goldfarb","startTime":167.04,"endTime":171.09,"body":"responses. So I'll read a couple"},{"speaker":"Charles Goldfarb","startTime":167.04,"endTime":171.09,"body":"of those. So this first one is"},{"speaker":"Charles Goldfarb","startTime":171.09,"endTime":174.45,"body":"near and dear to my heart. This"},{"speaker":"Charles Goldfarb","startTime":171.09,"endTime":174.45,"body":"is Matthew DeWolf, who's a hand"},{"speaker":"Charles Goldfarb","startTime":174.45,"endTime":177.78,"body":"and upper extremity surgeon at"},{"speaker":"Charles Goldfarb","startTime":174.45,"endTime":177.78,"body":"Berkshire Orthopedic Associates."},{"speaker":"Charles Goldfarb","startTime":177.78,"endTime":180.75,"body":"Now Chris, I don't know if you"},{"speaker":"Charles Goldfarb","startTime":177.78,"endTime":180.75,"body":"know where the Berkshires are,"},{"speaker":"Charles Goldfarb","startTime":180.81,"endTime":182.46,"body":"maybe do I hope you do"},{"speaker":"Chris Dy","startTime":182.7,"endTime":185.85,"body":"give it sounds like"},{"speaker":"Chris Dy","startTime":182.7,"endTime":185.85,"body":"there's some fancy money in that"},{"speaker":"Chris Dy","startTime":185.85,"endTime":186.18,"body":"area."},{"speaker":"Charles Goldfarb","startTime":186.42,"endTime":188.76,"body":"Well, the"},{"speaker":"Charles Goldfarb","startTime":186.42,"endTime":188.76,"body":"Berkshires are where Williams"},{"speaker":"Charles Goldfarb","startTime":188.76,"endTime":192.45,"body":"College is located, which went"},{"speaker":"Charles Goldfarb","startTime":188.76,"endTime":192.45,"body":"to school so as the"},{"speaker":"Chris Dy","startTime":192.48,"endTime":197.16,"body":"so I hear, just grow"},{"speaker":"Chris Dy","startTime":192.48,"endTime":197.16,"body":"they grow hand surgeons on trees"},{"speaker":"Chris Dy","startTime":197.16,"endTime":197.79,"body":"and Williams,"},{"speaker":"Charles Goldfarb","startTime":199.98,"endTime":202.32,"body":"Western Mass"},{"speaker":"Charles Goldfarb","startTime":199.98,"endTime":202.32,"body":"beautiful part of this country."},{"speaker":"Charles Goldfarb","startTime":202.38,"endTime":206.13,"body":"So Matt was very nice and said"},{"speaker":"Charles Goldfarb","startTime":202.38,"endTime":206.13,"body":"some really nice things and"},{"speaker":"Charles Goldfarb","startTime":206.13,"endTime":209.73,"body":"thanked us for the time and"},{"speaker":"Charles Goldfarb","startTime":206.13,"endTime":209.73,"body":"energy we put into this. I find"},{"speaker":"Charles Goldfarb","startTime":209.73,"endTime":212.19,"body":"it very entertaining and"},{"speaker":"Charles Goldfarb","startTime":209.73,"endTime":212.19,"body":"educational. And he has some"},{"speaker":"Charles Goldfarb","startTime":212.19,"endTime":216.6,"body":"suggestions including an HBr top"},{"speaker":"Charles Goldfarb","startTime":212.19,"endTime":216.6,"body":"HBr topic, which we already"},{"speaker":"Charles Goldfarb","startTime":216.6,"endTime":222.33,"body":"covered. So thanks, Matt. This"},{"speaker":"Charles Goldfarb","startTime":216.6,"endTime":222.33,"body":"will be an interesting one, I"},{"speaker":"Charles Goldfarb","startTime":222.33,"endTime":225.03,"body":"may have poured this onto you"},{"speaker":"Charles Goldfarb","startTime":222.33,"endTime":225.03,"body":"Brittany Mitchell is an"},{"speaker":"Charles Goldfarb","startTime":225.03,"endTime":230.1,"body":"occupational therapist, and"},{"speaker":"Charles Goldfarb","startTime":225.03,"endTime":230.1,"body":"really said that I still listen"},{"speaker":"Charles Goldfarb","startTime":230.1,"endTime":232.95,"body":"on my drives to work and to"},{"speaker":"Charles Goldfarb","startTime":230.1,"endTime":232.95,"body":"indoor swim lessons from my"},{"speaker":"Charles Goldfarb","startTime":232.95,"endTime":235.89,"body":"three and five year old. Most of"},{"speaker":"Charles Goldfarb","startTime":232.95,"endTime":235.89,"body":"my time recently has been"},{"speaker":"Charles Goldfarb","startTime":235.89,"endTime":240.03,"body":"dedicated studying for the CHT."},{"speaker":"Charles Goldfarb","startTime":235.89,"endTime":240.03,"body":"But she wants us to talk more"},{"speaker":"Charles Goldfarb","startTime":240.03,"endTime":243.33,"body":"about mallet fingers, which is"},{"speaker":"Charles Goldfarb","startTime":240.03,"endTime":243.33,"body":"not the most exciting topic but"},{"speaker":"Charles Goldfarb","startTime":243.36,"endTime":246.75,"body":"there's a lot there. So I think"},{"speaker":"Charles Goldfarb","startTime":243.36,"endTime":246.75,"body":"we could have a good mallet"},{"speaker":"Charles Goldfarb","startTime":246.75,"endTime":249.06,"body":"conversation at some point for"},{"speaker":"Charles Goldfarb","startTime":246.75,"endTime":249.06,"body":"sure."},{"speaker":"Chris Dy","startTime":249.48,"endTime":253.56,"body":"Yep. Share the people"},{"speaker":"Chris Dy","startTime":249.48,"endTime":253.56,"body":"aren't Chuck we got to do it."},{"speaker":"Charles Goldfarb","startTime":255.09,"endTime":258.57,"body":"Sharon. Sharon"},{"speaker":"Charles Goldfarb","startTime":255.09,"endTime":258.57,"body":"Stanley is a plastic hand"},{"speaker":"Charles Goldfarb","startTime":258.57,"endTime":261.96,"body":"surgeon at LSU New Orleans."},{"speaker":"Charles Goldfarb","startTime":258.57,"endTime":261.96,"body":"She's early in her practice sees"},{"speaker":"Charles Goldfarb","startTime":261.96,"endTime":264.9,"body":"a lot of holly trauma and"},{"speaker":"Charles Goldfarb","startTime":261.96,"endTime":264.9,"body":"devastating upper injured upper"},{"speaker":"Charles Goldfarb","startTime":264.9,"endTime":270.33,"body":"extremity injuries. She feels"},{"speaker":"Charles Goldfarb","startTime":264.9,"endTime":270.33,"body":"that she sees a lot of CRPS more"},{"speaker":"Charles Goldfarb","startTime":270.33,"endTime":273.0,"body":"than she realized previously,"},{"speaker":"Charles Goldfarb","startTime":270.33,"endTime":273.0,"body":"and we'd love to hear our"},{"speaker":"Charles Goldfarb","startTime":273.0,"endTime":277.53,"body":"thoughts on it. Maybe we can"},{"speaker":"Charles Goldfarb","startTime":273.0,"endTime":277.53,"body":"even talk about that one. And"},{"speaker":"Charles Goldfarb","startTime":277.53,"endTime":281.94,"body":"then I think the others we can"},{"speaker":"Charles Goldfarb","startTime":277.53,"endTime":281.94,"body":"mention another time. What do"},{"speaker":"Charles Goldfarb","startTime":281.94,"endTime":285.57,"body":"you think about that? How often"},{"speaker":"Charles Goldfarb","startTime":281.94,"endTime":285.57,"body":"do you see CRPS and do you find"},{"speaker":"Charles Goldfarb","startTime":285.57,"endTime":289.65,"body":"it associated with major traumas"},{"speaker":"Charles Goldfarb","startTime":285.57,"endTime":289.65,"body":"or or what's what's your what's"},{"speaker":"Charles Goldfarb","startTime":289.65,"endTime":292.14,"body":"your experience then, Mr. Rue?"},{"speaker":"Chris Dy","startTime":292.14,"endTime":295.59,"body":"Well, I think that I"},{"speaker":"Chris Dy","startTime":292.14,"endTime":295.59,"body":"see it. I see it more than other"},{"speaker":"Chris Dy","startTime":295.59,"endTime":298.92,"body":"people a because of my practice"},{"speaker":"Chris Dy","startTime":295.59,"endTime":298.92,"body":"and be because I recognize it"},{"speaker":"Chris Dy","startTime":298.92,"endTime":301.77,"body":"more. It's one of the things"},{"speaker":"Chris Dy","startTime":298.92,"endTime":301.77,"body":"where You may not see it, but"},{"speaker":"Chris Dy","startTime":301.77,"endTime":306.6,"body":"it'll see you. And it's hate."},{"speaker":"Chris Dy","startTime":301.77,"endTime":306.6,"body":"It's such a tough condition to"},{"speaker":"Chris Dy","startTime":306.63,"endTime":311.28,"body":"treat. And, you know, I think we"},{"speaker":"Chris Dy","startTime":306.63,"endTime":311.28,"body":"probably should do an episode on"},{"speaker":"Chris Dy","startTime":311.28,"endTime":314.58,"body":"CRPS. And we should have our"},{"speaker":"Chris Dy","startTime":311.28,"endTime":314.58,"body":"therapy friend Macy on the"},{"speaker":"Chris Dy","startTime":314.58,"endTime":316.77,"body":"episode for that. Because I"},{"speaker":"Chris Dy","startTime":314.58,"endTime":316.77,"body":"think that it's it's such a"},{"speaker":"Chris Dy","startTime":316.77,"endTime":319.44,"body":"challenging condition that will"},{"speaker":"Chris Dy","startTime":316.77,"endTime":319.44,"body":"not be treated solely by the"},{"speaker":"Chris Dy","startTime":319.44,"endTime":321.84,"body":"surgeon, although surgeons"},{"speaker":"Chris Dy","startTime":319.44,"endTime":321.84,"body":"certainly can have a role in"},{"speaker":"Chris Dy","startTime":321.84,"endTime":327.39,"body":"treatment. But the nastiest ones"},{"speaker":"Chris Dy","startTime":321.84,"endTime":327.39,"body":"are the crush injuries and the"},{"speaker":"Chris Dy","startTime":327.39,"endTime":328.11,"body":"dog bites."},{"speaker":"Charles Goldfarb","startTime":330.27,"endTime":333.27,"body":"Yeah, in my in"},{"speaker":"Charles Goldfarb","startTime":330.27,"endTime":333.27,"body":"my practice, it's typically a"},{"speaker":"Charles Goldfarb","startTime":333.27,"endTime":338.91,"body":"referred patient, maybe from"},{"speaker":"Charles Goldfarb","startTime":333.27,"endTime":338.91,"body":"another hand surgeon or not. And"},{"speaker":"Charles Goldfarb","startTime":338.97,"endTime":341.58,"body":"I'm always and we should talk"},{"speaker":"Charles Goldfarb","startTime":338.97,"endTime":341.58,"body":"about this is a great a great"},{"speaker":"Charles Goldfarb","startTime":341.58,"endTime":343.89,"body":"idea for an episode, I think"},{"speaker":"Charles Goldfarb","startTime":341.58,"endTime":343.89,"body":"we've talked about talking about"},{"speaker":"Charles Goldfarb","startTime":343.89,"endTime":347.61,"body":"this, and we never did it. It's"},{"speaker":"Charles Goldfarb","startTime":343.89,"endTime":347.61,"body":"a great idea for an episode. And"},{"speaker":"Charles Goldfarb","startTime":347.61,"endTime":351.09,"body":"I think there's a lot to share."},{"speaker":"Charles Goldfarb","startTime":347.61,"endTime":351.09,"body":"I never mind seeing those"},{"speaker":"Charles Goldfarb","startTime":351.09,"endTime":354.66,"body":"patients, but always lay out the"},{"speaker":"Charles Goldfarb","startTime":351.09,"endTime":354.66,"body":"expectations for my visit. If as"},{"speaker":"Charles Goldfarb","startTime":354.66,"endTime":357.87,"body":"a hand surgeon, I can help you,"},{"speaker":"Charles Goldfarb","startTime":354.66,"endTime":357.87,"body":"I'll do just that. If I can't,"},{"speaker":"Charles Goldfarb","startTime":358.11,"endTime":360.27,"body":"then you're better served with"},{"speaker":"Charles Goldfarb","startTime":358.11,"endTime":360.27,"body":"another physician. And I think"},{"speaker":"Charles Goldfarb","startTime":360.27,"endTime":362.64,"body":"that's an important kind of"},{"speaker":"Charles Goldfarb","startTime":360.27,"endTime":362.64,"body":"parameter to set early."},{"speaker":"Chris Dy","startTime":363.12,"endTime":365.43,"body":"Right. Right. Right."},{"speaker":"Chris Dy","startTime":363.12,"endTime":365.43,"body":"You know, it's interesting,"},{"speaker":"Chris Dy","startTime":365.43,"endTime":368.55,"body":"though, our role is hand"},{"speaker":"Chris Dy","startTime":365.43,"endTime":368.55,"body":"surgeons were probably the ones"},{"speaker":"Chris Dy","startTime":368.73,"endTime":373.53,"body":"physician wise, where we know a"},{"speaker":"Chris Dy","startTime":368.73,"endTime":373.53,"body":"lot about certain things. And if"},{"speaker":"Chris Dy","startTime":373.53,"endTime":376.11,"body":"there isn't a physician that is"},{"speaker":"Chris Dy","startTime":373.53,"endTime":376.11,"body":"better equipped, even if you're"},{"speaker":"Chris Dy","startTime":376.11,"endTime":379.5,"body":"not providing a surgical"},{"speaker":"Chris Dy","startTime":376.11,"endTime":379.5,"body":"service, sometimes I feel like"},{"speaker":"Chris Dy","startTime":379.5,"endTime":382.86,"body":"we should still quarterback or"},{"speaker":"Chris Dy","startTime":379.5,"endTime":382.86,"body":"run points on the situation. Now"},{"speaker":"Chris Dy","startTime":382.86,"endTime":386.67,"body":"CRPS, you know, I think"},{"speaker":"Chris Dy","startTime":382.86,"endTime":386.67,"body":"especially type one, you know,"},{"speaker":"Chris Dy","startTime":386.73,"endTime":390.48,"body":"the pain management teams are"},{"speaker":"Chris Dy","startTime":386.73,"endTime":390.48,"body":"fantastic at handling that from"},{"speaker":"Chris Dy","startTime":390.48,"endTime":395.22,"body":"a very multidisciplinary manner."},{"speaker":"Chris Dy","startTime":390.48,"endTime":395.22,"body":"But, you know, I had somebody"},{"speaker":"Chris Dy","startTime":395.22,"endTime":398.7,"body":"recently who didn't have a firm"},{"speaker":"Chris Dy","startTime":395.22,"endTime":398.7,"body":"diagnosis. But clearly, I think"},{"speaker":"Chris Dy","startTime":398.7,"endTime":401.76,"body":"what we were doing for her in"},{"speaker":"Chris Dy","startTime":398.7,"endTime":401.76,"body":"terms of guiding therapy, et"},{"speaker":"Chris Dy","startTime":401.76,"endTime":405.09,"body":"cetera, was helpful, and I"},{"speaker":"Chris Dy","startTime":401.76,"endTime":405.09,"body":"didn't think anybody else will"},{"speaker":"Chris Dy","startTime":405.09,"endTime":406.83,"body":"be able to help them out. So"},{"speaker":"Chris Dy","startTime":405.09,"endTime":406.83,"body":"it's like he had just come back"},{"speaker":"Chris Dy","startTime":406.83,"endTime":409.95,"body":"and I walked out the room was"},{"speaker":"Chris Dy","startTime":406.83,"endTime":409.95,"body":"like, I don't know why we're"},{"speaker":"Chris Dy","startTime":409.95,"endTime":411.63,"body":"having them come back. But I"},{"speaker":"Chris Dy","startTime":409.95,"endTime":411.63,"body":"think we're probably the best"},{"speaker":"Chris Dy","startTime":411.63,"endTime":414.12,"body":"people to take care of them. And"},{"speaker":"Chris Dy","startTime":411.63,"endTime":414.12,"body":"you know, one of our former"},{"speaker":"Chris Dy","startTime":414.12,"endTime":417.63,"body":"partners and mentors, Dr."},{"speaker":"Chris Dy","startTime":414.12,"endTime":417.63,"body":"Goldman would always tell me in"},{"speaker":"Chris Dy","startTime":417.63,"endTime":422.97,"body":"clinic, Chris, the buck stops"},{"speaker":"Chris Dy","startTime":417.63,"endTime":422.97,"body":"here. If you don't figure this"},{"speaker":"Chris Dy","startTime":422.97,"endTime":426.06,"body":"out, nobody else will. I"},{"speaker":"Chris Dy","startTime":422.97,"endTime":426.06,"body":"remember that every day."