Hypermobility Problems with Anesthesiologist Dr. Linda S. Bluestein


Will: [00:00:00] Knock,

knock, knock. Hi. Hello everybody. Welcome to Knock-Knock High with the Glock Pluckings. I am your host, will Flannery, also known as Dr. Glock Flecking. I am 

Kristin: also your host, Kristen Flannery, or Lady Glock Plein. 

Will: We’re excited for you to be here. We got a, um, a great episode for you. Yes. Uh, and one that’s, that’s, that’s pertinent to our lives.

That’s right. I mostly Kristen’s life talk to her. Yeah. And so we’ll get to that in a second. Well, before we get into that though, um, so we had this weekend, uh, was the second to last week of our daughter’s little spring soccer. Mm-hmm. Uh, and um, we’re also in the middle of a heat wave though. Yeah. And so it was like a perfect [00:01:00] storm of, of just unseasonably warm weather after we’ve had.

You know, winter with a ton of rain in Portland. Yeah. And, uh, physic, 

Kristin: but it was like a, a switch 

Will: just flipped. Yeah. So we had the heat plus physical activity. Yeah. 

Kristin: Uh, for plus no shade. Just direct sunshine for eight year olds. Yeah. So you can imagine. 

Will: And they’re gonna run around. You can imagine how, how this went.

Yeah. There was a lot of complaining. There was a lot of, of, of, uh, just the world is ending. Um, how could you make me do this? Right. Uh, I, my legs don’t work anymore. Which does make it difficult to play soccer. Oh man. The histrionics, uh, the exaggeration, the drama mm-hmm. Was outta control, uh, the final, especially from 

Kristin: our child.

And gee, I wonder where she gets that from. And 

Will: the final score was like two to one, which normally these [00:02:00] games are like, you know, 10 to eight. Right. So just not a lot of, of enthusiasm. Mm-hmm. And so it was, it was a struggle. And as, as the, uh, assistant coach for the under eight year old, uh, girls, uh, team named the Jellybean Tigers, it was a very, uh, challenging to get people motivated to play.

Yeah. But, um, 

Kristin: we got through it. Those jelly beans were not being very tiger 

Will: like we got through it. Yeah. Uh, and our team’s pretty good. 

Kristin: Yeah, they are. They’ve been together, what, three years now? When did they start? Three years. Yeah. Five-year-olds and now they’re eight-year-olds. Exactly. They’re 

Will: like, they’re pretty much the same team.

They’re a juggernaut. They’re uh, they’re like the New York 


Kristin: They’re known in the, uh, of, 

Will: of eighth local, of eight year old rec soccer. Yeah. But it did, uh, you know, The older they get, the more they’re experimenting with different sports and mm-hmm. Mm-hmm. And it’s actually kind of relevant to our conversation today.

Yeah. Physical, because we talk a little bit about [00:03:00] sports and, uh, performing arts and particular ballet mm-hmm. And gymnastics, which is what Kristen did a lot of as a Right. As 

Kristin: a, as a kid. I was a gymnast for 10 years when I retired at the ripe old age of 15 as gymnasts often 

Will: do. And the reason we were talking about this is because we interviewed, uh, Dr.

Linda Bluestein, who’s a board certified anesthesiologist, who’s now practicing, uh, as an integrative pain management specialist and does a ton of work on hypermobility. Yes. Alors, Dan, Lowes, hypermobility spectrum disorders. Mm-hmm. Uh, and, and so that’s how it kinda relates to sports. 

Kristin: Yeah. So, you know, we talked about, I loved gymnastics and, and it was so fun and I feel like, you know, I would still do it if I could even.

Knowing what I know, but it, you know, it ended up, it turns out that I have, you know, I’m somewhere on the hypermobility spectrum that’s, you know, in the problematic end. And, uh, I think gymnastics [00:04:00] ultimately didn’t really do my body any favors, um, in my, in my middle age. Um, but it was so fun and so, you know, it’s, it’s, uh, it’s tricky thinking about do you put your kids in something you know, that they’re interested in and are asking about and you know that you did and was so fun, but also, you know, that it, you know, they have the potential to, to, you know, kind of messed up their, be problematic a little bit.

Mess up their body. Yeah. So, So it’s, yeah, we talk about that a little bit with Dr. Bluestein. Um, it’s a tricky balance. Could put ’em in chess. In chess. Yeah. No. You know, if there’s other parents out there wondering about that. Right. It’s what I have learned in my struggles is you wanna look for things that, that, uh, foster strength and flexibility at the same time.

And so things like martial arts are really good things like swimming really good. But if you have a kid that’s that’s a little bit too flexible or has, you know, some party tricks, uh, you might wanna just think about what kind of, what kind of sports you’re putting them into. So, Hmm. I don’t know. It’s a different, different criteria, different decision for every family, [00:05:00] but Right.

Something to think about and look into. Yeah. Yeah. 

Will: All I do know is don’t put eight year olds on a, on a, mm-hmm. 80 degree day. 80 degrees. That’s all I know. It doesn’t sound, but again, they’re, they’re organ kids. Yeah. They’re 

Kristin: all, that’s organ kids. People in the south are like, 

Will: what? Yeah. You’re gonna be making fun of us.

And I get it, because I grew up, we both grew up in Texas. In Texas, 

Kristin: yeah. But now we can’t take it anymore. I’d 

Will: go and I’d play soccer as a kid where it’s like a thousand percent humidity, uh, degrees. Hundred degrees, degrees. And sun and whatever, like you just deal with it. But organ kids, they’re, yeah. And 

Kristin: us too.

We’ve acclimated. They’re all soft. We’ve gotten 

Will: soft. We’ve gotten, I’ve gotten so soft. Yeah. Like literally and figuratively. That’s true. So anyway, let’s get to our guest here. Again, this is Dr. Linda, uh, Bluestein. And so I hope you guys enjoy this one. Um, and, uh, yeah. Do I have anything else to add or am I just like to continue 

Kristin: to talk?

I think for reason, you know, for, for people who might think, uh, hypermobility, it’s got nothing to do with me, or, you know, [00:06:00] I don’t know. I could see how some people might think this is maybe not relevant to them, but actually as it turns out, it is relevant to every specialty. And Dr. Bluestein, uh, tells us why.

So be sure to stick around and Yeah. And hear how it might relate to 

Will: yours. Well, let’s get to Dr. Bluestein. Here she is.

All right. We are here with Dr. Linda Bluestein. Linda, thank you so much for joining us. It, I can’t tell you how excited, uh, Kristen in particular is to I am talk you today. I am too. But she has just been like circling on the calendar. Just, just so excited to talk with you. Aw, read 

Kristin: papers. That’s right.

Listening to your podcast. Oh, oh my goodness. That’s 

Will: so sweet. Yeah. And you have, you have such a fascinating background and, and journey in medicine to where you came to be today. And, uh, something that I’ve actually haven’t heard of is performing arts medicine. Oh. So may. So, so let’s start there. Okay. How [00:07:00] did, because I, I, and, and just give people just the background of like, I guess how you got to that point where you’re.

You’re focused on, you know, performing arts as, as one of the many things that you do 

Dr Linda Bluestein: well? Well, I have to confess, I, I’ve always wanted to be a ballet dancer. That was my number one goal was to be a professional ballet dancer. But my body had other ideas at a fairly young age, so I had to come up with a plan B, which turned out to be medicine.

But when I started really digging into hypermobility and I didn’t know that I was hyper mobile or any, I didn’t know about any of these conditions until I was probably in my forties, I guess. And like most people, I started reading and I was like, oh my gosh, this literally could explain my entire life.

Right? Yeah. Like so many people have that same experience. So I, um, but I quickly realized dancers must have this. Really commonly, and as I started to do more and more research, I realized that they might not all have any, some [00:08:00] kind of, you know, connective tissue disorder, but a lot of them do have joint hypermobility in one or more joints.

