We're excited today for today's show we're excited to have you here as a part of this if you if you're watching on Facebook share this show out to all your circle somebody's going to need to see what we have to talk about today I'm excited about the conference I'm excited about what we're going to show you what we're going to talk about and we're going to jump right into that really quickly the tag for today's show is the F you are failing dude let's keep them from failing out of this insurance school that they're trying to you know was it the stat is 92% of agents fail in the first three years so you could have just said and I think we did like you are failing you are failing because about 9.2 times out of 10 when we say that it's statistically correct unfortunately and this this show is about what's breaking down the deal right when we talk about specifics we talk about closing we talk about objections we talk about those things but if you step back just a little bit farther and you think about why why are you not more successful completely maybe you don't feel like that you're failing but why are you not more successful than you are 100% it's a 1.3 trillion dollar exactly it's crazy you're looking for this much of it but why are you not more successful so maybe you don't feel like you're failing but you are not reaching your potential and you don't want to be average don't be average right we want to be average we want to bring content to you that helps you be better every single day so if you if you agree then that you're not reaching your potential I mean hey you're watching this show you're learning from from content you're you're you're you're eager to learn yep so you know that you can be better so you know you can be more successful so maybe you feel like you're not failing but maybe maybe you feel like you can be more successful so let's talk start talking about that let's talk about the why why not more success everybody can have it right if you put two season that you can always have it why not more success so so I think we can break this down into three three reasons why you're not more successful okay so we're gonna talk through each of these number one is fear number two is bad info bad information okay and number three a lot of people blame their their failure on the fact the other people are giving them bad stuff right right we always like to blame when they could just find it we always like to we always like to have somebody to blame when we're not more successful right it's not us tell me that because I know the answer for me of these three which are the most likely reason for you to fail hypothetically if you were going to I know what it is for me for me it's pride yeah 100% that's why I want to talk about that one last but me to pride pride keeps us from I'm sorry I want to talk about that one we'll get to that because that's a big one that was that one covers both of us and it covers a lot of people man I think it's I think it's inherent to success to sales people in general yeah successful people in general but pride can be the reason why you're not more successful there's no doubt I'm excited to get to that one there's no we'll get there awesome so let's talk about fear why how can how can fear keep you from being successful give me some when your affected you it can hold you back it can make you second-guess taking action when you know you should right I know that it simply holds you back from doing the things that you know you should do I put it on faith I put it on Facebook back on Sunday and I said do it because you don't think you can hmm that's a good enough reason do it because you don't think you can and most people aren't able to achieve the level of success that that is their true potential because they don't believe they can get there yeah it in it handicaps them and it impairs them from doing the stuff they know they should fear to me fear makes you overthink like for me the fear is is it makes me overthink oh I don't I don't know I don't want to take a wrong step I don't want to do something wrong I have this fear of failure or whatever it is in a small chunk or a big chunk or whatever the fear of failure makes me overthink and makes me spend too much time thinking and puts me into a quagmire a mud that I can't get out of and it also makes you add time to maybe you're overthinking it in general but then you delay action and the reaction to do something because you're like most people would think about this for a month before they you know whatever it is whether it's a purchase whether it's investing in something whether it's the fear of picking up the phone whatever it is and most people disagree with this like there's a lot of people out there preaching preaching patience oh yeah and there's there's some there's some good times to be patient I'm not a big fan of the word because I knew I was marrying my wife the first time I saw her right I knew I was buying my wife this house the first time that we walked into it right I knew I was buying this little Lexus F F type coupe over here that that I own because the first time I saw it I wanted it you know it's just there but there's been a lot of times where we think about stuff we don't do it but we know that we really should have deep down we didn't need to think about it we didn't need to be patient and I'm always a believer in action is so much better than than non-action right so just take the action what and if you're talking about cold calling and you have a fear of cold calling just do it you may everybody has at one point right right you