},{"speaker":"Charles Goldfarb","startTime":426.33,"endTime":429.69,"body":"Well, it's"},{"speaker":"Charles Goldfarb","startTime":426.33,"endTime":429.69,"body":"true. i That's another good"},{"speaker":"Charles Goldfarb","startTime":429.69,"endTime":432.21,"body":"topic to discuss, you know, what"},{"speaker":"Charles Goldfarb","startTime":429.69,"endTime":432.21,"body":"do you do when you can't figure"},{"speaker":"Charles Goldfarb","startTime":432.21,"endTime":435.45,"body":"things out? What do you order?"},{"speaker":"Charles Goldfarb","startTime":432.21,"endTime":435.45,"body":"Who do you console, there's all"},{"speaker":"Charles Goldfarb","startTime":435.45,"endTime":438.72,"body":"kinds of strategies that we've"},{"speaker":"Charles Goldfarb","startTime":435.45,"endTime":438.72,"body":"developed, I'm sure you think"},{"speaker":"Charles Goldfarb","startTime":438.72,"endTime":441.99,"body":"about things differently than I"},{"speaker":"Charles Goldfarb","startTime":438.72,"endTime":441.99,"body":"do. But ultimately owning it."},{"speaker":"Charles Goldfarb","startTime":442.17,"endTime":445.14,"body":"And doing your darndest is is"},{"speaker":"Charles Goldfarb","startTime":442.17,"endTime":445.14,"body":"the right approach."},{"speaker":"Chris Dy","startTime":445.59,"endTime":448.95,"body":"Right? Well, thank you"},{"speaker":"Chris Dy","startTime":445.59,"endTime":448.95,"body":"for for those that wrote into,"},{"speaker":"Chris Dy","startTime":449.22,"endTime":455.79,"body":"in reply to the, the, the"},{"speaker":"Chris Dy","startTime":449.22,"endTime":455.79,"body":"listserv about episode feedback"},{"speaker":"Chris Dy","startTime":455.79,"endTime":460.35,"body":"and suggestions. I have a"},{"speaker":"Chris Dy","startTime":455.79,"endTime":460.35,"body":"question that came out of the"},{"speaker":"Chris Dy","startTime":460.89,"endTime":464.97,"body":"the email account if that's all"},{"speaker":"Chris Dy","startTime":460.89,"endTime":464.97,"body":"right, so it is about thinking"},{"speaker":"Chris Dy","startTime":464.97,"endTime":467.61,"body":"about C5 brachial plexus nerve."},{"speaker":"Charles Goldfarb","startTime":470.49,"endTime":471.84,"body":"Say it isn't"},{"speaker":"Charles Goldfarb","startTime":470.49,"endTime":471.84,"body":"so"},{"speaker":"Chris Dy","startTime":471.96,"endTime":474.24,"body":"now, but it was"},{"speaker":"Chris Dy","startTime":471.96,"endTime":474.24,"body":"actually spurred about by"},{"speaker":"Chris Dy","startTime":474.27,"endTime":477.21,"body":"listening to the radial nerve,"},{"speaker":"Chris Dy","startTime":474.27,"endTime":477.21,"body":"tendon, trans versus nerve"},{"speaker":"Chris Dy","startTime":477.21,"endTime":480.36,"body":"transfer episode. And this is"},{"speaker":"Chris Dy","startTime":477.21,"endTime":480.36,"body":"from Nick Coudray. Sorry, Nick,"},{"speaker":"Chris Dy","startTime":480.36,"endTime":483.3,"body":"if I didn't pronounce your last"},{"speaker":"Chris Dy","startTime":480.36,"endTime":483.3,"body":"name properly. He's actually an"},{"speaker":"Chris Dy","startTime":483.3,"endTime":485.82,"body":"outpatient ot up in our neck of"},{"speaker":"Chris Dy","startTime":483.3,"endTime":485.82,"body":"the woods. He's up in North"},{"speaker":"Chris Dy","startTime":485.82,"endTime":489.24,"body":"County. So you've seen some of"},{"speaker":"Chris Dy","startTime":485.82,"endTime":489.24,"body":"our patients too. And he's seen"},{"speaker":"Chris Dy","startTime":489.24,"endTime":491.91,"body":"one of my Plexus patients and"},{"speaker":"Chris Dy","startTime":489.24,"endTime":491.91,"body":"was just asking, in terms of"},{"speaker":"Chris Dy","startTime":491.91,"endTime":496.71,"body":"timing, you know, what, what you"},{"speaker":"Chris Dy","startTime":491.91,"endTime":496.71,"body":"expect in terms of the recovery"},{"speaker":"Chris Dy","startTime":496.71,"endTime":499.47,"body":"timeline after for nerve"},{"speaker":"Chris Dy","startTime":496.71,"endTime":499.47,"body":"transfers that I think that"},{"speaker":"Chris Dy","startTime":499.5,"endTime":503.01,"body":"probably it, in theory is a"},{"speaker":"Chris Dy","startTime":499.5,"endTime":503.01,"body":"little similar. But a lot of it"},{"speaker":"Chris Dy","startTime":503.01,"endTime":505.56,"body":"depends on the distance to"},{"speaker":"Chris Dy","startTime":503.01,"endTime":505.56,"body":"target in terms of you know, how"},{"speaker":"Chris Dy","startTime":505.56,"endTime":509.07,"body":"far the nerve has to regrow to"},{"speaker":"Chris Dy","startTime":505.56,"endTime":509.07,"body":"get to the muscle, and then how"},{"speaker":"Chris Dy","startTime":509.07,"endTime":511.17,"body":"long it takes to mature there"},{"speaker":"Chris Dy","startTime":509.07,"endTime":511.17,"body":"are certain nerve transfers that"},{"speaker":"Chris Dy","startTime":511.17,"endTime":514.65,"body":"just take a longer time to"},{"speaker":"Chris Dy","startTime":511.17,"endTime":514.65,"body":"mature, even once it re"},{"speaker":"Chris Dy","startTime":514.65,"endTime":517.8,"body":"innovation has actually started."},{"speaker":"Chris Dy","startTime":514.65,"endTime":517.8,"body":"And that process has has begun"},{"speaker":"Chris Dy","startTime":517.8,"endTime":521.52,"body":"when the nervous hit the muscle."},{"speaker":"Chris Dy","startTime":517.8,"endTime":521.52,"body":"I don't know have you noticed a"},{"speaker":"Chris Dy","startTime":521.52,"endTime":526.35,"body":"big difference in terms of"},{"speaker":"Chris Dy","startTime":521.52,"endTime":526.35,"body":"certain nerve regeneration over"},{"speaker":"Chris Dy","startTime":526.35,"endTime":528.78,"body":"the years and when you are"},{"speaker":"Chris Dy","startTime":526.35,"endTime":528.78,"body":"treating more of the traumatic"},{"speaker":"Chris Dy","startTime":528.78,"endTime":529.47,"body":"nerve injuries?"},{"speaker":"Charles Goldfarb","startTime":530.7,"endTime":535.2,"body":"Well, I mean,"},{"speaker":"Charles Goldfarb","startTime":530.7,"endTime":535.2,"body":"I assume my sense, I hope my"},{"speaker":"Charles Goldfarb","startTime":535.2,"endTime":538.89,"body":"sense is accurate, in that I"},{"speaker":"Charles Goldfarb","startTime":535.2,"endTime":538.89,"body":"find radio, it's not just"},{"speaker":"Charles Goldfarb","startTime":538.89,"endTime":541.65,"body":"distance in which I where I'm"},{"speaker":"Charles Goldfarb","startTime":538.89,"endTime":541.65,"body":"trying to interpret it. It's not"},{"speaker":"Charles Goldfarb","startTime":541.65,"endTime":544.77,"body":"just about distance to"},{"speaker":"Charles Goldfarb","startTime":541.65,"endTime":544.77,"body":"innovation point. It's just the"},{"speaker":"Charles Goldfarb","startTime":544.77,"endTime":548.01,"body":"nerve itself has intrinsic"},{"speaker":"Charles Goldfarb","startTime":544.77,"endTime":548.01,"body":"characteristics, which might be"},{"speaker":"Charles Goldfarb","startTime":548.01,"endTime":552.84,"body":"slower or faster. Yeah. For me,"},{"speaker":"Charles Goldfarb","startTime":548.01,"endTime":552.84,"body":"it's radial nerve, faster than"},{"speaker":"Charles Goldfarb","startTime":552.84,"endTime":555.93,"body":"median nerve faster than older"},{"speaker":"Charles Goldfarb","startTime":552.84,"endTime":555.93,"body":"nerve. But I would love to be"},{"speaker":"Charles Goldfarb","startTime":555.93,"endTime":557.13,"body":"corrected if I have that wrong."},{"speaker":"Chris Dy","startTime":558.09,"endTime":559.68,"body":"No, I think that's"},{"speaker":"Chris Dy","startTime":558.09,"endTime":559.68,"body":"right. I think the one of the"},{"speaker":"Chris Dy","startTime":559.68,"endTime":563.37,"body":"challenges I think with the"},{"speaker":"Chris Dy","startTime":559.68,"endTime":563.37,"body":"radial nerve is that it's um, if"},{"speaker":"Chris Dy","startTime":563.37,"endTime":566.16,"body":"you was actually looking at the"},{"speaker":"Chris Dy","startTime":563.37,"endTime":566.16,"body":"radial nerve today during a"},{"speaker":"Chris Dy","startTime":566.16,"endTime":572.01,"body":"nerve transfer case, it's such a"},{"speaker":"Chris Dy","startTime":566.16,"endTime":572.01,"body":"I mean, it's so nerdy. It's it"},{"speaker":"Chris Dy","startTime":572.01,"endTime":574.56,"body":"such a fascinating nerve, like"},{"speaker":"Chris Dy","startTime":572.01,"endTime":574.56,"body":"when you look at it, like right"},{"speaker":"Chris Dy","startTime":574.56,"endTime":577.83,"body":"at the so called spiral groove"},{"speaker":"Chris Dy","startTime":574.56,"endTime":577.83,"body":"that doesn't isn't really a"},{"speaker":"Chris Dy","startTime":577.83,"endTime":582.54,"body":"groove. But yeah, when you look"},{"speaker":"Chris Dy","startTime":577.83,"endTime":582.54,"body":"at it there, it's just got so"},{"speaker":"Chris Dy","startTime":582.54,"endTime":589.2,"body":"much fat. And it's not as it's"},{"speaker":"Chris Dy","startTime":582.54,"endTime":589.2,"body":"not as nice, organized and"},{"speaker":"Chris Dy","startTime":589.2,"endTime":593.94,"body":"defined set of tubes. Like the"},{"speaker":"Chris Dy","startTime":589.2,"endTime":593.94,"body":"ulnar nerve is in the breaking"},{"speaker":"Chris Dy","startTime":593.94,"endTime":596.1,"body":"like the media nervous into"},{"speaker":"Chris Dy","startTime":593.94,"endTime":596.1,"body":"breaking them and I think that's"},{"speaker":"Chris Dy","startTime":596.1,"endTime":600.12,"body":"probably why the radial nerve"},{"speaker":"Chris Dy","startTime":596.1,"endTime":600.12,"body":"responds differently to ver"},{"speaker":"Chris Dy","startTime":600.12,"endTime":603.51,"body":"Higher proximal repairs or"},{"speaker":"Chris Dy","startTime":600.12,"endTime":603.51,"body":"reconstructions, there's"},{"speaker":"Chris Dy","startTime":603.51,"endTime":606.81,"body":"something about the fat content"},{"speaker":"Chris Dy","startTime":603.51,"endTime":606.81,"body":"of that nerve, the soft, the"},{"speaker":"Chris Dy","startTime":607.32,"endTime":611.79,"body":"soft tissue around the nerve,"},{"speaker":"Chris Dy","startTime":607.32,"endTime":611.79,"body":"the me scenario, etc. That makes"},{"speaker":"Chris Dy","startTime":611.79,"endTime":614.19,"body":"a little more challenging to"},{"speaker":"Chris Dy","startTime":611.79,"endTime":614.19,"body":"align that properly and probably"},{"speaker":"Chris Dy","startTime":614.19,"endTime":618.45,"body":"has some implications for actual"},{"speaker":"Chris Dy","startTime":614.19,"endTime":618.45,"body":"nerve regeneration. But I think"},{"speaker":"Chris Dy","startTime":618.45,"endTime":621.6,"body":"as your more distal Yes, I agree"},{"speaker":"Chris Dy","startTime":618.45,"endTime":621.6,"body":"with exactly what you said in"},{"speaker":"Chris Dy","startTime":621.6,"endTime":625.83,"body":"terms of how nerve flow respond."},{"speaker":"Chris Dy","startTime":621.6,"endTime":625.83,"body":"But even as you you know, some"},{"speaker":"Chris Dy","startTime":625.83,"endTime":629.4,"body":"of the papers that look at"},{"speaker":"Chris Dy","startTime":625.83,"endTime":629.4,"body":"reconstructing and grafting"},{"speaker":"Chris Dy","startTime":629.4,"endTime":632.43,"body":"radial nerves and a distal half"},{"speaker":"Chris Dy","startTime":629.4,"endTime":632.43,"body":"and distal third of the"},{"speaker":"Chris Dy","startTime":632.43,"endTime":635.28,"body":"brachial, they do better than"},{"speaker":"Chris Dy","startTime":632.43,"endTime":635.28,"body":"people that are more proximal"},{"speaker":"Chris Dy","startTime":635.31,"endTime":637.53,"body":"and that might be distances"},{"speaker":"Chris Dy","startTime":635.31,"endTime":637.53,"body":"target that might be because the"},{"speaker":"Chris Dy","startTime":637.53,"endTime":641.22,"body":"nerve just becomes more"},{"speaker":"Chris Dy","startTime":637.53,"endTime":641.22,"body":"structured and more like the"},{"speaker":"Chris Dy","startTime":641.22,"endTime":643.62,"body":"median and ulnar nerve as you"},{"speaker":"Chris Dy","startTime":641.22,"endTime":643.62,"body":"get into the lower half just"},{"speaker":"Chris Dy","startTime":643.62,"endTime":644.4,"body":"above the elbow."},{"speaker":"Charles Goldfarb","startTime":645.51,"endTime":648.0,"body":"So I have to"},{"speaker":"Charles Goldfarb","startTime":645.51,"endTime":648.0,"body":"ask you a question. Where are"},{"speaker":"Charles Goldfarb","startTime":648.0,"endTime":652.08,"body":"you in that? Here's what here's"},{"speaker":"Charles Goldfarb","startTime":648.0,"endTime":652.08,"body":"what I'm visualizing. Dr. Dy is"},{"speaker":"Charles Goldfarb","startTime":652.08,"endTime":655.35,"body":"in the or he's looking at the"},{"speaker":"Charles Goldfarb","startTime":652.08,"endTime":655.35,"body":"radial nerve, and all of a"},{"speaker":"Charles Goldfarb","startTime":655.35,"endTime":659.43,"body":"sudden, someone is snapping,"},{"speaker":"Charles Goldfarb","startTime":655.35,"endTime":659.43,"body":"say, Dr. Dy Dr. Dy, come back"},{"speaker":"Charles Goldfarb","startTime":659.43,"endTime":660.09,"body":"with us."},{"speaker":"Chris Dy","startTime":661.47,"endTime":663.72,"body":"I did actually say I"},{"speaker":"Chris Dy","startTime":661.47,"endTime":663.72,"body":"was like, in radial nerve is so"},{"speaker":"Chris Dy","startTime":663.72,"endTime":666.42,"body":"fascinating. She said that out"},{"speaker":"Chris Dy","startTime":663.72,"endTime":666.42,"body":"loud. I can't believe I just"},{"speaker":"Chris Dy","startTime":666.42,"endTime":669.6,"body":"said that. But yes, they had to"},{"speaker":"Chris Dy","startTime":666.42,"endTime":669.6,"body":"they had to bring me back, bring"},{"speaker":"Chris Dy","startTime":669.6,"endTime":672.72,"body":"me back to the moment, we talked"},{"speaker":"Chris Dy","startTime":669.6,"endTime":672.72,"body":"about being present in our last"},{"speaker":"Chris Dy","startTime":672.72,"endTime":677.52,"body":"episode. I was I was off in my"},{"speaker":"Chris Dy","startTime":672.72,"endTime":677.52,"body":"own world, thinking about the"},{"speaker":"Chris Dy","startTime":677.52,"endTime":678.12,"body":"radial nerve"},{"speaker":"Charles Goldfarb","startTime":678.45,"endTime":680.43,"body":"is you know,"},{"speaker":"Charles Goldfarb","startTime":678.45,"endTime":680.43,"body":"when someone loves nerves, they"},{"speaker":"Charles Goldfarb","startTime":680.43,"endTime":683.31,"body":"love nerve and you know, we just"},{"speaker":"Charles Goldfarb","startTime":680.43,"endTime":683.31,"body":"have to accept that about you."},{"speaker":"Chris Dy","startTime":683.52,"endTime":687.12,"body":"Excited, it's a, it is"},{"speaker":"Chris Dy","startTime":683.52,"endTime":687.12,"body":"something that you just got to"},{"speaker":"Chris Dy","startTime":687.12,"endTime":690.9,"body":"deal with. It will say one more"},{"speaker":"Chris Dy","startTime":687.12,"endTime":690.9,"body":"one more listener email."},{"speaker":"Charles Goldfarb","startTime":691.5,"endTime":692.67,"body":"We answer the"},{"speaker":"Charles Goldfarb","startTime":691.5,"endTime":692.67,"body":"question, though,"},{"speaker":"Chris Dy","startTime":692.76,"endTime":695.79,"body":"I don't even remember."