And so by supporting them at a young age, maybe just, maybe we can help keep people more active. Cuz I’m sure both of you have heard of or seen people who are. In their twenties or you know, even younger who are really, really disabled. And so I just wanna avoid as much of that as possible and try to, not over medicalize, but catch people at the earliest possible stage and let them know what to watch for, what kind of things they can do.

And it was a way to merge my love of medicine and my love of dance in this phase of my career where, you know, my husband’s retired. Yeah. And he’s like, come on, join me in the retirement. I feel like I have not ready yet. Huh? I’m not ready yet. I feel like I have more left to give. And that was just such a, an easy marriage for 

Will: me.

I love what you just said [00:09:00] about merging, you know, the two, two things you’re very passionate about, you know, in science and medicine. And then, um, 

Kristin: we love it when we performing arts. We have people who are both, you know, artists or creative in some way and really scientific and, you know, have become physicians.

Well, I think, 

Will: I think most people in medicine are creative. I think most people in general have creativity, but medicine has a way of just stamping that out. Mm-hmm. Right? Like, just, just removing that entirely from your life. And so, uh, I, I, it’s, it’s, uh, it’s such a great thing that you’ve been able to really focus in on, on combining those two things and, and keeping it alive.

You know, we need more creativity in medicine, more people, you know. You know, embracing that side of themselves. 

Kristin: Definitely. And so you’re, you’re certified in, um, anesthesia, is that right? Right, right. 

Dr Linda Bluestein: My, my training was very traditional. I went to UCLA medical school, then I went to Mayo Clinic for residency, and I’m board certified in anesthesiology.

And I practiced for many years in [00:10:00] the operating room. And, um, so now what I’m doing is such an interesting path because I’m so open to any kind of information and try to judge, is this something that I can incorporate into my clinical practice? Is this something that I wanna share with my audience?

Because to me, the most frustrating thing about hypermobility is that there is so much low hanging fruit that most people are not aware of. And so many people, I, I truly believe, end up in a worse situation than really they. They needed to be in because they, their doctors didn’t know this information, they didn’t know this information.

And we don’t have enough data yet to be able to point to certain studies. But in the meantime, we can use anecdotal data, especially if it’s something that’s safe, you know? Um, of course we have to weigh the risks and benefits of everything, but if we’re recommending something that, where the risks are pretty low, hey, why not try it?

Yeah. Right. 

Kristin: So how did you [00:11:00] go from anesthesiology into integrative pain management and, and what is integrative pain management? 

Dr Linda Bluestein: So, so I was practicing as an anesthesiologist and started getting more and more medical problems. I had a lot of medical problems as a teenager and then was doing quite well for quite a number of years and then started running into more problems again.

And, um, basically ended up having some pretty major surgeries in my left upper extremity, which is my airway arm, and, uh, which it’s every anesthesiologist airway arm. I think even if you’re, even if you’re left-handed, I think you still hold, have, have right-handed. Yeah, exactly. I think you still hold the lingo scope with your left hand, come to think of it.

Um, so it, it became very, very challenging for me after my last surgery. I had C R P S complex regional pain syndrome and I thought I would be able to go back to work. My surgeons predicted 12 weeks cause I had bone grafting surgery. So that’s a pretty big operation. Oh my gosh. And, uh, because of the C R P S, I wasn’t able to return.

And so that [00:12:00] was really hard. That was really, really hard. Yeah. And I’m such a curious person though. I still went to anesthesia conferences and met people, and I met a woman who was the editor for a pain management journal. In fact, in fact, I, I literally have a copy of the most recent one that I wrote right here.

But that was in 2017. And she asked if I would, uh, write an article for their journal, which I did. And I was like, oh, what should I write it on? And I was in an Aqua Zumba class and I was like, oh, duh, I should write it on pain management for hypermobility because I had spent the last few years trying to improve my own quality of life.

And I had a lot of pain. I mean, I had much more pain in my late thirties and forties than I have now in my late fifties, which, Most of my patients are very happy to hear, um, about that aspect of things. So I, I then, uh, wrote this article and people started asking me, where can I come see you? And I had to tell [00:13:00] them I don’t have a practice.

And finally, uh, my mentor, Perdeep Chopra convinced me to open a practice. He’s like, you’re an anesthesiologist. So you know about the cardiopulmonary system, you know about mm-hmm. You know, uh, you know, gastrointestinal to a certain extent. And, you know, a lot of different skill sets that would be very helpful to manage.

Pain in this population. And as, as an anesthesiologist, you do some pain management. And in fact, I did have a pain management practice right my first two years after residency. So I was just returning back to what I had done, um, previously, but I also really felt very strongly that there were enough people that were doing interventional pain management.

And even though I had done epidurals and, um, you know, st gangland blocks and Celia ganglion blocks and things like that, I also was having enough issues with my hands. And I felt like there’s a lot of people that are doing those things. I want to take the best of western medicine and the best of eastern medicine and be open [00:14:00] to many, many different types of treatment approaches.

And so integrative pain management just seemed like a, a really good way to go. 

Kristin: Yeah. And there’s just nothing. I mean, you know, speaking from experience, you know, I’m, I’m somewhere on the hypermobility spectrum somewhere problematic. I don’t know exactly where. Um, but like you, I did not, I always knew that I was really flexible.

Mm-hmm. Right. And I always had the party tricks, you know, my elbows been too far and I could put my leg over my head still mm-hmm. In my late thirties, um, things like that. But it wasn’t until, and, and I had had pregnancies that just were so painful. Mm-hmm. And I didn’t know why, and I knew, I did know though, after our second kid, I was, I knew somewhere in my body this can’t, I can’t do it again.

Mm-hmm. Like my body will break. Mm-hmm. If I tried to do that again. Mm-hmm. Um, but I didn’t know why. And of course, you know, all [00:15:00] the, you know, medical tests and, and anytime I had been to a doctor about anything, there’s no like, You know, obvious reason why any of this is happening. And even, you know, will here, he’s a physician, he’s an ophthalmologist, so you know, doesn’t, that’s different.


Will: she knows not to come to me with 

Kristin: even him. You know, the thing that I got so tired of hearing is You are fine. Right. If I could just strike those words from the English language, I would, because I hate that phrase because No, I am not fine. You may not be able to tell what’s wrong with me, but I am not fine.

Right. And we’re not allowed to say that around the house. Not at all. Yeah. Um, but, you know, he would kind of poke fun and, and I would too. I would laugh at myself of, you know, I’m always. Bumping into things. I’m always having bruises for reasons that I don’t know why. Mm-hmm. And you know, just, just all these random, I sometimes I have trouble swallowing.

And he said, how have you not learned how to swallow in 35 years? Or whatever? Right. Like all [00:16:00] these 

Will: things, you do it every day. I’m just saying 

Kristin: I had a lot of practice, but I still trip up on it sometimes. Um, you know, I’ve got some, I mean, I could go on and on and on the GI stuff Right. That, you know, that I’ve only in retrospect, It wasn’t until my physical therapist, um, told me You are more say, yeah, God love the physical therapist.

Yes. Oh my goodness. But she told me, I have never seen someone. Cause with your range of motion. Mm-hmm. And I knew I was flexible, but that got me thinking like, Okay. That’s interesting cuz you do this all day, every day. Exactly. With lots of people. Mm-hmm. For years now. Um, and I had had a cervical disc replacement and so I had physical therapy after that.

And I have, um, okay, you’re gonna have to help me with the words, both of you. It’s anthesis Yes. On one of my, so like, I don’t know, one of the upper two, right? They’re row. Yep. And then a couple of the lower [00:17:00] two are retro. Retro, yeah. Retro. And then I got some other weird thing happening in my lower spot and like, who even knows anymore, you know, and it’s so.


Will: How often do you hear this type of story, uh, Linda, about, you know Yeah. All these, all the time. This constellation of symptoms and, and you know. Yeah. 

