{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":0.0,"endTime":7.14,"body":"Chuck, welcome"},{"speaker":"Charles Goldfarb","startTime":0.0,"endTime":7.14,"body":"to the upper hand podcast where"},{"speaker":"Charles Goldfarb","startTime":7.14,"endTime":8.88,"body":"Chuck and Chris talk hand"},{"speaker":"Charles Goldfarb","startTime":7.14,"endTime":8.88,"body":"surgery."},{"speaker":"Chris Dy","startTime":9.54,"endTime":11.46,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":9.54,"endTime":11.46,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":11.46,"endTime":14.4,"body":"University in St Louis, here to"},{"speaker":"Chris Dy","startTime":11.46,"endTime":14.4,"body":"talk about all things hand"},{"speaker":"Chris Dy","startTime":14.4,"endTime":16.62,"body":"surgery related, from technical"},{"speaker":"Chris Dy","startTime":14.4,"endTime":16.62,"body":"to personal."},{"speaker":"Charles Goldfarb","startTime":16.62,"endTime":20.36,"body":"Please"},{"speaker":"Charles Goldfarb","startTime":16.62,"endTime":20.36,"body":"subscribe wherever you get your podcasts,"},{"speaker":"Chris Dy","startTime":20.36,"endTime":23.117,"body":"And thank you in"},{"speaker":"Chris Dy","startTime":20.36,"endTime":23.117,"body":"advance for leaving a review and"},{"speaker":"Chris Dy","startTime":23.173,"endTime":26.55,"body":"a rating that helps us get the"},{"speaker":"Chris Dy","startTime":23.173,"endTime":26.55,"body":"word out. You can email us at"},{"speaker":"Chris Dy","startTime":26.606,"endTime":29.42,"body":"handpodcast@gmail.com so let's"},{"speaker":"Chris Dy","startTime":26.606,"endTime":29.42,"body":"get to the episode."},{"speaker":"Charles Goldfarb","startTime":30.98,"endTime":32.06,"body":"Oh, hey Chris,"},{"speaker":"Chris Dy","startTime":32.3,"endTime":33.2,"body":"hey, Chuck. How are"},{"speaker":"Chris Dy","startTime":32.3,"endTime":33.2,"body":"you?"},{"speaker":"Charles Goldfarb","startTime":33.8,"endTime":35.36,"body":"I'm great. How"},{"speaker":"Charles Goldfarb","startTime":33.8,"endTime":35.36,"body":"are you?"},{"speaker":"Chris Dy","startTime":35.6,"endTime":38.54,"body":"I'm good. I'm good."},{"speaker":"Chris Dy","startTime":35.6,"endTime":38.54,"body":"I'm in a different location than"},{"speaker":"Chris Dy","startTime":38.54,"endTime":41.8,"body":"our usual. Those of you watching"},{"speaker":"Chris Dy","startTime":38.54,"endTime":41.8,"body":"on YouTube. See this lovely"},{"speaker":"Chris Dy","startTime":41.8,"endTime":44.62,"body":"Embassy Suites lay out in the"},{"speaker":"Chris Dy","startTime":41.8,"endTime":44.62,"body":"background here."},{"speaker":"Charles Goldfarb","startTime":44.44,"endTime":46.819,"body":"Nice. Yeah,"},{"speaker":"Charles Goldfarb","startTime":44.44,"endTime":46.819,"body":"you look very nice. Tell us"},{"speaker":"Charles Goldfarb","startTime":46.88,"endTime":48.1,"body":"about where you are."},{"speaker":"Chris Dy","startTime":48.34,"endTime":51.7,"body":"I am at the what's"},{"speaker":"Chris Dy","startTime":48.34,"endTime":51.7,"body":"been, I think, my third trip to"},{"speaker":"Chris Dy","startTime":51.7,"endTime":55.24,"body":"the orthopedic research"},{"speaker":"Chris Dy","startTime":51.7,"endTime":55.24,"body":"society's clinician scientist"},{"speaker":"Chris Dy","startTime":55.24,"endTime":59.02,"body":"development program. So it's"},{"speaker":"Chris Dy","startTime":55.24,"endTime":59.02,"body":"actually a, it's a really cool"},{"speaker":"Chris Dy","startTime":59.38,"endTime":63.18,"body":"program, I think, for the people"},{"speaker":"Chris Dy","startTime":59.38,"endTime":63.18,"body":"that are interested in in"},{"speaker":"Chris Dy","startTime":63.6,"endTime":66.66,"body":"working as a clinician scholar"},{"speaker":"Chris Dy","startTime":63.6,"endTime":66.66,"body":"when they're out in the wild,"},{"speaker":"Chris Dy","startTime":66.72,"endTime":72.66,"body":"and I attend this in 2011 Wow,"},{"speaker":"Chris Dy","startTime":66.72,"endTime":72.66,"body":"as a resident sponsored by the"},{"speaker":"Chris Dy","startTime":72.66,"endTime":76.08,"body":"American Foundation for surgery"},{"speaker":"Chris Dy","startTime":72.66,"endTime":76.08,"body":"the hand. So thank you. Afsh"},{"speaker":"Chris Dy","startTime":76.08,"endTime":79.68,"body":"donors around that time, and"},{"speaker":"Chris Dy","startTime":76.08,"endTime":79.68,"body":"have come back on the faculty"},{"speaker":"Chris Dy","startTime":79.92,"endTime":83.06,"body":"for three years now, it's an"},{"speaker":"Chris Dy","startTime":79.92,"endTime":83.06,"body":"honor to be invited to come back"},{"speaker":"Chris Dy","startTime":83.06,"endTime":88.04,"body":"and to talk about wonderful"},{"speaker":"Chris Dy","startTime":83.06,"endTime":88.04,"body":"things like how to start as a"},{"speaker":"Chris Dy","startTime":88.04,"endTime":91.22,"body":"clinician scientist, how to get"},{"speaker":"Chris Dy","startTime":88.04,"endTime":91.22,"body":"promoted, that kind of"},{"speaker":"Charles Goldfarb","startTime":91.1,"endTime":94.971,"body":"Yeah, and is"},{"speaker":"Charles Goldfarb","startTime":91.1,"endTime":94.971,"body":"it every year this conference is"},{"speaker":"Charles Goldfarb","startTime":95.057,"endTime":95.66,"body":"held..."},{"speaker":"Chris Dy","startTime":95.66,"endTime":98.109,"body":"it's every year and"},{"speaker":"Chris Dy","startTime":95.66,"endTime":98.109,"body":"its in the same hotel? And I've"},{"speaker":"Chris Dy","startTime":98.157,"endTime":101.086,"body":"learned a lot of things about"},{"speaker":"Chris Dy","startTime":98.157,"endTime":101.086,"body":"the Embassy Suites in Rosemont,"},{"speaker":"Chris Dy","startTime":101.134,"endTime":104.16,"body":"Illinois, including that their"},{"speaker":"Chris Dy","startTime":101.134,"endTime":104.16,"body":"gym is quite limited in terms of"},{"speaker":"Chris Dy","startTime":104.208,"endTime":106.897,"body":"what's available, number of"},{"speaker":"Chris Dy","startTime":104.208,"endTime":106.897,"body":"machines available, and what"},{"speaker":"Chris Dy","startTime":106.945,"endTime":109.586,"body":"number changes is that"},{"speaker":"Chris Dy","startTime":106.945,"endTime":109.586,"body":"orthopedic surgeons want to work"},{"speaker":"Chris Dy","startTime":109.634,"endTime":111.94,"body":"out in the morning. So it's"},{"speaker":"Chris Dy","startTime":109.634,"endTime":111.94,"body":"always a bit shuffle"},{"speaker":"Charles Goldfarb","startTime":111.94,"endTime":115.078,"body":"Yeah, I can"},{"speaker":"Charles Goldfarb","startTime":111.94,"endTime":115.078,"body":"imagine. I can imagine. Well,"},{"speaker":"Charles Goldfarb","startTime":115.154,"endTime":119.9,"body":"good. Well, we have a, I think,"},{"speaker":"Charles Goldfarb","startTime":115.154,"endTime":119.9,"body":"a very robust set of things to"},{"speaker":"Charles Goldfarb","startTime":119.976,"endTime":124.722,"body":"discuss. And I'd love to start"},{"speaker":"Charles Goldfarb","startTime":119.976,"endTime":124.722,"body":"with both of our experiences at"},{"speaker":"Charles Goldfarb","startTime":124.798,"endTime":130.08,"body":"the American Society of hand"},{"speaker":"Charles Goldfarb","startTime":124.798,"endTime":130.08,"body":"therapy, hand therapists and therapists."},{"speaker":"Chris Dy","startTime":130.5,"endTime":133.68,"body":"Yeah, I was, I really"},{"speaker":"Chris Dy","startTime":130.5,"endTime":133.68,"body":"enjoyed the meeting. I was I was"},{"speaker":"Chris Dy","startTime":133.68,"endTime":138.54,"body":"a participant. I was able to"},{"speaker":"Chris Dy","startTime":133.68,"endTime":138.54,"body":"watch our our research team, two"},{"speaker":"Chris Dy","startTime":138.54,"endTime":141.68,"body":"medical students, gave fantastic"},{"speaker":"Chris Dy","startTime":138.54,"endTime":141.68,"body":"podium presentations on their"},{"speaker":"Chris Dy","startTime":141.68,"endTime":144.44,"body":"research. So thank you to the"},{"speaker":"Chris Dy","startTime":141.68,"endTime":144.44,"body":"program chairs for accepting"},{"speaker":"Chris Dy","startTime":144.44,"endTime":148.04,"body":"their abstracts and allowing to"},{"speaker":"Chris Dy","startTime":144.44,"endTime":148.04,"body":"present podiums. One of them was"},{"speaker":"Chris Dy","startTime":148.04,"endTime":153.2,"body":"on our initiative to understand"},{"speaker":"Chris Dy","startTime":148.04,"endTime":153.2,"body":"how we contemporize and"},{"speaker":"Chris Dy","startTime":153.2,"endTime":157.1,"body":"contemporize outcome assessments"},{"speaker":"Chris Dy","startTime":153.2,"endTime":157.1,"body":"after like a plexus injuries"},{"speaker":"Chris Dy","startTime":157.1,"endTime":159.92,"body":"using things like video"},{"speaker":"Chris Dy","startTime":157.1,"endTime":159.92,"body":"goniometry, which is"},{"speaker":"Chris Dy","startTime":159.92,"endTime":162.22,"body":"interesting, try to automate"},{"speaker":"Chris Dy","startTime":159.92,"endTime":162.22,"body":"some of this process, or at"},{"speaker":"Chris Dy","startTime":162.22,"endTime":165.64,"body":"least make it more objective"},{"speaker":"Chris Dy","startTime":162.22,"endTime":165.64,"body":"down the line. And Steven"},{"speaker":"Chris Dy","startTime":165.64,"endTime":168.52,"body":"dimartini gave great"},{"speaker":"Chris Dy","startTime":165.64,"endTime":168.52,"body":"presentation on that. And then"},{"speaker":"Chris Dy","startTime":168.82,"endTime":172.9,"body":"Ishaan sane gave a great talk"},{"speaker":"Chris Dy","startTime":168.82,"endTime":172.9,"body":"about our work trying to"},{"speaker":"Chris Dy","startTime":172.9,"endTime":175.96,"body":"understand how to implement a"},{"speaker":"Chris Dy","startTime":172.9,"endTime":175.96,"body":"navigator position for patients"},{"speaker":"Chris Dy","startTime":175.96,"endTime":179.44,"body":"with brachial plexus injury. So"},{"speaker":"Chris Dy","startTime":175.96,"endTime":179.44,"body":"a new thing for us that is long"},{"speaker":"Chris Dy","startTime":179.44,"endTime":182.1,"body":"overdue, somebody who can kind"},{"speaker":"Chris Dy","startTime":179.44,"endTime":182.1,"body":"of be a flex player and"},{"speaker":"Chris Dy","startTime":182.16,"endTime":186.12,"body":"incorporate some of the elements"},{"speaker":"Chris Dy","startTime":182.16,"endTime":186.12,"body":"of social work, you know, some"},{"speaker":"Chris Dy","startTime":186.12,"endTime":188.7,"body":"medical aspects of things"},{"speaker":"Chris Dy","startTime":186.12,"endTime":188.7,"body":"patient education, essentially"},{"speaker":"Chris Dy","startTime":188.7,"endTime":191.28,"body":"be a closer or somebody who"},{"speaker":"Chris Dy","startTime":188.7,"endTime":191.28,"body":"brings goes the extra mile and"},{"speaker":"Chris Dy","startTime":191.28,"endTime":193.86,"body":"gets people across the finish"},{"speaker":"Chris Dy","startTime":191.28,"endTime":193.86,"body":"line for things like disability"},{"speaker":"Chris Dy","startTime":193.86,"endTime":195.42,"body":"insurance applications, etc."},{"speaker":"Charles Goldfarb","startTime":195.96,"endTime":197.46,"body":"Yeah,"},{"speaker":"Charles Goldfarb","startTime":195.96,"endTime":197.46,"body":"navigator positions are"},{"speaker":"Charles Goldfarb","startTime":197.46,"endTime":200.1,"body":"interesting. And I'm sure some"},{"speaker":"Charles Goldfarb","startTime":197.46,"endTime":200.1,"body":"of our listeners have experience"},{"speaker":"Charles Goldfarb","startTime":200.34,"endTime":204.74,"body":"in that there is no question of"},{"speaker":"Charles Goldfarb","startTime":200.34,"endTime":204.74,"body":"the value of that role. It helps"},{"speaker":"Charles Goldfarb","startTime":204.74,"endTime":207.68,"body":"the physician, it helps the"},{"speaker":"Charles Goldfarb","startTime":204.74,"endTime":207.68,"body":"patients, helps everyone in"},{"speaker":"Charles Goldfarb","startTime":207.68,"endTime":212.6,"body":"between. But it's not a revenue"},{"speaker":"Charles Goldfarb","startTime":207.68,"endTime":212.6,"body":"creating position, and so it's"},{"speaker":"Charles Goldfarb","startTime":212.6,"endTime":216.08,"body":"it's yet another person in the"},{"speaker":"Charles Goldfarb","startTime":212.6,"endTime":216.08,"body":"team, and it sounds it's hard to"},{"speaker":"Charles Goldfarb","startTime":216.08,"endTime":219.5,"body":"justify, even though everyone"},{"speaker":"Charles Goldfarb","startTime":216.08,"endTime":219.5,"body":"understands the value"},{"speaker":"Chris Dy","startTime":219.98,"endTime":223.42,"body":"Yes, and that's a long"},{"speaker":"Chris Dy","startTime":219.98,"endTime":223.42,"body":"history in things like oncology"},{"speaker":"Chris Dy","startTime":223.9,"endTime":228.04,"body":"and cancer, obviously. So yes,"},{"speaker":"Chris Dy","startTime":223.9,"endTime":228.04,"body":"the way that we're able to get"},{"speaker":"Chris Dy","startTime":228.04,"endTime":230.56,"body":"this done is that we were"},{"speaker":"Chris Dy","startTime":228.04,"endTime":230.56,"body":"fortunate enough to get a grant"},{"speaker":"Chris Dy","startTime":230.56,"endTime":233.32,"body":"from the foundation for the"},{"speaker":"Chris Dy","startTime":230.56,"endTime":233.32,"body":"Barnes Jewish Hospital to at"},{"speaker":"Chris Dy","startTime":233.32,"endTime":236.08,"body":"least get us started, and"},{"speaker":"Chris Dy","startTime":233.32,"endTime":236.08,"body":"hopefully we can very clearly"},{"speaker":"Chris Dy","startTime":236.08,"endTime":238.72,"body":"demonstrate value and try to"},{"speaker":"Chris Dy","startTime":236.08,"endTime":238.72,"body":"find a way to fold this person"},{"speaker":"Chris Dy","startTime":238.72,"endTime":241.68,"body":"into the team on a more"},{"speaker":"Chris Dy","startTime":238.72,"endTime":241.68,"body":"permanent basis. Yeah,"},{"speaker":"Charles Goldfarb","startTime":241.44,"endTime":244.547,"body":"I love that."