Dialed In Health

Healing with horses: a horse reads what you are carrying and shows it back to you. Dr. Kimberly Ammerman, pharmacist and founder of Healing Hearts with Horses, explains what horses pick up on that people miss.

Dr. Kimberly Ammerman is a practicing pharmacist, a lifelong horsewoman and a coach. She keeps 17 horses on 100 acres in the Black Hills near Whitewood, South Dakota. Host Melissa Goodwin asks what really happens in a session, how this is different from equine therapy, and who it is for.

• Why a horse runs when an anxious person steps into the round pen, and walks right up to a calm one
• What "the horse mirrors you" means in plain words
• Why Dr. Kimberly trains horses and will not "break" them
• What happens in a session, and why grooming a horse can be the whole lesson
• The man who called it stupid, and what a horse named Oakley did next
• How equine-assisted coaching is different from equine therapy
• Whether you need horse experience (you do not), and what if horses scare you
• How Dr. Kimberly trains other people to do this work, in three levels
• Her answer to "this sounds a little woo woo"

• 0:00 What a horse does when an anxious person walks in
• 0:35 Meet Dr. Kimberly Ammerman: pharmacist, horsewoman, healer
• 1:12 Why she became a pharmacist
• 2:46 The drive home from Denver that started it all
• 4:56 The farrier's girlfriend becomes her first client
• 7:39 Why she does not use a barn
• 8:12 Growing up on horseback: Sugar and Tiny
• 10:15 Training a horse without breaking its spirit
• 12:03 What "horse whisperer" really means
• 12:22 Misty and Starfellow: trading horses with her twin brother
• 14:27 Working cattle and the barbed wire fence
• 16:35 What do horses pick up on that people miss?
• 17:59 How a horse mirrors your energy
• 18:36 What happens in a session: on the ground, no riding
• 19:36 "I don't think this horse likes me"
• 21:50 Coach, not therapist: the man who called it stupid
• 24:17 Who comes to Healing Hearts with Horses?
• 24:55 What if you are afraid of horses?
• 26:03 Training others: the three-level program
• 28:29 Is this too woo woo?
• 29:45 What to wear and what a retreat is like
• 30:50 If you feel stuck, start here
• 31:58 How to find Healing Hearts with Horses

Dr. Kimberly Ammerman, PharmD, is a Doctor of Pharmacy, a practicing pharmacist, a published author and the founder of Healing Hearts with Horses. She has been riding since she was three. She offers equine-assisted coaching, retreats, private sessions and a three-level training program.

• Website: healingheartswithhorses.com
• Retreats: healingheartswithhorses.com/retreats
• Training: healingheartswithhorses.com/certification
• Facebook: Healing Hearts with Horses
• Instagram: @healing.hearts.with.horses

• Watch on YouTube: YOUTUBE-LINK-HERE
• Episode page, transcript and FAQs: dialedin.health/podcast/episode-41-healing-with-horses
• Find a provider: dialedin.health/the-directory

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This episode is educational and informational only. It is not medical advice and is not a substitute for evaluation, diagnosis or treatment by a licensed provider. Healing Hearts with Horses offers equine-assisted coaching and personal-development programs. These are coaching services. They are not psychotherapy, counseling or medical care.

Tantrum vs meltdown: a tantrum can be bargained with. A meltdown is an overwhelmed nervous system, and reasoning will not reach it. Pediatric occupational therapist Kristin Wittmayer explains the difference and what to do in the moment.

Kristin Wittmayer, MS, OTR/L, is a pediatric occupational therapist with 20 years of experience and the Director of Move U, a pediatric therapy clinic in Sioux Falls, South Dakota. Host Melissa Goodwin asks how to tell a tantrum from a meltdown, when "just a phase" is worth a phone call, and why Move U builds its sessions on DIR Floortime.

• How a meltdown differs from a tantrum, and why bartering stops working
• What to do in the moment: get to their level, stop talking, give space and time
• The empty threat, and why follow through matters
• How to tell a phase from something that keeps coming back
• Why a sticker chart works for behavior and not for sensory overload
• Picky eating: the sensory side and the oral motor side
• Engine speeds: too slow, too fast and just right
• Why parents are the child's safe person, and have to regulate first
• What DIR Floortime is, and how Kristin compares it with ABA
• Four myths, answered: boys talk late, therapy needs a diagnosis, tantrums are manipulation, child-led play teaches nothing
• Insurance, session length and how often kids come to Move U