Dr Linda Bluestein: And the, and, and the thing is, um, I feel like it’s not even just a hypermobility problem. I, I took my son who’s very athletic and he had, um, he was playing ultimate Frisbee and did a, you know, massive dive for the Frisbee, landed on his shoulder and, you know, went in and got imaging cuz I mean, the kid never complains of pain, but he was complaining of pain and the, the PA came back in and said, you’re fine.

Yes. And, and what I wish she would’ve said is there’s nothing fractured. Mm-hmm. But if you’re hurting, you have a soft tissue injury, so you probably should baby it until it stops hurting. That’s what she should have told him. And [00:18:00] uh, my story, Kristen, is so similar to yours. Mm-hmm. I kept telling my internal medicine doctor, something is wrong with me.

Yeah. I get injured really easily. My tissues, I had tearing of certain tissues during things that should not have happened. Um, right. I did have an ophthalmologic problem. I had a corneal ulcer at one point, so Oh, ouch. Yeah, that was really painful. That was actually while I was writing that 2017 article.

So then trying to write the, the post march release part was so painful. Oh God. That was while you have an 

Will: eye infection. Yeah. Yeah. 

Dr Linda Bluestein: It was awful. 

Kristin: That’s when you need voice to text, just close your eyes. Exactly. That’s 

Dr Linda Bluestein: right. Exactly. Um, but I hear this all the time. All the time, and I, what I wish people would realize is words matter.

They matter. Yes. So much if we just instead said, I don’t know exactly what the problem is, but, but I wanna help you. And maybe they don’t know at that visit how to help, but why don’t you come back? We’ll, kind of, you know, they could have [00:19:00] their staff look into some resources or something. Just, it’s so frustrating when people are given messages because the labs are normal and the imaging is normal and they’re told you’re fine.

It’s like, well, wait a minute. Don’t, aren’t there limitations with our imaging and with our labs and there’s a lot of, with our knowledge, right? Totally. Yeah. Yeah. 

Kristin: Yeah. And it’s so, it, it hurts so much to be dismissed like that when you know something is wrong, but you can’t articulate what it is and they can’t find what it is.

Mm-hmm. And then you’re written off as it’s all in your head. Mm-hmm. Or you’re seeking attention, or you’re seeking drugs or, you know, they have all these other explanations in their minds for, for why it is that you have, you know, these visits with them. But, um, but that’s why I love so much what you’re doing, because you educate, you know, in addition to your, to helping patients who also educate physicians about hypermobility and the hypermobility [00:20:00] spectrum, you know, disorder and AORs Danlos syndromes and all of those things.

And I think it’s not, for whatever reason, it’s not taught, but it seems so common. So I don’t know why that is. 

Will: Well, I’m just thinking about my education and, you know, I was taught about AORs Danlos. Mm-hmm. I guess I never really thought of hypermobility as a spectrum. Mm-hmm. Right. Well that’s 

Dr Linda Bluestein: newer, right?

Oh, definitely. Yeah. That’s definitely newer. And, and Kristen, like you, I could put my feet behind my head. I could do all these different things, but I wasn’t the bendiest dancer in, in my class. So you were in a, 

Kristin: in a skewed populations, right? 

Dr Linda Bluestein: Right. Exactly. 

Will: What was the question actually I had was you talk about, you know, you know, some, maybe some patients not having an actual connective tissue like disease.

Mm-hmm. But so is it. I’ll use ballet for an example. Is, is it the training that you go through that makes you hypermobile? Is, is there some part of that or is it like, is it, what’s the chicken of the egg, chicken [00:21:00] egg type 

Dr Linda Bluestein: thing? Yeah. Yeah. It’s a, is a fascinating question. And, uh, professor Rodney Graham, Kristin, you probably know who he is.

I don’t know if you know who he is or not, but he’s one of the grandfathers of Alors. Dan Lawson, just a, an amazing man. But he published a study in 1972 comparing student nurses versus student ballet dancers. And he found that even the fifth finger, um, how much it could extend, and also with 10 pounds of pressure, how far it extended.

He found that that joint was more hyper mobile in the student ballet dancers as compared to the student nurses, which would suggest that part of it at least is that, that when people are hyper mobile, they will stay and dance longer. They’re more drawn to the profession because they can excel at it. But will, to answer your question, There’s also a lot of additional factors that can be involved.

For example, let’s say you have hip dysplasia, so that’s when you have a really, really shallow hip socket, right? So if you have hip [00:22:00] dysplasia, you can have incredible range of motion of your hips, but you might not have any other, um, excessive range of motion in other joints. So that can be very beneficial in something like ballet, but maybe you don’t have a connective tissue disorder.

And nowadays, I think we’re also seeing a lot of forced hypermobility because dancers are doing thing crazy things like putting their feet on chairs. I have patients who, you know, they say, oh yeah, my teacher, my dance teacher put my feet on chairs and then pushed my body down in between the chairs in the splits.

So going into the hyper splits. Yes. Yes. My God. You can imagine what that does to your knees. Oh, yeah. And to your hips. So I, I believe that. There are some people where, you know, they’re, they start out, they’re hyper mobile in a variety of joints and so then they’re drawn to ballet cuz they can excel at it.

Mm-hmm. In other forms of dance. But I think of ballet in particular, just because of the [00:23:00] aesthetics of ballet. And then in other cases I think that maybe people didn’t start out hyper mobile, but because of the training, then they developed hypermobility in some of the joints. Mm-hmm. 

Will: Well, Kristen was a, you grew up as a gymnast.

A gymnast, 

Kristin: yeah. Oh yeah. Yeah. And I had no problem. It was great because, you know, of course all of this I’ve learned much later in life, but you know, that really builds a lot of muscle. Mm-hmm. As well. Mm-hmm. So, you know, I was hyper mobile, but I didn’t have any issues with it at the time. I was young still and I had, you know, the strength I think to support it.

But then, you know, once I went through my first pregnancy, it’s like my body never recovered until I learned what I had and how to, to support it. And I, you know, I’m even just now kind of figuring all of that. Out. Mm-hmm. But yeah, it, it did, it made it easier to be a gymnast, but then, you know, now I’m like, I’ve got two daughters.

I don’t know if I wanna put them in gymnastics because, you know, they’re interested. And it was so fun. And it was su, I mean, I love gymnastics to the point. Mm-hmm. Like you, [00:24:00] I’m sure that it’s part of your identity, right? Mm-hmm. Totally. Um, but, It has also done a lot. I, I don’t know it, and my hypermobility probably have mm-hmm.

Have done a lot of damage. Um, so yeah, it’s always tricky thinking about do you want your kids to do that stuff or maybe try to get them in, I don’t know, swimming. Yeah. 

Dr Linda Bluestein: That be better. I, I think the devil is really in the details. You know, if you are at a school where, whether it’s a dance school or a gymnastics studio, um, or gym where the teachers are really respectful of the students and they’re really trying to train them in the healthiest possible way, I really think that those kinds of activities are hugely beneficial because they’re, they’re good for our psyche, they’re good for building muscle mass, as you pointed out.

They’re good for social engagement, which especially nowadays, you know, it’s so easy to be disconnected from people, even for kids. So I think there’s tremendous benefit that we can get from doing those kinds of activities. I think it’s [00:25:00] all on how we do them. 

Will: Yeah. Right. Well, I know whenever I met Kristen and I saw how flexible she was and knowing her gymnastics background, it made me realize just how inflexible I am.

It’s like, uh, yeah, I, I thought I was like, good being able to touch my toes when I was like 25. Uh, and like here she is able to like, put her palms on the floor. It’s like, uh, it’s, 

Kristin: it’s, well, I think the word you’re looking for is normal. You were normal. Well, 

Will: yeah, 

Dr Linda Bluestein: but I think that’s an interesting point and something that I tell people all the time, you know, you only know what your own body is like.