},{"speaker":"Charles Goldfarb","startTime":241.44,"endTime":244.547,"body":"Love that. What I really enjoy"},{"speaker":"Charles Goldfarb","startTime":244.619,"endTime":248.666,"body":"about the ASHT and I guess I"},{"speaker":"Charles Goldfarb","startTime":244.619,"endTime":248.666,"body":"would say hand therapist in"},{"speaker":"Charles Goldfarb","startTime":248.738,"endTime":253.146,"body":"general, is their passion for"},{"speaker":"Charles Goldfarb","startTime":248.738,"endTime":253.146,"body":"what they do is really cool and"},{"speaker":"Charles Goldfarb","startTime":253.218,"endTime":257.193,"body":"it, you know, it's, it's"},{"speaker":"Charles Goldfarb","startTime":253.218,"endTime":257.193,"body":"demonstrated in many different"},{"speaker":"Charles Goldfarb","startTime":257.265,"endTime":261.311,"body":"ways, attendance on Sunday"},{"speaker":"Charles Goldfarb","startTime":257.265,"endTime":261.311,"body":"morning would be one example,"},{"speaker":"Charles Goldfarb","startTime":261.384,"endTime":265.719,"body":"and not just attendance. So we"},{"speaker":"Charles Goldfarb","startTime":261.384,"endTime":265.719,"body":"had a couple of things Sunday"},{"speaker":"Charles Goldfarb","startTime":265.792,"endTime":270.055,"body":"morning. And not only were"},{"speaker":"Charles Goldfarb","startTime":265.792,"endTime":270.055,"body":"people there, they were engaged."},{"speaker":"Charles Goldfarb","startTime":270.127,"endTime":274.463,"body":"And really it's just a great"},{"speaker":"Charles Goldfarb","startTime":270.127,"endTime":274.463,"body":"group of people who really care"},{"speaker":"Charles Goldfarb","startTime":274.535,"endTime":278.943,"body":"about what they do and how they"},{"speaker":"Charles Goldfarb","startTime":274.535,"endTime":278.943,"body":"you know, make patients lives"},{"speaker":"Charles Goldfarb","startTime":279.016,"endTime":283.351,"body":"better. So I had a great time,"},{"speaker":"Charles Goldfarb","startTime":279.016,"endTime":283.351,"body":"and always enjoy the sht. And"},{"speaker":"Charles Goldfarb","startTime":283.424,"endTime":287.759,"body":"it's the second time it's been"},{"speaker":"Charles Goldfarb","startTime":283.424,"endTime":287.759,"body":"in St Louis in recent memory."},{"speaker":"Charles Goldfarb","startTime":287.832,"endTime":292.24,"body":"And I think they, they like St"},{"speaker":"Charles Goldfarb","startTime":287.832,"endTime":292.24,"body":"Louis as a hosting city. Yeah,"},{"speaker":"Chris Dy","startTime":292.78,"endTime":294.88,"body":"I think it's, it's the"},{"speaker":"Chris Dy","startTime":292.78,"endTime":294.88,"body":"the size of the meeting fits"},{"speaker":"Chris Dy","startTime":294.88,"endTime":298.78,"body":"pretty well for the size of our"},{"speaker":"Chris Dy","startTime":294.88,"endTime":298.78,"body":"city. And there's obviously a"},{"speaker":"Chris Dy","startTime":298.78,"endTime":301.56,"body":"rich legacy of hand there."},{"speaker":"Chris Dy","startTime":298.78,"endTime":301.56,"body":"Purpose and expertise in hand"},{"speaker":"Chris Dy","startTime":301.56,"endTime":304.5,"body":"therapy in St Louis, so it's"},{"speaker":"Chris Dy","startTime":301.56,"endTime":304.5,"body":"great to have them. So I hope"},{"speaker":"Chris Dy","startTime":304.5,"endTime":306.84,"body":"they come back, because it's"},{"speaker":"Chris Dy","startTime":304.5,"endTime":306.84,"body":"always nice to have a meeting at"},{"speaker":"Chris Dy","startTime":306.84,"endTime":309.72,"body":"home. It's interesting to have a"},{"speaker":"Chris Dy","startTime":306.84,"endTime":309.72,"body":"meeting at home. I had a special"},{"speaker":"Chris Dy","startTime":309.72,"endTime":312.84,"body":"companion for the afternoon"},{"speaker":"Chris Dy","startTime":309.72,"endTime":312.84,"body":"portion. On Saturday, my"},{"speaker":"Chris Dy","startTime":312.84,"endTime":315.06,"body":"daughter's soccer game was"},{"speaker":"Chris Dy","startTime":312.84,"endTime":315.06,"body":"canceled because the fields were"},{"speaker":"Chris Dy","startTime":315.06,"endTime":318.84,"body":"wet, so she came and my six year"},{"speaker":"Chris Dy","startTime":315.06,"endTime":318.84,"body":"old daughter was sitting front"},{"speaker":"Chris Dy","startTime":318.84,"endTime":321.32,"body":"and center as we watched our"},{"speaker":"Chris Dy","startTime":318.84,"endTime":321.32,"body":"medical students give a talk."},{"speaker":"Chris Dy","startTime":321.32,"endTime":324.38,"body":"They were so kind. They printed"},{"speaker":"Chris Dy","startTime":321.32,"endTime":324.38,"body":"out a name tag for her American"},{"speaker":"Chris Dy","startTime":324.38,"endTime":328.22,"body":"Girl doll. It was, it was fun."},{"speaker":"Chris Dy","startTime":324.38,"endTime":328.22,"body":"She got to see kind of a piece"},{"speaker":"Chris Dy","startTime":328.22,"endTime":331.76,"body":"of what, what I do at work. So"},{"speaker":"Chris Dy","startTime":328.22,"endTime":331.76,"body":"she got to meet daddy's work"},{"speaker":"Chris Dy","startTime":331.76,"endTime":335.6,"body":"friends. End quote, and had a"},{"speaker":"Chris Dy","startTime":331.76,"endTime":335.6,"body":"great time. Yeah, I didn't, I"},{"speaker":"Chris Dy","startTime":335.6,"endTime":338.54,"body":"didn't have her stick around for"},{"speaker":"Chris Dy","startTime":335.6,"endTime":338.54,"body":"the IC or for the course that"},{"speaker":"Chris Dy","startTime":338.54,"endTime":341.26,"body":"Macy and I were, we're teaching"},{"speaker":"Chris Dy","startTime":338.54,"endTime":341.26,"body":"together. I would have been a"},{"speaker":"Chris Dy","startTime":341.26,"endTime":344.08,"body":"little bit more challenging, and"},{"speaker":"Chris Dy","startTime":341.26,"endTime":344.08,"body":"the meeting organizers were on"},{"speaker":"Chris Dy","startTime":344.08,"endTime":346.24,"body":"high alert when they saw a six"},{"speaker":"Chris Dy","startTime":344.08,"endTime":346.24,"body":"year old was around. Then"},{"speaker":"Chris Dy","startTime":346.3,"endTime":348.22,"body":"they're like, you're gonna be"},{"speaker":"Chris Dy","startTime":346.3,"endTime":348.22,"body":"with her the whole time around."},{"speaker":"Chris Dy","startTime":348.22,"endTime":351.94,"body":"Like, yeah, absolutely no"},{"speaker":"Chris Dy","startTime":348.22,"endTime":351.94,"body":"problem. I can't let you get"},{"speaker":"Chris Dy","startTime":351.94,"endTime":355.96,"body":"away without telling us about"},{"speaker":"Chris Dy","startTime":351.94,"endTime":355.96,"body":"your cocktail reception. People"},{"speaker":"Chris Dy","startTime":355.96,"endTime":359.38,"body":"bought tickets to have an"},{"speaker":"Chris Dy","startTime":355.96,"endTime":359.38,"body":"evening with a scholar like"},{"speaker":"Chris Dy","startTime":359.38,"endTime":363.36,"body":"yourself, so you were the"},{"speaker":"Chris Dy","startTime":359.38,"endTime":363.36,"body":"feature for this ticketed event,"},{"speaker":"Chris Dy","startTime":363.36,"endTime":365.7,"body":"and I heard you gave a great"},{"speaker":"Chris Dy","startTime":363.36,"endTime":365.7,"body":"presentation."},{"speaker":"Charles Goldfarb","startTime":366.48,"endTime":371.28,"body":"Thank you for"},{"speaker":"Charles Goldfarb","startTime":366.48,"endTime":371.28,"body":"saying that. Yeah, it's a it's"},{"speaker":"Charles Goldfarb","startTime":371.34,"endTime":375.6,"body":"the major fundraiser, I guess,"},{"speaker":"Charles Goldfarb","startTime":371.34,"endTime":375.6,"body":"annually, for the foundation."},{"speaker":"Charles Goldfarb","startTime":375.66,"endTime":380.36,"body":"And it was Friday evening from"},{"speaker":"Charles Goldfarb","startTime":375.66,"endTime":380.36,"body":"around 630 to eight, and I came"},{"speaker":"Charles Goldfarb","startTime":380.36,"endTime":384.14,"body":"down after business school and"},{"speaker":"Charles Goldfarb","startTime":380.36,"endTime":384.14,"body":"hadn't had a good time, and I"},{"speaker":"Charles Goldfarb","startTime":384.14,"endTime":388.16,"body":"talked about impact, how we"},{"speaker":"Charles Goldfarb","startTime":384.14,"endTime":388.16,"body":"consider our impact, and how we"},{"speaker":"Charles Goldfarb","startTime":388.16,"endTime":392.6,"body":"should think about our impact."},{"speaker":"Charles Goldfarb","startTime":388.16,"endTime":392.6,"body":"And again, audience was great."},{"speaker":"Charles Goldfarb","startTime":392.78,"endTime":397.28,"body":"And so I spoke for, I don't"},{"speaker":"Charles Goldfarb","startTime":392.78,"endTime":397.28,"body":"know, 3540 minutes, and then we"},{"speaker":"Charles Goldfarb","startTime":397.28,"endTime":400.78,"body":"talked, there were questions for"},{"speaker":"Charles Goldfarb","startTime":397.28,"endTime":400.78,"body":"another 20 or 25 minutes. So"},{"speaker":"Charles Goldfarb","startTime":400.96,"endTime":405.58,"body":"really thoroughly enjoyed it."},{"speaker":"Charles Goldfarb","startTime":400.96,"endTime":405.58,"body":"And, you know, hopefully it, I"},{"speaker":"Charles Goldfarb","startTime":405.58,"endTime":407.8,"body":"think it was positively"},{"speaker":"Charles Goldfarb","startTime":405.58,"endTime":407.8,"body":"received. You never really know,"},{"speaker":"Charles Goldfarb","startTime":407.8,"endTime":408.94,"body":"but I enjoyed it."},{"speaker":"Chris Dy","startTime":409.54,"endTime":412.24,"body":"Multiple people from"},{"speaker":"Chris Dy","startTime":409.54,"endTime":412.24,"body":"various factions of the hand"},{"speaker":"Chris Dy","startTime":412.24,"endTime":415.12,"body":"therapy world commented to me"},{"speaker":"Chris Dy","startTime":412.24,"endTime":415.12,"body":"about how great the presentation"},{"speaker":"Chris Dy","startTime":415.12,"endTime":418.42,"body":"was. So congratulations. I heard"},{"speaker":"Chris Dy","startTime":415.12,"endTime":418.42,"body":"that you had some tough"},{"speaker":"Chris Dy","startTime":418.42,"endTime":422.64,"body":"questions that you handled very"},{"speaker":"Chris Dy","startTime":418.42,"endTime":422.64,"body":"well, you know. So kudos to"},{"speaker":"Chris Dy","startTime":422.64,"endTime":425.04,"body":"that. That's always the wild"},{"speaker":"Chris Dy","startTime":422.64,"endTime":425.04,"body":"card about you know, you know"},{"speaker":"Chris Dy","startTime":425.04,"endTime":427.08,"body":"what your talk's gonna say and"},{"speaker":"Chris Dy","startTime":425.04,"endTime":427.08,"body":"probably how you're gonna"},{"speaker":"Chris Dy","startTime":427.08,"endTime":429.42,"body":"deliver it, but you never know"},{"speaker":"Chris Dy","startTime":427.08,"endTime":429.42,"body":"what the question is gonna be"},{"speaker":"Chris Dy","startTime":429.42,"endTime":432.48,"body":"coming from, the coming from the"},{"speaker":"Chris Dy","startTime":429.42,"endTime":432.48,"body":"audience of a group that you're"},{"speaker":"Chris Dy","startTime":432.48,"endTime":435.0,"body":"not as familiar with, say as if"},{"speaker":"Chris Dy","startTime":432.48,"endTime":435.0,"body":"you were presenting to a group"},{"speaker":"Chris Dy","startTime":435.0,"endTime":437.64,"body":"of hand surgeons or residents or"},{"speaker":"Chris Dy","startTime":435.0,"endTime":437.64,"body":"fellows or medical students."},{"speaker":"Charles Goldfarb","startTime":437.88,"endTime":439.92,"body":"Yeah, that's"},{"speaker":"Charles Goldfarb","startTime":437.88,"endTime":439.92,"body":"exactly right, and I think I"},{"speaker":"Charles Goldfarb","startTime":439.92,"endTime":443.42,"body":"don't mind looking silly and"},{"speaker":"Charles Goldfarb","startTime":439.92,"endTime":443.42,"body":"making fun of myself, which I"},{"speaker":"Charles Goldfarb","startTime":443.42,"endTime":447.62,"body":"think is always helpful in the Q"},{"speaker":"Charles Goldfarb","startTime":443.42,"endTime":447.62,"body":"and A and so no no hesitancy to"},{"speaker":"Charles Goldfarb","startTime":447.62,"endTime":450.2,"body":"say something silly and laugh at"},{"speaker":"Charles Goldfarb","startTime":447.62,"endTime":450.2,"body":"myself."},{"speaker":"Chris Dy","startTime":450.56,"endTime":453.5,"body":"Well, thank you to the"},{"speaker":"Chris Dy","startTime":450.56,"endTime":453.5,"body":"as HD for always welcoming the"},{"speaker":"Chris Dy","startTime":453.5,"endTime":456.74,"body":"hand surgeons to come to your"},{"speaker":"Chris Dy","startTime":453.5,"endTime":456.74,"body":"meeting and we I had learned a"},{"speaker":"Chris Dy","startTime":456.74,"endTime":459.56,"body":"ton personally, both from"},{"speaker":"Chris Dy","startTime":456.74,"endTime":459.56,"body":"watching the podiums that I was"},{"speaker":"Chris Dy","startTime":459.56,"endTime":463.9,"body":"in in the audience for and also"},{"speaker":"Chris Dy","startTime":459.56,"endTime":463.9,"body":"hearing, you know, the questions"},{"speaker":"Chris Dy","startTime":463.9,"endTime":468.28,"body":"that were asked of Macy and me"},{"speaker":"Chris Dy","startTime":463.9,"endTime":468.28,"body":"when we were giving our our"},{"speaker":"Chris Dy","startTime":468.28,"endTime":470.56,"body":"course. And I've always learned"},{"speaker":"Chris Dy","startTime":468.28,"endTime":470.56,"body":"a lot from Macy too, as"},{"speaker":"Chris Dy","startTime":470.56,"endTime":473.02,"body":"everybody does. I hear she's a"},{"speaker":"Chris Dy","startTime":470.56,"endTime":473.02,"body":"bit of a celebrity among the"},{"speaker":"Chris Dy","startTime":473.02,"endTime":477.16,"body":"hand therapists, for very good"},{"speaker":"Chris Dy","startTime":473.02,"endTime":477.16,"body":"reason, given her recurring"},{"speaker":"Chris Dy","startTime":477.22,"endTime":479.62,"body":"guest role on the pod, we should"},{"speaker":"Chris Dy","startTime":477.22,"endTime":479.62,"body":"have her back. We have it's been"},{"speaker":"Chris Dy","startTime":479.62,"endTime":480.18,"body":"a while. It's"},{"speaker":"Charles Goldfarb","startTime":480.18,"endTime":483.54,"body":"been a while."