you may fall down the first couple of times but you're gonna learn as you go and get better as you go maybe it's door knocking maybe it's the fear of talking to someone that you think is important or the reaching out to someone that you should be talking to a mentor or whatever a fear of of looking like I don't know what I'm doing I see that's a big fear for me that's a combination of fear and pride right a fear of looking like I don't know what I'm doing yeah right because I have so much confidence in myself and I want to always you know some people won't they won't play a sport because they're have a fear of looking like they don't know what they're doing some people won't play golf because they have a fear of looking like they don't know what they're doing dude if there's people in my life they're like that I'm done hanging out with you yeah just go just do there's some people like the other won't go play paintball because they're afraid of getting hit or because they've never done it or they won't jump out of the plane because they're afraid of exactly exactly whereas somebody told me earlier today that if you if you have that fear or that thought or whatever it is that is the instant you have that I don't know if I should do it or not that's when you should do it the longer you think about not jumping in the pool because it's cold or the lake or the whatever the less likely you are to actually do it it should be a red flag for you it should be a dinger that goes off in your brain that if I think that I shouldn't or I'm worried about what will happen that should be my trigger that I need to do it and then I need to go and then I need to be active and then I need to have the action so whatever the other thing is to if you have something on your list if you have something on your list for today or something on your whatever whatever you feel like the hardest thing is for you to accomplish that's what you should dive into first every right so whatever the hardest thing is whatever the the biggest mountain is that should be what you you should do first to overcome that fear right because whatever whatever is keeping you because that's keeping you from being more successful if nothing else it's dragging your day down a hundred percent but whatever the hardest thing is that should be the first thing on your list that should be the thing that needs to be attacked that should be the thing that you jump into first right and you just naturally get out of the way because deep down you know you should because when I've done that I've had a better day right I've had a better day and you know lots of stuff together that we've attacked early in the morning when we first get here simply because we know that we will have a good day if we do it first first and you know overarching what how can I be more successful why am I not more successful it's really one day at a time right it's really one day getting better overarching but it's every day so you know I want to put that up there because it's one day at a time but it's every day if you think about every day it's daunting if you think about one day at a time it's not but it adds up to every day it really does it adds up to a lot more rather than overthinking it getting some goosebumps exactly no I love that I love that thought process okay so let's talk about number two bad information why why are you not more successful why are you failing why are you not getting a bigger piece of the available pie I believe a lot of it's bad information especially in this industry is it through bad information or is it the excuse of bad information oh that's two different things yeah that's good I mean some people do get bad info but if I get bad info it's my job to figure out what is the right info if I feel it's bad well some people always look for an excuse for why they're failing or why they're not more successful you know it's the weather or it's labor day or you know it's 4th of July nobody's buying and 4th whatever which is why those same types of people fail when someone says hey dude the price is too much it's too expensive rather than that you out there and anyone that acts like that is instantly assuming that they can't afford it and they're thinking about that person's budget rather than the fact that maybe it's an internal problem maybe I didn't provide enough value and so you can make excuses and it made it maybe I didn't do my job right hey listen if you're watching comment on this give us your suggestions your input on fear or bad info we're going to go into bad info a little bit more but comment and which one are you if you're most likely to fail are you the fear guy are you the bad info guy are you the pride guy which one are you number one number two or number three yep I can tell you that I've had experience with all three but like we talked about pride is the biggest thing for me completely bad info so the excuse of bad info is one thing but actually having bad info following the wrong person listening to the wrong person you don't know that's the wrong person you may not you may not but you have to make a change right you at some point you're going to realize that that's what's keeping you down you know there's the whole idea of you are who you surround yourself with it's not just in social situations it's in business mindset it's in success even in the mentors you follow yeah exactly yeah maybe you're following the wrong and there's some people that everybody likes people differently based on their own personality there's some people that you shouldn't follow yeah but maybe others