• 0:00 Tantrum or meltdown? What this episode covers
• 0:23 Welcome to Dialed In Health
• 1:04 Meet Kristin Wittmayer, pediatric occupational therapist
• 1:48 What is Move U?
• 3:13 Why would a parent call a pediatric OT?
• 4:42 What is happening at home before the first call
• 6:15 Picky eating: sensory or oral motor?
• 7:11 Why Move U was built in Sioux Falls
• 9:23 Is it just a phase? How to tell
• 10:37 Who Move U works with
• 12:38 Signs it is time to call
• 13:34 Connection over compliance
• 14:25 What is DIR Floortime?
• 15:57 Why Move U chose DIR Floortime
• 16:49 Neurodiversity affirming play, explained
• 18:38 Motor planning: why play matters
• 20:18 DIR Floortime vs ABA therapy
• 21:29 What the research says about Floortime
• 22:27 Behavior is communication
• 24:38 Fidgeting in class: what is typical?
• 25:47 Tantrum vs meltdown: the difference
• 28:01 What parents do that makes it worse
• 28:43 What to do during a meltdown
• 29:56 How to prevent the next one
• 31:47 Band-aid strategies vs the root cause
• 33:01 What a regulated child looks like
• 34:08 Why parents have to regulate first
• 35:45 Myth: boys talk late
• 36:52 Myth: therapy is only for kids with a diagnosis
• 37:44 Myth: a tantrum is manipulation
• 38:59 Myth: child-led play teaches nothing
• 40:16 What parents can stop feeling guilty about
• 41:21 Insurance, cost and session length
• 43:27 How often kids come to therapy
• 44:24 How to find Move U
• 45:11 Thanks for watching

Kristin Wittmayer, MS, OTR/L, is a pediatric occupational therapist and the Director of Move U. She is certified in sensory processing and integration and in DIR Floortime. Move U offers pediatric occupational, physical and speech therapy, from infancy through the teen years.

Move U, 5020 S Tennis Ln Ste 6, Sioux Falls, SD 57108 (605) 409-9533 themoveu.com

• Full transcript, chapters and FAQ
• Watch on YouTube
• Move U in the Dialed In Health directory
• Find a vetted provider
• Newsletter and guest applications

If this helped, follow the show and leave a rating and review. It is how other parents find it. Then send this episode to one parent who needs it.

Educational and informational only. Not medical advice, and not a substitute for evaluation, diagnosis or treatment by a licensed provider.

Stuck in survival mode? Your body has to feel safe first. Spiritual director Jada Dobesh shares why, and a 30 second reset you can do anywhere.

Jada Dobesh is a certified spiritual director and the owner of Selah Space, a holistic wellness cooperative for women in Sioux Falls, South Dakota. Host Melissa Goodwin asks what a spiritual healer actually does, why so many high functioning women live in survival mode, and how somatic healing helps the body come back online.

• What a spiritual director does, and how it differs from therapy
• Why Jada says the root is a lack of safety in the body
• Why stress management is not enough, and what stress elimination means
• Where unfelt emotions tend to show up: neck, shoulders, belly
• Why so many women are afraid to let their emotions out
• What fragmentation feels like when you only feel your chest
• How her Reiki sessions work, with touch or without
• How she answers Christians who ask if Reiki fits their faith
• What The Body Keeps the Score gets right, and where she goes further
• Freeze and fawn: the stress responses women fall into most
• Why repair matters more than perfect parenting
• The 30 second hug that helps reset your nervous system
• Why emotions are tourists, not residents

• 0:00 Your body is not supposed to hurt every day
• 0:39 Welcome to Dialed In Health
• 1:22 Meet Jada Dobesh of Selah Space
• 1:55 What is a spiritual healer?
• 2:58 What happens in a spiritual direction session
• 4:06 Parts work: how old is the version of you in charge?
• 4:30 Reiki and Brainspotting, explained
• 4:56 How she became a spiritual director
• 6:40 Why she added Reiki
• 7:39 The Catholic roots of spiritual direction
• 8:10 Companionship, not teacher and student
• 8:55 The daughter wound and your relationship with God
• 9:53 Why she works with women
• 10:54 Carrying the weight of the world
• 12:01 You are not supposed to have headaches every day
• 12:52 The root: no safety in the body
• 13:42 Stress management vs stress elimination
• 14:02 Being held and witnessed in your pain
• 15:20 Opening Selah Space in 2020
• 16:57 The belief that it has to be your fault
• 18:31 The client who had no neck
• 19:36 Where unfelt emotions show up in the body
• 20:47 Why women are afraid to let emotions out
• 22:11 That energy has to go somewhere
• 22:46 Fragmentation: when your body goes quiet
• 23:54 How Reiki helps women reconnect
• 24:46 Melissa's first Reiki session
• 25:11 Touch, oxytocin and relaxation
• 26:26 Types of Reiki, including Holy Fire Reiki
• 26:58 How to choose a spiritual director or Reiki practitioner
• 28:33 Is Reiki Christian? How she answers
• 30:48 The Body Keeps the Score: what it gets right
• 31:42 The goal is to become unbothered
• 32:52 The little girl in charge of your nervous system
• 34:22 Flipping your lid
• 34:46 Freeze and fawn, explained
• 35:51 Fight turned inward
• 36:22 Parenting: repair over perfection
• 38:34 A Gen X mom asks about teen mental health
• 40:18 Grit vs emotional resilience
• 42:11 Emotions are tourists
• 43:30 Done with shoulds
• 43:56 The 30 second hug that resets your nervous system
• 45:14 The mom sway
• 45:43 Find connection
• 45:56 Jada Dobesh Healing, Selah Space and Circles of Care
• 48:25 How to find Jada
• 49:07 Thanks for watching

Jada Dobesh, Spiritual Director and Owner, Selah Space. 117 W 39th St, Sioux Falls, SD 57105. selahspacesd.com and jadadobeshhealing.com

Watch on YouTube. Full transcript, chapters and FAQ at dialedin.health. Find a vetted provider at the directory.