},{"speaker":"Charles Goldfarb","startTime":480.18,"endTime":483.54,"body":"So on Sunday morning, I walked"},{"speaker":"Charles Goldfarb","startTime":483.54,"endTime":486.6,"body":"in a little early before my"},{"speaker":"Charles Goldfarb","startTime":483.54,"endTime":486.6,"body":"session with Stacy. Stacy and I,"},{"speaker":"Charles Goldfarb","startTime":486.6,"endTime":489.66,"body":"on Sunday morning, talked about"},{"speaker":"Charles Goldfarb","startTime":486.6,"endTime":489.66,"body":"medial elbow injuries and the"},{"speaker":"Charles Goldfarb","startTime":489.66,"endTime":492.36,"body":"role of the ulnar nerve. You"},{"speaker":"Charles Goldfarb","startTime":489.66,"endTime":492.36,"body":"could have learned something,"},{"speaker":"Charles Goldfarb","startTime":492.54,"endTime":496.62,"body":"and, yeah, in adolescence. And"},{"speaker":"Charles Goldfarb","startTime":492.54,"endTime":496.62,"body":"it was great, great session. So"},{"speaker":"Charles Goldfarb","startTime":496.62,"endTime":499.26,"body":"I walked into Macy's room"},{"speaker":"Charles Goldfarb","startTime":496.62,"endTime":499.26,"body":"beforehand, and she was in the"},{"speaker":"Charles Goldfarb","startTime":499.26,"endTime":502.4,"body":"big room, and there was good"},{"speaker":"Charles Goldfarb","startTime":499.26,"endTime":502.4,"body":"attendance. And she's up talking"},{"speaker":"Charles Goldfarb","startTime":502.4,"endTime":506.18,"body":"about, you know, rehabilitation"},{"speaker":"Charles Goldfarb","startTime":502.4,"endTime":506.18,"body":"after free muscle transfer. And"},{"speaker":"Charles Goldfarb","startTime":506.18,"endTime":508.7,"body":"I walked in, and then she"},{"speaker":"Charles Goldfarb","startTime":506.18,"endTime":508.7,"body":"immediately just stopped and"},{"speaker":"Charles Goldfarb","startTime":508.7,"endTime":512.96,"body":"waves. It was hilarious. Bill"},{"speaker":"Charles Goldfarb","startTime":508.7,"endTime":512.96,"body":"Birmingham. Hello the"},{"speaker":"Charles Goldfarb","startTime":512.96,"endTime":516.56,"body":"Birmingham. Hello for those of"},{"speaker":"Charles Goldfarb","startTime":512.96,"endTime":516.56,"body":"you not aware of Macy Stoner and"},{"speaker":"Charles Goldfarb","startTime":516.56,"endTime":519.68,"body":"I met in St Louis, but we both"},{"speaker":"Charles Goldfarb","startTime":516.56,"endTime":519.68,"body":"grew up in Birmingham, Alabama,"},{"speaker":"Charles Goldfarb","startTime":519.92,"endTime":520.54,"body":"so"},{"speaker":"Chris Dy","startTime":520.659,"endTime":523.539,"body":"that's great. I heard"},{"speaker":"Chris Dy","startTime":520.659,"endTime":523.539,"body":"that talk was awesome too, for"},{"speaker":"Chris Dy","startTime":523.539,"endTime":525.759,"body":"so rehab after a free"},{"speaker":"Chris Dy","startTime":523.539,"endTime":525.759,"body":"functioning muscle transfer."},{"speaker":"Chris Dy","startTime":525.759,"endTime":528.219,"body":"Very niche topic, but super"},{"speaker":"Chris Dy","startTime":525.759,"endTime":528.219,"body":"important, if you're investing"},{"speaker":"Chris Dy","startTime":528.219,"endTime":530.799,"body":"that amount of time and effort"},{"speaker":"Chris Dy","startTime":528.219,"endTime":530.799,"body":"into a procedure like that, to"},{"speaker":"Chris Dy","startTime":530.799,"endTime":533.439,"body":"make sure that you can get it"},{"speaker":"Chris Dy","startTime":530.799,"endTime":533.439,"body":"across the finish line."},{"speaker":"Charles Goldfarb","startTime":533.56,"endTime":535.54,"body":"Yeah, what I"},{"speaker":"Charles Goldfarb","startTime":533.56,"endTime":535.54,"body":"heard, what I heard, was great."},{"speaker":"Charles Goldfarb","startTime":535.6,"endTime":539.32,"body":"Should we start by thanking one"},{"speaker":"Charles Goldfarb","startTime":535.6,"endTime":539.32,"body":"of our sponsors? This is brand"},{"speaker":"Chris Dy","startTime":539.68,"endTime":541.24,"body":"new information,"},{"speaker":"Chris Dy","startTime":539.68,"endTime":541.24,"body":"folks. The upper hand is"},{"speaker":"Chris Dy","startTime":541.24,"endTime":543.84,"body":"sponsored by practicelink.com"},{"speaker":"Chris Dy","startTime":541.24,"endTime":543.84,"body":"the practicelink.com the most"},{"speaker":"Chris Dy","startTime":543.84,"endTime":546.12,"body":"widely used physician. Job"},{"speaker":"Chris Dy","startTime":543.84,"endTime":546.12,"body":"searching, career advancement"},{"speaker":"Chris Dy","startTime":546.12,"endTime":546.48,"body":"resource,"},{"speaker":"Charles Goldfarb","startTime":546.6,"endTime":548.46,"body":"becoming a"},{"speaker":"Charles Goldfarb","startTime":546.6,"endTime":548.46,"body":"physician is hard. Finding the"},{"speaker":"Charles Goldfarb","startTime":548.46,"endTime":551.22,"body":"right job doesn't have to be"},{"speaker":"Charles Goldfarb","startTime":548.46,"endTime":551.22,"body":"joined. Practice link for free"},{"speaker":"Charles Goldfarb","startTime":551.22,"endTime":556.74,"body":"today@www.practicelink.com"},{"speaker":"Charles Goldfarb","startTime":551.22,"endTime":556.74,"body":"backslash the upper hand. All"},{"speaker":"Charles Goldfarb","startTime":556.74,"endTime":558.24,"body":"right, let's get into it."},{"speaker":"Chris Dy","startTime":558.78,"endTime":561.74,"body":"Yeah. So I had a I've"},{"speaker":"Chris Dy","startTime":558.78,"endTime":561.74,"body":"had, you know, as just like"},{"speaker":"Chris Dy","startTime":561.74,"endTime":565.52,"body":"anything in clinical practice,"},{"speaker":"Chris Dy","startTime":561.74,"endTime":565.52,"body":"things come and runs, and I've"},{"speaker":"Chris Dy","startTime":565.52,"endTime":568.88,"body":"had a run of patients who are"},{"speaker":"Chris Dy","startTime":565.52,"endTime":568.88,"body":"undergoing distal ulnar"},{"speaker":"Chris Dy","startTime":568.88,"endTime":574.64,"body":"resections. So the so called"},{"speaker":"Chris Dy","startTime":568.88,"endTime":574.64,"body":"Dara procedure, a very, I mean,"},{"speaker":"Chris Dy","startTime":574.7,"endTime":577.76,"body":"like any surgery, like a PRC,"},{"speaker":"Chris Dy","startTime":574.7,"endTime":577.76,"body":"that's been around for the"},{"speaker":"Chris Dy","startTime":577.76,"endTime":581.68,"body":"better part of a century, if not"},{"speaker":"Chris Dy","startTime":577.76,"endTime":581.68,"body":"longer, and we're still doing it"},{"speaker":"Chris Dy","startTime":582.04,"endTime":584.62,"body":"probably works for some good"},{"speaker":"Chris Dy","startTime":582.04,"endTime":584.62,"body":"reason, even though it sounds"},{"speaker":"Chris Dy","startTime":584.62,"endTime":588.1,"body":"kind of ridiculous when you're"},{"speaker":"Chris Dy","startTime":584.62,"endTime":588.1,"body":"talking about to a patient. So"},{"speaker":"Chris Dy","startTime":588.1,"endTime":591.94,"body":"for example, one of the patients"},{"speaker":"Chris Dy","startTime":588.1,"endTime":591.94,"body":"that I performed this procedure"},{"speaker":"Chris Dy","startTime":591.94,"endTime":596.02,"body":"on recently had been kind of, I"},{"speaker":"Chris Dy","startTime":591.94,"endTime":596.02,"body":"think probably the one of the"},{"speaker":"Chris Dy","startTime":596.02,"endTime":599.26,"body":"most common indications is, at"},{"speaker":"Chris Dy","startTime":596.02,"endTime":599.26,"body":"this point, is a patient that is"},{"speaker":"Chris Dy","startTime":599.26,"endTime":601.92,"body":"in their seven. Who had a"},{"speaker":"Chris Dy","startTime":599.26,"endTime":601.92,"body":"disarray is fracture that we"},{"speaker":"Chris Dy","startTime":601.98,"endTime":604.8,"body":"went through extensive shared"},{"speaker":"Chris Dy","startTime":601.98,"endTime":604.8,"body":"decision making and counseled"},{"speaker":"Chris Dy","startTime":604.8,"endTime":607.8,"body":"her about her fracture, and she"},{"speaker":"Chris Dy","startTime":604.8,"endTime":607.8,"body":"ended up with what I've called"},{"speaker":"Chris Dy","startTime":607.8,"endTime":612.18,"body":"now, and I think others do too,"},{"speaker":"Chris Dy","startTime":607.8,"endTime":612.18,"body":"an expected malaunion. And you"},{"speaker":"Chris Dy","startTime":612.18,"endTime":614.64,"body":"know, it counseled her about the"},{"speaker":"Chris Dy","startTime":612.18,"endTime":614.64,"body":"appearance of the wrist, both"},{"speaker":"Chris Dy","startTime":614.64,"endTime":618.3,"body":"coronally and sagittally, but"},{"speaker":"Chris Dy","startTime":614.64,"endTime":618.3,"body":"the ulna, while it was"},{"speaker":"Chris Dy","startTime":618.3,"endTime":620.72,"body":"prominent, it wasn't the"},{"speaker":"Chris Dy","startTime":618.3,"endTime":620.72,"body":"prominence that was bothering"},{"speaker":"Chris Dy","startTime":620.72,"endTime":625.58,"body":"her. It was the limitation in"},{"speaker":"Chris Dy","startTime":620.72,"endTime":625.58,"body":"forearm rotation. So this is a"},{"speaker":"Chris Dy","startTime":625.58,"endTime":628.04,"body":"patient I talked pretty"},{"speaker":"Chris Dy","startTime":625.58,"endTime":628.04,"body":"extensively about performing"},{"speaker":"Chris Dy","startTime":628.28,"endTime":632.3,"body":"this ulnar resection. What's"},{"speaker":"Chris Dy","startTime":628.28,"endTime":632.3,"body":"your talk with patients? Just to"},{"speaker":"Chris Dy","startTime":632.3,"endTime":636.38,"body":"start the conversation about"},{"speaker":"Chris Dy","startTime":632.3,"endTime":636.38,"body":"what to expect or when to do the"},{"speaker":"Chris Dy","startTime":636.38,"endTime":638.96,"body":"surgery, like, you know, for"},{"speaker":"Chris Dy","startTime":636.38,"endTime":638.96,"body":"that reason, and what reasons to"},{"speaker":"Chris Dy","startTime":638.96,"endTime":641.62,"body":"do the Dara, or just to say, you"},{"speaker":"Chris Dy","startTime":638.96,"endTime":641.62,"body":"know, it is what it is."},{"speaker":"Charles Goldfarb","startTime":642.4,"endTime":645.1,"body":"So a dare in"},{"speaker":"Charles Goldfarb","startTime":642.4,"endTime":645.1,"body":"the setting of a distro radius"},{"speaker":"Charles Goldfarb","startTime":645.1,"endTime":648.88,"body":"fracture, and whether it's post"},{"speaker":"Charles Goldfarb","startTime":645.1,"endTime":648.88,"body":"operative pain or limitation in"},{"speaker":"Charles Goldfarb","startTime":648.88,"endTime":652.66,"body":"motion or deformity in the"},{"speaker":"Charles Goldfarb","startTime":648.88,"endTime":652.66,"body":"setting of a distraught"},{"speaker":"Charles Goldfarb","startTime":652.66,"endTime":655.18,"body":"fracture, yeah, I think it's a"},{"speaker":"Charles Goldfarb","startTime":652.66,"endTime":655.18,"body":"really important question. And"},{"speaker":"Charles Goldfarb","startTime":655.18,"endTime":661.26,"body":"concept, I'll say that I was"},{"speaker":"Charles Goldfarb","startTime":655.18,"endTime":661.26,"body":"taught don't ever think about a"},{"speaker":"Charles Goldfarb","startTime":661.26,"endTime":664.44,"body":"second surgery after a distro"},{"speaker":"Charles Goldfarb","startTime":661.26,"endTime":664.44,"body":"radius fracture for at least one"},{"speaker":"Charles Goldfarb","startTime":664.44,"endTime":669.0,"body":"year. I don't think many of us"},{"speaker":"Charles Goldfarb","startTime":664.44,"endTime":669.0,"body":"accept that to be true any"},{"speaker":"Charles Goldfarb","startTime":669.0,"endTime":673.2,"body":"longer. I do think the message,"},{"speaker":"Charles Goldfarb","startTime":669.0,"endTime":673.2,"body":"though, is important is be"},{"speaker":"Charles Goldfarb","startTime":673.2,"endTime":677.46,"body":"patient before jumping in after"},{"speaker":"Charles Goldfarb","startTime":673.2,"endTime":677.46,"body":"a distro radius fracture. I'm"},{"speaker":"Charles Goldfarb","startTime":677.46,"endTime":681.02,"body":"not saying wait a year, but be"},{"speaker":"Charles Goldfarb","startTime":677.46,"endTime":681.02,"body":"patient. Give give patient, give"},{"speaker":"Charles Goldfarb","startTime":681.2,"endTime":685.46,"body":"the patient a time to get"},{"speaker":"Charles Goldfarb","startTime":681.2,"endTime":685.46,"body":"better, and don't rush, because"},{"speaker":"Charles Goldfarb","startTime":685.52,"endTime":687.74,"body":"some things just take time."},{"speaker":"Chris Dy","startTime":689.3,"endTime":692.18,"body":"Do you think that"},{"speaker":"Chris Dy","startTime":689.3,"endTime":692.18,"body":"there's a threshold where you"},{"speaker":"Chris Dy","startTime":692.18,"endTime":694.76,"body":"kind of know it's not going to"},{"speaker":"Chris Dy","startTime":692.18,"endTime":694.76,"body":"get better?"