should yeah that's true not everybody fits with everybody but bad information I think I mean even in this industry like I feel like that if you have been in this industry for a long time um you're doing things the way you used to do them and that was correct information 10 years ago yeah but it may not be correct information today it may not be now things change things change I mean uh you know 10 years ago we weren't we weren't doing digital we weren't doing digital leads we didn't all have a computer in our pocket on a cell phone it's true I remember having a wrist I remember you're right on your wrist I remember having a beeper and a flip phone and a palm pilot and for those that don't know what that is like me I think he's referring to a pager I'm just taking a game for those of you don't know what that is but I remember carrying a palm pilot for all my contacts did you have a blackberry 1.2 uh this is before blackberry the whole dang yeah this is before blackberry blackberry was it black blackberry that's actually a cool name though palm pilot blackberry was a great advance that a legit name for that palm pilot yeah it's the company that was really good name the company was named palm um and they had several products but the original was palm pilot and it was about this size a little bit bigger actually and thicker of course the everything was and it was literally an address book a digital address book and you couldn't do anything from it the original ones you couldn't do it there was no connections looking for it was keeping track of your business cards rather walking around with a big old plastic roller it was the replacement of the Rolodex yeah that's all it was and so I remember having a beeper and I remember I actually had a car a bag phone that was in the car have you ever seen that dude my dad used to have one of those in an old school accurate yeah yeah the phone in the car in the car I don't even know how it worked it didn't work very well but I remember having those the point is things change right yeah technology changes buyers change that's where bad info can get you in trouble is you stay in the past you don't adopt new things you don't want to learn because hey it's not for me exactly you get left behind that and that's the point that I was trying to make on that is is it may have been good information at one point it's not good information now yeah it's not the way to do it now well there's new ways all the time and you need to be finding the new way you need to be open to the new way because if you're not somebody's going to pass you up we'll talk about new way yeah there's people selling insurance over the phone completely over the phone newer than it used to be people still think that's you know impossible there's someone at this conference that is going to be talking about it in a big way how to do and is I mean you're going to leave with I mean you should have paid us a million bucks when you come to this thing and listen to Vince Pampinato every one of the speakers at this event is going to give you a nugget that's going to change your business grow your business scale your business on Monday after the conference I mean immediately yeah Vince is a wonderful person and he is owner of this business yeah north star insurance north star insurance advisors all tele sales all over the phone it's amazing what they do and the numbers that they put up oh it's incredible unreal and to most of our audience that's a foreign concept yeah completely that's a foreign concept so we're going to go to uh a little little little little brief uh cut up of Vince there man I'm gonna we're gonna it's it's it's just a short little thing from Vince he's going to tell you a little bit about what he's going to do and he's going to be excited to speak to all of you at the conference eight percent nation dot com check that out but here's a little bit from Vince and we'll be right back talking about pride hey hey hey Vince Spampinato with north star insurance advisors and I am coming to you live today to talk about the eight percent nation insurance conference that's going down on October the 26th and 27th in Nissan stadium we're gonna have great speakers there like Grant Cardone, Tanner Exxerbype, we're gonna have Ray Lewis, the Hall of Famer, we're gonna have Tim Storys the most unbelievable speaker I've ever seen we're gonna have coach Bert there coaching you up on how to make sales we're gonna have so many unbelievable speakers there and Cody Askins came to me and he said Vince you know you are disrupting the final expense insurance game and people need to know what's going on in the business today people need to understand that there's another way to sell final expense and that's through the internet and phone folks if you want to learn how to sell at high volume 100 online paperless and through the phone making the whole united states your territory if you want to learn how to sell final expense and generate marketing online you don't want to miss the speech that I'm gonna give I am gonna show you how we are disrupting and reshaping the way final expense insurance is sold today folks you don't want to be left behind get your tickets to the eight percent nation insurance conference now get them now while they're cheap I look forward to seeing you there and shaking your hands have a great day 10x baby 10x hey welcome back to dealbreakers uh Vince is a powerful speaker passionate man he's a passionate guy and what he's doing to disrupt the industry he's a disruptor what he's doing to disrupt the industry is amazing is amazing and