Exactly. Kristin, you can, 

Kristin: I didn’t know 

Dr Linda Bluestein: I was abnormal. Yeah. You can probably relate to this. Like, you know, you just get in the habit of basically dislocating your shoulders every time when you’re, when you’re young and you’re presymptomatic you, when you put on a little top, you know, or a sports bra or something.

You’re bas you may dislocate almost your shoulders putting it on or taking it off. Yes. But, but you just do it because number one, if it doesn’t hurt, doesn’t just what your body does. Yeah. Yep. It doesn’t worry [00:26:00] you. But yeah, my husband is the same way. He’s, you know, A lot less flexible than I am. Yeah. But we, we just don’t, no, and you’re right.

Dealing with a skewed population. If you’re training in valet or something, then you, everyone around you is crazy flexible too often. So yeah. It just seems 

Kristin: normal. But yeah, that’s why he, he ended up having to like, do all the baths of our kids. Mm-hmm. You know? Mm-hmm. Because you have to like, lean over the tub and I could not do that without just really having a lot of shoulder pain and, mm-hmm.

I mean, example after example, after example, and I know you’re familiar with them, but what can, so our audience is largely, um, you know, physicians or healthcare workers or people training to be one or people who know one. Um, what can you look for as a medical professional? What should they be paying attention to or what should, what should make the little bell go off in their head that says, oh, maybe this person is hyper mobile.

And then what do they do about it? 

Dr Linda Bluestein: Sure. So that’s a fabulous question, and I will start out with the punchline and then we’ll back up. There’s a, there’s a saying that was, I [00:27:00] believe, first said by Dr. Heidi Collins. If you can’t connect the issues, think connective tissues. Mm. That’s good. And I think that summarizes it beautifully because Yeah, you know, someone comes into your office and they’ve got gastrointestinal complaints, they’re dizzy when they stand up.

They’ve got some musculoskeletal stuff that you can’t explain. See? Yeah, I know Tendonopathies, you know, it, it’s, it is interesting though, because I also see so often people also on the flip side, you know, thinking that everything is related. I. So, you know, it’s, mm-hmm. Um, it’s having that balance of, you know, understanding connective tissue and, and what it does, and that it is present everywhere in the body.

And so, you know, a great example is if you have lax connective tissue in your gastrointestinal tract, it makes sense that you’re gonna have slower motility through the gastro gastrointestinal tract, which could put you at risk for sibo, small intestinal bacterial overgrowth in the upper gastrointestinal tract.

And then constipation is [00:28:00] an extremely common problem for people, um, in the lower gastrointestinal tract, and they can have disorders, et cetera. Um, gastroparesis or slow gastric emptying is just extremely common. And so people get nausea, they get pain, abdominal pain after eating and things like that. So it’s.

It’s so incredibly important for people no matter what your specialty is, um, to just be aware that connective tissue is everywhere. So regardless of your specialty, you will see these patients. And so having it on your radar can just be so incredibly helpful. I saw an E N T doctor once, speaking of swallowing, I saw an E n T doctor once and I was having recurrent sore throat without infection, and I didn’t understand what was going on.

And of course they scoped me, what, what do they always do? They scope you, you know? Mm-hmm. And, uh, basically told me, no, this couldn’t be related to your e D s. And I was like, Hmm. Well, okay. If you say so, but if you think about it, why [00:29:00] would that part of the body be exempt? You know? Right. I mean, we, there’s, there’s a lot of connective tissue in the upper airway, and so I was having a vocal strain and I ended up actually ultimately going to, um, speech therapy for my recurrent sore throat without infection.

And that did help. A lot and a lot of my patients have swallowing difficulties and, um, you know, challenges of speech and cervical, cervical stability issues. Mm-hmm. Various, you know, musculoskeletal, um, you know, it’s, it’s pretty much any system that you can think of. Is something that we need to really be thinking about.

Kristin: Right? Yeah. I used to ask people, do you ever feel like your head is like too heavy for your neck? You know? And they would look at me funny and no. And then I’d come to find out, oh, my head was too heavy for my neck because my neck was so, you know, weak. It had so many instability issues. So yeah, [00:30:00] I love that.

If you can’t connect the issues in connective tissues, because I think what happens a lot right now is if you can’t connect the issues, say you are fine. Right? Right. Exactly. So let’s move away from that model into thinking about the connective tissues before. Yeah. You say you’re fine, let’s just strike.

You’re fine, in 

Dr Linda Bluestein: fact. Right, right. Yeah. Right. Totally. Totally. And, and you know, I think it’s so important for us as physicians to be able to say, I don’t know, and for patients to not judge us for saying, I don’t know, I feel like sometimes I see people say, I just want my doctor to say I don’t know. But then I also know that I’ve heard from patients.

Who are talking about another physician, and they’ll say they didn’t know. It’s like, Yeah, you can’t possibly know even everything within your own pretty narrow scope. I, my husband and I used to joke, especially for ophthalmologists, I, we have a cousin who’s a retinal surgeon, and, and we would joke that ophthalmology become so specialized that pretty soon you’re gonna specialize in either the right eye or [00:31:00] the left eye.

Will: Yeah. Or just a part of the right eye. Right eye or the left eye. Yeah. Right, right. Because I, yeah, we have like seven different, uh, subspecialties. It’s 

Kristin: where you’ll only be dealing with three square millimeters. Right. 

Will: Right. Well, one, one thing I wanted to ask you about is, um, you talked a a bit about transitioning from your job as an anesthesiologist, you know, leaving the operating room, uh, which I, I assume was, was not because of, um, at least in part.

Uh, dealing with the surgeon personalities, was that, did that play into your decision at all? I know there was like some health issues, but I mean, let’s be honest. It’s okay. You can be truthful here. 

Dr Linda Bluestein: Okay. Well, if I’m gonna be truthful, man, I would’ve left the operating room a long time ago, and it wasn’t the ophthalmologist that were the most guilty, but my husband is a surgeon.

Oh. Doesn’t surprise me. My husband. My, yeah. My husband is a urologist with a U Yes. And I say with a U because urology and neurology of course sound very similar. So that’s why I have to clarify. But, um, he used to say to me all [00:32:00] the time, you have so many issues. Your issues have issues. Yeah. Up, um, you know, because we didn’t know what was wrong with me.

Yeah. Like you guys, you know, we didn’t know. Right. And, uh, it was hard for him, you know, to understand and Yeah. And you know, as a surgeon, you’re very used to having more discreet problems and you have you, yeah. And you’re either I, I, 

Will: yeah. I love having just one problem to deal with. Yeah. Yeah. That’s fantastic.

Kristin: But it’s the same right. Of a, it sets up this marital dynamic. Right, 

Dr Linda Bluestein: right. Yeah, you’re fine. Yeah. And it, and it’s a binary thing. You’re gonna operate on the person or you’re not, pretty much. Mm-hmm. You know? 

Will: Yeah. And well then maybe, can I, can I just say, instead of saying, you’re fine, can I just say I’m an ophthalmologist?

Is that, is that that 

Kristin: better? I would prefer you leave your profession out of it and be a sympathetic husband. I can do that. We can talk about that off my, I can do that. Yeah. Yeah. 

Dr Linda Bluestein: And that is a big challenge that a lot of people face, and I see people on all ends of that spectrum. I see [00:33:00] patients where it’s like, do you understand what your spouse is going through?

Like this is, you know, We all have to do our part, right? I mean, we all need to recognize that. Of course we have needs, but everyone else in our life they have needs too. So it’s just trying to strike that balance. And it is really, it is hard. Marriage is hard. Life is hard. You know, striking that balance can be really hard.

But my husband and I just celebrated our 31st wedding anniversary, so Oh, wow. You guys probably aren’t even that old. So 

Kristin: sadly we are. We feel like it we’re, well, not old enough to be married 31 years, but we’re, we’re getting up 

Will: there. Yeah. Well, let’s, let’s take a quick break and then, uh, we’ll come back here and talk some more with Dr.