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Educational and informational only. Not medical advice and not a substitute for evaluation, diagnosis or treatment by a licensed provider. If you are in crisis, call or text 988.

Is your high protein food really high protein? Certified nutrition coach Sydney St Clair shares a 10 second label test: drop the last digit off the calories. If the grams of protein match or beat it, it is high protein.

Sydney owns Let's Reach New Heights Nutrition (LRNH Nutrition) in Wagner, South Dakota. Host Melissa Goodwin asks what she sees in her clients every week: women under eating, protein on every package, GLP-1 users with no hunger cues, and food noise. Then Sydney tests snacks from Melissa's pantry live.

In this episode

• The high protein label test, and why peanut butter and whole eggs fall short
• The most common mistake: under eating whole food carbs
• Why a little under half of her women clients need to eat more, and how to add 100 calories a week
• What to focus on when you start a GLP-1: protein, fiber, strength training, steps
• What food noise is and what quiets it
• How much fiber you need, and which fiber counts
• Protein bars, collagen and protein powder: where they fit

Chapters

0:00 Why food has so many layers 1:04 Meet Sydney St Clair, Let's Reach New Heights Nutrition 2:02 From teacher to certified nutrition coach 3:12 Why she tracks a full week before changing anything 3:46 Keto, Whole30, carnivore: sorting fact from fiction 4:19 Start with the basics: protein, produce, fewer supplements 5:06 What a 5th and 6th grade teacher sees kids eating 6:29 The most common mistake: under eating whole food carbs 7:59 Three types of clients: under eaters, on track, over eaters 9:03 The high protein craze and protein Doritos 9:41 Is skinny back? Body positivity and the pendulum 12:25 Eating on a GLP-1: protein goals and muscle 13:24 What to know when you start a GLP-1 14:39 Strength training and steps on a GLP-1 15:45 What is food noise? 16:59 Night cravings and habit snacking 18:40 Do men and women need different calories? 19:40 Eating 1,100 calories with no energy 20:31 How to eat more without gaining weight 21:27 How many women are under eating 21:46 Blue Zones and learning to like healthy food 22:46 Meal prep that does not get boring 24:08 Grocery pickup to save money and skip the junk 25:01 Protein on everything: marketing or health? 26:12 The high protein test: grams vs calories 27:19 Is peanut butter high protein? 28:51 Are eggs high protein? The fat math 29:52 High protein, low fat foods that are not boring 31:43 Sauces and swaps: G Hughes, ranch, balsamic 33:02 How to build a plate 34:27 Potatoes, Greek yogurt and portion sizes 35:13 Vegetarian and plant protein 36:28 Protein needs as you age 37:23 Snack test: protein granola 38:26 Grape Nuts and how much fiber you need 39:42 Triscuits and cheese 41:04 Kids cereal: make it better with yogurt 42:00 Applesauce pouches and added gums 43:28 Soda, diet soda and fancy coffee sugar 44:49 Afternoon energy without the jitters 46:33 The first change: know what you are eating 47:32 The one product she would zap off the shelf 48:15 Are there any good protein bars? 48:53 Collagen and protein powder 49:47 Whey vs bone broth protein 50:32 What to count, and in what order 51:03 Where the name Let's Reach New Heights comes from 52:12 How to work with Sydney 52:48 Nutrition is like chemistry 53:38 That's our show

About the guest

Sydney St Clair, Certified Nutrition Coach Owner, Let's Reach New Heights Nutrition Wagner, SD, virtual and in person lrnhnutrition.com | [email protected] Facebook and Instagram: Let's Reach New Heights Nutrition

Resources

• Full transcript, FAQ and chapters: https://dialedin.health/podcast/episode-38-high-protein-foods
• Watch on YouTube: youtube.com/@dialedinhealth
• Find a vetted provider: dialedin.health/the-directory
• Be a guest: apply here
• Newsletter: get new episodes

If this helped, follow the show and leave a rating and review. It helps other people find it. Know someone who needs this one? Send it to them.

If food or eating feels out of control, the ANAD eating disorders helpline is 1-888-375-7767, Monday to Friday, 9 AM to 9 PM Central.

This episode is educational and informational only. It is not medical advice and it is not a substitute for evaluation, diagnosis, or treatment by a licensed provider. Sydney St Clair is a certified nutrition coach, not a prescriber.

Peripheral neuropathy: here are the five things Dr. Jordan Stenzel, DC tells people to do at home every day. Movement, food, e-stem, PEMF and red light therapy, in that order.

The first neuropathy episode passed 74,000 views and drew more than 200 comments. Almost all of them said the same thing. Slower. Simpler. Tell me what to do, what to take and how. Dr. Stenzel came back to Dialed In Health with host Melissa Goodwin and did exactly that.

Dr. Jordan Stenzel, DC is a chiropractic physician at Stenzel Chiropractic Clinic in Mankato and Mapleton, Minnesota. He built his peripheral neuropathy protocol over five to seven years around six things a nerve needs to live, grow and thrive. He wrote Healing the Hidden Nerves and he trains other providers to run the protocol.