he's going to be speaking at the conference we're super excited to have him there but you said something during the commercial that I kind of surprised me and uh this is what we're telling the group here yeah what are we doing I've got something special going on that they've got a font they've got a call in what I want to do is we've never done this before I want to give away something that we sell in-house for over a thousand dollars today we sell that we sell it almost every day through our website over a thousand bucks I want to give it away for free if you end up taking some action with us but I want you to call in or leave your phone number or leave your phone number even better even easier put your phone number in comments on on Facebook or YouTube and we will call you and let you know how you can obtain this one thousand dollar item for free it's special today we're only doing this today but yep but we really want you to be at this conference we know that this product that we sell every day for a thousand dollars is an amazing product and we'll we'll help you in your business immediately completely our job is to help you and to increase your business and make you more successful and make you more not average this product is amazing and we're giving it away tag yourself or put your phone number on the on the comments we'll call you we'll have one of the business consultants give you a call walk through this with you it's an amazing it's a little bit of a surprise because I don't want people that watch this later to be able to take as much action as you can now no it's a surprise and and the sales guys don't know about it yet so as soon as you call them just explain to them that this is what we're talking about and I'm sure they're watching they'll figure it out but that's they always but a thousand dollar product to give it away if you participate in in and kind of what we're doing so it's it's an awesome thing all right so again deal breakers is about what breaks down the deal and we get specifics all the time but what backing up and saying you know I don't want to fail maybe I don't feel like I'm a failure but I know I can be more successful I know I can be more successful what I need to do and what I need to leave out to be more successful yep so we talked about what you know what's the why why are you not more successful fear comes in bad info can can keep you from being more successful but I want to talk about pride pride I want to preach a little bit let's talk about pride I said it from the beginning pride is the reason why I am not more successful than I am today it's kept me down so many different times it's something that I it's hard to admit right it's really difficult to admit naturally when you know that okay well for instance when something is not going the way you want it to you have two choices right I'm going to figure it out okay and maybe you will yeah maybe it'll take an extra year longer to figure it out than someone who's already done it right or you can learn from someone that has done it has experience with it and you can reach out and learn from someone and take pride out of the equation normally that's the reason that something doesn't go well for me because I think I we've got this far we'll figure it out when in reality even with this event and this conference I've had to reach out and learn from other people that have successfully thrown events well you have no clue we're doing if you think about just in a in a macro space we we should be learning from everybody we come into contact with completely doesn't matter if it's a six-year-old kid or you know whatever in life to say that you that you know everything and that you have everything figured out is is ignorant with nothing else we always have to be learning right and my pride gets in the way just like what you've talked about you know I feel like that I can do I can do anything I want I can do this I got this I'll figure it out yeah I've done this before you know and you just you just you shut yourself off from the potential success completely because you're not open to what someone else has to give you yep and the most successful people that you've ever encountered are ones that are open to learning from somebody else if you don't have weird that they're coachable yeah you wouldn't think they would be they're absorbed they absorb all the time they learn all the time you know they they gather something from every conversation every every interaction every day whatever it is yeah because they're always open and they're not shut down but it's a pretty important quality to be coachable be able to listen want to learn yeah that's not natural for human beings we like to be know at all especially when we get a little bit of success yeah we get a little bit of success I don't need anybody anymore I don't need anybody anymore I've got this figured out it's happened to me it's happening all the time to me if you don't have a mentor and a mentor doesn't have to be somebody that you that you you know know personally it could be somebody that you follow it could be somebody that you're reading their book whatever it is if you don't have a mentor if you don't have somebody that is filling you up with new things and exciting things then you are shut down and you are going backwards completely if you're not growing you're going backwards completely so to me pride is the biggest problem that not only this industry has but every every person can be susceptible to pride right what is it that gets in the way what why are we because we have a taste of success