Linda Bluestein.

Hey, Kristen. I have a PSA for you and all of our listeners from our friends from Tarsus. Let’s hear it. You know how sometimes you can get red, itchy, irritated eyelids? Okay, well, do you know what that might be? What. Eyelid mites. No. Yeah, it’s [00:34:00] true. No, it’s a disease that’s called demodex Blepharitis. That’s disgusting.

It’s pretty common. That’s horrifying. So if you have itchy, red, irritated eyelids, go talk to your eye doctor. They can take a look at you, tell you if you’re not alone. That’s right. But don’t freak out. Just get checked out. All right. To find out more, go to eyelid check.com. Again, that’s eyelid check.com to get more information about Demodex Blepharitis.

Today’s episode is brought to you by the nuanced Dragon Ambient Experience, or Dax for short. This is AI powered ambient technology. It just sits there in the room with you, just helps you be more efficient and it helps with, uh, reducing clinical documentation 

Kristin: burden. Yeah. And that can help you feel less overwhelmed and burnt out, and just kind of restore the joy to practicing medicine.


Will: we all want that. So stick around after the episode or visit nuance.com/discover. Dax. That’s N U A N C e.com/discover. D a X.[00:35:00] 

All right, we are back with, uh, Dr. Linda Bluestein. So Linda, we are going to, uh, as for all of our guests, we ask you to bring a couple stories. Cause we like, we love stories on this podcast. And, uh, and you, you, I have a couple prompts for, uh, that were, um, from you to like, remind me to, to get to, you know, get you to talk about these stories.

And I, I have to do it because one of them, all it says is eyes and nose, which is, uh, I mean, you know how to, how to really get me excited about something. Just put I in there. And so, uh, please tell us, uh, what, what do eyes and nos have to do with your history and your time as 

Dr Linda Bluestein: a physician? Okay? So for those that are just listening, you are missing me blushing like crazy right now because this, this was so embarrassing.

I was a third year medical student. And as will, as you know, like, you know, when you start your third year, you’re, you are. Brand new into the clinical rotations. And I know now [00:36:00] there is a little bit more, in some schools anyway, there’s a little bit more of an clinical introduction earlier on in the process.

But at U C L A back in the dark ages when we had stone tablets, the first two years were all in the classroom, and then the third year you’re doing your clinical rotation. So anyway, I was on the ward at one of the hospitals and I was, uh, going around with my staff and you know the tears, right? I was the medical student.

Then you have the junior resident, the senior resident, et cetera. And they asked me about this particular patient that I was taking care of. And they asked me, well, how are their eyes and nose? And I was like, what? And they s they said, well, go ask the nurses, because they were in morning report. They said, go ask the nurses.

This question. I mean, they clearly didn’t realize that I didn’t know what they were talking about. So I go into this room full of nurses. They’re sitting there at their own morning report and there were probably 20 of them sitting around the table discussing different patients [00:37:00] and, and you know, exchanging information and things like that.

So I said, on rooms 302, um, I need to know about their eyes and nose. And they all looked at me like, What? And then one of them said, do you mean their eyes and os intake and output? Oh my God. Not eyes and noses. And I just like, oh, and they, oh, you must have died. I was, that was song. God, they got such a good chuckle out of it then.

Oh, I’m sure. Yeah. Yeah. And then of course when I had to come back and, you know, with my head hanging and, and tell my staff, okay, so apparently you were asking for. Eyes and o’s and not eyes and nose, 

Will: you know, that mis misunderstanding actually, I think might have saved you because, um, going into a room where a bunch of nurses are doing signout and interrupting [00:38:00] their signout and asking a question, that’s like another way to, to get, uh, disappeared in medicine.

So, yeah, exactly. Uh, I think instead you gave them a laugh, which much safer. They probably needed that anyway. Right, right. I love it. Oh, that’s funny. And then you gave it one more, uh, this time as a p I love stories as a, whenever a physician can relate to, uh, or, you know, experiences as a patient as well.

And so, uh, you also have one, uh, that involves a tennis ball at a wedding. I, I love, see this is the way we need to do it. I, I want like, Two or three words. Oh yeah, yeah. That really get me like, okay, what on earth is this gonna be about? As 

Dr Linda Bluestein: soon as you said that, I was like, you probably were wondering what a tennis ball at a wedding.

Um, so, so this was when I was in a really dark time health-wise and had no idea what was going on, and my doctors didn’t know what was going on and I was undergoing all kinds of procedures and they kept thinking that my prob my main problem at [00:39:00] that point was like radicular uh, pain going down my left leg.

So pain that was kinda shooting from my, my back down in the back aspect of my left leg. And so I was going to a wedding of a, of a cousin, another cousin story, and I was gonna go, even though I was in a lot of pain and I had figured out that by sitting on a tennis ball and kind of putting it underneath that hamstring insertion area, probably, it just was painful enough that it kind of distracted me from my original pain.

And that’s how it was. Felt to be helpful. But anyway, I brought a tennis ball for this purpose, right? So, um, you can probably already guess where this is going. So I’m sitting in my seat and I’ve got the tennis ball underneath my. You know, uh, yeah. Underneath my leg, right upper leg. And I’m sitting there with the tennis ball and it’s the middle of the ceremony, and somehow the tennis ball broke free and goes rolling down the aisle.

Kristin: Oh no. [00:40:00] 

Dr Linda Bluestein: Oh my gosh. It was so embarrassing. Did you have to go chase after it? I did. I did. Go chase. Oh no, 

Kristin: I would’ve just let it go. You know who did that? 

Dr Linda Bluestein: Yeah, that’s good. Probably should have just let it go, but I did go chase after it. Yeah. And, and we were sitting, you know, pretty close to the front.

Nobody missed me going and getting that ball. And I’m sure, I mean, you know, balance, bounce. Yeah. Now 

Will: everybody has a wonderful weird story about a time they, you know, someone was chasing a tennis ball at a wedding, so 

Dr Linda Bluestein: there you go. Exactly. Great. If there’s anyone that was in attendance that’s listening to this, they’re gonna be like, oh my gosh, I was 

Kristin: there.

That’s why. Yeah. 

Will: Well, let’s, um, I want to get into the, uh, because I’m really excited about this, this game. This is the first time we’ve played this little game. Okay. Um, it’s, uh, called this for me. Yeah, that’s for you. It’s called Backwards Medical Tret. T because, uh, what we’re gonna be doing is spelling.

It’s a spelling test. Oh, no. Yes, [00:41:00] yes it is. I’d say there were, uh, two different types of words that, that, um, actually Kristen has, I helped her put together the list, but I don’t know which one she’s gonna ask. Um, there’s, there’s hypermobility terms and there’s also some ophthalmology terms. Oh, boy. There.

And it’s called medical, uh, backwards medical, because we’re gonna be spelling the words backwards. Oh, boy. Okay. 

Kristin: All right. Oh, T is term. It’s 

Will: terms spelled backwards. I that, yeah. Okay. Backwards medical, smt. There you go. Oh boy. So do you, would you like to, I, I, let’s, let’s have our guest go first. 

Kristin: Okay. I was gonna say, I’ll try to start with an easy one for you, but I, all of these words are horrendous.

Then don’t, 

Will: then don’t give, then don’t give an ophthalmology term. 

Kristin: Well, I was gonna say no. Yeah, I know. I was gonna say given in the 

Dr Linda Bluestein: hypermobility area. Yeah. Given that I was struggling with terms, I’m getting a little nervous right now and I’m getting outta pen. 

Kristin: Okay. Yeah, there you go. Um, [00:42:00] okay. This, see, I think this might be the easiest one I have.