},{"speaker":"Charles Goldfarb","startTime":695.6,"endTime":699.26,"body":"Yeah, I would"},{"speaker":"Charles Goldfarb","startTime":695.6,"endTime":699.26,"body":"say the pain component is most"},{"speaker":"Charles Goldfarb","startTime":699.26,"endTime":703.96,"body":"likely to get better over time."},{"speaker":"Charles Goldfarb","startTime":699.26,"endTime":703.96,"body":"I would think that we and our"},{"speaker":"Charles Goldfarb","startTime":703.96,"endTime":709.0,"body":"therapy partners probably about"},{"speaker":"Charles Goldfarb","startTime":703.96,"endTime":709.0,"body":"know by three months whether"},{"speaker":"Charles Goldfarb","startTime":709.0,"endTime":712.06,"body":"we're going to see improved"},{"speaker":"Charles Goldfarb","startTime":709.0,"endTime":712.06,"body":"motion. Is that your sense? I"},{"speaker":"Charles Goldfarb","startTime":712.06,"endTime":712.48,"body":"think so. I"},{"speaker":"Chris Dy","startTime":712.54,"endTime":714.34,"body":"think the die is"},{"speaker":"Chris Dy","startTime":712.54,"endTime":714.34,"body":"probably cast by three months,"},{"speaker":"Chris Dy","startTime":714.34,"endTime":716.56,"body":"and then you get a sense of"},{"speaker":"Chris Dy","startTime":714.34,"endTime":716.56,"body":"where their motion is going to"},{"speaker":"Chris Dy","startTime":716.56,"endTime":719.86,"body":"land, and then also how they can"},{"speaker":"Chris Dy","startTime":716.56,"endTime":719.86,"body":"compensate. So if it's truly"},{"speaker":"Chris Dy","startTime":720.16,"endTime":722.7,"body":"limited form rotation, you get a"},{"speaker":"Chris Dy","startTime":720.16,"endTime":722.7,"body":"lot of wiggle room through the"},{"speaker":"Chris Dy","startTime":722.7,"endTime":725.76,"body":"shoulder to compensate, or if"},{"speaker":"Chris Dy","startTime":722.7,"endTime":725.76,"body":"their shoulder is not great, and"},{"speaker":"Chris Dy","startTime":725.76,"endTime":728.16,"body":"that clearly limits their"},{"speaker":"Chris Dy","startTime":725.76,"endTime":728.16,"body":"abilities to do that, the pain"},{"speaker":"Chris Dy","startTime":728.34,"endTime":730.92,"body":"part of it, I think, is more of"},{"speaker":"Chris Dy","startTime":728.34,"endTime":730.92,"body":"the wildcard. And I think pain"},{"speaker":"Chris Dy","startTime":730.92,"endTime":733.08,"body":"is what would push me to"},{"speaker":"Chris Dy","startTime":730.92,"endTime":733.08,"body":"potentially consider"},{"speaker":"Chris Dy","startTime":733.08,"endTime":736.32,"body":"intervention a little bit"},{"speaker":"Chris Dy","startTime":733.08,"endTime":736.32,"body":"sooner. But yeah, I think you"},{"speaker":"Chris Dy","startTime":736.32,"endTime":738.84,"body":"kind of know, and I think you"},{"speaker":"Chris Dy","startTime":736.32,"endTime":738.84,"body":"start laying the crepe in terms"},{"speaker":"Chris Dy","startTime":738.84,"endTime":743.36,"body":"of planting the seeds for"},{"speaker":"Chris Dy","startTime":738.84,"endTime":743.36,"body":"discussion at future visits. And"},{"speaker":"Chris Dy","startTime":743.78,"endTime":745.76,"body":"most of the times, I'm not"},{"speaker":"Chris Dy","startTime":743.78,"endTime":745.76,"body":"seeing just patients with"},{"speaker":"Chris Dy","startTime":745.76,"endTime":748.76,"body":"dissaraeus fractures beyond"},{"speaker":"Chris Dy","startTime":745.76,"endTime":748.76,"body":"three months, to be honest with"},{"speaker":"Chris Dy","startTime":748.76,"endTime":751.88,"body":"you, unless they've got an"},{"speaker":"Chris Dy","startTime":748.76,"endTime":751.88,"body":"ongoing issue, like something"},{"speaker":"Chris Dy","startTime":751.88,"endTime":752.42,"body":"like this."},{"speaker":"Charles Goldfarb","startTime":753.8,"endTime":755.48,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":753.8,"endTime":755.48,"body":"that's, that's, that's great."},{"speaker":"Charles Goldfarb","startTime":755.48,"endTime":757.94,"body":"That's really true. What's"},{"speaker":"Charles Goldfarb","startTime":755.48,"endTime":757.94,"body":"interesting about range of"},{"speaker":"Charles Goldfarb","startTime":757.94,"endTime":760.78,"body":"motion, in my mind, I want to"},{"speaker":"Charles Goldfarb","startTime":757.94,"endTime":760.78,"body":"hear more about your experience"},{"speaker":"Charles Goldfarb","startTime":760.78,"endTime":764.32,"body":"with this patient is we usually"},{"speaker":"Charles Goldfarb","startTime":760.78,"endTime":764.32,"body":"get pronation back pretty"},{"speaker":"Charles Goldfarb","startTime":764.32,"endTime":768.76,"body":"quickly after, I would say, a"},{"speaker":"Charles Goldfarb","startTime":764.32,"endTime":768.76,"body":"standard distal radius fracture"},{"speaker":"Charles Goldfarb","startTime":768.88,"endTime":772.36,"body":"and treatment with a volar"},{"speaker":"Charles Goldfarb","startTime":768.88,"endTime":772.36,"body":"plate, for example, and we might"},{"speaker":"Charles Goldfarb","startTime":772.36,"endTime":776.5,"body":"struggle to get supination back."},{"speaker":"Charles Goldfarb","startTime":772.36,"endTime":776.5,"body":"Pronation far more important for"},{"speaker":"Charles Goldfarb","startTime":776.5,"endTime":779.74,"body":"daily life, even though patients"},{"speaker":"Charles Goldfarb","startTime":776.5,"endTime":779.74,"body":"want their supination back as"},{"speaker":"Charles Goldfarb","startTime":779.74,"endTime":783.36,"body":"well. What's your what was this"},{"speaker":"Charles Goldfarb","startTime":779.74,"endTime":783.36,"body":"patient's complaint regarding"},{"speaker":"Charles Goldfarb","startTime":783.36,"endTime":783.84,"body":"motion?"},{"speaker":"Chris Dy","startTime":784.68,"endTime":786.78,"body":"So this patient's"},{"speaker":"Chris Dy","startTime":784.68,"endTime":786.78,"body":"complaint with motion was"},{"speaker":"Chris Dy","startTime":786.78,"endTime":789.54,"body":"actually trying to get both"},{"speaker":"Chris Dy","startTime":786.78,"endTime":789.54,"body":"pronation and supination, so she"},{"speaker":"Chris Dy","startTime":789.54,"endTime":793.14,"body":"was kind of limited in both both"},{"speaker":"Chris Dy","startTime":789.54,"endTime":793.14,"body":"ranges. And I think it's"},{"speaker":"Chris Dy","startTime":793.14,"endTime":796.08,"body":"interesting that we've shifted"},{"speaker":"Chris Dy","startTime":793.14,"endTime":796.08,"body":"now to a pronated world, right?"},{"speaker":"Chris Dy","startTime":796.08,"endTime":798.48,"body":"With keyboards. I think the"},{"speaker":"Chris Dy","startTime":796.08,"endTime":798.48,"body":"teaching before with supination"},{"speaker":"Chris Dy","startTime":798.48,"endTime":801.98,"body":"was better for grip and function"},{"speaker":"Chris Dy","startTime":798.48,"endTime":801.98,"body":"in daily life, but now with, you"},{"speaker":"Chris Dy","startTime":801.98,"endTime":804.56,"body":"know, our you know, being behind"},{"speaker":"Chris Dy","startTime":801.98,"endTime":804.56,"body":"keyboards for a lot of things,"},{"speaker":"Chris Dy","startTime":804.56,"endTime":808.82,"body":"not just for work, pernation"},{"speaker":"Chris Dy","startTime":804.56,"endTime":808.82,"body":"becomes more important, perhaps"},{"speaker":"Chris Dy","startTime":808.82,"endTime":812.0,"body":"with devices and texting and"},{"speaker":"Chris Dy","startTime":808.82,"endTime":812.0,"body":"using, you know, those things"},{"speaker":"Chris Dy","startTime":812.0,"endTime":815.78,"body":"more than keyboard may be less"},{"speaker":"Chris Dy","startTime":812.0,"endTime":815.78,"body":"important, but she was just all"},{"speaker":"Chris Dy","startTime":815.78,"endTime":818.36,"body":"around bothered by it. And I"},{"speaker":"Chris Dy","startTime":815.78,"endTime":818.36,"body":"think it's a different ballgame"},{"speaker":"Chris Dy","startTime":818.36,"endTime":821.86,"body":"when you've got expected"},{"speaker":"Chris Dy","startTime":818.36,"endTime":821.86,"body":"deformity of the radius, as"},{"speaker":"Chris Dy","startTime":821.86,"endTime":824.74,"body":"opposed to the situation where"},{"speaker":"Chris Dy","startTime":821.86,"endTime":824.74,"body":"you've got a vulner plate and"},{"speaker":"Chris Dy","startTime":824.74,"endTime":828.1,"body":"you've got hopefully anatomic or"},{"speaker":"Chris Dy","startTime":824.74,"endTime":828.1,"body":"closely anatomic alignment, both"},{"speaker":"Chris Dy","startTime":828.1,"endTime":831.1,"body":"coronally and sagitt of the"},{"speaker":"Chris Dy","startTime":828.1,"endTime":831.1,"body":"radius. Now"},{"speaker":"Charles Goldfarb","startTime":831.16,"endTime":833.74,"body":"how do you"},{"speaker":"Charles Goldfarb","startTime":831.16,"endTime":833.74,"body":"decide whether to address the"},{"speaker":"Charles Goldfarb","startTime":833.74,"endTime":838.12,"body":"distal radius versus addressing"},{"speaker":"Charles Goldfarb","startTime":833.74,"endTime":838.12,"body":"the distal ulna, or potentially"},{"speaker":"Charles Goldfarb","startTime":838.12,"endTime":841.02,"body":"addressing both? But in this"},{"speaker":"Charles Goldfarb","startTime":838.12,"endTime":841.02,"body":"case, it seems like you were"},{"speaker":"Charles Goldfarb","startTime":841.02,"endTime":845.64,"body":"totally focused on the distal"},{"speaker":"Charles Goldfarb","startTime":841.02,"endTime":845.64,"body":"ulna, which must mean the distal"},{"speaker":"Charles Goldfarb","startTime":845.64,"endTime":848.94,"body":"radius, while not anatomical,"},{"speaker":"Charles Goldfarb","startTime":845.64,"endTime":848.94,"body":"was still in the realm of"},{"speaker":"Charles Goldfarb","startTime":848.94,"endTime":850.14,"body":"acceptable. Yeah,"},{"speaker":"Chris Dy","startTime":850.14,"endTime":852.36,"body":"I think motion, arc,"},{"speaker":"Chris Dy","startTime":850.14,"endTime":852.36,"body":"flexion, extension was"},{"speaker":"Chris Dy","startTime":852.36,"endTime":855.42,"body":"acceptable for her from a grip"},{"speaker":"Chris Dy","startTime":852.36,"endTime":855.42,"body":"perspective, which I think"},{"speaker":"Chris Dy","startTime":855.42,"endTime":858.18,"body":"honestly, at the end of the day,"},{"speaker":"Chris Dy","startTime":855.42,"endTime":858.18,"body":"is probably the most important"},{"speaker":"Chris Dy","startTime":858.18,"endTime":860.96,"body":"thing for the radius. She was"},{"speaker":"Chris Dy","startTime":858.18,"endTime":860.96,"body":"doing well, she wasn't having"},{"speaker":"Chris Dy","startTime":860.96,"endTime":864.08,"body":"any signs of some the carpal"},{"speaker":"Chris Dy","startTime":860.96,"endTime":864.08,"body":"tunnel syndrome that can occur"},{"speaker":"Chris Dy","startTime":864.08,"endTime":868.52,"body":"in about 15 to 20% of patients"},{"speaker":"Chris Dy","startTime":864.08,"endTime":868.52,"body":"after just a radius mal Union."},{"speaker":"Chris Dy","startTime":868.94,"endTime":871.28,"body":"It really was the illness. And"},{"speaker":"Chris Dy","startTime":868.94,"endTime":871.28,"body":"to be honest with you, and"},{"speaker":"Chris Dy","startTime":871.28,"endTime":874.16,"body":"somebody in their 70s, I'm"},{"speaker":"Chris Dy","startTime":871.28,"endTime":874.16,"body":"hoping to do one surgery and be"},{"speaker":"Chris Dy","startTime":874.16,"endTime":877.7,"body":"done and keep it simple and not"},{"speaker":"Chris Dy","startTime":874.16,"endTime":877.7,"body":"have to rely on a protracted"},{"speaker":"Chris Dy","startTime":878.6,"endTime":880.18,"body":"rehab. And"},{"speaker":"Charles Goldfarb","startTime":880.18,"endTime":885.04,"body":"how do you"},{"speaker":"Charles Goldfarb","startTime":880.18,"endTime":885.04,"body":"think about Dara versus Dr uj"},{"speaker":"Charles Goldfarb","startTime":885.04,"endTime":888.88,"body":"release? Now, drej release is"},{"speaker":"Charles Goldfarb","startTime":885.04,"endTime":888.88,"body":"not an operation we talk a lot"},{"speaker":"Charles Goldfarb","startTime":888.88,"endTime":893.26,"body":"about. You know, Marty Boyer"},{"speaker":"Charles Goldfarb","startTime":888.88,"endTime":893.26,"body":"may, in our practice, may be the"},{"speaker":"Charles Goldfarb","startTime":893.26,"endTime":896.68,"body":"most likely to to provide that"},{"speaker":"Charles Goldfarb","startTime":893.26,"endTime":896.68,"body":"intervention. I will do it"},{"speaker":"Charles Goldfarb","startTime":896.74,"endTime":900.12,"body":"rarely. I mean super rarely"},{"speaker":"Charles Goldfarb","startTime":896.74,"endTime":900.12,"body":"every couple of years. But. How"},{"speaker":"Charles Goldfarb","startTime":900.12,"endTime":902.76,"body":"do you think about that"},{"speaker":"Charles Goldfarb","startTime":900.12,"endTime":902.76,"body":"procedure versus simply the"},{"speaker":"Charles Goldfarb","startTime":902.76,"endTime":904.08,"body":"excision of the distal ulna?"},{"speaker":"Chris Dy","startTime":905.28,"endTime":907.98,"body":"To overly simplify it,"},{"speaker":"Chris Dy","startTime":905.28,"endTime":907.98,"body":"that's a surgery for a younger"},{"speaker":"Chris Dy","startTime":907.98,"endTime":912.0,"body":"person. And I think about it."