I get that uh deep dive a little deeper what's the reason that someone's asking well someone's out there out there right now they're struggling but they don't ask anybody for help yeah what's going on like why you know why are why are we like that you know I think pride is a sneaky thing it sneaks up on you right you don't it's not like you don't think that you're a brat that's on you know that that's a jerk it sneaks up on you it builds up on you and it comes from a taste of success it comes from selfish you know the most self-assured people the confident people I think are more susceptible to it than anybody else but I just I keep thinking you know how can I keep pride from being a problem for me right because I know it's a problem for me I know that pride can get in the way of me being more successful that's just like and that's undeniable so how can I keep pride from being you know I think I think I just need to be open I need to be open to every conversation and look at every conversation as a chance to learn we all fell in some way at something every single day it doesn't feel like it it's not a grand scheme you know grandstand failure it's just a small failure which happens all the time when those little failures happen could they have been avoided could we have not failed or the fact that we realize that we have what that we fell every single day anyway maybe makes us more open to see I there's the there's a book called Failing Forward and it's about really what I mean it's okay to fail as long as you learn right yeah the craziest part is you do the same thing over and over and over again and get the and expect a different result I failed every week for 26 weeks well that's because you're stupid well if you felt the same thing if you don't make any improvements if you don't try to find new information if you don't try to find a mentor then that's just crazy but I think it's okay to fail again we talked about getting fear out of the way by being action getting getting more action makes you feel alive when you fell occasionally because of how much how far you're trying to push yourself you're trying to go farther than you've ever been stretch yourself yeah stretch yourself and fail and then learn stretch yourself and then fail and then learn but every failure yeah you learn forward it's far where it's yeah I actually worked with a guy that would count his nose on sales calls because he knew that if he got so many no's that and that's why he's not failing right he's counting because he knows he's gonna get a yes completely um but but I want to so I want to kind of dig it we talked about these three and comment tell us which of these three what are you struggling with out there put your phone number in there if you want to take advantage of the deal that we have today we're giving away a thousand dollar product a thousand dollar product for free free free so and share this out to your group because somebody's going to need to see this but of these three which of the three do you deal the most with or you have a struggle with or you are cognizant and you know that this is what you have to deal with so let's talk a little bit about before we go onto the next thing let's talk a little bit about how to keep these from from being a problem like I feel like pride if if pride is something that you know that you're going to struggle with you need to be open to new experiences you need to be open to learning from somebody new what's the old uh what's the old what's the old biblical adage pride comes before the fall yeah it's true I mean it's like you can't deny that we get prideful and and we're gonna we're gonna end up felling and falling and hitting you know and landing on our face yeah we maybe could avoid it though yeah so being open being open to learning something new uh being open to every interaction that you come into contact with somebody or you read something or always looking to find something that you can pull from that interaction I think it's a way to fight pride naturally we can let pride get in the way of us not reading books learning listen to audio books I find myself uh I feel like I find that happening to me sometimes they're like you know what things are going really well I don't need to learn anymore yeah it's stupid I don't need to read any more books dumb I don't need to look at anything else I got I got enough going on because I mean we're gonna fail like if like we talked about earlier if we try hard enough we are going to fail yeah it's just I'm not afraid of the failure uh because I want action but I'm afraid of the pride that's gonna keep me from the action which one's more like if you guys fear bad info or pride so how do you so how do you combat the bad info uh bad information keeping how do you how do you overcome that because like right now there's a funny the funny thing is I don't feel like I have any bad information and people that have bad information don't feel like they have any bad information that's true right that's true unless they're trying to use it as an excuse true but most people that have bad information don't know it so completely what what how do you keep that one from well and sometimes sometimes it's not even bad information uh they they fail and think it was right but maybe it wasn't and so you're gonna find a pattern here but I believe to combat the fact that you might have bad information you have to be open to learning if you're open to learning and you're and you're learning and you're finding something and you're reading something you're following a mentor and you're doing