I don’t even know how to say these things, so apologies to the listeners fight’s, 

Will: why this is gonna be so fun. Incorrect. Because Kristen has never, she actually, this is the first time she’s seen this list, and I am not in 

Kristin: medicine, 

Will: so, yeah. So we get to hear her pronounce these. Okay. 

Kristin: Okay.

Osteopenia, penia, osteopenia. Osteopenia. That’s good. 

Dr Linda Bluestein: Now, am I supposed to spell that backwards? 

Kristin: You spell that backwards? 

Dr Linda Bluestein: Yeah. Oh, boy. Do I get to write this? You know what Peno. Oss? No. So 

Will: you don’t have to pronounce it backwards. Yeah, yeah. Just spell it. You just 

Dr Linda Bluestein: spell it backwards. Okay. A i n e p o e t o s O.


Kristin: Very 

Will: nice. Nice. Well done. You got it. All right. Gimme one. Okay, gimme 

Kristin: one. Okay. One for you. And what 

Will: is osteo Osteopenia like? Oh yeah. Tell us 

Dr Linda Bluestein: what it’s lack [00:43:00] of. Uh, low bone density. Low bone density. Yeah. Yeah. Okay. Something I’m getting evaluated for this week. Osteopenia, osteoporosis. So, yeah, there you go.


Kristin: We’ll stitch, is that more common in hyper mobile patients or just It is. Okay. Yeah. Um, okay. I’ll, I’ll do the same. I’ll start with an easier ophthalmology one for you, and then I won’t be nice anymore. So, um, aniridia. 

Will: Anuria. Yeah. Lack of an iris. 

Dr Linda Bluestein: Oh my gosh. I didn’t even have that was a thing. 

Will: It is, it is a thing.

An Anne Auria. Wow. Uh, um, a. I D I r, uh, r i n a. 

Kristin: Yes. You got it. 

Will: There’s a lot of eyes in there. Why is ophthalmology so, but, um, ophthalmology is so full of vows. Eyes. 

Dr Linda Bluestein: Yeah. You guys have your, it’s full of eyes. You have your own. Yes. It’s full of eyes. It’s, it’s 

Will: full of eyes. That’s true. 

Dr Linda Bluestein: And you have [00:44:00] so many acronyms.

Will: Oh my gosh. We do. Yes. We, we, we, we throw them at people. Yeah. And it just makes people more scared about eyeballs. 

Kristin: Yeah. Yep. Okay. Dr. Bluestein, let’s go with, oh, this is, um, you know, topical? Mm-hmm. Spondylothesis. Oh, okay. 

Will: Spon. That’s such a long, 

Kristin: it’s so 

Dr Linda Bluestein: long. Okay. S i s If I could read my own handwriting, it would be easier.

S i s e t h i l O. Did I make a mistake? L Y D N O P s I think. 

Kristin: Okay. So there was somewhere you said t h where I think it should have been ht ht. But other than that, 

Dr Linda Bluestein: other than that I did. Okay. 

Kristin: Yeah. Pretty good now. Okay. And spondylolisthesis is what? 

Dr Linda Bluestein: Spondylolisthesis is where you, like you were talking about earlier, where, where the bones instead of stacking nicely, where they slide forward the, sorry, the [00:45:00] vertebral bodies.

Yeah, yeah. 

Will: Vertebral bodies do it, yeah. Okay. Sounds 

Dr Linda Bluestein: painful. It is quite, so then there’s the retrolisthesis and anthesis. Gotcha. Right. 

Kristin: And I have both cuz I’m a lucky winner. Is that common? Is that like there’s no, does it usually go one way or another way or? No, 

Dr Linda Bluestein: it, it’s, it’s very common and it’s really important to know what the grading is and it’s, so again, this is where the words matter so much.

I have patients who they were literally told. You have the worst spine I’ve ever seen. Oh, yeah. That really, you know, does a lot Yeah. Psychologically, so. Right. I really feel like, uh, we need to be so careful with those kinds of things, and I, I was offered once to have a free, a free upright M r i and I was like, of my neck.

I’m like, Hmm, I don’t think so, because Yeah. I’m not having problems. I don’t wanna know, like, you know. Yeah. It’s not gonna change. They’re not to know what’s happening in, it’s not gonna change anything that I’m doing, so. Yeah. Yeah. 

Kristin: That’s smart. All right. 

Will: Don’t gimme, gimme a, gimme a, a hypermobility word.

Ooh. [00:46:00] I spent all day with ophthalmology terms. Those 

Kristin: words are harder. Let’s, okay. I’ll give you, I’ll give you a hypermobility and then I’m coming back. Okay. Um, CAO, scoliosis. 

Will: Cao, scoliosis, uh, S i S O I L O C S. O H P Y K. 

Kristin: You got it? Woo. Does covering one eye help you had your eye covered? Yes. 

Will: That’s my, I was trying to, I I, I’m, I’m just smashing my head to hold my brain in place.

Love. So I can think better that way. 

Kristin: Gosh. Okay. What SCO scoliosis. Yeah. Right. Covering one eye. Oh my god. Is a better one or two. Um, yeah. So what is kypo scoliosis? 

Will: Oh, um, uh, [00:47:00] yes. Kypo scoliosis is is where, um, it’s a, an abnormal curvature of the spine. Um, I guess I think of like lordosis as, as like a con concave kinda, and then ky O is like the opposite.


Kristin: you do Dr. Luine? 

Will: I think you did. Okay. How would you describe, yeah, what is, what is the definition? Cause I know we put that in there. Curvature of the spine. Typh. Yeah. 

Dr Linda Bluestein: Let her tell us is the upper spine, you know, being, be, being hunched. Right? Kyphoscoliosis, I’m not sure if that refers specifically to the upper spine, having a scoliotic curve.

I’m not sure. 

Will: Oh, it’s like a kind of a sideways 

Kristin: curve maybe. Yeah, it says a curvature of the spine in both the lateral and posterior directions, which can be caused, but yes. Ah, okay. 

Dr Linda Bluestein: So it’s it’s gonna be like a Yeah, probably could be lumber or thoracic. Okay. 

Kristin: Okay. Um, do a couple more. Couple more. Dr.

Bluestein, um, dis, 

Dr Linda Bluestein: A [00:48:00] I m o n o t u a s. Y d 

Kristin: Yay. You got it. Perfect. Pretty 

Will: good. I’m impressed. Diso, should we 

Dr Linda Bluestein: define what 

Kristin: Diso is? Please do. Cuz I have these, uh, symptoms sometimes and have many a time been told by this man here. You’re fine. Oh, come 

Will: on. You’re making me look bad. Oh 

Dr Linda Bluestein: my gosh. Do you know how many 

Kristin: times they No, but they are, they’re just like weird little things that all on their own.

It’s like, yeah. A nothing burger, right? But then when you see the pattern of them together, it starts to 

Dr Linda Bluestein: become something. And, and it’s so important because, um, something like dysautonomia, again, most of these things are, are, are somewhat on a spectrum. So dysautonomia is dysfunction of the autonomic nervous system, which is the part of your nervous system that, you know, controls all of your automatic bodily function.

So your, uh, basically your, you know, gut motility, the size of your pupil, your um, temperature regulation, your heart rate, your blood pressure, all of those kinds of [00:49:00] things. And especially, um, Upright posture requires a lot of effort on the part of your autonomic nervous system. So it’s very common for people with these conditions to experience problems with that.

But if you have the flu and you’re in bed for a week, you’re gonna have the same type of picture, so mm-hmm. It’s, um, it’s knowing how much is problematic also. So a lot of times people read some of these things and they think, oh, I have that, or I’ve had that. But it, again, it’s, you know, if you, if it’s happened to you a few times, that’s one thing, but if it’s something that you struggle with on a regular basis, that’s, that’s a whole nother ball 

Kristin: game.