• The five things to do at home every day, in the order he gives them
• How to buy a red light that reaches the tissue: the wavelength ranges and the power he looks for
• Why NAD+ in a bottle cannot cross into the cell, and what a precursor does instead
• Whether it is too late if you have had neuropathy for years
• Why "it is not diabetes so this does not apply to me" is false
• What he says about coming off gabapentin, and the one mistake he sees most
• What to do about metformin
• What to do before a first chemotherapy infusion
• Where people waste the most money
• Who this protocol is not for

PASTE THE CHAPTER LIST FROM THE YOUTUBE DESCRIPTION SECTION ABOVE, UNCHANGED.

Dr. Jordan Stenzel, DC, chiropractic physician, Stenzel Chiropractic Clinic, Mankato and Mapleton, Minnesota. Author of Healing the Hidden Nerves. Runs the Healing the Hidden Nerves community and a provider training program. stenzelchiropractic.com

Dialed In Health is hosted by Melissa Goodwin. Every episode brings in the people who actually do the work: providers, practitioners and the experts who see clients every day. We ask the questions you would ask if you were sitting across from them.

• Healing the Hidden Nerves, the book, on Amazon
• Healing the Hidden Nerves, the community on Skool
• The Neuropathy Project
• Stenzel Chiropractic Clinic, Mankato and Mapleton MN
• Episode 1 with Dr. Stenzel: Reverse Peripheral Neuropathy, 6 Things Your Nerves Need to Heal

Watch on YouTube at @dialedinhealth. Full episode page, chapters and transcript at dialedin.health. Find a vetted provider at dialedin.health/the-directory.

If this was useful, follow the show and leave a rating and review. Reviews are a real ranking factor and they are how the next person with burning feet at 2am finds this. Then send this episode to the one person you thought of while you were listening.

FULL TRANSCRIPT APPENDED HERE. Use the cleaned transcript, not the raw SRT.

This episode is educational and informational only. It is not medical advice and not a substitute for evaluation, diagnosis or treatment by a licensed provider. Do not start or stop any prescription based on anything in this episode.

A tight pelvic floor is not a weak one. If yours is already tight, a hundred more Kegels can make your symptoms worse.

Ember Smith, PT, DPT of Well Balanced Physical Therapy in Sioux Falls, South Dakota was a gymnast who leaked through high school and never told anyone. She now treats the problem she had. Host Melissa Goodwin asks what the pelvic floor is, whether Kegels work, how to tell tight from weak, what diastasis recti really means, and whether a weighted vest builds bone.

No referral needed in South Dakota. Direct access.

• What the pelvic floor is, and why the hips, core and abdominals share its wall
• Why some women doing Kegels push down and out, the exact opposite of the movement
• Why a tight muscle is not a strong one, and why more contractions make it worse
• That her own trimester handout from a large health system told her to do Kegels
• What EMG studies show: squats and glute bridges can recruit the pelvic floor harder than a Kegel
• The two and a half finger rule for diastasis recti, and the depth nobody measures
• Why the old advice to avoid crunches after pregnancy was backwards
• Pressure management, and the pop can model of your core
• Whether a weighted vest builds bone density
• Why common is not the same as normal, and why it is never too late

• 0:00 Kegels are not the answer
• 0:55 Welcome to Dialed In Health
• 1:32 Why she went into pelvic health
• 2:27 Her two pelvic health certifications
• 3:14 Why she evaluates women standing up
• 3:51 Leaking as a high school gymnast
• 5:22 What is the pelvic floor?
• 6:33 The townhouse: why it is never just the pelvic floor
• 7:56 Who walks through her door
• 8:55 Hormones or pelvic floor? How to tell
• 9:28 The Kegel chairs and machines
• 10:09 What a Kegel is, and who it was named after
• 10:50 Doing it backwards: pushing down and out
• 11:30 A tight pelvic floor needs lengthening, not squeezing
• 11:51 The trimester handout that is still wrong
• 12:13 No symptoms? Then you do not need Kegels
• 13:05 Stay active, and find the right stimulus
• 13:59 What women are most embarrassed to say out loud
• 14:27 What changes at each stage of life
• 15:27 Liner to pads to UTIs to falls: how it compounds
• 16:25 Diastasis recti, explained properly
• 17:41 The two and a half finger rule
• 18:17 The depth measurement nobody talks about
• 18:54 How diastasis connects to the pelvic floor
• 19:59 Crunches narrow the gap. The old advice was backwards
• 20:49 Pressure management
• 21:10 The pop can model of your core
• 22:01 What men run into
• 22:45 Weight gain, beer belly, and diastasis
• 23:19 GLP-1 weight loss and the gap underneath
• 24:47 Why she rarely starts with a Kegel
• 25:05 What EMG studies actually show
• 26:22 The weighted vest craze
• 26:50 Weighted vests do not build bone. Impact and lifting do
• 27:49 Zone two, walking, and running
• 28:47 Strength or cardio, if you had to pick one
• 30:07 Sweating is not the measure of a workout
• 31:08 What to do in your 20s and 30s
• 31:44 The worst advice on social media
• 32:28 No referral needed in South Dakota
• 32:46 What an evaluation looks like
• 33:42 The longevity clinic
• 34:31 The billboard answer
• 35:30 Where to find Well Balanced

Ember Smith, PT, DPT, Well Balanced Physical Therapy, 7000 S Lyncrest Place, Floor 1, Sioux Falls, SD 57108. Call or text 605-610-8220. wellbalancedphysicaltherapy.com

Watch on YouTube. Full transcript and chapters at dialedin.health. Find a vetted provider at the directory.