something new every day and you're taking action whatever it is then you're going to find out that you had bad info yeah but if you're not doing all those things if you're not open to learning you're not going to find out that you have bad info ever ever and people that have bad information do not realize they have that bad information matter of fact they preach it like it's great information yeah like it's current information 100 because they believe they they're drinking the kool-aid they're sold man which is which is better than making an excuse how do you keep bad info or not how do you keep fear from being an issue how do you keep fear from being an issue how do you keep my guess is you have to be open to learning i think that's part of it but i really think immediate action what we talked about earlier immediate action taking time in the equation not thinking about it not letting it fester not letting it build not letting it grow i think you have to be open to new ideas and i think you have to be you have to take immediate action yeah always i think taking immediate action will keep you from uh from pride getting in the way it'll keep you from bad information getting away i think taking immediate action when you have a thought or when you have this is the biggest thing i have to tackle you do it first instead of waiting you don't get stuck in the thought process of things yeah don't get stuck in the thought process of things do do and learn as you go because you're going to get better if you do if you take action really will simon and doug thanks for the comments on youtube but guys we appreciate it very much yep awesome so now we're going to go to a little bit about uh tim story one of the speakers uh at eight percent nation conference um tell him a little bit about the uh the kind of the what the conference is going to be and what the really the mantra of the conference the theme we've talked about we've even renamed it to be called an insurance wealth conference because at the end of the day the purpose of being in this business is to create financial freedom is to be wealthy is to learn something so what you're going to learn at this conference is you're going to learn the mindset to keep going you're going to learn the mission to improve your why and you're going to learn the moves to produce millions from all of these incredible speakers it's going to blow your mind because the end of the day there's problems that you're experiencing in your business that's holding you back from being better from being a better you from making more money and being more successful there's problems there's holes in your boat and we're going to fix them and tim story is going to fix them and listen here to exactly what you can learn from him and how he's going to fix those holes at this conference hello my name is tim story i'm so excited to be speaking at the eight percent nation insurance conference where's it going to be nissan stadium can you imagine where the titans play i'm going to be teaching on utmost living don't get stuck in an almost life to find out more go to our website and we will tell you how to sign up make sure and be there people will be coming from everywhere to get their lives changed life is good hey welcome back Tim story Vince just missed his video like like like Vince missed it 10 minutes ago he's just jumping on now yeah you gotta go back and watch this man yeah yeah eight percent nation is going to be an amazing amazing conference and i'm super excited i cannot wait to be there and i can't wait to meet all of you guys when you're there this deal that we're giving away today i can't believe that you're giving away a thousand dollar product you gotta call in to find out put your phone do me a favor just i'll make it easy put your phone number in comments when you call in my guys will tell you how you can get a one thousand dollar product that we sell every single day on the website for free yeah one thousand bucks one thousand dollars we sell for a thousand bucks all the time we're going to give it to you for free simply by putting your phone number in comments or calling in to a 334 agent can we please yeah a 334 agent is the number can we please cap this i don't want to give this away a thousand times today can we can we do well the first time we sell it i'd prefer we didn't if i i yeah you seem to be giving away stuff all the time and i'm the one that has to say hey no let's charge for it let's so the first 10 that either call in or leave their number on the on the messaging there uh we'll get a chance to to take home this first eight no in honor of eight percent eight percent all right first eight first eight point eight eight point eight all right so um thousand dollar item for free all you got to do is call in or put your phone number in comments and we'll show you how to get it don't be average right you're not reaching your potential you're not reaching your potential no no no you are not really i am not reaching my potential you guys are not reaching your potential there's always a little more we can do don't be average you know it it's one day at a time but it adds up to every day i mean if you if you really think about this don't think about the every day the the daunting every day of but today what's the biggest thing on your list get the fear out of the way look for the bad information that you've been passing off as good information in your own mind by learning open yourself up to the the fact that pride is shutting you down and and find a mentor find that which one's the most popular one for but