},{"speaker":"Chris Dy","startTime":907.98,"endTime":912.0,"body":"I've done it, and I've also sent"},{"speaker":"Chris Dy","startTime":912.0,"endTime":918.48,"body":"people to Marty to do it. That's"},{"speaker":"Chris Dy","startTime":912.0,"endTime":918.48,"body":"a tough case with somewhat, not"},{"speaker":"Chris Dy","startTime":918.48,"endTime":922.46,"body":"somewhat, with less predictable"},{"speaker":"Chris Dy","startTime":918.48,"endTime":922.46,"body":"outcomes, I would say. And you"},{"speaker":"Chris Dy","startTime":922.46,"endTime":925.58,"body":"really got to hit it hard with"},{"speaker":"Chris Dy","startTime":922.46,"endTime":925.58,"body":"therapy. You know, the surgery"},{"speaker":"Chris Dy","startTime":925.58,"endTime":928.4,"body":"is just the beginning salvo and"},{"speaker":"Chris Dy","startTime":925.58,"endTime":928.4,"body":"the whole thing. And I think"},{"speaker":"Chris Dy","startTime":928.4,"endTime":931.4,"body":"it's the ability to know that"},{"speaker":"Chris Dy","startTime":928.4,"endTime":931.4,"body":"they're going to go to therapy"},{"speaker":"Chris Dy","startTime":931.82,"endTime":935.3,"body":"and that they're actually going"},{"speaker":"Chris Dy","startTime":931.82,"endTime":935.3,"body":"to do whatever it takes to get"},{"speaker":"Chris Dy","startTime":935.54,"endTime":939.68,"body":"what is likely to be improved,"},{"speaker":"Chris Dy","startTime":935.54,"endTime":939.68,"body":"but incomplete recovery of"},{"speaker":"Chris Dy","startTime":939.68,"endTime":942.22,"body":"forearm rotation. What is your"},{"speaker":"Chris Dy","startTime":939.68,"endTime":942.22,"body":"take on it?"},{"speaker":"Charles Goldfarb","startTime":942.28,"endTime":944.26,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":942.28,"endTime":944.26,"body":"that's right. I mean, what we"},{"speaker":"Charles Goldfarb","startTime":944.38,"endTime":947.44,"body":"what we know, is that drej"},{"speaker":"Charles Goldfarb","startTime":944.38,"endTime":947.44,"body":"doesn't typically get stiff, and"},{"speaker":"Charles Goldfarb","startTime":947.44,"endTime":950.74,"body":"so there usually is an"},{"speaker":"Charles Goldfarb","startTime":947.44,"endTime":950.74,"body":"extenuating circumstance,"},{"speaker":"Charles Goldfarb","startTime":950.74,"endTime":954.22,"body":"whether leading to prolonged"},{"speaker":"Charles Goldfarb","startTime":950.74,"endTime":954.22,"body":"immobilization of the forearm,"},{"speaker":"Charles Goldfarb","startTime":954.76,"endTime":957.16,"body":"because most patients start"},{"speaker":"Charles Goldfarb","startTime":954.76,"endTime":957.16,"body":"moving at least a little bit"},{"speaker":"Charles Goldfarb","startTime":957.16,"endTime":961.38,"body":"right away. And so it's uncommon"},{"speaker":"Charles Goldfarb","startTime":957.16,"endTime":961.38,"body":"to have isolated druj stiffness,"},{"speaker":"Charles Goldfarb","startTime":961.44,"endTime":965.04,"body":"and it is less predictable of an"},{"speaker":"Charles Goldfarb","startTime":961.44,"endTime":965.04,"body":"intervention. And while the Dara"},{"speaker":"Charles Goldfarb","startTime":965.1,"endTime":969.48,"body":"is far more predictable, it does"},{"speaker":"Charles Goldfarb","startTime":965.1,"endTime":969.48,"body":"carry some risks, which I'm"},{"speaker":"Charles Goldfarb","startTime":969.48,"endTime":971.64,"body":"certain we're going to talk"},{"speaker":"Charles Goldfarb","startTime":969.48,"endTime":971.64,"body":"about. So"},{"speaker":"Chris Dy","startTime":971.64,"endTime":975.24,"body":"if we just kind of"},{"speaker":"Chris Dy","startTime":971.64,"endTime":975.24,"body":"veer away from form stiffness"},{"speaker":"Chris Dy","startTime":975.24,"endTime":979.08,"body":"and we think more about drej"},{"speaker":"Chris Dy","startTime":975.24,"endTime":979.08,"body":"instability, is there a role for"},{"speaker":"Chris Dy","startTime":979.08,"endTime":981.86,"body":"a Dara in that or and then,"},{"speaker":"Chris Dy","startTime":979.08,"endTime":981.86,"body":"what's the role for an ulnar"},{"speaker":"Chris Dy","startTime":981.86,"endTime":985.58,"body":"shortening in your practice, for"},{"speaker":"Chris Dy","startTime":981.86,"endTime":985.58,"body":"in the instability setting? And"},{"speaker":"Chris Dy","startTime":985.58,"endTime":988.28,"body":"let's take the TFCC out of the"},{"speaker":"Chris Dy","startTime":985.58,"endTime":988.28,"body":"picture. Because I know you're"},{"speaker":"Chris Dy","startTime":988.28,"endTime":989.42,"body":"going to bring up the fovea,"},{"speaker":"Charles Goldfarb","startTime":990.32,"endTime":991.94,"body":"yeah, we'll"},{"speaker":"Charles Goldfarb","startTime":990.32,"endTime":991.94,"body":"take the TFC out of the picture."},{"speaker":"Charles Goldfarb","startTime":991.94,"endTime":995.72,"body":"There. There is, I mean,"},{"speaker":"Charles Goldfarb","startTime":991.94,"endTime":995.72,"body":"obviously the TFCC is in the"},{"speaker":"Charles Goldfarb","startTime":995.72,"endTime":999.5,"body":"background, but I would say"},{"speaker":"Charles Goldfarb","startTime":995.72,"endTime":999.5,"body":"there is a reasonable"},{"speaker":"Charles Goldfarb","startTime":999.5,"endTime":1002.7,"body":"intervention, which is a formal"},{"speaker":"Charles Goldfarb","startTime":999.5,"endTime":1002.7,"body":"ulnar shortening with platen"},{"speaker":"Charles Goldfarb","startTime":1002.7,"endTime":1006.42,"body":"screws, where you migrate the"},{"speaker":"Charles Goldfarb","startTime":1002.7,"endTime":1006.42,"body":"ulna proximally, and therefore"},{"speaker":"Charles Goldfarb","startTime":1006.42,"endTime":1010.68,"body":"you tighten the ulna carpal"},{"speaker":"Charles Goldfarb","startTime":1006.42,"endTime":1010.68,"body":"joint and the drej and so some"},{"speaker":"Charles Goldfarb","startTime":1010.68,"endTime":1015.36,"body":"degree of drej laxity is"},{"speaker":"Charles Goldfarb","startTime":1010.68,"endTime":1015.36,"body":"corrected with a formal ulnar"},{"speaker":"Charles Goldfarb","startTime":1015.36,"endTime":1019.86,"body":"shortening osteotomy. And so it"},{"speaker":"Charles Goldfarb","startTime":1015.36,"endTime":1019.86,"body":"is absolutely an option in the"},{"speaker":"Charles Goldfarb","startTime":1019.86,"endTime":1024.98,"body":"setting of a non arthritic joint"},{"speaker":"Charles Goldfarb","startTime":1019.86,"endTime":1024.98,"body":"and reasonable bony alignment,"},{"speaker":"Charles Goldfarb","startTime":1025.76,"endTime":1028.34,"body":"and it's a really good surgery"},{"speaker":"Charles Goldfarb","startTime":1025.76,"endTime":1028.34,"body":"in those situations."},{"speaker":"Chris Dy","startTime":1028.819,"endTime":1031.579,"body":"Do you think that a"},{"speaker":"Chris Dy","startTime":1028.819,"endTime":1031.579,"body":"shortening can improve rotation"},{"speaker":"Chris Dy","startTime":1031.579,"endTime":1034.759,"body":"by getting the ulna to sit more"},{"speaker":"Chris Dy","startTime":1031.579,"endTime":1034.759,"body":"appropriately with an acquired"},{"speaker":"Chris Dy","startTime":1034.759,"endTime":1035.179,"body":"notch?"},{"speaker":"Charles Goldfarb","startTime":1036.44,"endTime":1040.6,"body":"I would say"},{"speaker":"Charles Goldfarb","startTime":1036.44,"endTime":1040.6,"body":"unlikely, unless the Mao union"},{"speaker":"Charles Goldfarb","startTime":1040.6,"endTime":1044.98,"body":"of the distal radius allows it,"},{"speaker":"Charles Goldfarb","startTime":1040.6,"endTime":1044.98,"body":"but usually a malunion is a"},{"speaker":"Charles Goldfarb","startTime":1044.98,"endTime":1047.86,"body":"three dimensional malune unit,"},{"speaker":"Charles Goldfarb","startTime":1044.98,"endTime":1047.86,"body":"even if it's say, for example,"},{"speaker":"Charles Goldfarb","startTime":1047.98,"endTime":1051.64,"body":"primarily dorsal tilt of the"},{"speaker":"Charles Goldfarb","startTime":1047.98,"endTime":1051.64,"body":"distal articular surface. But I"},{"speaker":"Charles Goldfarb","startTime":1051.64,"endTime":1055.36,"body":"don't think we usually see"},{"speaker":"Charles Goldfarb","startTime":1051.64,"endTime":1055.36,"body":"improved rotation with an ulnar"},{"speaker":"Charles Goldfarb","startTime":1055.36,"endTime":1056.32,"body":"shorting osteotomy."},{"speaker":"Chris Dy","startTime":1056.62,"endTime":1059.02,"body":"Maybe we also probably"},{"speaker":"Chris Dy","startTime":1056.62,"endTime":1059.02,"body":"underappreciate some extension"},{"speaker":"Chris Dy","startTime":1059.02,"endTime":1062.1,"body":"of the fractures into the"},{"speaker":"Chris Dy","startTime":1059.02,"endTime":1062.1,"body":"sigmoid notch as well, which"},{"speaker":"Chris Dy","startTime":1062.46,"endTime":1067.14,"body":"potentially could predilec to"},{"speaker":"Chris Dy","startTime":1062.46,"endTime":1067.14,"body":"drJ arthritis. Do you think the,"},{"speaker":"Chris Dy","startTime":1067.2,"endTime":1070.62,"body":"you know, the ulnar shortening"},{"speaker":"Chris Dy","startTime":1067.2,"endTime":1070.62,"body":"still an option if they've got"},{"speaker":"Chris Dy","startTime":1070.62,"endTime":1073.5,"body":"drJ early arthritis that's"},{"speaker":"Chris Dy","startTime":1070.62,"endTime":1073.5,"body":"developing? Or do you pivot at"},{"speaker":"Chris Dy","startTime":1073.5,"endTime":1074.88,"body":"that point to the Dara?"},{"speaker":"Charles Goldfarb","startTime":1075.48,"endTime":1079.5,"body":"So I would"},{"speaker":"Charles Goldfarb","startTime":1075.48,"endTime":1079.5,"body":"pivot to a Dara 100% now, others"},{"speaker":"Charles Goldfarb","startTime":1079.5,"endTime":1083.24,"body":"would pivot to survey kapanji in"},{"speaker":"Charles Goldfarb","startTime":1079.5,"endTime":1083.24,"body":"our institution that's not been"},{"speaker":"Charles Goldfarb","startTime":1083.24,"endTime":1087.98,"body":"a primary intervention. At the"},{"speaker":"Charles Goldfarb","startTime":1083.24,"endTime":1087.98,"body":"hand, meeting a few weeks ago, a"},{"speaker":"Charles Goldfarb","startTime":1087.98,"endTime":1092.9,"body":"well respected dystrodias"},{"speaker":"Charles Goldfarb","startTime":1087.98,"endTime":1092.9,"body":"authority commented that she"},{"speaker":"Charles Goldfarb","startTime":1092.9,"endTime":1096.92,"body":"particularly prefers surveys,"},{"speaker":"Charles Goldfarb","startTime":1092.9,"endTime":1096.92,"body":"and I just hadn't had the"},{"speaker":"Charles Goldfarb","startTime":1096.92,"endTime":1099.38,"body":"results with that intervention"},{"speaker":"Charles Goldfarb","startTime":1096.92,"endTime":1099.38,"body":"that I've had with Dara. So I"},{"speaker":"Charles Goldfarb","startTime":1099.38,"endTime":1100.52,"body":"don't usually do a survey."},{"speaker":"Chris Dy","startTime":1101.12,"endTime":1105.46,"body":"So can you, for the"},{"speaker":"Chris Dy","startTime":1101.12,"endTime":1105.46,"body":"audience, summarize what a"},{"speaker":"Chris Dy","startTime":1105.46,"endTime":1108.7,"body":"Solvay kapanji is, and thank you"},{"speaker":"Chris Dy","startTime":1105.46,"endTime":1108.7,"body":"for clarifying that it's not a"},{"speaker":"Chris Dy","startTime":1108.7,"endTime":1113.74,"body":"suave kapanji, which is a pet"},{"speaker":"Chris Dy","startTime":1108.7,"endTime":1113.74,"body":"peeve of our partner, Dr Boyer."},{"speaker":"Charles Goldfarb","startTime":1114.04,"endTime":1119.86,"body":"That is true."},{"speaker":"Charles Goldfarb","startTime":1114.04,"endTime":1119.86,"body":"So in the sovey, you take the"},{"speaker":"Charles Goldfarb","startTime":1119.92,"endTime":1124.62,"body":"distal radius and the distal"},{"speaker":"Charles Goldfarb","startTime":1119.92,"endTime":1124.62,"body":"ulna, so the very distal aspect"},{"speaker":"Charles Goldfarb","startTime":1124.62,"endTime":1128.82,"body":"of the ulna, and you essentially"},{"speaker":"Charles Goldfarb","startTime":1124.62,"endTime":1128.82,"body":"fuse the drej. So you remove the"},{"speaker":"Charles Goldfarb","startTime":1128.82,"endTime":1132.12,"body":"cartilage between the radius and"},{"speaker":"Charles Goldfarb","startTime":1128.82,"endTime":1132.12,"body":"the ulna, the sigmoid notch, you"},{"speaker":"Charles Goldfarb","startTime":1132.12,"endTime":1136.26,"body":"fuse the distal ulna to the"},{"speaker":"Charles Goldfarb","startTime":1132.12,"endTime":1136.26,"body":"distal radius, and then proximal"},{"speaker":"Charles Goldfarb","startTime":1136.32,"endTime":1139.5,"body":"to that fusion site, you take"},{"speaker":"Charles Goldfarb","startTime":1136.32,"endTime":1139.5,"body":"out a segment of ulna, and so"},{"speaker":"Charles Goldfarb","startTime":1139.5,"endTime":1143.42,"body":"you created a long, wide"},{"speaker":"Charles Goldfarb","startTime":1139.5,"endTime":1143.42,"body":"platform for the carpus, and"},{"speaker":"Charles Goldfarb","startTime":1143.42,"endTime":1147.86,"body":"then you allow rotation proximal"},{"speaker":"Charles Goldfarb","startTime":1143.42,"endTime":1147.86,"body":"to that. And so it's again, a"},{"speaker":"Charles Goldfarb","startTime":1147.86,"endTime":1150.86,"body":"procedure has been around for a"},{"speaker":"Charles Goldfarb","startTime":1147.86,"endTime":1150.86,"body":"really long time. It's not"},{"speaker":"Charles Goldfarb","startTime":1150.98,"endTime":1155.72,"body":"laborious. It doesn't take much"},{"speaker":"Charles Goldfarb","startTime":1150.98,"endTime":1155.72,"body":"hardware, but it does move your"},{"speaker":"Charles Goldfarb","startTime":1156.08,"endTime":1159.62,"body":"mobile segment more proximally"},{"speaker":"Charles Goldfarb","startTime":1156.08,"endTime":1159.62,"body":"to allow rotation."