},{"speaker":"Chris Dy","startTime":692.76,"endTime":695.79,"body":"I think we did. I mean, Plexus"},{"speaker":"Chris Dy","startTime":695.79,"endTime":699.12,"body":"is such a, you know, grab bag in"},{"speaker":"Chris Dy","startTime":695.79,"endTime":699.12,"body":"terms of you know, you don't"},{"speaker":"Chris Dy","startTime":699.12,"endTime":701.85,"body":"always have your routine"},{"speaker":"Chris Dy","startTime":699.12,"endTime":701.85,"body":"transfers, you know, in terms of"},{"speaker":"Chris Dy","startTime":701.88,"endTime":704.91,"body":"yes, sometimes you can do your"},{"speaker":"Chris Dy","startTime":701.88,"endTime":704.91,"body":"classic Psalm sack triceps, the"},{"speaker":"Chris Dy","startTime":704.91,"endTime":707.52,"body":"axillary and your double"},{"speaker":"Chris Dy","startTime":704.91,"endTime":707.52,"body":"overland or double for circular,"},{"speaker":"Chris Dy","startTime":707.52,"endTime":710.19,"body":"whatever you want to call it."},{"speaker":"Chris Dy","startTime":707.52,"endTime":710.19,"body":"Sometimes you don't have that."},{"speaker":"Chris Dy","startTime":710.37,"endTime":713.82,"body":"And you're dealing with what you"},{"speaker":"Chris Dy","startTime":710.37,"endTime":713.82,"body":"what's available. And I think"},{"speaker":"Chris Dy","startTime":713.82,"endTime":717.96,"body":"that's the allure and the"},{"speaker":"Chris Dy","startTime":713.82,"endTime":717.96,"body":"challenge, all in one. But the"},{"speaker":"Chris Dy","startTime":717.96,"endTime":720.69,"body":"lack of predictability will"},{"speaker":"Chris Dy","startTime":717.96,"endTime":720.69,"body":"drive some people a little bit"},{"speaker":"Chris Dy","startTime":720.69,"endTime":722.55,"body":"crazy, especially if you're in"},{"speaker":"Chris Dy","startTime":720.69,"endTime":722.55,"body":"the therapy side of it."},{"speaker":"Charles Goldfarb","startTime":723.69,"endTime":725.43,"body":"That is fair,"},{"speaker":"Charles Goldfarb","startTime":723.69,"endTime":725.43,"body":"that is fair. Well said."},{"speaker":"Chris Dy","startTime":726.24,"endTime":728.46,"body":"There's one more email"},{"speaker":"Chris Dy","startTime":726.24,"endTime":728.46,"body":"I wanted to go through. Dr."},{"speaker":"Chris Dy","startTime":728.46,"endTime":732.15,"body":"Sarah Shippers is a freshly"},{"speaker":"Chris Dy","startTime":728.46,"endTime":732.15,"body":"minted orthopedic cancer and in"},{"speaker":"Chris Dy","startTime":732.15,"endTime":735.09,"body":"first year in practice, and"},{"speaker":"Chris Dy","startTime":732.15,"endTime":735.09,"body":"really enjoyed the the radial"},{"speaker":"Chris Dy","startTime":735.09,"endTime":738.24,"body":"nerve, tendon versus nerve"},{"speaker":"Chris Dy","startTime":735.09,"endTime":738.24,"body":"episodes, and especially the"},{"speaker":"Chris Dy","startTime":738.24,"endTime":741.39,"body":"therapy episode, because now she"},{"speaker":"Chris Dy","startTime":738.24,"endTime":741.39,"body":"has a podcast that she can"},{"speaker":"Chris Dy","startTime":741.48,"endTime":745.53,"body":"resource she can send her"},{"speaker":"Chris Dy","startTime":741.48,"endTime":745.53,"body":"therapists to, since they may"},{"speaker":"Chris Dy","startTime":745.53,"endTime":749.34,"body":"not see this kind of rehab on a"},{"speaker":"Chris Dy","startTime":745.53,"endTime":749.34,"body":"regular basis. So she's very"},{"speaker":"Chris Dy","startTime":749.34,"endTime":752.52,"body":"happy about that. And she"},{"speaker":"Chris Dy","startTime":749.34,"endTime":752.52,"body":"thanked us for our dedication to"},{"speaker":"Chris Dy","startTime":752.52,"endTime":754.89,"body":"hand surgery education. So"},{"speaker":"Chris Dy","startTime":752.52,"endTime":754.89,"body":"that's very kind of you, Sarah,"},{"speaker":"Chris Dy","startTime":754.89,"endTime":757.29,"body":"thank you for sending that. When"},{"speaker":"Chris Dy","startTime":754.89,"endTime":757.29,"body":"you did."},{"speaker":"Charles Goldfarb","startTime":758.01,"endTime":759.93,"body":"Absolutely. I"},{"speaker":"Charles Goldfarb","startTime":758.01,"endTime":759.93,"body":"thought there was a question in"},{"speaker":"Charles Goldfarb","startTime":759.93,"endTime":761.22,"body":"there. Oh, no, I"},{"speaker":"Chris Dy","startTime":761.22,"endTime":762.9,"body":"just wanted to thank"},{"speaker":"Chris Dy","startTime":761.22,"endTime":762.9,"body":"you for all that you've done,"},{"speaker":"Chris Dy","startTime":762.9,"endTime":764.01,"body":"Chuck. Oh,"},{"speaker":"Charles Goldfarb","startTime":764.01,"endTime":766.56,"body":"I love that."},{"speaker":"Charles Goldfarb","startTime":764.01,"endTime":766.56,"body":"That's so nice. Good luck. And"},{"speaker":"Charles Goldfarb","startTime":767.01,"endTime":771.66,"body":"hopefully the upper hand Podcast"},{"speaker":"Charles Goldfarb","startTime":767.01,"endTime":771.66,"body":"is your partner in this career"},{"speaker":"Charles Goldfarb","startTime":771.66,"endTime":772.2,"body":"journey."},{"speaker":"Chris Dy","startTime":773.77,"endTime":777.61,"body":"And I agree with that."},{"speaker":"Chris Dy","startTime":773.77,"endTime":777.61,"body":"And the upper hand podcast is"},{"speaker":"Chris Dy","startTime":777.61,"endTime":781.81,"body":"sponsored by practicelink.com."},{"speaker":"Chris Dy","startTime":777.61,"endTime":781.81,"body":"It was widely used physician job"},{"speaker":"Chris Dy","startTime":781.81,"endTime":784.18,"body":"search and career advancement"},{"speaker":"Chris Dy","startTime":781.81,"endTime":784.18,"body":"resource."},{"speaker":"Charles Goldfarb","startTime":784.99,"endTime":787.81,"body":"Nice, nice,"},{"speaker":"Charles Goldfarb","startTime":784.99,"endTime":787.81,"body":"nice. Becoming a physician is"},{"speaker":"Charles Goldfarb","startTime":787.81,"endTime":791.71,"body":"hard. Finding the right job"},{"speaker":"Charles Goldfarb","startTime":787.81,"endTime":791.71,"body":"doesn't have to be joined"},{"speaker":"Charles Goldfarb","startTime":791.71,"endTime":797.11,"body":"practice link for free today at"},{"speaker":"Charles Goldfarb","startTime":791.71,"endTime":797.11,"body":"www.practicelink.com/theupperhand,"},{"speaker":"Charles Goldfarb","startTime":797.47,"endTime":801.16,"body":"just go to the site and look at"},{"speaker":"Charles Goldfarb","startTime":797.47,"endTime":801.16,"body":"it. It's pretty impressive. I'm"},{"speaker":"Charles Goldfarb","startTime":801.16,"endTime":803.68,"body":"not telling you to switch jobs,"},{"speaker":"Charles Goldfarb","startTime":801.16,"endTime":803.68,"body":"but it's always nice to know"},{"speaker":"Charles Goldfarb","startTime":803.68,"endTime":804.46,"body":"what's out there."},{"speaker":"Chris Dy","startTime":805.42,"endTime":808.96,"body":"Yeah, let me go look."},{"speaker":"Chris Dy","startTime":805.42,"endTime":808.96,"body":"Now Chuck, good to see you"},{"speaker":"Chris Dy","startTime":808.96,"endTime":809.35,"body":"later."},{"speaker":"Charles Goldfarb","startTime":810.79,"endTime":813.58,"body":"So speaking of"},{"speaker":"Charles Goldfarb","startTime":810.79,"endTime":813.58,"body":"switching jobs, can we can we"},{"speaker":"Charles Goldfarb","startTime":813.58,"endTime":817.3,"body":"digress? Is it appropriate? For"},{"speaker":"Charles Goldfarb","startTime":813.58,"endTime":817.3,"body":"me to digress and talk about the"},{"speaker":"Charles Goldfarb","startTime":817.3,"endTime":819.76,"body":"NBA trade deadline? How exciting"},{"speaker":"Charles Goldfarb","startTime":817.3,"endTime":819.76,"body":"that"},{"speaker":"Chris Dy","startTime":819.79,"endTime":823.09,"body":"wow, that's yes. I was"},{"speaker":"Chris Dy","startTime":819.79,"endTime":823.09,"body":"just talking with somebody about"},{"speaker":"Chris Dy","startTime":823.09,"endTime":825.4,"body":"how the Brooklyn Nets you know,"},{"speaker":"Chris Dy","startTime":823.09,"endTime":825.4,"body":"basically tilt their entire"},{"speaker":"Chris Dy","startTime":825.46,"endTime":826.0,"body":"roster."},{"speaker":"Charles Goldfarb","startTime":826.93,"endTime":829.42,"body":"Yeah. Oh, my"},{"speaker":"Charles Goldfarb","startTime":826.93,"endTime":829.42,"body":"goodness. You know, it is"},{"speaker":"Charles Goldfarb","startTime":829.42,"endTime":832.51,"body":"interesting that there was so"},{"speaker":"Charles Goldfarb","startTime":829.42,"endTime":832.51,"body":"much excitement around the NBA"},{"speaker":"Charles Goldfarb","startTime":832.72,"endTime":835.39,"body":"during Super Bowl week, which by"},{"speaker":"Charles Goldfarb","startTime":832.72,"endTime":835.39,"body":"the time this episode drops,"},{"speaker":"Charles Goldfarb","startTime":835.39,"endTime":840.61,"body":"it's going to be long over. But"},{"speaker":"Charles Goldfarb","startTime":835.39,"endTime":840.61,"body":"in the in the NBA I really enjoy"},{"speaker":"Charles Goldfarb","startTime":840.61,"endTime":843.19,"body":"in part because it's can be so"},{"speaker":"Charles Goldfarb","startTime":840.61,"endTime":843.19,"body":"unpredictable."},{"speaker":"Chris Dy","startTime":843.7,"endTime":847.99,"body":"Yes, yes, the word"},{"speaker":"Chris Dy","startTime":843.7,"endTime":847.99,"body":"shitshow often comes up is"},{"speaker":"Chris Dy","startTime":847.99,"endTime":851.14,"body":"interesting. How do you feel I"},{"speaker":"Chris Dy","startTime":847.99,"endTime":851.14,"body":"mean, this is not a sports"},{"speaker":"Chris Dy","startTime":851.14,"endTime":855.58,"body":"podcast, or at least what actual"},{"speaker":"Chris Dy","startTime":851.14,"endTime":855.58,"body":"sports but you are an expert in"},{"speaker":"Chris Dy","startTime":856.33,"endTime":860.08,"body":"in basketball. So do you think"},{"speaker":"Chris Dy","startTime":856.33,"endTime":860.08,"body":"these are good moves made by the"},{"speaker":"Chris Dy","startTime":860.08,"endTime":863.29,"body":"teams that you know are the Suns"},{"speaker":"Chris Dy","startTime":860.08,"endTime":863.29,"body":"gonna be happy or the man is"},{"speaker":"Chris Dy","startTime":863.29,"endTime":864.07,"body":"going to be happy?"},{"speaker":"Charles Goldfarb","startTime":864.85,"endTime":866.35,"body":"The Suns are"},{"speaker":"Charles Goldfarb","startTime":864.85,"endTime":866.35,"body":"going to be happy if everyone"},{"speaker":"Charles Goldfarb","startTime":866.35,"endTime":869.32,"body":"stays healthy, and they I would"},{"speaker":"Charles Goldfarb","startTime":866.35,"endTime":869.32,"body":"predict they'll come out of the"},{"speaker":"Charles Goldfarb","startTime":869.32,"endTime":873.43,"body":"west and play the Boston Celtics"},{"speaker":"Charles Goldfarb","startTime":869.32,"endTime":873.43,"body":"if everyone's healthy, my Golden"},{"speaker":"Charles Goldfarb","startTime":873.43,"endTime":877.54,"body":"State Warriors it's looking like"},{"speaker":"Charles Goldfarb","startTime":873.43,"endTime":877.54,"body":"an uphill uphill battle for"},{"speaker":"Charles Goldfarb","startTime":877.54,"endTime":883.24,"body":"them. Dallas and now you know"},{"speaker":"Charles Goldfarb","startTime":877.54,"endTime":883.24,"body":"with Kyrie you know, we don't"},{"speaker":"Charles Goldfarb","startTime":883.24,"endTime":885.55,"body":"want to get too detailed here"},{"speaker":"Charles Goldfarb","startTime":883.24,"endTime":885.55,"body":"that that one's gonna be a tough"},{"speaker":"Charles Goldfarb","startTime":885.55,"endTime":888.94,"body":"one. So a lot of excitement"},{"speaker":"Charles Goldfarb","startTime":885.55,"endTime":888.94,"body":"around the trade deadline which"},{"speaker":"Charles Goldfarb","startTime":888.94,"endTime":892.06,"body":"just makes the NBA more"},{"speaker":"Charles Goldfarb","startTime":888.94,"endTime":892.06,"body":"exciting. And I was thinking on"},{"speaker":"Charles Goldfarb","startTime":892.06,"endTime":894.97,"body":"my drive in as I was listening"},{"speaker":"Charles Goldfarb","startTime":892.06,"endTime":894.97,"body":"to one of my favorite podcasts"},{"speaker":"Charles Goldfarb","startTime":895.0,"endTime":898.69,"body":"aside from this one. Bill"},{"speaker":"Charles Goldfarb","startTime":895.0,"endTime":898.69,"body":"Simmons who talks about really"},{"speaker":"Charles Goldfarb","startTime":898.69,"endTime":902.86,"body":"the NFL and the NBA and and it's"},{"speaker":"Charles Goldfarb","startTime":898.69,"endTime":902.86,"body":"just there's so many characters"},{"speaker":"Charles Goldfarb","startTime":902.89,"endTime":906.67,"body":"and I was trying to think NBA"},{"speaker":"Charles Goldfarb","startTime":902.89,"endTime":906.67,"body":"characters are there those same"},{"speaker":"Charles Goldfarb","startTime":906.67,"endTime":910.0,"body":"characters in the hand society"},{"speaker":"Charles Goldfarb","startTime":906.67,"endTime":910.0,"body":"that we just don't know about?"},{"speaker":"Chris Dy","startTime":910.27,"endTime":912.1,"body":"For sure. I will not"},{"speaker":"Chris Dy","startTime":910.27,"endTime":912.1,"body":"tell you I think the Kyrie"},{"speaker":"Chris Dy","startTime":912.1,"endTime":916.21,"body":"Irving of the hits. That thought"},{"speaker":"Chris Dy","startTime":912.1,"endTime":916.21,"body":"did cross my mind. And I"},{"speaker":"Chris Dy","startTime":916.21,"endTime":917.74,"body":"actually had a sense you were"},{"speaker":"Chris Dy","startTime":916.21,"endTime":917.74,"body":"going there."},{"speaker":"Charles Goldfarb","startTime":918.91,"endTime":921.07,"body":"That is so"},{"speaker":"Charles Goldfarb","startTime":918.91,"endTime":921.07,"body":"funny. I'm sure we all have our"},{"speaker":"Charles Goldfarb","startTime":921.07,"endTime":924.94,"body":"little, yes, this person is x"},{"speaker":"Charles Goldfarb","startTime":921.07,"endTime":924.94,"body":"and that person's y? Because he"},{"speaker":"Charles Goldfarb","startTime":924.94,"endTime":927.58,"body":"answered you super exciting"},{"speaker":"Charles Goldfarb","startTime":924.94,"endTime":927.58,"body":"Doctor Dy, and it's just as"},{"speaker":"Charles Goldfarb","startTime":927.58,"endTime":928.51,"body":"exciting as the NBA,"},{"speaker":"Chris Dy","startTime":928.619,"endTime":932.429,"body":"or nerdy or nerdy"},{"speaker":"Chris Dy","startTime":928.619,"endTime":932.429,"body":"little world. So I'm gonna, I'm"},{"speaker":"Chris Dy","startTime":932.429,"endTime":934.649,"body":"gonna say something, sometimes"},{"speaker":"Chris Dy","startTime":932.429,"endTime":934.649,"body":"you say something out loud,"},{"speaker":"Chris Dy","startTime":934.649,"endTime":937.289,"body":"hoping that it comes, you know,"},{"speaker":"Chris Dy","startTime":934.649,"endTime":937.289,"body":"to keep yourself accountable. So"},{"speaker":"Chris Dy","startTime":937.289,"endTime":940.319,"body":"it will come true. I'm gonna say"},{"speaker":"Chris Dy","startTime":937.289,"endTime":940.319,"body":"something out loud in hopes that"},{"speaker":"Chris Dy","startTime":940.319,"endTime":945.479,"body":"it doesn't come true. So in"},{"speaker":"Chris Dy","startTime":940.319,"endTime":945.479,"body":"right now, my role as fourth"},{"speaker":"Chris Dy","startTime":945.509,"endTime":949.949,"body":"assistant coach of the first"},{"speaker":"Chris Dy","startTime":945.509,"endTime":949.949,"body":"grade basketball team of my kids"},{"speaker":"Chris Dy","startTime":949.949,"endTime":955.079,"body":"team, they have, of course, put"},{"speaker":"Chris Dy","startTime":949.949,"endTime":955.079,"body":"practices on Thursdays at 3pm,"},{"speaker":"Chris Dy","startTime":955.079,"endTime":958.079,"body":"which means I can never ever"},{"speaker":"Chris Dy","startTime":955.079,"endTime":958.079,"body":"make it like come on guys, like"},{"speaker":"Chris Dy","startTime":958.079,"endTime":959.819,"body":"seriously, like, couldn't even"},{"speaker":"Chris Dy","startTime":958.079,"endTime":959.819,"body":"do like an extra hour later."