i know pride was it for us i think it's fear if you had to choose one that encompasses a majority of people half of the audience yeah i think it's fear fear and you know what's funny is they may not realize that they may not realize that fear is keeping them down well if you're taking coffee breaks going to the bathroom and not picking up the phone and making excuses then that's your problem because you're scared yeah and you don't know yeah that's the truth that's the truth um this morning or i was talking to dj earlier um and you guys i don't know if you've got the camera back there where you can see all the group but i was talking to dj earlier and i'm i'm excited about not i'm i'm excited about the industry yeah i'm excited about the conference i'm excited we are in an industry that helps people that help people that help people right yeah so there is nothing negative about this industry it's and it's also massive it's a massive industry that is growing there's agents coming on every day completely there's more than enough to go around it is an awesome place to be it's an awesome space to be and i'm just super excited about that because i know this conference is going to make a difference in a lot of people's lives a ton of people's lives dug thanks for putting your phone number brother we'll make sure we grab it and give you a call as soon as this thing is over man i'll make sure you get this thousand dollar item in your hands man it'll change your life for sure awesome awesome so how do you want to how do we want to close out today man you know what i want to do is i want to reiterate the the mission of the conference right people are struggling and they don't know it and we're going to do something that is going to blow your mind give us your number call in get that i mean do they want to change their mindset do they want to change their mindset i mean when i change my mindset i you know i i literally for 40 x any amount of money i've ever made in my life once i had a singular mission and a purpose for why i am here and what i'm doing i was able to add fuel to the fire that the mindset the mission was the fuel for the mindset and then once i had these specific moves the techniques the tips the tips and actual how to then and only then once i had all three of the mindset the mission and the moves then i was able to produce millions in my business and i know i know that we can get you to that point too you can't we can't do without you taking action man you can't do it without taking action you can't stay in the mindset if you just had the mindset yeah you're gonna be stuck in the thought right you're gonna be stuck you know if you if you don't know the mission if you don't know your personal mission if you don't know what it is that you're going to change tomorrow or change today to make it today a better dog that dog is getting his mind right he's putting his phone number in he wants a thousand dollar item for free because he's like dude i don't have a pride issue why not dogs like dude i can learn man i can learn every single day guarantee you every one of us can learn something every day right yeah i'm learning something every day you're everybody is and dogs taking advantage of the the opportunity to learn something hundred percent thousand dollar that's the biggest thing is that you're struggling with the mindset you don't have the proper mindset right now and you don't even know it yep you don't have a mission and a purpose and it's killing you inside and you don't know what moves that you need to put forth to produce on the Monday after the conference on the Monday after the conference these moves are going to make a difference in your business think about the amount of money you're making right now yeah and if hypothetically if you knew that we and these other speakers and this event could 10x your business within 60 days oh yeah would you make sure that you were there to learn and soak up the mindset the mission and the moves to produce millions in your business if you could give somebody a hundred dollars today yeah knowing that 60 days from now you're getting a million back who wouldn't do that completely i mean why it's it's really wait at the playbook we're giving you the playbook we're giving you the actions when i thought small and i didn't have the mindset when i thought small and i didn't have the right proper mindset that i was never able to make a million bucks not even close once i had the mindset and once you learn the mindset and we teach you the mindset and all these incredible speakers the grant card owns the ray lewis's the tim stories it's not the coach burke the charlie chinas the vince bumpinados the ryan palaminis the tylerese the medicare cafe team i mean i'm a brian askin to everybody once you have the chuck mcdowell for crying out loud i mean that dude is a multi-million dollar business wednesday financial group at a national and he knows because he's learned the mindset he has a mission and he knows the how to moves to produce millions and i know that we're going to implement that into your business and to your life simply by taking action and being at this event three there's three reasons why you won't attend you're scared yeah fears a problem fears a factor for you yep you've received bad info yep that investing investing in yourself is wrong or that you're that you don't need it or that your pride is getting in the way because you don't feel like it's going to help and that you don't need it which is crazy i'll do this anybody that attends this conference you can call me the monday after the conference and say hey dude i didn't learn anything it was a joke dude i'll give you your money back yeah it's just not possible i don't even care it's not possible seriously it's not 100 percent man we're excited to have you guys today at dealbreakers we love doing what we do yep we are here to help you if you need leads if you need coaching or training or a script or if you need help with the door knocking or the cold calling with the cold calling show or whatever it is do my favorite real quick put your phone number in 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Once you start trying to interpret your anatomy as a clinical neuroanatomy, it becomes a correlative clinical neuroanatomy, translational clinical neuroanatomy, things completely change their perspective.  