},{"speaker":"Chris Dy","startTime":1161.54,"endTime":1164.38,"body":"What's the patients"},{"speaker":"Chris Dy","startTime":1161.54,"endTime":1164.38,"body":"bring this up and they ask, why"},{"speaker":"Chris Dy","startTime":1164.38,"endTime":1167.98,"body":"can't you just replace the"},{"speaker":"Chris Dy","startTime":1164.38,"endTime":1167.98,"body":"joint? So what's been your"},{"speaker":"Chris Dy","startTime":1168.34,"endTime":1172.0,"body":"current indications to send"},{"speaker":"Chris Dy","startTime":1168.34,"endTime":1172.0,"body":"patients to one of our partners"},{"speaker":"Chris Dy","startTime":1172.48,"endTime":1176.2,"body":"for drJ arthroplasty? Is there"},{"speaker":"Chris Dy","startTime":1172.48,"endTime":1176.2,"body":"any role for that? And what's"},{"speaker":"Chris Dy","startTime":1176.2,"endTime":1179.5,"body":"your role for that to practice"},{"speaker":"Chris Dy","startTime":1176.2,"endTime":1179.5,"body":"in general? Yeah, I"},{"speaker":"Charles Goldfarb","startTime":1179.56,"endTime":1181.68,"body":"listen. I"},{"speaker":"Charles Goldfarb","startTime":1179.56,"endTime":1181.68,"body":"think that is increasingly"},{"speaker":"Charles Goldfarb","startTime":1181.68,"endTime":1184.92,"body":"accepted as a really good"},{"speaker":"Charles Goldfarb","startTime":1181.68,"endTime":1184.92,"body":"operation for patients of all"},{"speaker":"Charles Goldfarb","startTime":1184.92,"endTime":1189.18,"body":"ages. You know, it's not the"},{"speaker":"Charles Goldfarb","startTime":1184.92,"endTime":1189.18,"body":"same as a wrist replacement, and"},{"speaker":"Charles Goldfarb","startTime":1189.18,"endTime":1191.58,"body":"we probably should have a guest"},{"speaker":"Charles Goldfarb","startTime":1189.18,"endTime":1191.58,"body":"on to talk about some of this"},{"speaker":"Charles Goldfarb","startTime":1191.58,"endTime":1194.28,"body":"would be interesting as someone"},{"speaker":"Charles Goldfarb","startTime":1191.58,"endTime":1194.28,"body":"who does it all the time, but a"},{"speaker":"Charles Goldfarb","startTime":1194.28,"endTime":1198.3,"body":"wrist replacement or"},{"speaker":"Charles Goldfarb","startTime":1194.28,"endTime":1198.3,"body":"arthroplasty is different, and"},{"speaker":"Charles Goldfarb","startTime":1198.3,"endTime":1202.28,"body":"it's low demand patients only."},{"speaker":"Charles Goldfarb","startTime":1198.3,"endTime":1202.28,"body":"And lifespan is not great, but"},{"speaker":"Charles Goldfarb","startTime":1202.28,"endTime":1207.14,"body":"the druj arthroplasty can really"},{"speaker":"Charles Goldfarb","startTime":1202.28,"endTime":1207.14,"body":"be long lasting and highly"},{"speaker":"Charles Goldfarb","startTime":1207.14,"endTime":1211.52,"body":"effective. I just tend to"},{"speaker":"Charles Goldfarb","startTime":1207.14,"endTime":1211.52,"body":"attempt a simple approach first,"},{"speaker":"Charles Goldfarb","startTime":1211.82,"endTime":1216.86,"body":"and that's the Dara. And for me,"},{"speaker":"Charles Goldfarb","startTime":1211.82,"endTime":1216.86,"body":"the the druj arthroplasty is a"},{"speaker":"Charles Goldfarb","startTime":1216.86,"endTime":1219.68,"body":"bailout for a failed Dara. How"},{"speaker":"Charles Goldfarb","startTime":1216.86,"endTime":1219.68,"body":"do you think about"},{"speaker":"Chris Dy","startTime":1220.34,"endTime":1222.82,"body":"it? Fame, and"},{"speaker":"Chris Dy","startTime":1220.34,"endTime":1222.82,"body":"honestly, I'm guilty of not"},{"speaker":"Chris Dy","startTime":1223.12,"endTime":1227.14,"body":"learning as much about the drej"},{"speaker":"Chris Dy","startTime":1223.12,"endTime":1227.14,"body":"arthroplasties and the risk"},{"speaker":"Chris Dy","startTime":1227.14,"endTime":1230.8,"body":"arthroplasties because we're"},{"speaker":"Chris Dy","startTime":1227.14,"endTime":1230.8,"body":"spoiled. Marty takes care of all"},{"speaker":"Chris Dy","startTime":1230.8,"endTime":1233.5,"body":"these people, and he's a pretty"},{"speaker":"Chris Dy","startTime":1230.8,"endTime":1233.5,"body":"well recognized authority in"},{"speaker":"Chris Dy","startTime":1233.5,"endTime":1236.8,"body":"this area, and he loves it. And"},{"speaker":"Chris Dy","startTime":1233.5,"endTime":1236.8,"body":"I also recognize at some point,"},{"speaker":"Chris Dy","startTime":1236.92,"endTime":1240.3,"body":"I'll need to learn about this,"},{"speaker":"Chris Dy","startTime":1236.92,"endTime":1240.3,"body":"and we'll need to share the load"},{"speaker":"Chris Dy","startTime":1240.3,"endTime":1244.26,"body":"a bit more at some point. So"},{"speaker":"Chris Dy","startTime":1240.3,"endTime":1244.26,"body":"yeah, I think about that in the"},{"speaker":"Chris Dy","startTime":1244.26,"endTime":1248.82,"body":"same way. And just now getting"},{"speaker":"Chris Dy","startTime":1244.26,"endTime":1248.82,"body":"circling back to the Dara, what"},{"speaker":"Chris Dy","startTime":1250.2,"endTime":1253.56,"body":"do you tell patients to expect"},{"speaker":"Chris Dy","startTime":1250.2,"endTime":1253.56,"body":"in terms of either motion or how"},{"speaker":"Chris Dy","startTime":1253.56,"endTime":1255.84,"body":"long it takes to get over the"},{"speaker":"Chris Dy","startTime":1253.56,"endTime":1255.84,"body":"surgery, that kind of thing?"},{"speaker":"Charles Goldfarb","startTime":1256.38,"endTime":1258.48,"body":"Yeah, I"},{"speaker":"Charles Goldfarb","startTime":1256.38,"endTime":1258.48,"body":"typically maybe, and I might do"},{"speaker":"Charles Goldfarb","startTime":1258.48,"endTime":1260.54,"body":"it differently than you. I"},{"speaker":"Charles Goldfarb","startTime":1258.48,"endTime":1260.54,"body":"typically have mobilized for"},{"speaker":"Charles Goldfarb","startTime":1260.54,"endTime":1264.92,"body":"about four weeks to allow the"},{"speaker":"Charles Goldfarb","startTime":1260.54,"endTime":1264.92,"body":"soft tissues to stabilize,"},{"speaker":"Charles Goldfarb","startTime":1264.92,"endTime":1269.06,"body":"tighten up a bit. I don't"},{"speaker":"Charles Goldfarb","startTime":1264.92,"endTime":1269.06,"body":"necessarily put them in a"},{"speaker":"Charles Goldfarb","startTime":1269.06,"endTime":1272.9,"body":"monster or a long arm cast. I"},{"speaker":"Charles Goldfarb","startTime":1269.06,"endTime":1272.9,"body":"just ask them not to"},{"speaker":"Charles Goldfarb","startTime":1272.9,"endTime":1276.26,"body":"intentionally rotate, and they"},{"speaker":"Charles Goldfarb","startTime":1272.9,"endTime":1276.26,"body":"tend to self regulate in that"},{"speaker":"Charles Goldfarb","startTime":1276.26,"endTime":1279.44,"body":"regard. And then I get them out"},{"speaker":"Charles Goldfarb","startTime":1276.26,"endTime":1279.44,"body":"of immobilization and start"},{"speaker":"Charles Goldfarb","startTime":1279.44,"endTime":1283.12,"body":"rotating. I do think. And maybe"},{"speaker":"Charles Goldfarb","startTime":1279.44,"endTime":1283.12,"body":"we're going to circle back, we"},{"speaker":"Charles Goldfarb","startTime":1283.12,"endTime":1285.64,"body":"should talk a little about"},{"speaker":"Charles Goldfarb","startTime":1283.12,"endTime":1285.64,"body":"technical, yeah,"},{"speaker":"Chris Dy","startTime":1285.64,"endTime":1289.3,"body":"absolutely, I think I"},{"speaker":"Chris Dy","startTime":1285.64,"endTime":1289.3,"body":"just, I'm thinking about the"},{"speaker":"Chris Dy","startTime":1290.32,"endTime":1294.7,"body":"talk to patients, and I'm, I'm a"},{"speaker":"Chris Dy","startTime":1290.32,"endTime":1294.7,"body":"little less restrictive in terms"},{"speaker":"Chris Dy","startTime":1294.7,"endTime":1297.82,"body":"of immobilization, you know, I"},{"speaker":"Chris Dy","startTime":1294.7,"endTime":1297.82,"body":"try to keep it simple. And"},{"speaker":"Chris Dy","startTime":1297.82,"endTime":1300.42,"body":"honestly, if her issue was"},{"speaker":"Chris Dy","startTime":1297.82,"endTime":1300.42,"body":"rotation, I kind of let her"},{"speaker":"Chris Dy","startTime":1300.42,"endTime":1303.24,"body":"rotate right away, because I"},{"speaker":"Chris Dy","startTime":1300.42,"endTime":1303.24,"body":"think that most patients are"},{"speaker":"Chris Dy","startTime":1303.24,"endTime":1306.3,"body":"going to be self limiting in"},{"speaker":"Chris Dy","startTime":1303.24,"endTime":1306.3,"body":"terms of not overdoing it for"},{"speaker":"Chris Dy","startTime":1306.3,"endTime":1310.68,"body":"activity before we jump into"},{"speaker":"Chris Dy","startTime":1306.3,"endTime":1310.68,"body":"kind of technical aspects. I"},{"speaker":"Chris Dy","startTime":1310.68,"endTime":1314.1,"body":"think we should acknowledge our"},{"speaker":"Chris Dy","startTime":1310.68,"endTime":1314.1,"body":"other sponsor again, brand new"},{"speaker":"Chris Dy","startTime":1314.1,"endTime":1315.9,"body":"information, checkpoint."},{"speaker":"Chris Dy","startTime":1314.1,"endTime":1315.9,"body":"Surgical,"},{"speaker":"Charles Goldfarb","startTime":1316.26,"endTime":1318.3,"body":"absolutely the"},{"speaker":"Charles Goldfarb","startTime":1316.26,"endTime":1318.3,"body":"upper hand. Sponsor by"},{"speaker":"Charles Goldfarb","startTime":1318.3,"endTime":1321.32,"body":"checkpoint surgical, a leader in"},{"speaker":"Charles Goldfarb","startTime":1318.3,"endTime":1321.32,"body":"peripheral nerve surgery"},{"speaker":"Charles Goldfarb","startTime":1321.32,"endTime":1326.36,"body":"solutions with a bipolar"},{"speaker":"Charles Goldfarb","startTime":1321.32,"endTime":1326.36,"body":"stimulation probe, checkpoint"},{"speaker":"Charles Goldfarb","startTime":1326.36,"endTime":1331.16,"body":"Gemini bipolar nerve stimulator."},{"speaker":"Charles Goldfarb","startTime":1326.36,"endTime":1331.16,"body":"Mouthful provides finally"},{"speaker":"Charles Goldfarb","startTime":1331.16,"endTime":1334.76,"body":"controlled stimulation even at"},{"speaker":"Charles Goldfarb","startTime":1331.16,"endTime":1334.76,"body":"the vesicular level, allowing"},{"speaker":"Charles Goldfarb","startTime":1334.76,"endTime":1337.88,"body":"surgeons to take actions based"},{"speaker":"Charles Goldfarb","startTime":1334.76,"endTime":1337.88,"body":"on the most precise information"},{"speaker":"Charles Goldfarb","startTime":1337.88,"endTime":1339.14,"body":"available. Learn"},{"speaker":"Charles Goldfarb","startTime":1337.88,"endTime":1339.14,"body":"more@www.checkpointsurgical.com"},{"speaker":"Chris Dy","startTime":1342.08,"endTime":1343.84,"body":"checkpoint surgical,"},{"speaker":"Chris Dy","startTime":1342.08,"endTime":1343.84,"body":"checkpoint surgical, driving"},{"speaker":"Chris Dy","startTime":1343.84,"endTime":1347.2,"body":"innovation and nerve surgery and"},{"speaker":"Chris Dy","startTime":1343.84,"endTime":1347.2,"body":"giving Dr Goldfarb a whole lot"},{"speaker":"Chris Dy","startTime":1347.2,"endTime":1348.94,"body":"of stuff to read. Geez,"},{"speaker":"Charles Goldfarb","startTime":1348.94,"endTime":1350.98,"body":"that was a lot"},{"speaker":"Charles Goldfarb","startTime":1348.94,"endTime":1350.98,"body":"of anxiety trying to get all"},{"speaker":"Charles Goldfarb","startTime":1350.98,"endTime":1352.66,"body":"that out. But you"},{"speaker":"Chris Dy","startTime":1352.66,"endTime":1355.84,"body":"got it, you're good."},{"speaker":"Chris Dy","startTime":1352.66,"endTime":1355.84,"body":"So back to the back to our case."},{"speaker":"Chris Dy","startTime":1357.1,"endTime":1360.3,"body":"Approach pretty simple for me,"},{"speaker":"Chris Dy","startTime":1357.1,"endTime":1360.3,"body":"at least. I try to keep it"},{"speaker":"Chris Dy","startTime":1360.3,"endTime":1364.62,"body":"simple, I go essentially on the"},{"speaker":"Chris Dy","startTime":1360.3,"endTime":1364.62,"body":"ulnar side of the dorsal distal"},{"speaker":"Chris Dy","startTime":1364.62,"endTime":1368.1,"body":"forearm, kind of over the"},{"speaker":"Chris Dy","startTime":1364.62,"endTime":1368.1,"body":"prominence of the ulnar head at"},{"speaker":"Chris Dy","startTime":1368.1,"endTime":1370.8,"body":"the distal aspect. I'm looking"},{"speaker":"Chris Dy","startTime":1368.1,"endTime":1370.8,"body":"out for the dorsal cutaneous"},{"speaker":"Chris Dy","startTime":1370.8,"endTime":1373.32,"body":"branch of the ulnar nerve as it"},{"speaker":"Chris Dy","startTime":1370.8,"endTime":1373.32,"body":"starts to make its way from"},{"speaker":"Chris Dy","startTime":1373.32,"endTime":1376.86,"body":"volar to dorsal to mid axial"},{"speaker":"Chris Dy","startTime":1373.32,"endTime":1376.86,"body":"line anatomy is a little bit"},{"speaker":"Chris Dy","startTime":1376.86,"endTime":1379.32,"body":"distorted, given the fact that"},{"speaker":"Chris Dy","startTime":1376.86,"endTime":1379.32,"body":"you're on the carpal joints,"},{"speaker":"Chris Dy","startTime":1379.5,"endTime":1383.9,"body":"distorted with the prominence of"},{"speaker":"Chris Dy","startTime":1379.5,"endTime":1383.9,"body":"the ulnar head, and then I"},{"speaker":"Chris Dy","startTime":1383.96,"endTime":1386.06,"body":"visualize my ECU and use that as"},{"speaker":"Chris Dy","startTime":1383.96,"endTime":1386.06,"body":"my guide."