},{"speaker":"Chris Dy","startTime":959.819,"endTime":965.249,"body":"But, but I actually happen to"},{"speaker":"Chris Dy","startTime":959.819,"endTime":965.249,"body":"make it yesterday, which was"},{"speaker":"Chris Dy","startTime":965.249,"endTime":970.169,"body":"super exciting, because my son"},{"speaker":"Chris Dy","startTime":965.249,"endTime":970.169,"body":"was jazz that I was there. And"},{"speaker":"Chris Dy","startTime":970.169,"endTime":972.839,"body":"some of the some of the coaches"},{"speaker":"Chris Dy","startTime":970.169,"endTime":972.839,"body":"and dads were talking about"},{"speaker":"Chris Dy","startTime":972.869,"endTime":976.439,"body":"setting up a little pickup game,"},{"speaker":"Chris Dy","startTime":972.869,"endTime":976.439,"body":"you know, on one of the"},{"speaker":"Chris Dy","startTime":976.439,"endTime":980.609,"body":"weeknights, and I am totally in,"},{"speaker":"Chris Dy","startTime":976.439,"endTime":980.609,"body":"but I'm gonna put it out here"},{"speaker":"Chris Dy","startTime":980.609,"endTime":983.279,"body":"that I really do not want my"},{"speaker":"Chris Dy","startTime":980.609,"endTime":983.279,"body":"Achilles tendon rupture, because"},{"speaker":"Chris Dy","startTime":983.279,"endTime":987.899,"body":"I feel like that is the setup. I"},{"speaker":"Chris Dy","startTime":983.279,"endTime":987.899,"body":"like I pride myself in being in"},{"speaker":"Chris Dy","startTime":987.899,"endTime":990.839,"body":"very reasonable shape. And I can"},{"speaker":"Chris Dy","startTime":987.899,"endTime":990.839,"body":"do a lot of things. But I think"},{"speaker":"Chris Dy","startTime":990.839,"endTime":993.119,"body":"the sprinting and the stop,"},{"speaker":"Chris Dy","startTime":990.839,"endTime":993.119,"body":"start up and down the court"},{"speaker":"Chris Dy","startTime":993.119,"endTime":994.439,"body":"might be a little too much for"},{"speaker":"Chris Dy","startTime":993.119,"endTime":994.439,"body":"me."},{"speaker":"Charles Goldfarb","startTime":994.89,"endTime":997.47,"body":"Oh, it's not"},{"speaker":"Charles Goldfarb","startTime":994.89,"endTime":997.47,"body":"too much your strength will be"},{"speaker":"Charles Goldfarb","startTime":997.47,"endTime":1001.49,"body":"just that. If you warm up"},{"speaker":"Charles Goldfarb","startTime":997.47,"endTime":1001.49,"body":"appropriately. You know, the"},{"speaker":"Charles Goldfarb","startTime":1001.49,"endTime":1004.1,"body":"first game, just see what"},{"speaker":"Charles Goldfarb","startTime":1001.49,"endTime":1004.1,"body":"happens after that the other"},{"speaker":"Charles Goldfarb","startTime":1004.1,"endTime":1006.17,"body":"dads are getting tired and"},{"speaker":"Charles Goldfarb","startTime":1004.1,"endTime":1006.17,"body":"you're gonna be going strong."},{"speaker":"Chris Dy","startTime":1006.409,"endTime":1009.169,"body":"Yeah, you know, I need"},{"speaker":"Chris Dy","startTime":1006.409,"endTime":1009.169,"body":"to I need to stretch. That's"},{"speaker":"Chris Dy","startTime":1009.169,"endTime":1012.409,"body":"actually what I need to do. But"},{"speaker":"Chris Dy","startTime":1009.169,"endTime":1012.409,"body":"you know, we've we had a couple"},{"speaker":"Chris Dy","startTime":1012.409,"endTime":1015.109,"body":"of really nice days here"},{"speaker":"Chris Dy","startTime":1012.409,"endTime":1015.109,"body":"recently in St. Louis. And, you"},{"speaker":"Chris Dy","startTime":1015.109,"endTime":1017.869,"body":"know, they're happy with myself."},{"speaker":"Chris Dy","startTime":1015.109,"endTime":1017.869,"body":"I went and banged out an eight"},{"speaker":"Chris Dy","startTime":1017.869,"endTime":1020.839,"body":"mile run in the park. I kind of"},{"speaker":"Chris Dy","startTime":1017.869,"endTime":1020.839,"body":"didn't realize I was going to do"},{"speaker":"Chris Dy","startTime":1020.839,"endTime":1022.789,"body":"that. And I paid for it the next"},{"speaker":"Chris Dy","startTime":1020.839,"endTime":1022.789,"body":"day for sure."},{"speaker":"Charles Goldfarb","startTime":1023.419,"endTime":1026.509,"body":"Wow. But"},{"speaker":"Charles Goldfarb","startTime":1023.419,"endTime":1026.509,"body":"that's great. Yeah, we did have"},{"speaker":"Charles Goldfarb","startTime":1026.509,"endTime":1030.469,"body":"some nice days. And those first"},{"speaker":"Charles Goldfarb","startTime":1026.509,"endTime":1030.469,"body":"few nice days are absolutely"},{"speaker":"Charles Goldfarb","startTime":1030.469,"endTime":1033.169,"body":"inspiring. Hopefully, others"},{"speaker":"Charles Goldfarb","startTime":1030.469,"endTime":1033.169,"body":"across the country are getting"},{"speaker":"Charles Goldfarb","startTime":1033.169,"endTime":1035.899,"body":"to experience the same but it"},{"speaker":"Charles Goldfarb","startTime":1033.169,"endTime":1035.899,"body":"wasn't even that warm. It was"},{"speaker":"Charles Goldfarb","startTime":1035.899,"endTime":1037.909,"body":"like mid 50s. But it was sunny"},{"speaker":"Charles Goldfarb","startTime":1035.899,"endTime":1037.909,"body":"and beautiful."},{"speaker":"Chris Dy","startTime":1037.939,"endTime":1041.629,"body":"Mid 50s is great. Are"},{"speaker":"Chris Dy","startTime":1037.939,"endTime":1041.629,"body":"you kidding me? Our friends in"},{"speaker":"Chris Dy","startTime":1041.629,"endTime":1045.739,"body":"Florida are like yeah, you"},{"speaker":"Chris Dy","startTime":1041.629,"endTime":1045.739,"body":"suckers. So while you we talked"},{"speaker":"Chris Dy","startTime":1045.739,"endTime":1049.129,"body":"about being workaholics and in"},{"speaker":"Chris Dy","startTime":1045.739,"endTime":1049.129,"body":"the last episode, and I will say"},{"speaker":"Chris Dy","startTime":1049.129,"endTime":1053.029,"body":"I'm a bit I've known to be a bit"},{"speaker":"Chris Dy","startTime":1049.129,"endTime":1053.029,"body":"competitive. And, you know, one"},{"speaker":"Chris Dy","startTime":1053.029,"endTime":1057.709,"body":"of our partners, Dr. David"},{"speaker":"Chris Dy","startTime":1053.029,"endTime":1057.709,"body":"Brogan is a marathon runner and"},{"speaker":"Chris Dy","startTime":1057.919,"endTime":1061.279,"body":"very skilled long distance"},{"speaker":"Chris Dy","startTime":1057.919,"endTime":1061.279,"body":"runner. And I always want to"},{"speaker":"Chris Dy","startTime":1061.279,"endTime":1065.029,"body":"tell him, like, you know, I just"},{"speaker":"Chris Dy","startTime":1061.279,"endTime":1065.029,"body":"want to be able to tell him at"},{"speaker":"Chris Dy","startTime":1065.029,"endTime":1068.299,"body":"any point that I could run a"},{"speaker":"Chris Dy","startTime":1065.029,"endTime":1068.299,"body":"half marathon. So I just That's"},{"speaker":"Chris Dy","startTime":1068.299,"endTime":1072.199,"body":"my my crazy fitness goal is to"},{"speaker":"Chris Dy","startTime":1068.299,"endTime":1072.199,"body":"be able to say I just banged out"},{"speaker":"Chris Dy","startTime":1072.199,"endTime":1074.959,"body":"a you know, 13 miles, you know,"},{"speaker":"Chris Dy","startTime":1072.199,"endTime":1074.959,"body":"I still got it, David, I could"},{"speaker":"Chris Dy","startTime":1074.959,"endTime":1075.889,"body":"catch you at some point."},{"speaker":"Charles Goldfarb","startTime":1076.58,"endTime":1079.58,"body":"Here's here's"},{"speaker":"Charles Goldfarb","startTime":1076.58,"endTime":1079.58,"body":"my life advice. Do it now."},{"speaker":"Charles Goldfarb","startTime":1079.61,"endTime":1083.03,"body":"Because when you're old like I"},{"speaker":"Charles Goldfarb","startTime":1079.61,"endTime":1083.03,"body":"am, that ship has sailed. I've"},{"speaker":"Charles Goldfarb","startTime":1083.06,"endTime":1086.09,"body":"finally admitted that ship has"},{"speaker":"Charles Goldfarb","startTime":1083.06,"endTime":1086.09,"body":"sailed. I'd be happy to walk I"},{"speaker":"Charles Goldfarb","startTime":1086.09,"endTime":1086.81,"body":"happen or thought."},{"speaker":"Chris Dy","startTime":1087.59,"endTime":1090.14,"body":"I've gotten my feel. I"},{"speaker":"Chris Dy","startTime":1087.59,"endTime":1090.14,"body":"think I'm done with marathons,"},{"speaker":"Chris Dy","startTime":1090.14,"endTime":1093.14,"body":"although I may meet my midlife"},{"speaker":"Chris Dy","startTime":1090.14,"endTime":1093.14,"body":"crisis. And you know, I had a"},{"speaker":"Chris Dy","startTime":1093.14,"endTime":1097.16,"body":"good couple. And I think I'm"},{"speaker":"Chris Dy","startTime":1093.14,"endTime":1097.16,"body":"good. So anyway, when we talking"},{"speaker":"Chris Dy","startTime":1097.16,"endTime":1099.59,"body":"about some actual hand surgery"},{"speaker":"Chris Dy","startTime":1097.16,"endTime":1099.59,"body":"before people turn this off,"},{"speaker":"Charles Goldfarb","startTime":1100.16,"endTime":1103.97,"body":"maybe to"},{"speaker":"Charles Goldfarb","startTime":1100.16,"endTime":1103.97,"body":"eight. All right, why don't we"},{"speaker":"Charles Goldfarb","startTime":1103.97,"endTime":1105.17,"body":"want to share a case?"},{"speaker":"Chris Dy","startTime":1105.74,"endTime":1109.4,"body":"Yet interesting case,"},{"speaker":"Chris Dy","startTime":1105.74,"endTime":1109.4,"body":"you know, that was referred to"},{"speaker":"Chris Dy","startTime":1109.4,"endTime":1113.39,"body":"me by one of my partners, one of"},{"speaker":"Chris Dy","startTime":1109.4,"endTime":1113.39,"body":"our partners, a patient who had"},{"speaker":"Chris Dy","startTime":1113.39,"endTime":1116.87,"body":"had a prior subcutaneous"},{"speaker":"Chris Dy","startTime":1113.39,"endTime":1116.87,"body":"transposition elsewhere. crashy"},{"speaker":"Chris Dy","startTime":1116.87,"endTime":1121.43,"body":"started as an insight to then"},{"speaker":"Chris Dy","startTime":1116.87,"endTime":1121.43,"body":"was revised to a subcutaneous"},{"speaker":"Chris Dy","startTime":1121.43,"endTime":1125.72,"body":"transposition and then came in"},{"speaker":"Chris Dy","startTime":1121.43,"endTime":1125.72,"body":"with just a boatload of pain"},{"speaker":"Chris Dy","startTime":1125.72,"endTime":1132.62,"body":"right over the chest anterior to"},{"speaker":"Chris Dy","startTime":1125.72,"endTime":1132.62,"body":"the medial lateral condyle. Tap"},{"speaker":"Chris Dy","startTime":1132.62,"endTime":1136.7,"body":"on that area, it drives them"},{"speaker":"Chris Dy","startTime":1132.62,"endTime":1136.7,"body":"absolutely crazy. The nerve"},{"speaker":"Chris Dy","startTime":1136.7,"endTime":1139.61,"body":"itself is actually functioning"},{"speaker":"Chris Dy","startTime":1136.7,"endTime":1139.61,"body":"pretty well the ulnar nerve"},{"speaker":"Chris Dy","startTime":1139.97,"endTime":1142.73,"body":"insensate in the posterior"},{"speaker":"Chris Dy","startTime":1139.97,"endTime":1142.73,"body":"branch of the medial inner"},{"speaker":"Chris Dy","startTime":1142.73,"endTime":1147.77,"body":"brachial cutaneous nerve"},{"speaker":"Chris Dy","startTime":1142.73,"endTime":1147.77,"body":"distribution. So, I see the"},{"speaker":"Chris Dy","startTime":1147.77,"endTime":1151.55,"body":"patient, our partner is"},{"speaker":"Chris Dy","startTime":1147.77,"endTime":1151.55,"body":"convinced it's an ABC neuroma,"},{"speaker":"Chris Dy","startTime":1151.76,"endTime":1155.96,"body":"and nothing else. And I kind of"},{"speaker":"Chris Dy","startTime":1151.76,"endTime":1155.96,"body":"thought that was the case. And,"},{"speaker":"Chris Dy","startTime":1156.26,"endTime":1159.02,"body":"you know, we get a nerve study,"},{"speaker":"Chris Dy","startTime":1156.26,"endTime":1159.02,"body":"nerve study comes back,"},{"speaker":"Chris Dy","startTime":1159.08,"endTime":1161.87,"body":"essentially that the ulnar nerve"},{"speaker":"Chris Dy","startTime":1159.08,"endTime":1161.87,"body":"is working pretty darn good."},{"speaker":"Chris Dy","startTime":1162.53,"endTime":1165.2,"body":"Which anytime you're going into"},{"speaker":"Chris Dy","startTime":1162.53,"endTime":1165.2,"body":"a revision surgery like oh man"},{"speaker":"Chris Dy","startTime":1165.74,"endTime":1171.98,"body":"can only make that worse. But an"},{"speaker":"Chris Dy","startTime":1165.74,"endTime":1171.98,"body":"ultrasound, very compelling"},{"speaker":"Chris Dy","startTime":1172.1,"endTime":1177.53,"body":"shows just a huge honking"},{"speaker":"Chris Dy","startTime":1172.1,"endTime":1177.53,"body":"neuroma for the SABC. So how do"},{"speaker":"Chris Dy","startTime":1177.53,"endTime":1179.96,"body":"you approach that patient who's"},{"speaker":"Chris Dy","startTime":1177.53,"endTime":1179.96,"body":"got a functioning ulnar nerve"},{"speaker":"Chris Dy","startTime":1179.96,"endTime":1184.55,"body":"but has pain and you suspect"},{"speaker":"Chris Dy","startTime":1179.96,"endTime":1184.55,"body":"that there's a neuroma in that"},{"speaker":"Chris Dy","startTime":1184.55,"endTime":1184.94,"body":"area?"},{"speaker":"Charles Goldfarb","startTime":1185.9,"endTime":1190.97,"body":"So you believe"},{"speaker":"Charles Goldfarb","startTime":1185.9,"endTime":1190.97,"body":"that irritated segment is the"},{"speaker":"Charles Goldfarb","startTime":1190.97,"endTime":1194.39,"body":"older nerve itself right at the"},{"speaker":"Charles Goldfarb","startTime":1190.97,"endTime":1194.39,"body":"right ad or on the medial"},{"speaker":"Charles Goldfarb","startTime":1194.39,"endTime":1198.05,"body":"epicondyle in addition to a"},{"speaker":"Charles Goldfarb","startTime":1194.39,"endTime":1198.05,"body":"reactive cutaneous nerve?"