Follow Dialed In Health so you do not miss an episode, and please rate and review. It is the single biggest thing that helps another woman find this one.

Educational and informational only. Not medical advice and not a substitute for evaluation, diagnosis or treatment by a licensed provider.

MTHFR is not a disease. It is a gene variant that slows your methylation cycle, and 40 to 50 percent of people carry a copy of it. Kristine Cassar, owner of BeeWell Functional Wellness in The Woodlands, Texas, carries two copies. So does her daughter.

Host Melissa Goodwin asks the questions people actually search: what MTHFR stands for, what the variant does to folate and B12, whether it explains anxiety and brain fog, whether you should get tested, and what to look for on a supplement label. Kristine also takes on the hardest question in her field head on, that the American College of Medical Genetics recommends against routine MTHFR testing, and says plainly where she thinks they are right and where she thinks conventional care does not test enough.

• What MTHFR stands for and what the enzyme does in your body
• Why 40 to 50 percent of people carry one copy and 10 to 12 percent carry two, per the 1000 Genomes Project data Kristine cites
• How much a variant slows methylation: roughly 30 percent with one copy, up to 70 percent with two
• The symptoms she sees most: brain fog, tiredness, irritability, anxiety, panic attacks, stress hormones that stay high
• Why she says MTHFR does not cause disease, and what she says it can do instead
• The two SNPs she looks at: C677T and A1298C
• Why grabbing a methylated B vitamin off the shelf can backfire, and what over-methylation feels like
• Folic acid vs folate vs methylfolate, and why she does not recommend folic acid
• The two things to look for on a label: L-5-MTHF and methylcobalamin, and why folate without B12 does not work
• What homocysteine is, what most labs call normal, and the number she wants to see
• What testing costs, and when her answer is to do nothing at all

0:00 The symptoms people never connect to MTHFR 1:07 Why this episode exists 2:32 What BeeWell Functional Wellness does 3:44 What MTHFR stands for and what the enzyme does 5:18 Is it a mutation? 40 to 50 percent carry one copy 6:14 One copy vs two copies: 30 percent vs 70 percent slower 6:51 Brain fog, irritability, anxiety, panic attacks 7:41 What methylation is and why you should care 9:13 You have the variant and you feel fine. Now what? 10:21 C677T, A1298C, and how common they really are 11:45 Does MTHFR cause disease? The honest answer 14:18 Her daughter, 1997, and the test that changed everything 16:09 The methylated B vitamin mistake and over-methylation 18:12 Why people actually walk into her practice 18:58 The genetics guideline says the evidence is not there 21:52 What MTHFR testing costs 23:02 Pregnancy, folic acid, and what she recommends instead 24:51 Folic acid vs folate vs methylfolate 25:29 What to look for on a supplement label 27:24 Homocysteine and the number she wants to see 28:40 Liposomal vs pill vs sublingual 30:01 The biggest mistake after a positive test 31:08 What the internet gets wrong about MTHFR 32:02 Is any of this pseudoscience? 32:58 What working with her actually looks like 36:43 Why this work matters to her 37:44 Her own daily routine 39:52 The billboard answer 40:54 Where to find BeeWell Functional Wellness

Kristine Cassar is the owner and operator of BeeWell Functional Wellness in The Woodlands, Texas, with a brick and mortar clinic and a virtual practice. She came to this work in 1997 when her two year old daughter had health issues conventional care was not resolving. Testing showed her daughter was a homozygous carrier of the MTHFR variant. Kristine was later tested and found she carries two copies as well.

Website: beewellwoodlands.com Facebook and Instagram: BeeWell Functional Wellness

Kristine offers something useful to listeners: photograph the front and back of your supplement bottle, send it to her by direct message on Instagram or Facebook, and she will tell you whether that supplement is doing what you think it is doing.

• American College of Medical Genetics practice guideline on MTHFR polymorphism testing
• 1000 Genomes Project carrier frequency data
• Standard lab testing through LabCorp or Quest, roughly 50 to 200 dollars
• Food sources of folate named on the show: dark leafy greens, asparagus, eggs, beef liver

Watch this episode on YouTube: @dialedinhealth Full transcript and episode page: dialedin.health Find a vetted provider: dialedin.health/the-directory

Follow Dialed In Health wherever you listen, and leave a rating and a review. Reviews are how the next person searching for a straight answer finds this show. Then do one more thing: send this episode to the person who came to mind while you were listening.

Are you a health or wellness provider who wants to be on the show? The application link is on dialedin.health.

This episode is educational and informational only. It is not medical advice and it is not a substitute for evaluation, diagnosis, or treatment by a licensed provider. Talk to your own provider before starting, stopping, or changing any supplement, especially if you are pregnant or trying to conceive.

Ketamine is the only psychedelic available nationwide by prescription, and Jerry Cook explains exactly what a session feels like, start to finish.

Jerry Cook is a trained psychedelic journey guide and integration consultant and the owner of Metanoia Journey Consulting in Sioux Falls, South Dakota. He is not a prescriber. Ketamine is prescribed and administered through licensed medical partners after a full medical screening. In this conversation with host Melissa Goodwin, Jerry walks through why ketamine is the psychedelic he works with, what actually happens in the room during a three hour session, why the integration afterward matters as much as the medicine, and the honest limits of what this work can do.