},{"speaker":"Charles Goldfarb","startTime":1387.14,"endTime":1389.48,"body":"I like what"},{"speaker":"Charles Goldfarb","startTime":1387.14,"endTime":1389.48,"body":"you said. I will say that I you"},{"speaker":"Charles Goldfarb","startTime":1389.48,"endTime":1392.3,"body":"know, it's very satisfying to me"},{"speaker":"Charles Goldfarb","startTime":1389.48,"endTime":1392.3,"body":"when I take a little different"},{"speaker":"Charles Goldfarb","startTime":1392.42,"endTime":1396.02,"body":"teaching approach. So I had a"},{"speaker":"Charles Goldfarb","startTime":1392.42,"endTime":1396.02,"body":"very strange ganglion cyst"},{"speaker":"Charles Goldfarb","startTime":1396.02,"endTime":1399.14,"body":"emanating from the ulna carpal"},{"speaker":"Charles Goldfarb","startTime":1396.02,"endTime":1399.14,"body":"joint, and so I asked the"},{"speaker":"Charles Goldfarb","startTime":1399.14,"endTime":1403.42,"body":"resident to draw the path of the"},{"speaker":"Charles Goldfarb","startTime":1399.14,"endTime":1403.42,"body":"ulnar sensory nerve. And she's"},{"speaker":"Charles Goldfarb","startTime":1403.42,"endTime":1407.08,"body":"an excellent resident. And she"},{"speaker":"Charles Goldfarb","startTime":1403.42,"endTime":1407.08,"body":"drew it just dorsal, like it was"},{"speaker":"Charles Goldfarb","startTime":1407.08,"endTime":1410.98,"body":"just a straight line, dorsal."},{"speaker":"Charles Goldfarb","startTime":1407.08,"endTime":1410.98,"body":"And I it just feels good when"},{"speaker":"Charles Goldfarb","startTime":1410.98,"endTime":1413.62,"body":"you like. I don't usually do"},{"speaker":"Charles Goldfarb","startTime":1410.98,"endTime":1413.62,"body":"that. And I'm like, she's gonna"},{"speaker":"Charles Goldfarb","startTime":1413.98,"endTime":1417.52,"body":"that is something I do. That's"},{"speaker":"Charles Goldfarb","startTime":1413.98,"endTime":1417.52,"body":"exactly right. That's exactly"},{"speaker":"Charles Goldfarb","startTime":1417.52,"endTime":1419.98,"body":"what I was thinking. Is"},{"speaker":"Charles Goldfarb","startTime":1417.52,"endTime":1419.98,"body":"something you would do. And I"},{"speaker":"Charles Goldfarb","startTime":1419.98,"endTime":1423.36,"body":"realized the value she had drawn"},{"speaker":"Charles Goldfarb","startTime":1419.98,"endTime":1423.36,"body":"it perfectly, I would have felt"},{"speaker":"Charles Goldfarb","startTime":1423.36,"endTime":1427.26,"body":"silly and never done it again."},{"speaker":"Charles Goldfarb","startTime":1423.36,"endTime":1427.26,"body":"But making them draw it on the"},{"speaker":"Charles Goldfarb","startTime":1427.26,"endTime":1429.42,"body":"patient is really impactful."},{"speaker":"Chris Dy","startTime":1430.08,"endTime":1432.18,"body":"The other time that"},{"speaker":"Chris Dy","startTime":1430.08,"endTime":1432.18,"body":"I'll use the marking pen, I'll"},{"speaker":"Chris Dy","startTime":1432.18,"endTime":1435.84,"body":"either make a game plan on the"},{"speaker":"Chris Dy","startTime":1432.18,"endTime":1435.84,"body":"drapes, in terms of like, if we"},{"speaker":"Chris Dy","startTime":1435.84,"endTime":1438.48,"body":"need to simulate certain nerves"},{"speaker":"Chris Dy","startTime":1435.84,"endTime":1438.48,"body":"in a certain timeline, and here"},{"speaker":"Chris Dy","startTime":1438.48,"endTime":1441.86,"body":"are the goals, etc, or if we're"},{"speaker":"Chris Dy","startTime":1438.48,"endTime":1441.86,"body":"cutting fascia, either in a"},{"speaker":"Chris Dy","startTime":1441.86,"endTime":1444.92,"body":"setting of an ulnar nerve"},{"speaker":"Chris Dy","startTime":1441.86,"endTime":1444.92,"body":"transposition, and we're, you"},{"speaker":"Chris Dy","startTime":1444.92,"endTime":1447.62,"body":"know, releasing the fascia"},{"speaker":"Chris Dy","startTime":1444.92,"endTime":1447.62,"body":"overlying the two heads of the"},{"speaker":"Chris Dy","startTime":1447.62,"endTime":1451.76,"body":"FCU. I like to see if they can"},{"speaker":"Chris Dy","startTime":1447.62,"endTime":1451.76,"body":"see the rafae between the ulnar"},{"speaker":"Chris Dy","startTime":1451.76,"endTime":1454.88,"body":"and humeral heads, and have them"},{"speaker":"Chris Dy","startTime":1451.76,"endTime":1454.88,"body":"mark it out on the fascia."},{"speaker":"Chris Dy","startTime":1454.94,"endTime":1459.2,"body":"Again, total teaching point."},{"speaker":"Chris Dy","startTime":1454.94,"endTime":1459.2,"body":"Doesn't change what we do. Makes"},{"speaker":"Chris Dy","startTime":1459.2,"endTime":1462.04,"body":"it look slicker, though, and"},{"speaker":"Chris Dy","startTime":1459.2,"endTime":1462.04,"body":"then also releasing a perineal"},{"speaker":"Chris Dy","startTime":1462.04,"endTime":1464.5,"body":"nerve, you know, kind of"},{"speaker":"Chris Dy","startTime":1462.04,"endTime":1464.5,"body":"tracking the course of the deep"},{"speaker":"Chris Dy","startTime":1464.5,"endTime":1466.54,"body":"perineal nervous that goes"},{"speaker":"Chris Dy","startTime":1464.5,"endTime":1466.54,"body":"underneath all the lateral"},{"speaker":"Chris Dy","startTime":1466.54,"endTime":1469.0,"body":"anterior compartment"},{"speaker":"Chris Dy","startTime":1466.54,"endTime":1469.0,"body":"musculature, putting dots on the"},{"speaker":"Chris Dy","startTime":1469.0,"endTime":1472.18,"body":"fascia with the marking pen so"},{"speaker":"Chris Dy","startTime":1469.0,"endTime":1472.18,"body":"as to see where they think they"},{"speaker":"Chris Dy","startTime":1472.18,"endTime":1474.58,"body":"need to release. Because for"},{"speaker":"Chris Dy","startTime":1472.18,"endTime":1474.58,"body":"that, when you do have to be"},{"speaker":"Chris Dy","startTime":1474.58,"endTime":1476.98,"body":"kind of dead on with your"},{"speaker":"Chris Dy","startTime":1474.58,"endTime":1476.98,"body":"fascial cuts to make sure that"},{"speaker":"Chris Dy","startTime":1476.98,"endTime":1479.74,"body":"you're able to decompress the"},{"speaker":"Chris Dy","startTime":1476.98,"endTime":1479.74,"body":"nerve without excessive"},{"speaker":"Chris Dy","startTime":1479.74,"endTime":1483.0,"body":"exposure. So sorry for bringing"},{"speaker":"Chris Dy","startTime":1479.74,"endTime":1483.0,"body":"nerve into our talk, but yes,"},{"speaker":"Chris Dy","startTime":1483.0,"endTime":1485.34,"body":"that's when I use that. So"},{"speaker":"Charles Goldfarb","startTime":1485.34,"endTime":1488.22,"body":"I love that. I"},{"speaker":"Charles Goldfarb","startTime":1485.34,"endTime":1488.22,"body":"like your approach using the ECU"},{"speaker":"Charles Goldfarb","startTime":1488.22,"endTime":1491.94,"body":"as a guide. And then, quite"},{"speaker":"Charles Goldfarb","startTime":1488.22,"endTime":1491.94,"body":"simply, I try to take my"},{"speaker":"Charles Goldfarb","startTime":1491.94,"endTime":1494.64,"body":"sagittal saw, which I don't"},{"speaker":"Charles Goldfarb","startTime":1491.94,"endTime":1494.64,"body":"always use in different"},{"speaker":"Charles Goldfarb","startTime":1494.64,"endTime":1497.88,"body":"osteotomies, but I use a"},{"speaker":"Charles Goldfarb","startTime":1494.64,"endTime":1497.88,"body":"sagittal saw. I use it just"},{"speaker":"Charles Goldfarb","startTime":1497.88,"endTime":1500.9,"body":"proximal to the articular"},{"speaker":"Charles Goldfarb","startTime":1497.88,"endTime":1500.9,"body":"surface. And I would say that's"},{"speaker":"Charles Goldfarb","startTime":1500.9,"endTime":1503.84,"body":"step one. How do you take out"},{"speaker":"Charles Goldfarb","startTime":1500.9,"endTime":1503.84,"body":"the ulnar head?"},{"speaker":"Chris Dy","startTime":1505.22,"endTime":1507.26,"body":"So, yeah, actually,"},{"speaker":"Chris Dy","startTime":1505.22,"endTime":1507.26,"body":"when I was doing this, a very"},{"speaker":"Chris Dy","startTime":1507.26,"endTime":1510.14,"body":"astute resident, Dr Ryan Wilbur,"},{"speaker":"Chris Dy","startTime":1507.26,"endTime":1510.14,"body":"is working with me right now."},{"speaker":"Chris Dy","startTime":1510.14,"endTime":1512.9,"body":"He's fantastic. And we were"},{"speaker":"Chris Dy","startTime":1510.14,"endTime":1512.9,"body":"talking about different"},{"speaker":"Chris Dy","startTime":1512.9,"endTime":1515.72,"body":"approaches to this. And he was"},{"speaker":"Chris Dy","startTime":1512.9,"endTime":1515.72,"body":"mentioning that some folks"},{"speaker":"Chris Dy","startTime":1515.72,"endTime":1520.1,"body":"preserve the ulnar styloid, you"},{"speaker":"Chris Dy","startTime":1515.72,"endTime":1520.1,"body":"know, as part of this, that has"},{"speaker":"Chris Dy","startTime":1520.1,"endTime":1525.64,"body":"not been very helpful to me. And"},{"speaker":"Chris Dy","startTime":1520.1,"endTime":1525.64,"body":"I, honestly, I find, you know, I"},{"speaker":"Chris Dy","startTime":1525.82,"endTime":1528.94,"body":"release the periosteum, and then"},{"speaker":"Chris Dy","startTime":1525.82,"endTime":1528.94,"body":"I just kind of work my way"},{"speaker":"Chris Dy","startTime":1528.94,"endTime":1534.16,"body":"around the ulna and going"},{"speaker":"Chris Dy","startTime":1528.94,"endTime":1534.16,"body":"distally, and try to keep take"},{"speaker":"Chris Dy","startTime":1534.16,"endTime":1537.04,"body":"everything right off of the"},{"speaker":"Chris Dy","startTime":1534.16,"endTime":1537.04,"body":"bone, and I don't do much"},{"speaker":"Chris Dy","startTime":1537.04,"endTime":1539.62,"body":"handling the TFCC, and I make my"},{"speaker":"Chris Dy","startTime":1537.04,"endTime":1539.62,"body":"cut more proximal."},{"speaker":"Charles Goldfarb","startTime":1540.22,"endTime":1543.24,"body":"Yeah, look,"},{"speaker":"Charles Goldfarb","startTime":1540.22,"endTime":1543.24,"body":"preserving the ulna might sound"},{"speaker":"Charles Goldfarb","startTime":1543.24,"endTime":1547.68,"body":"good, but ultimately, the"},{"speaker":"Charles Goldfarb","startTime":1543.24,"endTime":1547.68,"body":"styloid insertion of the TFCC is"},{"speaker":"Charles Goldfarb","startTime":1547.68,"endTime":1551.1,"body":"not the stabilizing portion of"},{"speaker":"Charles Goldfarb","startTime":1547.68,"endTime":1551.1,"body":"the TFC, so I don't think that"},{"speaker":"Charles Goldfarb","startTime":1551.1,"endTime":1554.22,"body":"helps. So like you said, I"},{"speaker":"Charles Goldfarb","startTime":1551.1,"endTime":1554.22,"body":"sharply dissect"},{"speaker":"Charles Goldfarb","startTime":1554.22,"endTime":1558.36,"body":"circumferentially and then make"},{"speaker":"Charles Goldfarb","startTime":1554.22,"endTime":1558.36,"body":"my cut, and I'm done."},{"speaker":"Chris Dy","startTime":1558.66,"endTime":1561.02,"body":"Is this a metaphyseal"},{"speaker":"Chris Dy","startTime":1558.66,"endTime":1561.02,"body":"cut? Diaphyseal somewhere in"},{"speaker":"Chris Dy","startTime":1561.02,"endTime":1563.66,"body":"between. Like, how far proximal"},{"speaker":"Chris Dy","startTime":1561.02,"endTime":1563.66,"body":"to the sigmoid notch Are you"},{"speaker":"Chris Dy","startTime":1563.66,"endTime":1565.64,"body":"going for your cut? Are you just"},{"speaker":"Charles Goldfarb","startTime":1565.4,"endTime":1567.415,"body":"just a little"},{"speaker":"Charles Goldfarb","startTime":1565.4,"endTime":1567.415,"body":"bit right proximal? Are you"},{"speaker":"Charles Goldfarb","startTime":1567.464,"endTime":1570.02,"body":"making it more proximal than"},{"speaker":"Charles Goldfarb","startTime":1567.464,"endTime":1570.02,"body":"that? I'm more proximal"},{"speaker":"Chris Dy","startTime":1570.56,"endTime":1572.6,"body":"because if I'm trying"},{"speaker":"Chris Dy","startTime":1570.56,"endTime":1572.6,"body":"to gain rotation, I want to"},{"speaker":"Chris Dy","startTime":1572.6,"endTime":1576.86,"body":"leave no question that I'm going"},{"speaker":"Chris Dy","startTime":1572.6,"endTime":1576.86,"body":"to be able to get the rotation."},{"speaker":"Chris Dy","startTime":1576.86,"endTime":1579.44,"body":"So I tend to make my cut"},{"speaker":"Chris Dy","startTime":1576.86,"endTime":1579.44,"body":"proximal to the sigmoid notch."},{"speaker":"Chris Dy","startTime":1579.44,"endTime":1582.58,"body":"So that time, honestly, one and"},{"speaker":"Chris Dy","startTime":1579.44,"endTime":1582.58,"body":"done. And then, obviously, you"},{"speaker":"Chris Dy","startTime":1582.58,"endTime":1586.54,"body":"can cut back. For this case, we"},{"speaker":"Chris Dy","startTime":1582.58,"endTime":1586.54,"body":"checked rotation, and then we"},{"speaker":"Chris Dy","startTime":1586.54,"endTime":1588.82,"body":"didn't need to cut back more,"},{"speaker":"Chris Dy","startTime":1586.54,"endTime":1588.82,"body":"but you can cut back more. And"},{"speaker":"Chris Dy","startTime":1588.82,"endTime":1591.7,"body":"then, as we bring things to a"},{"speaker":"Chris Dy","startTime":1588.82,"endTime":1591.7,"body":"close, I guess I would like to"},{"speaker":"Chris Dy","startTime":1591.7,"endTime":1595.36,"body":"know, you know, as one of the"},{"speaker":"Chris Dy","startTime":1591.7,"endTime":1595.36,"body":"potential issues with this is"},{"speaker":"Chris Dy","startTime":1595.36,"endTime":1599.62,"body":"convergence in the coronal"},{"speaker":"Chris Dy","startTime":1595.36,"endTime":1599.62,"body":"plane, so the ulna converging on"},{"speaker":"Chris Dy","startTime":1599.68,"endTime":1605.22,"body":"the radius, you know, on the AP"},{"speaker":"Chris Dy","startTime":1599.68,"endTime":1605.22,"body":"view, and then also instability"},{"speaker":"Chris Dy","startTime":1605.22,"endTime":1607.74,"body":"of the ulnar stump. You've"},{"speaker":"Chris Dy","startTime":1605.22,"endTime":1607.74,"body":"obviously cut the on the bone,"},{"speaker":"Chris Dy","startTime":1607.74,"endTime":1610.8,"body":"and you is that stump gonna go"},{"speaker":"Chris Dy","startTime":1607.74,"endTime":1610.8,"body":"dorsal and become problematic?"},{"speaker":"Chris Dy","startTime":1611.34,"endTime":1611.76,"body":"So I think"},{"speaker":"Charles Goldfarb","startTime":1611.76,"endTime":1614.28,"body":"there's two"},{"speaker":"Charles Goldfarb","startTime":1611.76,"endTime":1614.28,"body":"other technical considerations."