},{"speaker":"Chris Dy","startTime":1198.74,"endTime":1200.21,"body":"Yeah, and I actually"},{"speaker":"Chris Dy","startTime":1198.74,"endTime":1200.21,"body":"thought was more For the"},{"speaker":"Chris Dy","startTime":1200.21,"endTime":1202.73,"body":"reactive cutaneous nerve,"},{"speaker":"Chris Dy","startTime":1200.21,"endTime":1202.73,"body":"because the ulnar nerve and the"},{"speaker":"Chris Dy","startTime":1203.33,"endTime":1206.36,"body":"motor sensory function and"},{"speaker":"Chris Dy","startTime":1203.33,"endTime":1206.36,"body":"clinical exam was pretty good,"},{"speaker":"Chris Dy","startTime":1206.36,"endTime":1208.82,"body":"and the nerve study was pretty"},{"speaker":"Chris Dy","startTime":1206.36,"endTime":1208.82,"body":"good. And the nerve was not"},{"speaker":"Chris Dy","startTime":1208.82,"endTime":1212.3,"body":"terribly enlarged on the on the"},{"speaker":"Chris Dy","startTime":1208.82,"endTime":1212.3,"body":"ultrasound, but the MA BC was"},{"speaker":"Chris Dy","startTime":1212.3,"endTime":1214.85,"body":"the size of the older nerve."},{"speaker":"Chris Dy","startTime":1212.3,"endTime":1214.85,"body":"It's like the same cross"},{"speaker":"Chris Dy","startTime":1214.85,"endTime":1217.64,"body":"sectional area. So I actually"},{"speaker":"Chris Dy","startTime":1214.85,"endTime":1217.64,"body":"thought it was an MVC surgery,"},{"speaker":"Chris Dy","startTime":1217.64,"endTime":1219.44,"body":"but I was going to be right next"},{"speaker":"Chris Dy","startTime":1217.64,"endTime":1219.44,"body":"to the ulnar nerve."},{"speaker":"Charles Goldfarb","startTime":1219.77,"endTime":1223.34,"body":"Right. Well, I"},{"speaker":"Charles Goldfarb","startTime":1219.77,"endTime":1223.34,"body":"guess my a couple of comments,"},{"speaker":"Charles Goldfarb","startTime":1223.34,"endTime":1226.52,"body":"you know, we have discussed"},{"speaker":"Charles Goldfarb","startTime":1223.34,"endTime":1226.52,"body":"this, the literature proves this"},{"speaker":"Charles Goldfarb","startTime":1226.76,"endTime":1231.11,"body":"a failed. Decompression is is"},{"speaker":"Charles Goldfarb","startTime":1226.76,"endTime":1231.11,"body":"not as easy as simply"},{"speaker":"Charles Goldfarb","startTime":1231.11,"endTime":1235.16,"body":"transposing the nerve. And"},{"speaker":"Charles Goldfarb","startTime":1231.11,"endTime":1235.16,"body":"that's why I take even more care"},{"speaker":"Charles Goldfarb","startTime":1235.16,"endTime":1238.64,"body":"in that decision making process"},{"speaker":"Charles Goldfarb","startTime":1235.16,"endTime":1238.64,"body":"today because we know from Dr."},{"speaker":"Charles Goldfarb","startTime":1238.64,"endTime":1241.28,"body":"Cathy's paper that those"},{"speaker":"Charles Goldfarb","startTime":1238.64,"endTime":1241.28,"body":"patients just don't do as well."},{"speaker":"Charles Goldfarb","startTime":1241.28,"endTime":1244.61,"body":"So that's number one. Number"},{"speaker":"Charles Goldfarb","startTime":1241.28,"endTime":1244.61,"body":"two, I really liked that"},{"speaker":"Charles Goldfarb","startTime":1244.61,"endTime":1249.35,"body":"pasture, cutaneous, or adipose"},{"speaker":"Charles Goldfarb","startTime":1244.61,"endTime":1249.35,"body":"flap anteriorly rather than an"},{"speaker":"Charles Goldfarb","startTime":1249.35,"endTime":1252.44,"body":"Eaton flap with fascia, because"},{"speaker":"Charles Goldfarb","startTime":1249.35,"endTime":1252.44,"body":"I think it allows you to keep"},{"speaker":"Charles Goldfarb","startTime":1252.44,"endTime":1255.26,"body":"the nerve more lateral and away"},{"speaker":"Charles Goldfarb","startTime":1252.44,"endTime":1255.26,"body":"from the middle of a condo, I"},{"speaker":"Charles Goldfarb","startTime":1255.26,"endTime":1258.83,"body":"don't think that nerve is happy."},{"speaker":"Charles Goldfarb","startTime":1255.26,"endTime":1258.83,"body":"And you may disagree. I don't"},{"speaker":"Charles Goldfarb","startTime":1258.83,"endTime":1261.32,"body":"think that nerve is quite as"},{"speaker":"Charles Goldfarb","startTime":1258.83,"endTime":1261.32,"body":"happy when it's really far"},{"speaker":"Charles Goldfarb","startTime":1261.32,"endTime":1264.89,"body":"medial or near the bone. That's"},{"speaker":"Charles Goldfarb","startTime":1261.32,"endTime":1264.89,"body":"my second takeaway. And then my"},{"speaker":"Charles Goldfarb","startTime":1264.89,"endTime":1269.9,"body":"third comment regarding planning"},{"speaker":"Charles Goldfarb","startTime":1264.89,"endTime":1269.9,"body":"is, I would plan to go in and"},{"speaker":"Charles Goldfarb","startTime":1269.9,"endTime":1274.04,"body":"evaluate that medial brachial"},{"speaker":"Charles Goldfarb","startTime":1269.9,"endTime":1274.04,"body":"cutaneous nerve, neuro Lysaght"},{"speaker":"Charles Goldfarb","startTime":1274.1,"endTime":1279.56,"body":"or potentially excise it if that"},{"speaker":"Charles Goldfarb","startTime":1274.1,"endTime":1279.56,"body":"looks like the best indicator,"},{"speaker":"Charles Goldfarb","startTime":1279.56,"endTime":1282.29,"body":"of course, with preoperative"},{"speaker":"Charles Goldfarb","startTime":1279.56,"endTime":1282.29,"body":"discussions around numbness, and"},{"speaker":"Charles Goldfarb","startTime":1282.29,"endTime":1284.6,"body":"then assess the nerve. And if"},{"speaker":"Charles Goldfarb","startTime":1282.29,"endTime":1284.6,"body":"the nerve is scarred in and"},{"speaker":"Charles Goldfarb","startTime":1284.6,"endTime":1287.42,"body":"doesn't look good, then I think"},{"speaker":"Charles Goldfarb","startTime":1284.6,"endTime":1287.42,"body":"you have to go so muscular with"},{"speaker":"Charles Goldfarb","startTime":1287.42,"endTime":1287.57,"body":"it."},{"speaker":"Chris Dy","startTime":1288.77,"endTime":1291.83,"body":"Yeah, I agree. I think"},{"speaker":"Chris Dy","startTime":1288.77,"endTime":1291.83,"body":"that I think the nerve does not"},{"speaker":"Chris Dy","startTime":1291.83,"endTime":1295.13,"body":"like being right next to the"},{"speaker":"Chris Dy","startTime":1291.83,"endTime":1295.13,"body":"medial epicondyle if it's on top"},{"speaker":"Chris Dy","startTime":1295.13,"endTime":1298.04,"body":"of it. I think that if you're"},{"speaker":"Chris Dy","startTime":1295.13,"endTime":1298.04,"body":"going so muscular, I think it's"},{"speaker":"Chris Dy","startTime":1298.04,"endTime":1301.58,"body":"okay to put the nerve, you know,"},{"speaker":"Chris Dy","startTime":1298.04,"endTime":1301.58,"body":"closer to the bone. As long as"},{"speaker":"Chris Dy","startTime":1301.58,"endTime":1305.24,"body":"it's you get them moving early."},{"speaker":"Chris Dy","startTime":1301.58,"endTime":1305.24,"body":"Because if you put it closer to"},{"speaker":"Chris Dy","startTime":1305.24,"endTime":1308.54,"body":"the bone on the anterior side of"},{"speaker":"Chris Dy","startTime":1305.24,"endTime":1308.54,"body":"it, or you know, not, you know,"},{"speaker":"Chris Dy","startTime":1308.54,"endTime":1311.45,"body":"where it sits inside too, but on"},{"speaker":"Chris Dy","startTime":1308.54,"endTime":1311.45,"body":"the other side of meetup calm"},{"speaker":"Chris Dy","startTime":1311.45,"endTime":1315.56,"body":"now closer to the median nerve."},{"speaker":"Chris Dy","startTime":1311.45,"endTime":1315.56,"body":"You know, that's a nice smoother"},{"speaker":"Chris Dy","startTime":1315.56,"endTime":1317.63,"body":"course for that nerve, it is"},{"speaker":"Chris Dy","startTime":1315.56,"endTime":1317.63,"body":"much more likely to be in a"},{"speaker":"Chris Dy","startTime":1317.63,"endTime":1319.58,"body":"straight line and"},{"speaker":"Chris Dy","startTime":1317.63,"endTime":1319.58,"body":"topographically it doesn't have"},{"speaker":"Chris Dy","startTime":1319.58,"endTime":1322.67,"body":"to go up and down like it would"},{"speaker":"Chris Dy","startTime":1319.58,"endTime":1322.67,"body":"if you did it, you know, with"},{"speaker":"Chris Dy","startTime":1322.67,"endTime":1325.55,"body":"the subcutaneous. So if you're"},{"speaker":"Chris Dy","startTime":1322.67,"endTime":1325.55,"body":"doing a subcutaneous, I think it"},{"speaker":"Chris Dy","startTime":1325.55,"endTime":1329.3,"body":"is important to pull it away"},{"speaker":"Chris Dy","startTime":1325.55,"endTime":1329.3,"body":"from the medial condyle. And"},{"speaker":"Chris Dy","startTime":1329.3,"endTime":1333.89,"body":"I've seen some fail or have to"},{"speaker":"Chris Dy","startTime":1329.3,"endTime":1333.89,"body":"be revised, have to as a strong"},{"speaker":"Chris Dy","startTime":1333.89,"endTime":1336.71,"body":"term, but would benefit from"},{"speaker":"Chris Dy","startTime":1333.89,"endTime":1336.71,"body":"revision because it was just"},{"speaker":"Chris Dy","startTime":1336.77,"endTime":1338.45,"body":"right on the bone right on top"},{"speaker":"Chris Dy","startTime":1336.77,"endTime":1338.45,"body":"of the bone."},{"speaker":"Charles Goldfarb","startTime":1338.93,"endTime":1340.4,"body":"So what did"},{"speaker":"Charles Goldfarb","startTime":1338.93,"endTime":1340.4,"body":"you do in this case?"},{"speaker":"Chris Dy","startTime":1341.26,"endTime":1344.71,"body":"So we plan for"},{"speaker":"Chris Dy","startTime":1341.26,"endTime":1344.71,"body":"revision surgery. It was mainly"},{"speaker":"Chris Dy","startTime":1344.77,"endTime":1348.1,"body":"immediately supposed to be an"},{"speaker":"Chris Dy","startTime":1344.77,"endTime":1348.1,"body":"MABC neuroma surgery but I said"},{"speaker":"Chris Dy","startTime":1348.13,"endTime":1350.71,"body":"we're going to be in the area. I"},{"speaker":"Chris Dy","startTime":1348.13,"endTime":1350.71,"body":"always have my guard up about"},{"speaker":"Chris Dy","startTime":1350.71,"endTime":1353.02,"body":"the ulnar nerve, there's a fair"},{"speaker":"Chris Dy","startTime":1350.71,"endTime":1353.02,"body":"chance I'll need to revise your"},{"speaker":"Chris Dy","startTime":1353.02,"endTime":1355.69,"body":"transposition, just because I"},{"speaker":"Chris Dy","startTime":1353.02,"endTime":1355.69,"body":"don't want anybody that ever"},{"speaker":"Chris Dy","startTime":1355.69,"endTime":1359.2,"body":"have to come back here again,"},{"speaker":"Chris Dy","startTime":1355.69,"endTime":1359.2,"body":"especially if your nerve is the"},{"speaker":"Chris Dy","startTime":1359.2,"endTime":1362.47,"body":"ulnar nerve ends up being the"},{"speaker":"Chris Dy","startTime":1359.2,"endTime":1362.47,"body":"source of your pain. So we"},{"speaker":"Chris Dy","startTime":1362.47,"endTime":1366.7,"body":"opened everything up, obviously"},{"speaker":"Chris Dy","startTime":1362.47,"endTime":1366.7,"body":"wide exposure on both ends. And"},{"speaker":"Chris Dy","startTime":1366.7,"endTime":1370.15,"body":"find the ulnar nerve and it is"},{"speaker":"Chris Dy","startTime":1366.7,"endTime":1370.15,"body":"just plastered to the flexor"},{"speaker":"Chris Dy","startTime":1370.15,"endTime":1373.63,"body":"pronator surface really close to"},{"speaker":"Chris Dy","startTime":1370.15,"endTime":1373.63,"body":"the middle of the condo. And it"},{"speaker":"Chris Dy","startTime":1373.63,"endTime":1376.57,"body":"matched the preoperative"},{"speaker":"Chris Dy","startTime":1373.63,"endTime":1376.57,"body":"tonnelle sign that we marked,"},{"speaker":"Chris Dy","startTime":1376.6,"endTime":1378.67,"body":"which I thought was going to be"},{"speaker":"Chris Dy","startTime":1376.6,"endTime":1378.67,"body":"more of the medial end of"},{"speaker":"Chris Dy","startTime":1378.67,"endTime":1381.7,"body":"brachial cutaneous neuroma. And"},{"speaker":"Chris Dy","startTime":1378.67,"endTime":1381.7,"body":"I always mark the preoptic own"},{"speaker":"Chris Dy","startTime":1381.7,"endTime":1384.46,"body":"holding because I think it can"},{"speaker":"Chris Dy","startTime":1381.7,"endTime":1384.46,"body":"be useful guide and it shows a"},{"speaker":"Chris Dy","startTime":1384.46,"endTime":1389.02,"body":"patient to kind of what your"},{"speaker":"Chris Dy","startTime":1384.46,"endTime":1389.02,"body":"plan is. And you know, lo and"},{"speaker":"Chris Dy","startTime":1389.02,"endTime":1392.05,"body":"behold, I mean, immediately next"},{"speaker":"Chris Dy","startTime":1389.02,"endTime":1392.05,"body":"door to it. There was a huge"},{"speaker":"Chris Dy","startTime":1392.05,"endTime":1394.3,"body":"honkin neuroma for the meal and"},{"speaker":"Chris Dy","startTime":1392.05,"endTime":1394.3,"body":"a breakthrough cutaneous nerve."},{"speaker":"Chris Dy","startTime":1394.3,"endTime":1397.84,"body":"So I'm not absolutely sure what"},{"speaker":"Chris Dy","startTime":1394.3,"endTime":1397.84,"body":"the pain generator was, if it"},{"speaker":"Chris Dy","startTime":1397.84,"endTime":1401.47,"body":"was one or the other or a"},{"speaker":"Chris Dy","startTime":1397.84,"endTime":1401.47,"body":"combination of the two. But it"},{"speaker":"Chris Dy","startTime":1401.47,"endTime":1404.53,"body":"was a it was a slog to get that"},{"speaker":"Chris Dy","startTime":1401.47,"endTime":1404.53,"body":"nerve out the ulnar nerve out of"},{"speaker":"Chris Dy","startTime":1404.53,"endTime":1405.07,"body":"that scar."},{"speaker":"Charles Goldfarb","startTime":1405.46,"endTime":1409.51,"body":"And so you"},{"speaker":"Charles Goldfarb","startTime":1405.46,"endTime":1409.51,"body":"neuralyzed The ulnar nerve, you"},{"speaker":"Charles Goldfarb","startTime":1409.51,"endTime":1413.53,"body":"excise the neuroma and the"},{"speaker":"Charles Goldfarb","startTime":1409.51,"endTime":1413.53,"body":"branch of the medial brachial."},{"speaker":"Chris Dy","startTime":1413.83,"endTime":1416.65,"body":"Yeah, so we revised"},{"speaker":"Chris Dy","startTime":1413.83,"endTime":1416.65,"body":"your eye we did an analysis on"},{"speaker":"Chris Dy","startTime":1416.65,"endTime":1419.32,"body":"the ulnar nerve and did a sub"},{"speaker":"Chris Dy","startTime":1416.65,"endTime":1419.32,"body":"muscular transposition kind of"},{"speaker":"Chris Dy","startTime":1419.32,"endTime":1423.19,"body":"the normal one left at very"},{"speaker":"Chris Dy","startTime":1419.32,"endTime":1423.19,"body":"loose in terms of you know, the"},{"speaker":"Chris Dy","startTime":1423.31,"endTime":1426.76,"body":"any area around the nerve that"},{"speaker":"Chris Dy","startTime":1423.31,"endTime":1426.76,"body":"does something that I had not"},{"speaker":"Chris Dy","startTime":1426.76,"endTime":1429.13,"body":"done in this particular"},{"speaker":"Chris Dy","startTime":1426.76,"endTime":1429.13,"body":"situation before but I thought"},{"speaker":"Chris Dy","startTime":1429.13,"endTime":1432.97,"body":"was interesting. You know, there"},{"speaker":"Chris Dy","startTime":1429.13,"endTime":1432.97,"body":"was always that we always have"},{"speaker":"Chris Dy","startTime":1432.97,"endTime":1437.47,"body":"our branches to the FCU and I"},{"speaker":"Chris Dy","startTime":1432.97,"endTime":1437.47,"body":"found a couple of branches FCU"},{"speaker":"Chris Dy","startTime":1437.47,"endTime":1442.0,"body":"and we ended up doing a targeted"},{"speaker":"Chris Dy","startTime":1437.47,"endTime":1442.0,"body":"muscle regeneration from the"},{"speaker":"Chris Dy","startTime":1442.03,"endTime":1447.4,"body":"MABC you know, neuroma branch."