Right. Yeah. For me it’s the dizziness and lightheaded against you get dizzy all the time. Mm-hmm. Yeah. Okay. Will one 

Will: more? I can do it. Okay. You ready? Although I’m, I’m, I’m using a lot of brain power today. You gotta get ready with the hands. It’s not even, it’s not even noon. Okay. Get your 

Kristin: hands ready.

Squeeze your head. All right. Gimme a word. Cyclo. Photocoagulation. Oh, geez. She, you’re the one that put it on this list. 

Will: This [00:50:00] is ophthalmology. So full of syllables. 

Kristin: Cyclo. Cyclo. Coagulation. 

Will: Coagulation. Um, N O I t, uh, a A L u G. Mm-hmm. A o c. 

Kristin: You got the coagulation. 

Will: O t o, uh, p, uh, hp. There you go. Uh, um, O L. C y c.


Kristin: That’s impressive. That is, that is incredibly impressive. Cyto photo, coag U laser. That’s nine syllables. That’s, that’s, 

Will: that’s, that word should not exist. That’s way too long. So, uh, what is it? Cyclo? Photocoagulation is a, is a treatment that you, uh, typically it’s, it’s for glaucoma where you destroy some of the Cary body, which is what, uh, [00:51:00] produces, um, aqueous fluid in the eye.

Hmm. So by destroying it, you can decrease the amount of fluid in the eye. You know, basically and decrease the pressure, so, gotcha. Which is a treatment for glaucoma. There you go. Well, there 


Dr Linda Bluestein: go. And I’ve, you’ve never heard that word before in my life. Yeah. 

Will: And you probably will never hear it. Uh, again.

Again. Yeah, that’s, that’s the last time. 

Kristin: Unless you end up needing it, would hope you don’t. 

Will: Thanks for playing backwards. Medical ette with us, man. Let’s take 

Dr Linda Bluestein: another excellent job, buddy. 

Will: Thank you for taking it easy on me. Oh yeah, we tried. Let’s take another quick break and we’ll come back.

All right, we are back. Let’s take a look at some of our favorite. Medical stories sent in by our listeners, and we have Dr. Linda Bluestein here to listen to these stories with us. Our first one is from an anonymous, uh, source. Hello, Dr. G. And Lady G I have an embarrassing mistake story from intern year. Uh, first I was only a couple weeks into my general surgery [00:52:00] intern year when all the best stories, like the first few weeks of intern year.

You can attest Linda. Oh, yeah. Um, on a night float service, it’s getting even better. Uh, so, uh, covering multiple teams and you know, when you’re on night float Yeah. You don’t know the patients like super well. Like you just, you kind of like, you’re aware of the issues, but you, you know, you’re just stepping in and, and taking, trying to just make sure everyone survives 

Dr Linda Bluestein: over there and hoping nothing bad happens.

Will: Yes, exactly. So I got a page from a nurse that a patient’s blood sugar was 700, which is very high. Okay. I referred to my insulin sliding scale. Gave the nurse an order to give a lot of insulin. Maybe an hour later I got a page. Is this the intern on call? I said yes, said this is Dr. C, the chief resident.

Did you just give my wife insulin? Oh, my first thought was, of course not. But the patient from before was indeed, indeed. Oh no. His 

Kristin: wife. So his patient’s spouse is his chief resident? Yes. 

Will: Oh dear. Yes. [00:53:00] And so, uh, she said, yeah, well, yes, I did give insulin. Well, she is hypoglycemic now. It turns out the blood sugar value the nurse called me about was from the, not from a routine finger stick, but was blood drawn from a line just downstream from the tpn.

Oh, no, what is that? So TPN is when you’re getting nutrition through an iv. So if you take a blood from Oh, right, where that’s going in, 

Kristin: you’re. Just taking the sugar that was going into her for her, for distribution around her entire body. Yes. And just concentrating it. 

Will: Exactly. Measuring. Oh boy. And so you can see how that could be an, a false number, that 700.

Yeah. Lesson, lesson learned here. Oh, no. Uh, so this is the, the, the story, the person who sent this in says, lesson learned. If a lab value sounds crazy, confirm the source and or repeat it yourself. Fortunately, she was okay, but it, but I was mortified and never made that mistake again. No, I bet. Yeah. That is, man, we all have things like that though, right?

Yep. I mean, oh yeah. You know, you, you learn something like that and it, it’s true. You never make a mistake [00:54:00] like that again. Uh, some of the 

Kristin: mistakes that the chief resident was involved, you know, that it wasn’t just like an anonymous patient in their family. Exactly. Yeah. 

Will: Yeah. And some of the mistakes you just never make because you’re now smarter and some mistakes you never make again.

Because like if you’re like me, you just leave that part of medicine forever. That’s another way to do it. Yeah, for sure. Our second story comes from Colby. The first time I felt like an actual doctor was as an August intern, again, intern year, beginning of intern year during an emergency medicine rotation.

A guy in his early twenties came in with intense lower abdominal pain, so severe he was vomiting after passing him through the donut of truth, which is another name for the CT scanner. Oh, he had a, he had a testicle in his anguinal canal. I, I 

Kristin: don’t know what that is, but I take it It does not 

Will: belong there.

Nope, it does not. It’s too high. Too high up. Uh, so it’s not in the scrotum, it’s up in the anguinal, the body. Yep. So he either had three testicles or one had retracted back into his [00:55:00] in Guennol Canal. The patient was unaware of any issues with his testicles and when he checked on his boys, he started to panic.

As there was only one home, only one home. I was able to palpate and then reduce the testicle in the ED and his pain immediately resolved. I was so excited. I am back in the wor into the wor. I went back to the workroom and said, I have ball skills like Steph Curry.

I was subsequently called Steph for the remainder of my rotation. 

Kristin: Oh my. That’s hilarious. Colby sounds like a 

Will: party. I love those two stories cuz like the highs and lows of intern here. Yes. Yeah. That is classic training, right? Totally. You make some horrifying mistakes that you’re just embarrassed by, but then you do like the most amazing things.

They’ll just give you that high for like an entire keeps going. Sometimes just keeps you going. Totally. Uh, so thank you guys for those stories. Send us your stories. Knock, knock high at human dash content. Dot com. Uh, Dr. Linda Bluestein, thank you so much for joining us. Uh, before we go though, um, [00:56:00] tell us what you, what you got going on, anything you wanna promote?

Where can people find you when 


Dr Linda Bluestein: find you? All the things. Sure, sure. So, A few years ago, I founded, uh, an organiz, a second organization called Bendi Bodies. So my medical practice is Hypermobility MD and I, it, it was originally Wisconsin based on, I had a different name, but then, uh, I changed the name a few years ago.

So that’s my medical practice. And then the rest of my work is through Bendi Bodies, which is a organization designed to help people anywhere on the spectrum, regardless of where they are on the hypermobility spectrum and supporting them in creating a better quality of life through educational resources like my free podcast.

And I also do offer one-on-one sessions through Bendi Bodies, which allows people who cannot become a patient cuz they cannot travel to Colorado or Wisconsin, allows them to get a consultation and information that they can either enact on their own and or take to their local healthcare [00:57:00] professionals to take the next steps.

Kristin: That’s amazing. Awesome. I wish I had had something like that, you know, 10 years ago or something when I had no idea what was going 

Will: on. And you’ve also posted a, a couple of articles, um, that are on your website. Mm-hmm. Correct. Um, that are, that are really, really fascinating and have a lot of great information.

Yeah. And 

Kristin: it sounds like they’re, they’re from 

Will: hope for Hyper mo mobility for hyper 

Kristin: that’s, they’re directed mostly towards, um, medical professionals too, for some continuing education. Right. So 

Dr Linda Bluestein: this is a continuing medical education, um, journal, and they contacted me, um, again after writing the 2017 article.

They contacted me not too long ago and asked if I wanted to write an update. And I was fortunately able to pull together a bit of a team because back in 2017 I didn’t have a practice. I was out on medical leave basically. And so I had like, All the time in the world really. So writing an article back then was a lot easier.