},{"speaker":"Charles Goldfarb","startTime":1614.46,"endTime":1618.36,"body":"Paul manski used to always"},{"speaker":"Charles Goldfarb","startTime":1614.46,"endTime":1618.36,"body":"release the pronator quadratus"},{"speaker":"Charles Goldfarb","startTime":1618.36,"endTime":1622.34,"body":"from the distal ulna, and either"},{"speaker":"Charles Goldfarb","startTime":1618.36,"endTime":1622.34,"body":"just release it to take away a"},{"speaker":"Charles Goldfarb","startTime":1622.34,"endTime":1627.14,"body":"converging force, or release it"},{"speaker":"Charles Goldfarb","startTime":1622.34,"endTime":1627.14,"body":"and interpose it between the"},{"speaker":"Charles Goldfarb","startTime":1627.14,"endTime":1630.14,"body":"radius and the ulna. And I'll"},{"speaker":"Charles Goldfarb","startTime":1627.14,"endTime":1630.14,"body":"say I like both of those"},{"speaker":"Charles Goldfarb","startTime":1630.14,"endTime":1633.02,"body":"options. Certainly the release"},{"speaker":"Charles Goldfarb","startTime":1630.14,"endTime":1633.02,"body":"is simpler, but in certain"},{"speaker":"Charles Goldfarb","startTime":1633.02,"endTime":1635.6,"body":"situations, bringing it up"},{"speaker":"Charles Goldfarb","startTime":1633.02,"endTime":1635.6,"body":"between the radius and ulna"},{"speaker":"Charles Goldfarb","startTime":1635.6,"endTime":1638.18,"body":"makes sense. That's one"},{"speaker":"Charles Goldfarb","startTime":1635.6,"endTime":1638.18,"body":"technical consideration, and the"},{"speaker":"Charles Goldfarb","startTime":1638.18,"endTime":1642.1,"body":"other technical consideration,"},{"speaker":"Charles Goldfarb","startTime":1638.18,"endTime":1642.1,"body":"which I do regularly, especially"},{"speaker":"Charles Goldfarb","startTime":1642.22,"endTime":1646.24,"body":"if there is intraoperative a lot"},{"speaker":"Charles Goldfarb","startTime":1642.22,"endTime":1646.24,"body":"of laxity, I will take a Hemi"},{"speaker":"Charles Goldfarb","startTime":1646.24,"endTime":1651.52,"body":"slip of F, I'm sorry, of ECU,"},{"speaker":"Charles Goldfarb","startTime":1646.24,"endTime":1651.52,"body":"leave it attached distally, cut"},{"speaker":"Charles Goldfarb","startTime":1651.52,"endTime":1655.0,"body":"it as far proximally as"},{"speaker":"Charles Goldfarb","startTime":1651.52,"endTime":1655.0,"body":"possible, and then drill a hole"},{"speaker":"Charles Goldfarb","startTime":1655.0,"endTime":1659.14,"body":"in the distal ulna and pass it"},{"speaker":"Charles Goldfarb","startTime":1655.0,"endTime":1659.14,"body":"through the ulna medullary"},{"speaker":"Charles Goldfarb","startTime":1659.14,"endTime":1663.42,"body":"canal, out a drill hole dorsally"},{"speaker":"Charles Goldfarb","startTime":1659.14,"endTime":1663.42,"body":"and suture back onto itself. I"},{"speaker":"Charles Goldfarb","startTime":1663.42,"endTime":1667.02,"body":"like that option. I don't always"},{"speaker":"Charles Goldfarb","startTime":1663.42,"endTime":1667.02,"body":"do it. Do you do either of"},{"speaker":"Charles Goldfarb","startTime":1667.02,"endTime":1668.52,"body":"those? Both of those, neither"},{"speaker":"Chris Dy","startTime":1668.7,"endTime":1673.56,"body":"she I did one of each"},{"speaker":"Chris Dy","startTime":1668.7,"endTime":1673.56,"body":"so in the last two weeks. So,"},{"speaker":"Chris Dy","startTime":1673.62,"endTime":1676.26,"body":"you know, we had really nice on"},{"speaker":"Chris Dy","startTime":1673.62,"endTime":1676.26,"body":"one case, we had a really nice,"},{"speaker":"Chris Dy","startTime":1676.74,"endTime":1681.08,"body":"you know, tenderness portion of"},{"speaker":"Chris Dy","startTime":1676.74,"endTime":1681.08,"body":"the of the pronator quadratus,"},{"speaker":"Chris Dy","startTime":1681.56,"endTime":1686.0,"body":"so that in like insertional"},{"speaker":"Chris Dy","startTime":1681.56,"endTime":1686.0,"body":"portion, and I put an anchor"},{"speaker":"Chris Dy","startTime":1686.0,"endTime":1690.14,"body":"into the to the stump of the"},{"speaker":"Chris Dy","startTime":1686.0,"endTime":1690.14,"body":"ulna, and then sutured that"},{"speaker":"Chris Dy","startTime":1690.14,"endTime":1692.9,"body":"together to help, kind of hold"},{"speaker":"Chris Dy","startTime":1690.14,"endTime":1692.9,"body":"it in place and try to"},{"speaker":"Chris Dy","startTime":1692.9,"endTime":1696.26,"body":"neutralize that deforming force."},{"speaker":"Chris Dy","startTime":1692.9,"endTime":1696.26,"body":"And also tried to put it over"},{"speaker":"Chris Dy","startTime":1696.44,"endTime":1699.38,"body":"the dorsal side as well, to try"},{"speaker":"Chris Dy","startTime":1696.44,"endTime":1699.38,"body":"and keep that down. And then in"},{"speaker":"Chris Dy","startTime":1699.38,"endTime":1701.92,"body":"the second case, I did see that"},{"speaker":"Chris Dy","startTime":1699.38,"endTime":1701.92,"body":"they wanted to drift a bit"},{"speaker":"Chris Dy","startTime":1701.92,"endTime":1706.48,"body":"dorsally, so I did the Hemi slip"},{"speaker":"Chris Dy","startTime":1701.92,"endTime":1706.48,"body":"ECU that you described. And I"},{"speaker":"Chris Dy","startTime":1706.48,"endTime":1708.7,"body":"think it kind of is case"},{"speaker":"Chris Dy","startTime":1706.48,"endTime":1708.7,"body":"dependent. It's"},{"speaker":"Charles Goldfarb","startTime":1708.7,"endTime":1710.08,"body":"case"},{"speaker":"Charles Goldfarb","startTime":1708.7,"endTime":1710.08,"body":"dependent. I would say, if you"},{"speaker":"Charles Goldfarb","startTime":1710.08,"endTime":1713.74,"body":"do the Hemi slip, the problem is"},{"speaker":"Charles Goldfarb","startTime":1710.08,"endTime":1713.74,"body":"you never have enough length of"},{"speaker":"Charles Goldfarb","startTime":1713.74,"endTime":1718.06,"body":"the ECU. So you really do have"},{"speaker":"Charles Goldfarb","startTime":1713.74,"endTime":1718.06,"body":"to make your incision longer and"},{"speaker":"Charles Goldfarb","startTime":1718.06,"endTime":1721.5,"body":"really split it, and then you"},{"speaker":"Charles Goldfarb","startTime":1718.06,"endTime":1721.5,"body":"need the length to provide a"},{"speaker":"Charles Goldfarb","startTime":1721.5,"endTime":1723.42,"body":"reasonable stability point."},{"speaker":"Chris Dy","startTime":1723.96,"endTime":1728.1,"body":"Yeah, that's exactly"},{"speaker":"Chris Dy","startTime":1723.96,"endTime":1728.1,"body":"what we discussed and then also"},{"speaker":"Chris Dy","startTime":1728.1,"endTime":1732.48,"body":"experienced, so making sure we"},{"speaker":"Chris Dy","startTime":1728.1,"endTime":1732.48,"body":"had the length, and then it's"},{"speaker":"Chris Dy","startTime":1732.48,"endTime":1735.6,"body":"nice when you can suture that"},{"speaker":"Chris Dy","startTime":1732.48,"endTime":1735.6,"body":"back down to itself or to the"},{"speaker":"Chris Dy","startTime":1735.6,"endTime":1738.9,"body":"other part of the Hemi slip."},{"speaker":"Chris Dy","startTime":1735.6,"endTime":1738.9,"body":"That's helpful in terms of"},{"speaker":"Chris Dy","startTime":1738.9,"endTime":1741.98,"body":"controlling that sagittal"},{"speaker":"Chris Dy","startTime":1738.9,"endTime":1741.98,"body":"deformity. So I saw you putting"},{"speaker":"Chris Dy","startTime":1741.98,"endTime":1744.98,"body":"your loops on, which means"},{"speaker":"Chris Dy","startTime":1741.98,"endTime":1744.98,"body":"you've got to get to your case."},{"speaker":"Chris Dy","startTime":1745.7,"endTime":1748.28,"body":"But I think this was a great"},{"speaker":"Chris Dy","startTime":1745.7,"endTime":1748.28,"body":"discussion. If there are"},{"speaker":"Chris Dy","startTime":1748.28,"endTime":1751.7,"body":"listeners that have experience"},{"speaker":"Chris Dy","startTime":1748.28,"endTime":1751.7,"body":"either performing or rehabbing a"},{"speaker":"Chris Dy","startTime":1751.7,"endTime":1754.7,"body":"Dara procedure, it'd be great to"},{"speaker":"Chris Dy","startTime":1751.7,"endTime":1754.7,"body":"hear from you. So a hand"},{"speaker":"Chris Dy","startTime":1754.7,"endTime":1755.18,"body":"podcast@gmail.com"},{"speaker":"Charles Goldfarb","startTime":1756.5,"endTime":1758.36,"body":"Yes, or"},{"speaker":"Charles Goldfarb","startTime":1756.5,"endTime":1758.36,"body":"listeners that don't like the"},{"speaker":"Charles Goldfarb","startTime":1758.36,"endTime":1761.8,"body":"Dara and the problems that you"},{"speaker":"Charles Goldfarb","startTime":1758.36,"endTime":1761.8,"body":"may have experienced with it."},{"speaker":"Charles Goldfarb","startTime":1761.98,"endTime":1764.92,"body":"It's a controversial operation,"},{"speaker":"Charles Goldfarb","startTime":1761.98,"endTime":1764.92,"body":"let's be honest. And there are"},{"speaker":"Charles Goldfarb","startTime":1764.92,"endTime":1767.74,"body":"problems with it, and that's why"},{"speaker":"Charles Goldfarb","startTime":1764.92,"endTime":1767.74,"body":"not everyone immediately goes to"},{"speaker":"Charles Goldfarb","startTime":1767.74,"endTime":1772.18,"body":"it. But I think in the right"},{"speaker":"Charles Goldfarb","startTime":1767.74,"endTime":1772.18,"body":"situation, it can be a huge home"},{"speaker":"Charles Goldfarb","startTime":1772.18,"endTime":1776.98,"body":"run, kind of like the Mets home"},{"speaker":"Charles Goldfarb","startTime":1772.18,"endTime":1776.98,"body":"run last night to knock out the"},{"speaker":"Charles Goldfarb","startTime":1776.98,"endTime":1778.84,"body":"brewers. And where we talked"},{"speaker":"Charles Goldfarb","startTime":1776.98,"endTime":1778.84,"body":"about,"},{"speaker":"Chris Dy","startTime":1778.84,"endTime":1781.38,"body":"we talked about not"},{"speaker":"Chris Dy","startTime":1778.84,"endTime":1781.38,"body":"dating the podcast, when we when"},{"speaker":"Chris Dy","startTime":1781.38,"endTime":1783.84,"body":"we record it. But that was"},{"speaker":"Chris Dy","startTime":1781.38,"endTime":1783.84,"body":"pretty incredible. I was eating"},{"speaker":"Chris Dy","startTime":1783.84,"endTime":1786.48,"body":"dinner in a restaurant last"},{"speaker":"Chris Dy","startTime":1783.84,"endTime":1786.48,"body":"night, and hold heard somebody"},{"speaker":"Chris Dy","startTime":1786.48,"endTime":1789.06,"body":"just scream out expletives. Must"},{"speaker":"Chris Dy","startTime":1786.48,"endTime":1789.06,"body":"have been a Mets fan. They were"},{"speaker":"Chris Dy","startTime":1789.06,"endTime":1792.12,"body":"happy expletives. But yeah, I"},{"speaker":"Chris Dy","startTime":1789.06,"endTime":1792.12,"body":"looked up and as, oh, okay,"},{"speaker":"Chris Dy","startTime":1792.12,"endTime":1794.82,"body":"cool, something. I guess it's"},{"speaker":"Chris Dy","startTime":1792.12,"endTime":1794.82,"body":"October baseball going on."},{"speaker":"Chris Dy","startTime":1795.12,"endTime":1795.54,"body":"October"},{"speaker":"Charles Goldfarb","startTime":1795.54,"endTime":1797.28,"body":"baseball, the"},{"speaker":"Charles Goldfarb","startTime":1795.54,"endTime":1797.28,"body":"Mets haven't had a lot to cheer"},{"speaker":"Charles Goldfarb","startTime":1797.28,"endTime":1799.26,"body":"about for a really long time."},{"speaker":"Chris Dy","startTime":1799.32,"endTime":1801.62,"body":"Exactly. At the end,"},{"speaker":"Chris Dy","startTime":1799.32,"endTime":1801.62,"body":"they got that playoff pumpkin. I"},{"speaker":"Chris Dy","startTime":1801.62,"endTime":1804.26,"body":"saw that in the locker room. So"},{"speaker":"Chris Dy","startTime":1801.62,"endTime":1804.26,"body":"anyway, enjoy your day. Enjoy"},{"speaker":"Chris Dy","startTime":1804.26,"endTime":1805.82,"body":"your case. Thanks. Take care."},{"speaker":"Charles Goldfarb","startTime":1807.2,"endTime":1809.24,"body":"Hey, Chris,"},{"speaker":"Charles Goldfarb","startTime":1807.2,"endTime":1809.24,"body":"that was fun. Let's do it again"},{"speaker":"Charles Goldfarb","startTime":1809.24,"endTime":1809.84,"body":"real soon."},{"speaker":"Chris Dy","startTime":1810.38,"endTime":1812.54,"body":"Sounds good. Well, be"},{"speaker":"Chris Dy","startTime":1810.38,"endTime":1812.54,"body":"sure to email us with topic"},{"speaker":"Chris Dy","startTime":1812.54,"endTime":1814.7,"body":"suggestions and feedback. You"},{"speaker":"Chris Dy","startTime":1812.54,"endTime":1814.7,"body":"can reach us at"},{"speaker":"Chris Dy","startTime":1814.7,"endTime":1815.54,"body":"handpodcast@gmail.com"},{"speaker":"Charles Goldfarb","startTime":1817.28,"endTime":1819.44,"body":"and remember,"},{"speaker":"Charles Goldfarb","startTime":1817.28,"endTime":1819.44,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":1819.44,"endTime":1820.4,"body":"get your podcast,"},{"speaker":"Chris Dy","startTime":1820.82,"endTime":1823.72,"body":"and be sure to leave a"},{"speaker":"Chris Dy","startTime":1820.82,"endTime":1823.72,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":1823.72,"endTime":1824.14,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":1824.8,"endTime":1826.84,"body":"Special,"},{"speaker":"Charles Goldfarb","startTime":1824.8,"endTime":1826.84,"body":"thanks to Peter Martin for the"},{"speaker":"Charles Goldfarb","startTime":1826.84,"endTime":1828.64,"body":"amazing music, and"},{"speaker":"Chris Dy","startTime":1828.64,"endTime":1830.8,"body":"remember, keep the"},{"speaker":"Chris Dy","startTime":1828.64,"endTime":1830.8,"body":"upper hand. Come back next time"},{"speaker":"Chris Dy","startTime":1830.8,"endTime":1830.92,"body":"you"}]}