• Why ketamine and not psilocybin or MDMA, and where psychedelic access actually stands right now
• The three levels of ketamine use: low dose for symptom management, mid dose for psychedelic and psycholytic processing, and high dose as a surgical anesthetic used in operating rooms worldwide
• What a psychedelic dose is compared to a surgical dose, in Jerry's own numbers
• The default mode network, and why a thought loop laid down at five years old is so hard to talk your way out of
• The full screening path: a 15 to 30 minute intro call, an hour of medical work up for contraindications, then a prescription, then a 45 to 60 minute pre journey session
• Inside the three hour session: settling in, two to five minutes for the medicine to land, a 30 to 45 minute psychedelic window, then an hour and a half of psycholytic work
• Why the follow up happens inside 24 hours, while the brain is still in a neuroplastic state
• Whether you hallucinate, whether you remember it, and whether you can lose control
• What the room looks like: low light, an eye mask, a floor mat, and a guide sitting on the floor beside you
• Why detachment from the old pattern comes before attachment to the new one
• Straight answers on whether ketamine is addictive
• Why a hard journey is often the useful one
• Where microdosing, Spravato and ketamine tablets sit on the continuum, and who this work is not for

• 0:00 Most people picture the 1950s. This is not that.
• 1:27 What "metanoia" means, and how Jerry got here
• 3:43 What veterans were doing for PTSD and trauma
• 4:10 Why ketamine, and not psilocybin or MDMA
• 4:19 FDA approved, off label, born as a surgical anesthetic
• 5:16 A psychedelic dose versus a surgical dose
• 6:30 The default mode network, and why thought loops stick
• 7:50 Where psilocybin access actually stands
• 7:57 Dissociation, and the enhanced dream state
• 9:04 How this is different from recreational use
• 10:17 Set and setting, and why the 1960s went wrong
• 11:28 How do you know if you are stuck?
• 12:33 When talk therapy plateaus
• 14:00 The intro call, and who this is not for
• 14:30 Medical screening and contraindications
• 15:00 The prescription and the pre journey session
• 15:42 Inside the three hour session, minute by minute
• 16:18 The psycholytic state, where the real talking happens
• 16:48 The neuroplastic window and the 24 hour follow up
• 17:48 Ketamine is not a panacea
• 19:11 How many journeys, and how long results last
• 20:36 A client story: the five year old still running the show
• 26:20 Will I hallucinate? Blissful or hard?
• 28:06 Titrating the dose for people who are scared
• 30:10 The room: eye mask, floor mat, a guide on the floor
• 33:15 Do people forget what happened?
• 34:00 Myth busters: tripping, party drug, addictive, bad trips
• 36:51 "I went to hell in one of mine," and why that was good
• 38:02 Microdosing, Spravato, and the three dose levels
• 39:37 How to reach Jerry Cook at Metanoia

Jerry Cook is the owner of Metanoia Journey Consulting in Sioux Falls, South Dakota, where he works as a psychedelic journey guide and integration consultant. He trained in ketamine assisted psychotherapy after his own search for something talk therapy could not reach, and he works alongside licensed medical partners who handle screening, prescribing and dosing. He serves clients in South Dakota, Minnesota, Iowa and Nebraska. "Metanoia" is Greek for a fundamental change in thought and life direction, a nod to the years he spent in Greece as a boy.

Web: metanoiajc.com Email: [email protected] Phone: 605-376-4660

• Episode page and full transcript: dialedin.health/podcast/episode-34-ketamine-assisted-therapy
• Watch on YouTube: @dialedinhealth
• Find a vetted provider: dialedin.health/the-directory
• Apply to be a guest: dialedinhealth.kit.com
• Metanoia Journey Consulting: metanoiajc.com

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One thing to do next: if you have been curious about psychedelic assisted therapy but did not know where to start, book a 15 minute intro call with a guide and ask about their screening process. Jerry describes his in this episode, and it is the fastest way to tell a legitimate practice from a careless one.

Health and wellness is confusing. There is a new trend every week, everyone has an opinion, and half the time you cannot tell what is legit and what is good marketing. Dialed In Health brings in the people who actually do this work: providers, practitioners and specialists who see clients every day. Host Melissa Goodwin asks the questions you would ask if you were sitting across from them, so you can find the right people and make better decisions. New episodes weekly. Full transcripts and provider details at dialedin.health/podcast.

The full transcript for this episode is on the episode page: dialedin.health/podcast/episode-34-ketamine-assisted-therapy

This episode is educational and informational only. It is not medical advice and it is not a substitute for evaluation, diagnosis or treatment by a licensed provider. Ketamine is prescribed and administered only by licensed medical professionals after screening. If you are in crisis, contact a licensed provider or call or text 988 in the United States.

Direct primary care costs $80 a month for adults and $60 for children at Prairie Roots Health in Sioux Falls, and it buys unlimited visits, one-hour appointments, and your provider's cell number.