},{"speaker":"Chris Dy","startTime":1442.03,"endTime":1447.4,"body":"So we excised out the neuroma"},{"speaker":"Chris Dy","startTime":1447.4,"endTime":1449.74,"body":"and went back to healthy"},{"speaker":"Chris Dy","startTime":1447.4,"endTime":1449.74,"body":"fascicles. We did have to use a"},{"speaker":"Chris Dy","startTime":1450.76,"endTime":1454.54,"body":"an Allah graft to make that TMR"},{"speaker":"Chris Dy","startTime":1450.76,"endTime":1454.54,"body":"reach but you know, I'm not sure"},{"speaker":"Chris Dy","startTime":1454.54,"endTime":1457.03,"body":"which part of this neuroma"},{"speaker":"Chris Dy","startTime":1454.54,"endTime":1457.03,"body":"treatment is going to be the"},{"speaker":"Chris Dy","startTime":1457.03,"endTime":1461.08,"body":"thing that that helps the most."},{"speaker":"Chris Dy","startTime":1457.03,"endTime":1461.08,"body":"Whether it's the excision of the"},{"speaker":"Chris Dy","startTime":1461.11,"endTime":1464.26,"body":"painful neuroma, whether it's"},{"speaker":"Chris Dy","startTime":1461.11,"endTime":1464.26,"body":"the nerve growing into the alley"},{"speaker":"Chris Dy","startTime":1464.26,"endTime":1467.71,"body":"graft or whether it's actually"},{"speaker":"Chris Dy","startTime":1464.26,"endTime":1467.71,"body":"making it to the to the FCU"},{"speaker":"Chris Dy","startTime":1467.71,"endTime":1468.16,"body":"bridge."},{"speaker":"Charles Goldfarb","startTime":1469.27,"endTime":1471.49,"body":"Interesting."},{"speaker":"Charles Goldfarb","startTime":1469.27,"endTime":1471.49,"body":"Alright, so let me just make"},{"speaker":"Charles Goldfarb","startTime":1471.49,"endTime":1474.7,"body":"sure I understand this. So you"},{"speaker":"Charles Goldfarb","startTime":1471.49,"endTime":1474.7,"body":"dealt with the ulnar nerve and"},{"speaker":"Charles Goldfarb","startTime":1474.7,"endTime":1478.09,"body":"it sounds like that was almost a"},{"speaker":"Charles Goldfarb","startTime":1474.7,"endTime":1478.09,"body":"straightforward but in the end,"},{"speaker":"Charles Goldfarb","startTime":1478.12,"endTime":1481.93,"body":"we understand what you did and"},{"speaker":"Charles Goldfarb","startTime":1478.12,"endTime":1481.93,"body":"then you didn't just excise the"},{"speaker":"Charles Goldfarb","startTime":1481.93,"endTime":1487.12,"body":"neuroma or bury the stump. You"},{"speaker":"Charles Goldfarb","startTime":1481.93,"endTime":1487.12,"body":"excise the aroma. You brought an"},{"speaker":"Charles Goldfarb","startTime":1487.12,"endTime":1493.06,"body":"expensive Allah graft in a suit"},{"speaker":"Charles Goldfarb","startTime":1487.12,"endTime":1493.06,"body":"you add it to the residual MABC"},{"speaker":"Charles Goldfarb","startTime":1493.36,"endTime":1496.69,"body":"and then you put that allograft"},{"speaker":"Charles Goldfarb","startTime":1493.36,"endTime":1496.69,"body":"into the FCU"},{"speaker":"Chris Dy","startTime":1497.2,"endTime":1499.0,"body":"It wasn't that"},{"speaker":"Chris Dy","startTime":1497.2,"endTime":1499.0,"body":"expensive. I mean, come on."},{"speaker":"Chris Dy","startTime":1499.75,"endTime":1502.12,"body":"Thank you compare it to some of"},{"speaker":"Chris Dy","startTime":1499.75,"endTime":1502.12,"body":"the arthroscopy stuff if you use"},{"speaker":"Chris Dy","startTime":1502.6,"endTime":1506.41,"body":"all those fancy all those fancy"},{"speaker":"Chris Dy","startTime":1502.6,"endTime":1506.41,"body":"suture tapes I mean in this"},{"speaker":"Chris Dy","startTime":1506.41,"endTime":1510.61,"body":"grand scheme of things it yes"},{"speaker":"Chris Dy","startTime":1506.41,"endTime":1510.61,"body":"but that's that's yes the"},{"speaker":"Chris Dy","startTime":1510.64,"endTime":1515.35,"body":"allograft was intercalary"},{"speaker":"Chris Dy","startTime":1510.64,"endTime":1515.35,"body":"between the MABC and the and the"},{"speaker":"Chris Dy","startTime":1515.35,"endTime":1518.53,"body":"FCU branch and this is something"},{"speaker":"Chris Dy","startTime":1515.35,"endTime":1518.53,"body":"that I've done before obviously"},{"speaker":"Chris Dy","startTime":1518.53,"endTime":1521.41,"body":"I've done TMR before and I've"},{"speaker":"Chris Dy","startTime":1518.53,"endTime":1521.41,"body":"done TMR and painful neuroma"},{"speaker":"Chris Dy","startTime":1521.41,"endTime":1526.45,"body":"cases. I remember one. You're"},{"speaker":"Chris Dy","startTime":1521.41,"endTime":1526.45,"body":"gonna laugh at this. In revision"},{"speaker":"Chris Dy","startTime":1526.48,"endTime":1532.99,"body":"Morton neuroma case. She kind of"},{"speaker":"Chris Dy","startTime":1526.48,"endTime":1532.99,"body":"had surgery. Yeah. Yep. And did"},{"speaker":"Chris Dy","startTime":1532.99,"endTime":1539.17,"body":"TMR. And so one of the one of"},{"speaker":"Chris Dy","startTime":1532.99,"endTime":1539.17,"body":"the foot interossei. And it was"},{"speaker":"Chris Dy","startTime":1539.17,"endTime":1539.77,"body":"great."},{"speaker":"Charles Goldfarb","startTime":1541.18,"endTime":1542.47,"body":"Do you even"},{"speaker":"Charles Goldfarb","startTime":1541.18,"endTime":1542.47,"body":"know what they're called"},{"speaker":"Chris Dy","startTime":1543.85,"endTime":1546.1,"body":"Lumbrical. Interossei-"},{"speaker":"Chris Dy","startTime":1543.85,"endTime":1546.1,"body":"some kind of intrinsic muscle in"},{"speaker":"Chris Dy","startTime":1546.1,"endTime":1551.17,"body":"the foot that most people that"},{"speaker":"Chris Dy","startTime":1546.1,"endTime":1551.17,"body":"die, but you know. But ya know,"},{"speaker":"Chris Dy","startTime":1551.17,"endTime":1554.35,"body":"that was that was a very, it's"},{"speaker":"Chris Dy","startTime":1551.17,"endTime":1554.35,"body":"nice, because for that"},{"speaker":"Chris Dy","startTime":1554.35,"endTime":1558.04,"body":"particular situation, you know"},{"speaker":"Chris Dy","startTime":1554.35,"endTime":1558.04,"body":"exactly where the nerve is going"},{"speaker":"Chris Dy","startTime":1558.04,"endTime":1560.47,"body":"to go, you don't risk it"},{"speaker":"Chris Dy","startTime":1558.04,"endTime":1560.47,"body":"dislodging out of muscle. I know"},{"speaker":"Chris Dy","startTime":1560.47,"endTime":1562.63,"body":"the other option, obviously, and"},{"speaker":"Chris Dy","startTime":1560.47,"endTime":1562.63,"body":"I've done this a lot before too."},{"speaker":"Chris Dy","startTime":1562.63,"endTime":1565.9,"body":"And so view is to implant the"},{"speaker":"Chris Dy","startTime":1562.63,"endTime":1565.9,"body":"buried the cut end of the nerve"},{"speaker":"Chris Dy","startTime":1565.9,"endTime":1568.81,"body":"into muscle. And that's still I"},{"speaker":"Chris Dy","startTime":1565.9,"endTime":1568.81,"body":"think, a great go to treatment."},{"speaker":"Chris Dy","startTime":1568.81,"endTime":1571.48,"body":"I mean, what one of the"},{"speaker":"Chris Dy","startTime":1568.81,"endTime":1571.48,"body":"takeaways I had from the ESPN"},{"speaker":"Chris Dy","startTime":1571.48,"endTime":1576.37,"body":"meeting was. That doesn't mean"},{"speaker":"Chris Dy","startTime":1571.48,"endTime":1576.37,"body":"there's no, it's not going to be"},{"speaker":"Chris Dy","startTime":1576.4,"endTime":1580.54,"body":"always TMR or rpmi, or whatever"},{"speaker":"Chris Dy","startTime":1576.4,"endTime":1580.54,"body":"other treatment you have for a"},{"speaker":"Chris Dy","startTime":1580.54,"endTime":1582.64,"body":"painful neuroma, it's knowing"},{"speaker":"Chris Dy","startTime":1580.54,"endTime":1582.64,"body":"about how to do all of them,"},{"speaker":"Chris Dy","startTime":1582.97,"endTime":1585.91,"body":"because they're going to be some"},{"speaker":"Chris Dy","startTime":1582.97,"endTime":1585.91,"body":"nerves in particular, that are"},{"speaker":"Chris Dy","startTime":1585.91,"endTime":1588.73,"body":"going to respond better to each"},{"speaker":"Chris Dy","startTime":1585.91,"endTime":1588.73,"body":"different treatment, and then"},{"speaker":"Chris Dy","startTime":1588.73,"endTime":1592.0,"body":"some scenarios in which you're"},{"speaker":"Chris Dy","startTime":1588.73,"endTime":1592.0,"body":"not going to have other options."},{"speaker":"Chris Dy","startTime":1592.0,"endTime":1594.88,"body":"So it is important to know kind"},{"speaker":"Chris Dy","startTime":1592.0,"endTime":1594.88,"body":"of the full spectrum. But let's"},{"speaker":"Chris Dy","startTime":1594.88,"endTime":1595.9,"body":"hear a case from you."},{"speaker":"Charles Goldfarb","startTime":1596.14,"endTime":1599.92,"body":"Sure, I was"},{"speaker":"Charles Goldfarb","startTime":1596.14,"endTime":1599.92,"body":"debating I try to some of the"},{"speaker":"Charles Goldfarb","startTime":1599.92,"endTime":1602.11,"body":"most interesting cases or"},{"speaker":"Charles Goldfarb","startTime":1599.92,"endTime":1602.11,"body":"congenital cases. And I"},{"speaker":"Charles Goldfarb","startTime":1602.11,"endTime":1605.29,"body":"recognize that a lot of the"},{"speaker":"Charles Goldfarb","startTime":1602.11,"endTime":1605.29,"body":"audience, you know, might find"},{"speaker":"Charles Goldfarb","startTime":1605.29,"endTime":1609.04,"body":"them interesting, but might not"},{"speaker":"Charles Goldfarb","startTime":1605.29,"endTime":1609.04,"body":"truly relate. So I want to share"},{"speaker":"Charles Goldfarb","startTime":1609.07,"endTime":1612.46,"body":"and I'm not gonna share a sports"},{"speaker":"Charles Goldfarb","startTime":1609.07,"endTime":1612.46,"body":"a complete sports case, but I'm"},{"speaker":"Charles Goldfarb","startTime":1612.46,"endTime":1617.41,"body":"going to share an adolescent"},{"speaker":"Charles Goldfarb","startTime":1612.46,"endTime":1617.41,"body":"case. So 15 year old male comes"},{"speaker":"Charles Goldfarb","startTime":1617.41,"endTime":1622.39,"body":"in with a drnj dislocation in a"},{"speaker":"Charles Goldfarb","startTime":1617.41,"endTime":1622.39,"body":"history of fracture. Now, if"},{"speaker":"Charles Goldfarb","startTime":1622.39,"endTime":1624.79,"body":"someone walked in and said that"},{"speaker":"Charles Goldfarb","startTime":1622.39,"endTime":1624.79,"body":"to me, or one of my colleagues"},{"speaker":"Charles Goldfarb","startTime":1624.79,"endTime":1628.54,"body":"said that to me, my brain would"},{"speaker":"Charles Goldfarb","startTime":1624.79,"endTime":1628.54,"body":"immediately go to distal 1/3 of"},{"speaker":"Charles Goldfarb","startTime":1628.54,"endTime":1634.33,"body":"the radius fracture. Now union"},{"speaker":"Charles Goldfarb","startTime":1628.54,"endTime":1634.33,"body":"only ends up dorsally. And those"},{"speaker":"Charles Goldfarb","startTime":1634.33,"endTime":1637.72,"body":"cases I love when those go man,"},{"speaker":"Charles Goldfarb","startTime":1634.33,"endTime":1637.72,"body":"I hate for the kids. But when"},{"speaker":"Charles Goldfarb","startTime":1637.72,"endTime":1642.37,"body":"that case walks in, I know I can"},{"speaker":"Charles Goldfarb","startTime":1637.72,"endTime":1642.37,"body":"make that child better by"},{"speaker":"Charles Goldfarb","startTime":1642.37,"endTime":1646.6,"body":"correcting the radius deformity."},{"speaker":"Charles Goldfarb","startTime":1642.37,"endTime":1646.6,"body":"So really like that, and that's,"},{"speaker":"Charles Goldfarb","startTime":1646.63,"endTime":1650.92,"body":"that's an adolescent, you know,"},{"speaker":"Charles Goldfarb","startTime":1646.63,"endTime":1650.92,"body":"in someone our age or your age"},{"speaker":"Charles Goldfarb","startTime":1650.92,"endTime":1653.26,"body":"or my age, it may not be so"},{"speaker":"Charles Goldfarb","startTime":1650.92,"endTime":1653.26,"body":"straightforward, but in a"},{"speaker":"Charles Goldfarb","startTime":1653.26,"endTime":1654.88,"body":"younger patient, it's a great"},{"speaker":"Charles Goldfarb","startTime":1653.26,"endTime":1654.88,"body":"case."},{"speaker":"Chris Dy","startTime":1655.06,"endTime":1657.07,"body":"Is that scenario"},{"speaker":"Chris Dy","startTime":1655.06,"endTime":1657.07,"body":"typically the one where they're"},{"speaker":"Chris Dy","startTime":1657.61,"endTime":1659.44,"body":"going to remodel but they didn't"},{"speaker":"Chris Dy","startTime":1657.61,"endTime":1659.44,"body":"remodel?"},{"speaker":"Charles Goldfarb","startTime":1659.8,"endTime":1660.91,"body":"Yeah, when"},{"speaker":"Charles Goldfarb","startTime":1659.8,"endTime":1660.91,"body":"they're they're going to read"},{"speaker":"Charles Goldfarb","startTime":1660.94,"endTime":1664.45,"body":"when they're 13, and they're"},{"speaker":"Charles Goldfarb","startTime":1660.94,"endTime":1664.45,"body":"gonna remodel 40 degrees, and I"},{"speaker":"Chris Dy","startTime":1664.45,"endTime":1666.61,"body":"had air quotes with my"},{"speaker":"Chris Dy","startTime":1664.45,"endTime":1666.61,"body":"gonna remodel for those of you"},{"speaker":"Chris Dy","startTime":1666.61,"endTime":1667.99,"body":"that are not watching on"},{"speaker":"Chris Dy","startTime":1666.61,"endTime":1667.99,"body":"YouTube."},{"speaker":"Charles Goldfarb","startTime":1668.14,"endTime":1671.53,"body":"Yes, exactly."},{"speaker":"Charles Goldfarb","startTime":1668.14,"endTime":1671.53,"body":"So this case was interesting"},{"speaker":"Charles Goldfarb","startTime":1671.53,"endTime":1675.04,"body":"because this patient had a"},{"speaker":"Charles Goldfarb","startTime":1671.53,"endTime":1675.04,"body":"procedure done a soft tissue"},{"speaker":"Charles Goldfarb","startTime":1675.04,"endTime":1679.84,"body":"procedure of some sort done near"},{"speaker":"Charles Goldfarb","startTime":1675.04,"endTime":1679.84,"body":"the distal ulna. And I believe"},{"speaker":"Charles Goldfarb","startTime":1679.84,"endTime":1684.79,"body":"the growth plate may have been"},{"speaker":"Charles Goldfarb","startTime":1679.84,"endTime":1684.79,"body":"affected. And so it over grew"},{"speaker":"Charles Goldfarb","startTime":1684.79,"endTime":1688.15,"body":"dorsally with the growth plate"},{"speaker":"Charles Goldfarb","startTime":1684.79,"endTime":1688.15,"body":"was still growing normally"},{"speaker":"Charles Goldfarb","startTime":1688.15,"endTime":1692.68,"body":"there. And that led to a"},{"speaker":"Charles Goldfarb","startTime":1688.15,"endTime":1692.68,"body":"dislocation of the Dr. uj"},{"speaker":"Chris Dy","startTime":1693.34,"endTime":1695.92,"body":"kind of soft tissue"},{"speaker":"Chris Dy","startTime":1693.34,"endTime":1695.92,"body":"procedure would bugger up the"},{"speaker":"Chris Dy","startTime":1695.92,"endTime":1696.49,"body":"faces."},{"speaker":"Charles Goldfarb","startTime":1696.7,"endTime":1700.06,"body":"I think it was"},{"speaker":"Charles Goldfarb","startTime":1696.7,"endTime":1700.06,"body":"unusual maths of some sort,"},{"speaker":"Charles Goldfarb","startTime":1700.24,"endTime":1703.36,"body":"which was volar and close and I"},{"speaker":"Charles Goldfarb","startTime":1700.24,"endTime":1703.36,"body":"don't know the details."