So this time around it was huge that I was able to, to pull together a team to write. [00:58:00] A two-part ended up being so long and they didn’t wanna cut anything out. They said, well, why don’t we make this a two-part series? And it, it is a subscription C m E journal. However, I think we did a nice job in really kind of outlining why clinicians need to know about these things.

What are the things that you could expect to see in your clinical practice, what to watch for? And then the part two is what are some treatment approaches that I have found successful in my practice? I love that 

Kristin: you don’t just point out the problem you actually like are providing at least, you know, something you can do to treat it while we are, are still learning more about it and, and working 

Dr Linda Bluestein: hard, right?

And, and, and one person, um, you know, so. I don’t know how often will that you get, uh, trolls or whatever on social media because, you know, all the time. And my husband and my husband is constantly telling me, don’t listen to them. Don’t listen to them. Yeah. But sometimes it is, you know, they, they kind of make you think about things.

But one person was like reading, they read part two and they’re like, okay, so basically eat, eat healthy [00:59:00] and, you know, exercise it, you’re, you’re telling me nothing that I don’t already know. But as Peter Atia talks about in his amazing book, outlive that just recently came out that I’m just devouring, he, he says, for people to have these bonus years or bonus decades, it’s not just the what, but the how.

So I feel like with people with hypermobility, the, the devil really is in the details and it’s really the how is so much harder for people to Yes. Accomplish. So by giving them some extra guidance in how they can actually achieve these things, I think is really important. 

Kristin: Yeah. I mean, you have to learn, first of all, there’s a whole like, process of like acceptance, right?

Yes. And this new identity that you have for yourself of, I don’t have a normal body. I can’t do easy, normal things that people usually do, but I can do these other things to help me get there, or at least a little closer. Yeah. Um, so it’s like learning how to move your body, not just that you should move your body, but how should you and how shouldn’t you?

And that differs from the, you know, quote unquote normal population. So, uh, but [01:00:00] definitely go grab 

Will: those. Thank you so much for being here. This really was a pleasure to talk with you. Thank you so much 

Dr Linda Bluestein: for having me. Yeah. I love what you guys are doing. 

Kristin: Oh, thank you. Vice versa. I, I just wanna jump out of my seat and, and take you to lunch and talk to me.

Me too. 

Dr Linda Bluestein: So, hey, I’m, I’m free. Let’s go. 

Will: All take care, Dr. Thank you so much. 

Dr Linda Bluestein: Bye-bye. Bye.

Will: Well, that was a lot of 

Kristin: fun. Yes. So interesting. I could talk for days and days and days about that 

Will: chef. She, she was, was really fascinating to listen to and her story. Yes. And, and I know, uh, you’ve been, it’s like Christmas morning 

Kristin: for you. I know. Well, when you go your whole life with this thing that no one can explain and everyone tells you is all in your head and then you find an explanation for it, you know, you just wanna shout it from the rooftops.

So yeah. I love what she’s doing. I hope everybody goes to check out, check it out, the work, check out for sure. And learn more about hypermobility and aor stain syndromes. Um, it’s, it’s [01:01:00] important things and like she said, you all have them and you’re, you are seeing these patients every day. Um, you just may not be recognizing it yet.

So definitely go check out how to recognize them. Absolutely. 

Will: And, uh, thank you for everybody for sending your stories into us. We love those as well. Uh, and again, let us know what you thought of the episode, uh, what you thought of our what. Backwards. Medical Smrt. 

Kristin: T tmt. That’s right. Smt t. It’s difficult to say 

Will: Smartt.

That’s it’s t Yes, it’s, 

Kristin: you should say it in that tone 

Will: next time. Uh, there’s lots of ways to hit us up, to give us your thoughts. You can email us, knock knock high@humancontent.com. We’re all over social media, all the platforms. Or you can hang out with us on our, on our Human Content podcast family on Instagram and TikTok at Human Content Pods.

And thank you to all the great listeners leaving wonderful feedback and reviews even after all of my fumbles throughout all this episode. Uh, if you subscribe and comment on your favorite podcasting app on YouTube, we can give you a shout out. Like today, [01:02:00] we got at dorky doctor songs on YouTube. No, I’m intrigued.

Kristin: I dorky Doctor Song. Need to go look that up after this. 

Will: Yeah. At Dorky Doctor songs on YouTube said, YouTube have become my battling the traffic soundtrack on the days I drive into work and at a very non ophthalmologic. Hospital. Well, good. Oh, I’m glad. I’m glad I could help. Especially with hospital work.

I’m enjoying your podcast. And it even entertains my non-medical husband. Oh, yay. That’s, I love, that’s what we like to hear. That’s, that’s some of my favorite feedback right 

Kristin: there. Yes. Awesome. Thank you. Dorky doctor 

Will: songs. Absolutely. Keep sending us all of your, your guest ideas, your stories, your jokes.

We’d love to hear 

Kristin: all that stuff. And maybe send your songs over to That’s 

Will: right. Your, your dorky doctor songs. Yeah. Um, full video episodes of this podcast are up every week on my YouTube channel at d Glock Fleck, and we also have a Patreon. Lots of fun perks, bonus episodes, or react to medical shows and movies.

Hang out with other members of this community. We’re there. We love seeing [01:03:00] you. We love, uh, commenting all this stuff. Mm-hmm. Early ad-free episode access, interactive q and a livestream events. Mm-hmm. Behind the scenes stuff, lots more. Uh, patreon.com/glock flecking, or go to glock flecking.com. Speaking of Patreon, community Perks, new members, shout out to Shaban s.

Hey, Shaban. How you doing? Welcome. Thanks for joining. Uh, shout out to all the Jonathans. As always. We got Stephen, g, Abby, h, Brianna, Lee, c, shaver, w, Dr. J Edward, k, Jonathan, a Jonathan F. Love having two Jonathans and the Jonathan. Uh, Patreon Tear. Uh, Caitlin, C k l, Leah, Lucia, C Marian, W Mark, Mary, h Mr.

Granddaddy Omer, Patrick Robox and Sharon s Patreon, roulette time. All right. Emergency medicine here. Pat on roll please. Random shout out to Kelly B Hi, Kelly. Hi. Thanks for being a patron, and thank you all for listening. We are your [01:04:00] host, will and Kristen Flannery, also known as the Glock Fleck. And special thanks to our guests today, Dr.

Linda Bluestein. Our executive Con producers are Will Flannery, Kristin Flannery, Aron, Korney, Rob, Goldman, and Shanti, broker, editor and engineers, Jason Porter. Our music is by Omer. Sp. To learn about our NAN Knock Highs program disclaimer, ethics, policy submission verification, and licensing terms and HIPAA release terms.

You can go to glock.com or reach out to us at night. Knock high@humancontent.com with any questions, concerns, or fun medical puns if you have to. Nan Knock High is a human content production.

Hey, Kristen, do you know why I got into medicine in the first place 

Kristin: To spend your evenings on documentation? Of 

Will: course. Uh, no, actually that never even crossed my mind. Hmm. Weird. I got into medicine to actually take care of patients to, to be able to form relationships with them, that is a better reason.

And care [01:05:00] for them to listen to them, to actually look at their eyeballs while I’m treating their eyeballs. Well, I 

Kristin: would hope that you look at where you’re treating. It’s an important 

Will: part of being an ophthalmologist and it’s easier than ever with the nuanced dragon ambient experience, or Dax for sure.

This is AI powered ambient technology. It’s just in the room with you and it helps you be more efficient and reduce clinical documentation burden. Uh, it basically lets you get back to being a physician and practicing the way you wanna practice. So 

Kristin: it’s like having a Jonathan. 

Will: It really is. To learn more about the nuanced dragon ambient experience or Dax, visit nuance.com/discover.

Dax. That’s N U A N c.com/discover. Dx.