Sam Niewenhuis is a family nurse practitioner and founder of Prairie Roots Health, a direct primary care clinic in Sioux Falls, South Dakota. Host Melissa Goodwin asks him what people type into Google before they switch: what direct primary care is, what the membership actually covers, whether you still need health insurance, what happens when you need imaging or a specialist, what a full lab panel costs, and whether an HSA can pay the fee. Sam caps his panel at 200 to 400 members. Conventional primary care runs 3,000 to 6,000. That ratio explains almost everything else in this conversation.

• What direct primary care is, described by a practicing family NP: "an innovative alternative to insurance driven healthcare"
• What $80 a month covers for adults, $60 for children, and why he calls it unlimited
• Why he gives members his cell number, and how rarely it actually rings
• A full hour with a new member instead of fifteen minutes with a nurse first
• Why he still tells people to carry a catastrophic plan, a high deductible plan with an HSA, or a health share
• A comprehensive lab panel at wholesale for roughly $100 to $150
• Who bills your insurance when you need an X-ray, imaging, or a specialist
• Direct primary care versus concierge medicine, cleanly separated
• Why family practice providers refer out biopsies and workups they are trained to do
• The Weston A. Price Foundation, fermented foods, fiber, and freshly milled grain
• A myth round: HSAs, wealth, medical records, alternative medicine, and whether DPC is a fad
• Who direct primary care is honestly not a good fit for

• 0:00 Health advice is confusing, and that is the show
• 0:41 Medicine used to come to your door
• 1:31 What is direct primary care?
• 2:04 What $80 a month buys, and $60 for kids
• 2:10 Why members get his cell number
• 4:32 A full hour, not fifteen minutes
• 5:41 Getting seen the same day you call
• 6:34 A flat fee and no surprise bills
• 7:35 Do you still need health insurance?
• 8:14 Why paying cash changes who shows up
• 9:24 Labs for $100 to $150, not insurance pricing
• 10:06 Who actually joins a DPC clinic
• 11:27 Primary care is underused, and dermatology waits
• 13:06 Imaging and specialists: who bills your insurance
• 13:49 Why he left the conventional system
• 16:50 House calls, still a real thing
• 17:17 The cholesterol phone call that sends people looking
• 18:36 The Weston A. Price Foundation and food as medicine
• 19:37 Freshly milled flour, and why store flour is empty
• 20:48 Why so many young people have gut problems
• 23:44 Myth: DPC is concierge medicine, renamed
• 24:19 200 to 400 members versus 3,000 to 6,000
• 24:50 Myth: you cannot use an HSA for direct primary care
• 25:12 Myths: only for wealthy people, and losing your records
• 26:07 Myth: direct primary care is a fad
• 26:28 Who should be calling him tomorrow
• 27:05 Chronic illness and functional medicine
• 27:42 Who direct primary care is not for
• 29:00 The free meet and greet, and how to find him

Sam Niewenhuis, Family Nurse Practitioner, is the founder of Prairie Roots Health, a direct primary care clinic at 5010 S Broadband Ln, Suite 110, Sioux Falls, SD 57106. Phone (605) 307-5737. He practices full scope family medicine from newborns through adults over 75, offers house calls in the Sioux Falls area, and is finishing his certification with the Institute for Functional Medicine. He is part of the Weston A. Price Foundation.

prairierootshealth.com/direct-primary-care

• Weston A. Price Foundation
• Institute for Functional Medicine
• Samaritan Ministries (named as an example of a health share)
• IRS Notice 2026-05, the HSA and direct primary care rule effective for months beginning after December 31, 2025

There is a new health trend every week and half the time you cannot tell what is legitimate and what is good marketing. Dialed In Health brings in the people who do the work and asks what you would ask if you were sitting across from them. Hosted by Melissa Goodwin. Weekly, across Sioux Falls, the Twin Cities, and Omaha.

• Watch this episode on YouTube: [YOUTUBE URL]
• Full transcript, chapters, and FAQ: dialedin.health/podcast/episode-33-direct-primary-care
• Find a vetted provider: dialedin.health/the-directory
• Every episode: dialedin.health/podcast

If this was useful: follow Dialed In Health wherever you listen, and leave a rating and a review. It genuinely moves the show in front of people looking for these answers. Are you a health or wellness provider who wants to be on the show? Apply at dialedinhealth.kit.com.

Disclaimer: This episode is educational and informational only. It is not medical advice and not a substitute for evaluation, diagnosis, or treatment by a licensed provider. Nothing here is tax advice. Talk with your own clinician and your own tax professional.

Read the full transcript

Why can't you sleep? Dr. Jerome Puryear, MD, an obesity medicine physician who diagnosed his own sleep apnea, explains what is actually going wrong at night and how to fix it no matter what shift you work.

Dr. Jerome Puryear, MD, Dipl. ABOM, is an obesity medicine physician and interventional radiologist who spent years surviving night call before a doctor told him he was overweight and pre-diabetic. A sleep physician made the diagnosis he had missed in himself: obstructive sleep apnea. He went on to add board certification in health and wellness coaching, found the Puryear Wellness Institute, and write Sleep Deprivation: A Doctor's Guide to Why You Can't Sleep and How to Get Better Sleep. On this episode of Dialed In Health, host Melissa Goodwin asks him the questions you would ask if you were sitting across from him.