},{"speaker":"Chris Dy","startTime":1704.59,"endTime":1708.46,"body":"So this is like some"},{"speaker":"Chris Dy","startTime":1704.59,"endTime":1708.46,"body":"kind of in the distal ulna like"},{"speaker":"Chris Dy","startTime":1708.46,"endTime":1712.03,"body":"a volar, physeal bar, almost"},{"speaker":"Chris Dy","startTime":1708.46,"endTime":1712.03,"body":"from some kind of trauma or"},{"speaker":"Chris Dy","startTime":1712.09,"endTime":1713.71,"body":"surgical traumas, I think"},{"speaker":"Charles Goldfarb","startTime":1713.71,"endTime":1715.33,"body":"that was"},{"speaker":"Charles Goldfarb","startTime":1713.71,"endTime":1715.33,"body":"happened to the faces was now"},{"speaker":"Charles Goldfarb","startTime":1715.33,"endTime":1718.36,"body":"closed. We're left with this"},{"speaker":"Charles Goldfarb","startTime":1715.33,"endTime":1718.36,"body":"deformity and we're left with a"},{"speaker":"Charles Goldfarb","startTime":1718.36,"endTime":1721.51,"body":"patient who couldn't rotate. Got"},{"speaker":"Charles Goldfarb","startTime":1718.36,"endTime":1721.51,"body":"it. Okay. Really interesting."},{"speaker":"Charles Goldfarb","startTime":1721.72,"endTime":1728.47,"body":"And so it, I was hoping that it"},{"speaker":"Charles Goldfarb","startTime":1721.72,"endTime":1728.47,"body":"would turn out like it would had"},{"speaker":"Charles Goldfarb","startTime":1728.47,"endTime":1733.69,"body":"the radius spin the issue. And"},{"speaker":"Charles Goldfarb","startTime":1728.47,"endTime":1733.69,"body":"so we went in, we did a closing"},{"speaker":"Charles Goldfarb","startTime":1733.69,"endTime":1738.85,"body":"wedge osteotomy on the owner,"},{"speaker":"Charles Goldfarb","startTime":1733.69,"endTime":1738.85,"body":"and put a vor plate on, which"},{"speaker":"Charles Goldfarb","startTime":1738.88,"endTime":1742.45,"body":"corrected the obvious angulation"},{"speaker":"Charles Goldfarb","startTime":1738.88,"endTime":1742.45,"body":"asymmetry to the other side,"},{"speaker":"Charles Goldfarb","startTime":1742.45,"endTime":1746.41,"body":"always X ray, the opposite side"},{"speaker":"Charles Goldfarb","startTime":1742.45,"endTime":1746.41,"body":"played on the radius, lower"},{"speaker":"Charles Goldfarb","startTime":1746.41,"endTime":1750.22,"body":"plate, we did a closing wedge"},{"speaker":"Charles Goldfarb","startTime":1746.41,"endTime":1750.22,"body":"osteotomy on the ulna Oh, ulna,"},{"speaker":"Charles Goldfarb","startTime":1750.46,"endTime":1753.76,"body":"yep. And then we basically"},{"speaker":"Charles Goldfarb","startTime":1750.46,"endTime":1753.76,"body":"closed it down. So the the owner"},{"speaker":"Charles Goldfarb","startTime":1753.76,"endTime":1757.72,"body":"was sitting dorsal, and then we"},{"speaker":"Charles Goldfarb","startTime":1753.76,"endTime":1757.72,"body":"close it down, put the plate on,"},{"speaker":"Charles Goldfarb","startTime":1757.81,"endTime":1763.93,"body":"and it went right back into the"},{"speaker":"Charles Goldfarb","startTime":1757.81,"endTime":1763.93,"body":"DRUJ and then the or we did a"},{"speaker":"Charles Goldfarb","startTime":1763.93,"endTime":1766.81,"body":"DRUJ release. I don't know if we"},{"speaker":"Charles Goldfarb","startTime":1763.93,"endTime":1766.81,"body":"had to or not in the or we had"},{"speaker":"Charles Goldfarb","startTime":1766.81,"endTime":1769.57,"body":"immediate full restoration in"},{"speaker":"Charles Goldfarb","startTime":1766.81,"endTime":1769.57,"body":"motion. It's kind of remarkable."},{"speaker":"Chris Dy","startTime":1770.11,"endTime":1771.88,"body":"That's pretty"},{"speaker":"Chris Dy","startTime":1770.11,"endTime":1771.88,"body":"impressive. So it just because"},{"speaker":"Chris Dy","startTime":1771.88,"endTime":1773.71,"body":"it was sitting out of the"},{"speaker":"Chris Dy","startTime":1771.88,"endTime":1773.71,"body":"sigmoid notch and you got it"},{"speaker":"Chris Dy","startTime":1773.71,"endTime":1775.15,"body":"back into the sigmoid notch then"},{"speaker":"Charles Goldfarb","startTime":1775.54,"endTime":1778.12,"body":"I think it's"},{"speaker":"Charles Goldfarb","startTime":1775.54,"endTime":1778.12,"body":"that simple. And I just it gives"},{"speaker":"Charles Goldfarb","startTime":1778.12,"endTime":1783.16,"body":"me you know, there's so much a"},{"speaker":"Charles Goldfarb","startTime":1778.12,"endTime":1783.16,"body":"remodeling potential and young"},{"speaker":"Charles Goldfarb","startTime":1783.16,"endTime":1787.84,"body":"patients but be just tolerance"},{"speaker":"Charles Goldfarb","startTime":1783.16,"endTime":1787.84,"body":"to different things. And so if"},{"speaker":"Charles Goldfarb","startTime":1787.84,"endTime":1790.78,"body":"we can if we can recreate the"},{"speaker":"Charles Goldfarb","startTime":1787.84,"endTime":1790.78,"body":"normal anatomy in a lot of these"},{"speaker":"Charles Goldfarb","startTime":1790.78,"endTime":1794.38,"body":"situations, the kids bounce back"},{"speaker":"Charles Goldfarb","startTime":1790.78,"endTime":1794.38,"body":"amazingly fast. It's really,"},{"speaker":"Charles Goldfarb","startTime":1794.41,"endTime":1796.9,"body":"really exciting, I think. Yeah,"},{"speaker":"Charles Goldfarb","startTime":1794.41,"endTime":1796.9,"body":"that's"},{"speaker":"Chris Dy","startTime":1796.93,"endTime":1799.9,"body":"that's a crazy case."},{"speaker":"Chris Dy","startTime":1796.93,"endTime":1799.9,"body":"That's great. How did you pick"},{"speaker":"Chris Dy","startTime":1799.9,"endTime":1802.6,"body":"your implant? Did you decide was"},{"speaker":"Chris Dy","startTime":1799.9,"endTime":1802.6,"body":"this just something that the use"},{"speaker":"Chris Dy","startTime":1802.6,"endTime":1805.66,"body":"of kind of a standard what a"},{"speaker":"Chris Dy","startTime":1802.6,"endTime":1805.66,"body":"mini frag or a small frag player"},{"speaker":"Chris Dy","startTime":1805.66,"endTime":1808.78,"body":"did you actually use the kind of"},{"speaker":"Chris Dy","startTime":1805.66,"endTime":1808.78,"body":"normal on there shortening"},{"speaker":"Chris Dy","startTime":1808.78,"endTime":1811.24,"body":"osteotomy set, which may not"},{"speaker":"Chris Dy","startTime":1808.78,"endTime":1811.24,"body":"work for a 13 year old?"},{"speaker":"Charles Goldfarb","startTime":1811.51,"endTime":1814.09,"body":"Yeah, it's"},{"speaker":"Charles Goldfarb","startTime":1811.51,"endTime":1814.09,"body":"interesting. I always struggle"},{"speaker":"Charles Goldfarb","startTime":1814.09,"endTime":1817.06,"body":"with implants around the distal"},{"speaker":"Charles Goldfarb","startTime":1814.09,"endTime":1817.06,"body":"ulna. I don't know about you."},{"speaker":"Charles Goldfarb","startTime":1817.06,"endTime":1820.3,"body":"But when there's fractures of"},{"speaker":"Charles Goldfarb","startTime":1817.06,"endTime":1820.3,"body":"the distal ulna, for example, or"},{"speaker":"Charles Goldfarb","startTime":1820.3,"endTime":1823.81,"body":"in this case, where we're doing"},{"speaker":"Charles Goldfarb","startTime":1820.3,"endTime":1823.81,"body":"a very distal osteotomy, I never"},{"speaker":"Charles Goldfarb","startTime":1823.81,"endTime":1827.26,"body":"know exactly what the right"},{"speaker":"Charles Goldfarb","startTime":1823.81,"endTime":1827.26,"body":"plate to use is, I usually have"},{"speaker":"Charles Goldfarb","startTime":1827.26,"endTime":1831.91,"body":"some type of 2.0, 2.4, 2.7 plate"},{"speaker":"Charles Goldfarb","startTime":1827.26,"endTime":1831.91,"body":"available. And that's what I did"},{"speaker":"Charles Goldfarb","startTime":1831.91,"endTime":1835.0,"body":"in this case, it was, I think it"},{"speaker":"Charles Goldfarb","startTime":1831.91,"endTime":1835.0,"body":"was a 2.3 plate, but it was"},{"speaker":"Charles Goldfarb","startTime":1835.0,"endTime":1838.39,"body":"locking, which is nice to have"},{"speaker":"Charles Goldfarb","startTime":1835.0,"endTime":1838.39,"body":"the bone actually was pretty"},{"speaker":"Charles Goldfarb","startTime":1838.39,"endTime":1841.15,"body":"disappointing, I guess, because"},{"speaker":"Charles Goldfarb","startTime":1838.39,"endTime":1841.15,"body":"there hadn't been motion of the"},{"speaker":"Charles Goldfarb","startTime":1841.15,"endTime":1846.46,"body":"form for a year. And it just"},{"speaker":"Charles Goldfarb","startTime":1841.15,"endTime":1846.46,"body":"came together nicely. And And"},{"speaker":"Charles Goldfarb","startTime":1846.46,"endTime":1850.0,"body":"nowadays, with the more rigid"},{"speaker":"Charles Goldfarb","startTime":1846.46,"endTime":1850.0,"body":"smaller plates, I think you'd be"},{"speaker":"Charles Goldfarb","startTime":1850.0,"endTime":1852.85,"body":"pretty comfortable with your"},{"speaker":"Charles Goldfarb","startTime":1850.0,"endTime":1852.85,"body":"ability to obtain and maintain a"},{"speaker":"Charles Goldfarb","startTime":1852.85,"endTime":1853.39,"body":"reduction."},{"speaker":"Chris Dy","startTime":1853.93,"endTime":1856.75,"body":"Now, would you? Whoa,"},{"speaker":"Chris Dy","startTime":1853.93,"endTime":1856.75,"body":"what, what's the postdoc"},{"speaker":"Chris Dy","startTime":1856.75,"endTime":1858.94,"body":"protocol for that patient? I"},{"speaker":"Chris Dy","startTime":1856.75,"endTime":1858.94,"body":"mean, how much are you going to"},{"speaker":"Chris Dy","startTime":1858.94,"endTime":1861.1,"body":"protect that obviously, you want"},{"speaker":"Chris Dy","startTime":1858.94,"endTime":1861.1,"body":"to get this thing moving,"},{"speaker":"Chris Dy","startTime":1861.1,"endTime":1863.26,"body":"because the patient hasn't been"},{"speaker":"Chris Dy","startTime":1861.1,"endTime":1863.26,"body":"moving their forearm in a while,"},{"speaker":"Charles Goldfarb","startTime":1864.04,"endTime":1866.17,"body":"yeah, two"},{"speaker":"Charles Goldfarb","startTime":1864.04,"endTime":1866.17,"body":"weeks in a splint for me, and"},{"speaker":"Charles Goldfarb","startTime":1866.17,"endTime":1869.41,"body":"then two weeks and, you know, a"},{"speaker":"Charles Goldfarb","startTime":1866.17,"endTime":1869.41,"body":"surgically applied splint. And"},{"speaker":"Charles Goldfarb","startTime":1869.41,"endTime":1871.63,"body":"then I'd see them back in the"},{"speaker":"Charles Goldfarb","startTime":1869.41,"endTime":1871.63,"body":"office and I'll have them in a"},{"speaker":"Charles Goldfarb","startTime":1871.66,"endTime":1875.44,"body":"therapy fabricated splint with"},{"speaker":"Charles Goldfarb","startTime":1871.66,"endTime":1875.44,"body":"early active motion, nothing"},{"speaker":"Charles Goldfarb","startTime":1875.44,"endTime":1878.44,"body":"passive. And then hopefully, by"},{"speaker":"Charles Goldfarb","startTime":1875.44,"endTime":1878.44,"body":"five or six weeks, they're"},{"speaker":"Charles Goldfarb","startTime":1878.44,"endTime":1881.8,"body":"healed. And then we ramp up from"},{"speaker":"Charles Goldfarb","startTime":1878.44,"endTime":1881.8,"body":"there. So you know, it's still"},{"speaker":"Charles Goldfarb","startTime":1881.8,"endTime":1885.97,"body":"still the this, it's been about"},{"speaker":"Charles Goldfarb","startTime":1881.8,"endTime":1885.97,"body":"four weeks. So I need to see the"},{"speaker":"Charles Goldfarb","startTime":1885.97,"endTime":1887.86,"body":"patient back in a couple more"},{"speaker":"Charles Goldfarb","startTime":1885.97,"endTime":1887.86,"body":"weeks and see how they're doing."},{"speaker":"Charles Goldfarb","startTime":1887.86,"endTime":1889.75,"body":"But their two week visit, they"},{"speaker":"Charles Goldfarb","startTime":1887.86,"endTime":1889.75,"body":"were already doing pretty well."},{"speaker":"Charles Goldfarb","startTime":1889.75,"endTime":1891.04,"body":"So I'm pretty excited."},{"speaker":"Chris Dy","startTime":1891.46,"endTime":1893.44,"body":"Yeah, that's, that's"},{"speaker":"Chris Dy","startTime":1891.46,"endTime":1893.44,"body":"great. I just got a clarifying"},{"speaker":"Chris Dy","startTime":1893.44,"endTime":1897.37,"body":"question. Given what we're"},{"speaker":"Chris Dy","startTime":1893.44,"endTime":1897.37,"body":"dealing with here. Is your post"},{"speaker":"Chris Dy","startTime":1897.37,"endTime":1900.37,"body":"op splint that you fabricated a"},{"speaker":"Chris Dy","startTime":1897.37,"endTime":1900.37,"body":"sugar telling and is the therapy"},{"speaker":"Chris Dy","startTime":1900.37,"endTime":1903.52,"body":"splint going to be a monster? Or"},{"speaker":"Chris Dy","startTime":1900.37,"endTime":1903.52,"body":"are you letting them kind of"},{"speaker":"Chris Dy","startTime":1903.55,"endTime":1906.22,"body":"move ad lib and something below?"},{"speaker":"Chris Dy","startTime":1903.55,"endTime":1906.22,"body":"Below elbow?"},{"speaker":"Charles Goldfarb","startTime":1906.37,"endTime":1907.99,"body":"Yeah, I'm"},{"speaker":"Charles Goldfarb","startTime":1906.37,"endTime":1907.99,"body":"curious as to what you do when I"},{"speaker":"Charles Goldfarb","startTime":1907.99,"endTime":1914.65,"body":"operate on the radius. Or if I"},{"speaker":"Charles Goldfarb","startTime":1907.99,"endTime":1914.65,"body":"have a foveral TFCC repair, I"},{"speaker":"Charles Goldfarb","startTime":1914.65,"endTime":1920.02,"body":"tend to do a sugar tong to start"},{"speaker":"Charles Goldfarb","startTime":1914.65,"endTime":1920.02,"body":"and then a muenster. When I"},{"speaker":"Charles Goldfarb","startTime":1920.02,"endTime":1923.77,"body":"operate on the ulna as I did in"},{"speaker":"Charles Goldfarb","startTime":1920.02,"endTime":1923.77,"body":"this case, I think of is it as"},{"speaker":"Charles Goldfarb","startTime":1923.77,"endTime":1927.76,"body":"the constant unit with a radius"},{"speaker":"Charles Goldfarb","startTime":1923.77,"endTime":1927.76,"body":"rotating around it. So I just"},{"speaker":"Charles Goldfarb","startTime":1927.76,"endTime":1931.18,"body":"did a short arms on it. And I"},{"speaker":"Charles Goldfarb","startTime":1927.76,"endTime":1931.18,"body":"debated the longer but I just"},{"speaker":"Charles Goldfarb","startTime":1931.18,"endTime":1933.61,"body":"know what the short arms. How do"},{"speaker":"Charles Goldfarb","startTime":1931.18,"endTime":1933.61,"body":"you think about those"},{"speaker":"Charles Goldfarb","startTime":1933.61,"endTime":1934.51,"body":"situations?"},{"speaker":"Chris Dy","startTime":1935.17,"endTime":1939.218,"body":"I guess the only way,"},{"speaker":"Chris Dy","startTime":1935.17,"endTime":1939.218,"body":"the only if I'm worried about"},{"speaker":"Chris Dy","startTime":1939.297,"endTime":1944.298,"body":"the about the DRUJ. That's when"},{"speaker":"Chris Dy","startTime":1939.297,"endTime":1944.298,"body":"I go above elbow with the sugar"},{"speaker":"Chris Dy","startTime":1944.378,"endTime":1949.061,"body":"tong and a muenster for purely"},{"speaker":"Chris Dy","startTime":1944.378,"endTime":1949.061,"body":"for like an ulnar shortening"},{"speaker":"Chris Dy","startTime":1949.14,"endTime":1954.3,"body":"osteotomy in which it's more for"},{"speaker":"Chris Dy","startTime":1949.14,"endTime":1954.3,"body":"pain and less for stability. I'm"},{"speaker":"Chris Dy","startTime":1954.379,"endTime":1956.92,"body":"okay with something below elbow."