• When a sleep problem is worth seeing someone about: three or four bad nights a week, for two or three weeks straight.
• Seven to nine hours is the recommendation, but duration is only half of it. Waking up exhausted after nine hours means quality is the problem.
• What a microsleep is, and the 18 wheeler crash he watched happen three miles from a rest area.
• The most dangerous window to be on the road when you are short on sleep.
• Insomnia versus sleep apnea, in language you can actually use at an appointment.
• Why alcohol before bed shortens the time it takes to fall asleep and then fragments the whole night.
• The caffeine sources nobody counts, including decaf.
• What sleep trackers can and cannot tell you, and the one metric he trusts more.
• Straight answers on melatonin, prescription sleep medication, CBD, and THC.
• How shift workers build an intentional sleep plan instead of accepting bad sleep as part of the job.
• How sleep loss drives hunger through ghrelin and leptin, and how that connects to weight.
• The idea of drifting, and the question he asks people who keep putting their health last.

How many hours of sleep do I actually need? Seven to nine for the average adult, though it varies with age and illness. If you sleep nine and still wake up exhausted, the problem is quality, not hours.

What is the difference between insomnia and sleep apnea? Sleep apnea is airway collapse. Breathing stops, oxygen to the brain drops, and snoring with gasping is the warning sign. Insomnia is not being able to fall asleep or stay asleep.

When should I see a doctor about my sleep? When bad nights happen three or four times a week for two or three weeks straight. Bring a sleep diary. If you get brushed off and you think it is serious, ask for a specialist.

Does alcohol before bed help you sleep? No. It sedates you so onset improves, then fragments the rest of the night so the deep restorative sleep never arrives.

How do you sleep well if you work night shift? Bright light while you need to be awake, blackout when you sleep, noise and doorbells handled, and meals on a schedule instead of eating through the night to stay awake.

Do CBD or THC actually help you sleep? THC can sedate you but does not produce restorative sleep. CBD gummies carry a specific risk: the effect arrives late, so people keep taking more and the dose lands far past what they intended.

0:00 Sleep is the one thing most of us are getting wrong 1:14 The doctor who lived it: radiology, night call, and burnout 2:33 How he was diagnosed with sleep apnea 5:01 How do you know if your sleep is actually a problem? 6:00 The 18 wheeler story: watching a driver fall asleep 7:09 What is a microsleep, and why is it so dangerous? 9:34 Why sleep is the foundation: memory, heart, and immunity 11:23 The most dangerous hours to be on the road 12:21 How many hours of sleep do you actually need? 13:28 What a real sleep plan looks like 15:09 Caffeine, hidden sources, late workouts, and alcohol 17:53 Are sleep trackers and wearables worth it? 20:44 How a physician finally got in touch with his own health 25:41 The everyday habits sabotaging your sleep 28:02 Why screen light in bed suppresses melatonin 29:34 Insomnia vs sleep apnea: what is the difference? 31:28 Sleep, hunger hormones, and weight 32:41 Why he wrote the book 36:48 Shift work sleep disorder: the chapter nobody else wrote 38:38 Sleep hygiene, and the idea of drifting 41:03 Melatonin, prescription sleep meds, CBD, and THC 46:30 Myth: you can catch up on sleep over the weekend 47:03 Myth: some people only need five hours 49:31 Myth: snoring is harmless 49:44 Myth: bad sleep is just part of night shift 51:45 How long should a nap actually be? 53:14 Where to get the book and find Dr. Puryear

Dr. Jerome Puryear, MD, Dipl. ABOM is an obesity medicine physician and interventional radiologist, a board certified health and wellness coach, and the founder of the Puryear Wellness Institute. His book, Sleep Deprivation: A Doctor's Guide to Why You Can't Sleep and How to Get Better Sleep, is available on Amazon August 31 and on pre-order now.

Website and book: drjeromepuryear.com

• Sleep Deprivation: A Doctor's Guide to Why You Can't Sleep and How to Get Better Sleep, by Dr. Jerome Puryear, MD
• Puryear Wellness Institute
• Ramelteon, a prescription melatonin receptor agonist
• Cognitive behavioral therapy for insomnia
• Third party supplement verification

988 Suicide and Crisis Lifeline: call or text 988 SAMHSA National Helpline: 1-800-662-4357 Drowsy driving is dangerous. If you are fighting to stay awake at the wheel, pull over.

Health and wellness is confusing. There is a new trend every week, everyone has an opinion, and half the time you cannot tell what is legitimate and what is good marketing. Dialed In Health brings in the people who actually do this work, providers, practitioners, and experts who see clients every day, and asks the questions you would ask if you were sitting across from them. Hosted by Melissa Goodwin.

If this episode helped, follow Dialed In Health wherever you listen, and please rate and review. Reviews are how other tired people find this show.

Watch on YouTube: @dialedinhealth Full transcript and every chapter: dialedin.health/podcast/episode-33-why-cant-i-sleep Find a vetted provider: dialedin.health/the-directory Apply to be a guest: dialedinhealth.kit.com

Full transcript on the episode page: dialedin.health/podcast/episode-33-why-cant-i-sleep

This episode is educational and informational only. It is not medical advice and it is not a substitute for evaluation, diagnosis, or treatment by a licensed provider. Talk to your own clinician before changing anything about your health, your medication, or your sleep.