},{"speaker":"Charles Goldfarb","startTime":1957.65,"endTime":1960.313,"body":"Yeah, yeah, I"},{"speaker":"Charles Goldfarb","startTime":1957.65,"endTime":1960.313,"body":"agree with that for sure. The"},{"speaker":"Charles Goldfarb","startTime":1960.375,"endTime":1964.277,"body":"other cool case, as we wrap up,"},{"speaker":"Charles Goldfarb","startTime":1960.375,"endTime":1964.277,"body":"I've had two really interesting"},{"speaker":"Charles Goldfarb","startTime":1964.339,"endTime":1967.745,"body":"cases. And again, this is a"},{"speaker":"Charles Goldfarb","startTime":1964.339,"endTime":1967.745,"body":"little in the pediatric and"},{"speaker":"Charles Goldfarb","startTime":1967.807,"endTime":1971.585,"body":"congenital world. But as you"},{"speaker":"Charles Goldfarb","startTime":1967.807,"endTime":1971.585,"body":"remember, Dr. Dy Olliers disease"},{"speaker":"Charles Goldfarb","startTime":1971.647,"endTime":1975.363,"body":"is multiple enchondromatosis and"},{"speaker":"Charles Goldfarb","startTime":1971.647,"endTime":1975.363,"body":"the enchondromas can really"},{"speaker":"Charles Goldfarb","startTime":1975.425,"endTime":1979.265,"body":"affect growth of the bones and"},{"speaker":"Charles Goldfarb","startTime":1975.425,"endTime":1979.265,"body":"so I've had two of those in the"},{"speaker":"Charles Goldfarb","startTime":1979.327,"endTime":1982.92,"body":"last few weeks where I've"},{"speaker":"Charles Goldfarb","startTime":1979.327,"endTime":1982.92,"body":"lengthen the radius. And for one"},{"speaker":"Charles Goldfarb","startTime":1982.982,"endTime":1986.45,"body":"of them I did a osteotomy and"},{"speaker":"Charles Goldfarb","startTime":1982.982,"endTime":1986.45,"body":"application of an external"},{"speaker":"Charles Goldfarb","startTime":1986.512,"endTime":1990.538,"body":"fixture to gradually lengthen we"},{"speaker":"Charles Goldfarb","startTime":1986.512,"endTime":1990.538,"body":"needed more length and the other"},{"speaker":"Charles Goldfarb","startTime":1990.6,"endTime":1994.192,"body":"one I did a step cut. And I"},{"speaker":"Charles Goldfarb","startTime":1990.6,"endTime":1994.192,"body":"haven't done a lot of step cut"},{"speaker":"Charles Goldfarb","startTime":1994.254,"endTime":1998.28,"body":"osteotomies is where you can get"},{"speaker":"Charles Goldfarb","startTime":1994.254,"endTime":1998.28,"body":"about a centimeter and a half or"},{"speaker":"Charles Goldfarb","startTime":1998.342,"endTime":2001.996,"body":"sometimes a little more. It can"},{"speaker":"Charles Goldfarb","startTime":1998.342,"endTime":2001.996,"body":"be kind of fun. It's also a"},{"speaker":"Charles Goldfarb","startTime":2002.058,"endTime":2005.96,"body":"little harrowing because I worry"},{"speaker":"Charles Goldfarb","startTime":2002.058,"endTime":2005.96,"body":"about swelling when you do one"},{"speaker":"Charles Goldfarb","startTime":2006.022,"endTime":2009.367,"body":"stage lengthy things but"},{"speaker":"Charles Goldfarb","startTime":2006.022,"endTime":2009.367,"body":"thankfully all went well. But"},{"speaker":"Charles Goldfarb","startTime":2009.429,"endTime":2010.42,"body":"fun pays out cut"},{"speaker":"Chris Dy","startTime":2010.78,"endTime":2013.21,"body":"it Step Cut very"},{"speaker":"Chris Dy","startTime":2010.78,"endTime":2013.21,"body":"interesting technically is that"},{"speaker":"Chris Dy","startTime":2013.96,"endTime":2016.75,"body":"is that something that you find"},{"speaker":"Chris Dy","startTime":2013.96,"endTime":2016.75,"body":"very challenging aside from the"},{"speaker":"Chris Dy","startTime":2016.75,"endTime":2019.18,"body":"consideration for the swelling"},{"speaker":"Chris Dy","startTime":2016.75,"endTime":2019.18,"body":"but I mean getting the carpentry"},{"speaker":"Chris Dy","startTime":2019.18,"endTime":2020.65,"body":"just right must be very"},{"speaker":"Chris Dy","startTime":2019.18,"endTime":2020.65,"body":"challenging."},{"speaker":"Charles Goldfarb","startTime":2022.36,"endTime":2025.036,"body":"i It worked"},{"speaker":"Charles Goldfarb","startTime":2022.36,"endTime":2025.036,"body":"well. We had Jessica Billig, our"},{"speaker":"Charles Goldfarb","startTime":2025.096,"endTime":2028.989,"body":"fellow was there she was great."},{"speaker":"Charles Goldfarb","startTime":2025.096,"endTime":2028.989,"body":"And what we did was we worked in"},{"speaker":"Charles Goldfarb","startTime":2029.05,"endTime":2032.578,"body":"the metathesis of the distal"},{"speaker":"Charles Goldfarb","startTime":2029.05,"endTime":2032.578,"body":"radius near or in the side of"},{"speaker":"Charles Goldfarb","startTime":2032.638,"endTime":2036.227,"body":"the income drama which usually"},{"speaker":"Charles Goldfarb","startTime":2032.638,"endTime":2036.227,"body":"is a good thing they tend to"},{"speaker":"Charles Goldfarb","startTime":2036.288,"endTime":2040.059,"body":"heal well in that area. And we"},{"speaker":"Charles Goldfarb","startTime":2036.288,"endTime":2040.059,"body":"essentially made a longitudinal"},{"speaker":"Charles Goldfarb","startTime":2040.12,"endTime":2043.769,"body":"using K whereas longitudinally,"},{"speaker":"Charles Goldfarb","startTime":2040.12,"endTime":2043.769,"body":"we did about a century and a"},{"speaker":"Charles Goldfarb","startTime":2043.83,"endTime":2047.479,"body":"half and then we exited on one"},{"speaker":"Charles Goldfarb","startTime":2043.83,"endTime":2047.479,"body":"side distally exit and on one"},{"speaker":"Charles Goldfarb","startTime":2047.54,"endTime":2051.432,"body":"side proximately put two smooth"},{"speaker":"Charles Goldfarb","startTime":2047.54,"endTime":2051.432,"body":"laminar spreaders in one on each"},{"speaker":"Charles Goldfarb","startTime":2051.493,"endTime":2055.264,"body":"side and spread and things were"},{"speaker":"Charles Goldfarb","startTime":2051.493,"endTime":2055.264,"body":"well aligned and we put a long"},{"speaker":"Charles Goldfarb","startTime":2055.325,"endTime":2058.67,"body":"enough played on that we had"},{"speaker":"Charles Goldfarb","startTime":2055.325,"endTime":2058.67,"body":"good security proximal and"},{"speaker":"Charles Goldfarb","startTime":2058.731,"endTime":2061.833,"body":"distal and then one one"},{"speaker":"Charles Goldfarb","startTime":2058.731,"endTime":2061.833,"body":"transverse screw as well so"},{"speaker":"Charles Goldfarb","startTime":2061.894,"endTime":2065.604,"body":"pretty pretty, pretty good. I"},{"speaker":"Charles Goldfarb","startTime":2061.894,"endTime":2065.604,"body":"mean it's got to heal but I was"},{"speaker":"Charles Goldfarb","startTime":2065.665,"endTime":2066.76,"body":"pretty encouraged."},{"speaker":"Chris Dy","startTime":2067.21,"endTime":2070.81,"body":"Sounds pretty slick."},{"speaker":"Chris Dy","startTime":2067.21,"endTime":2070.81,"body":"Is that is the treat that like"},{"speaker":"Chris Dy","startTime":2070.81,"endTime":2073.54,"body":"any other osteotomy in terms of"},{"speaker":"Chris Dy","startTime":2070.81,"endTime":2073.54,"body":"post op protocols and rehab"},{"speaker":"Charles Goldfarb","startTime":2074.13,"endTime":2077.085,"body":"Yeah, I would"},{"speaker":"Charles Goldfarb","startTime":2074.13,"endTime":2077.085,"body":"go I'm done the Step Cut I would"},{"speaker":"Charles Goldfarb","startTime":2077.149,"endTime":2080.682,"body":"I really monitored for"},{"speaker":"Charles Goldfarb","startTime":2077.149,"endTime":2080.682,"body":"compartment syndrome and I think"},{"speaker":"Charles Goldfarb","startTime":2080.746,"endTime":2084.858,"body":"we go a little slow till we see"},{"speaker":"Charles Goldfarb","startTime":2080.746,"endTime":2084.858,"body":"some callus formation given that"},{"speaker":"Charles Goldfarb","startTime":2084.922,"endTime":2088.905,"body":"we're depending on a plate and a"},{"speaker":"Charles Goldfarb","startTime":2084.922,"endTime":2088.905,"body":"narrow bridge connecting bone"},{"speaker":"Charles Goldfarb","startTime":2088.969,"endTime":2092.759,"body":"but yeah, they're gonna heal"},{"speaker":"Charles Goldfarb","startTime":2088.969,"endTime":2092.759,"body":"well. The beauty is that these"},{"speaker":"Charles Goldfarb","startTime":2092.823,"endTime":2096.1,"body":"heal really well.  Two Olliers"},{"speaker":"Charles Goldfarb","startTime":2092.823,"endTime":2096.1,"body":"cases, That's a lot."},{"speaker":"Chris Dy","startTime":2096.52,"endTime":2100.33,"body":"That is a lot. You"},{"speaker":"Chris Dy","startTime":2096.52,"endTime":2100.33,"body":"have your boutique practice. Is"},{"speaker":"Chris Dy","startTime":2100.33,"endTime":2102.49,"body":"there a blog post coming?"},{"speaker":"Chris Dy","startTime":2100.33,"endTime":2102.49,"body":"Perhaps?"},{"speaker":"Charles Goldfarb","startTime":2103.09,"endTime":2105.4,"body":"You know what"},{"speaker":"Charles Goldfarb","startTime":2103.09,"endTime":2105.4,"body":"there should be if I was on my"},{"speaker":"Charles Goldfarb","startTime":2105.4,"endTime":2109.63,"body":"social media game? I did delete"},{"speaker":"Charles Goldfarb","startTime":2105.4,"endTime":2109.63,"body":"Twitter, but I had to reinstall"},{"speaker":"Charles Goldfarb","startTime":2109.63,"endTime":2109.99,"body":"it."},{"speaker":"Chris Dy","startTime":2110.05,"endTime":2112.9,"body":"What what? I do have"},{"speaker":"Chris Dy","startTime":2110.05,"endTime":2112.9,"body":"to reinstall it."},{"speaker":"Charles Goldfarb","startTime":2112.99,"endTime":2115.48,"body":"I just need to"},{"speaker":"Charles Goldfarb","startTime":2112.99,"endTime":2115.48,"body":"follow up on some stuff. And I"},{"speaker":"Charles Goldfarb","startTime":2115.48,"endTime":2118.15,"body":"want to get back into the"},{"speaker":"Charles Goldfarb","startTime":2115.48,"endTime":2118.15,"body":"Journal of hand surgery Twitter"},{"speaker":"Charles Goldfarb","startTime":2118.15,"endTime":2121.09,"body":"journal club in your car Twitter"},{"speaker":"Charles Goldfarb","startTime":2118.15,"endTime":2121.09,"body":"for that."},{"speaker":"Chris Dy","startTime":2121.57,"endTime":2125.14,"body":"Yes, yes, it does."},{"speaker":"Chris Dy","startTime":2121.57,"endTime":2125.14,"body":"Yes, it does. I think Twitter is"},{"speaker":"Chris Dy","startTime":2126.28,"endTime":2128.41,"body":"way beyond the scope of this"},{"speaker":"Chris Dy","startTime":2126.28,"endTime":2128.41,"body":"podcast, one of the things I"},{"speaker":"Chris Dy","startTime":2128.41,"endTime":2133.15,"body":"listened to outside of our stuff"},{"speaker":"Chris Dy","startTime":2128.41,"endTime":2133.15,"body":"is pivot. And we've talked about"},{"speaker":"Chris Dy","startTime":2133.15,"endTime":2136.39,"body":"Scott Galloway before. You had a"},{"speaker":"Chris Dy","startTime":2133.15,"endTime":2136.39,"body":"time they talk about Elon Musk"},{"speaker":"Chris Dy","startTime":2136.39,"endTime":2139.18,"body":"and Twitter is disproportionate"},{"speaker":"Chris Dy","startTime":2136.39,"endTime":2139.18,"body":"because a little too much."},{"speaker":"Chris Dy","startTime":2139.21,"endTime":2141.82,"body":"That's I know a lot of what's"},{"speaker":"Chris Dy","startTime":2139.21,"endTime":2141.82,"body":"going on at Twitter. And I"},{"speaker":"Chris Dy","startTime":2141.82,"endTime":2144.64,"body":"admit, I have not opened Twitter"},{"speaker":"Chris Dy","startTime":2141.82,"endTime":2144.64,"body":"really much in the last few"},{"speaker":"Chris Dy","startTime":2144.64,"endTime":2146.32,"body":"months because of all this"},{"speaker":"Chris Dy","startTime":2144.64,"endTime":2146.32,"body":"craziness going on."},{"speaker":"Charles Goldfarb","startTime":2146.709,"endTime":2148.269,"body":"I know, I"},{"speaker":"Charles Goldfarb","startTime":2146.709,"endTime":2148.269,"body":"know. I'm not gonna it's not"},{"speaker":"Charles Goldfarb","startTime":2148.269,"endTime":2150.399,"body":"gonna be part of my daily"},{"speaker":"Charles Goldfarb","startTime":2148.269,"endTime":2150.399,"body":"routine to go there. I do like"},{"speaker":"Charles Goldfarb","startTime":2150.399,"endTime":2155.649,"body":"Instagram. You know, but I'm"},{"speaker":"Charles Goldfarb","startTime":2150.399,"endTime":2155.649,"body":"old. No one expects much of me"},{"speaker":"Charles Goldfarb","startTime":2155.649,"endTime":2157.899,"body":"on on those on those forums."},{"speaker":"Chris Dy","startTime":2158.08,"endTime":2160.48,"body":"But that means that"},{"speaker":"Chris Dy","startTime":2158.08,"endTime":2160.48,"body":"you are exceeding everybody's"},{"speaker":"Chris Dy","startTime":2160.48,"endTime":2163.9,"body":"expectation. All right. Well,"},{"speaker":"Chris Dy","startTime":2160.48,"endTime":2163.9,"body":"you have a great rest of the"},{"speaker":"Chris Dy","startTime":2163.9,"endTime":2165.34,"body":"day. You too. Good"},{"speaker":"Charles Goldfarb","startTime":2165.34,"endTime":2168.07,"body":"to see you."},{"speaker":"Charles Goldfarb","startTime":2165.34,"endTime":2168.07,"body":"Take care. Nice seeing you. Hey,"},{"speaker":"Charles Goldfarb","startTime":2168.07,"endTime":2171.43,"body":"Chris, that was fun. Let's do it"},{"speaker":"Charles Goldfarb","startTime":2168.07,"endTime":2171.43,"body":"again real soon. Sounds good."},{"speaker":"Chris Dy","startTime":2171.01,"endTime":2173.629,"body":"Well, be sure to check"},{"speaker":"Chris Dy","startTime":2171.01,"endTime":2173.629,"body":"us out on Twitter @handpodcast."},{"speaker":"Chris Dy","startTime":2173.678,"endTime":2175.57,"body":"Hey, Chuck, what's your Twitter handle?"},{"speaker":"Charles Goldfarb","startTime":2175.9,"endTime":2178.03,"body":"Mine is @congenitalhand."},{"speaker":"Chris Dy","startTime":2178.15,"endTime":2181.521,"body":"What about you? Mine"},{"speaker":"Chris Dy","startTime":2178.15,"endTime":2181.521,"body":"is @ChrisDyMD spelled d-y. And"},{"speaker":"Chris Dy","startTime":2181.588,"endTime":2186.15,"body":"if you'd like to email us, you"},{"speaker":"Chris Dy","startTime":2181.588,"endTime":2186.15,"body":"can reach us at handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2186.73,"endTime":2188.86,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2186.73,"endTime":2188.86,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2188.86,"endTime":2189.94,"body":"get your podcast"},{"speaker":"Chris Dy","startTime":2190.0,"endTime":2192.19,"body":"and be sure to leave a"},{"speaker":"Chris Dy","startTime":2190.0,"endTime":2192.19,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2192.19,"endTime":2193.81,"body":"word out. Special thanks"},{"speaker":"Charles Goldfarb","startTime":2193.81,"endTime":2195.76,"body":"to Peter"},{"speaker":"Charles Goldfarb","startTime":2193.81,"endTime":2195.76,"body":"Martin for the amazing music."},{"speaker":"Charles Goldfarb","startTime":2196.0,"endTime":2199.27,"body":"And remember, keep the upper"},{"speaker":"Charles Goldfarb","startTime":2196.0,"endTime":2199.27,"body":"hand. Come back next time"}]}