So, let's talk about anti-survival fixation, the indications, technical tips and complications. So, basically we say that, oh everybody is getting old, but sometimes you know these patients have cervical myelopathy and we think they are getting old, you know. So, we know that, what are the indications for anti-survival disease? All of you I think know the difference between Smith Robinson and a Klobber's technique. So, basically they are just names of two scientists, Smith Robinson is just putting on a veg graft, right? And Klobber means there were, Klobber was another famous scientist, a neurosurgeon, so what he did was, he had a cylinder, so what you do is, you first put the cylinder, take a dowel of tissue, dowel of tissue from the eye lacrest and you put it at the cervical spine and just kind of drill it through, manually drill it through. So, exactly the same size dowel is taken out from the cervical spine, so then this dowel you put it there, so that's the Klobber's technique. Smith Robinson on the other hand means you drill and then take a wedge of bone and fix it there, so that's the difference between Klobber and Smith Robinson, both of them are equally useful and so therefore, what are the indications? Of course, you all know this, these indications, one is osteophytosis, disc and single or multiple level radiculopathy and if there you are talking about radiculopathy, then there has to be when would you operate, if there is a persistent neurological deficit, progressive neurological deficit, if there is a static neurological deficit, but with severe radiculopane that is your indication and of course, there has to be a clinical radiological correlation. So, these are your indications for surgery for this. Another very interesting thing is that if you review the literature on this, I mean I am just going to the next level because I am sure you all of you know about cervical. So, the important thing is that they found out that rather than you know doing a copectomy, a long segment copectomy, spinal stability was better maintained and there was less chances of kyphotic deformity developing by doing a multi-segmental disectomy rather than doing a long segment copectomy. So, unless there is something which is pressing from behind the body, if there are osteophytes or multiple discs of multiple level, then a lot of people recommend multiple level disectomy with osteophyte removal rather than doing a long segment copectomy. So, when would you not do a vertebrae to me? So, if you are doing a copectomy, anything more than three segments. So, anything less than three segments, you could do a copectomy, but anything more than three segments, then I think it is much better to go from the posterior approach, you do a laminoplasty if there is kyphosis or a laminate, I mean depending on what it is. But definitely, definitely with a long segment compression, canal stenosis, no copectomy, less than three segments, that is the recommended thing right now. And of course, we all know the other indication, we have an ossified posterior longitudinal ligament, different discs, tumors, fracture subluxations, you know this. So, you have a fracture subluxation, all of them will require plating, so now we come back to this. This is my favorite quote, so this is a very interesting thing, so now what we need to do is to actually go back and plan the surgery, before we actually do the surgery. So, coming on to this, correlative anatomy, what the very interesting thing is if you look at the vertebral artery, so vertebral artery goes through the foremen transversarium here. But if you actually look at the vertebral body and look at the groove of the vertebral artery, there is a very interesting thing that you will observe, where will you actually injure the vertebral artery in a copectomy or in a dysectomy, at what point will you injure, when you start your surgery, when you end your surgery or in the middle of your surgery. The vertebral artery is right in the middle, between the anterior and the posterior bodies, you just see the groove, so there are two points at which you can injure it. One is when you are using your monopolar to actually dissect of the longest coli here. And when you dissect of the longest coli here and your monopolar goes here inside, that's when you injure it. And the second point where you injure is when you are drilling it and you are standing on one side and the drill goes oblique, reaches the cortex at the middle of the vertebral body and goes laterally, that's where your vertebral body is. So, although you will see the vertebral artery when you are actually doing orthophyte removal right at the depth, the greatest chance of its injury are at the middle level, when it is directly lateral to it. Just remember that, so when you are actually doing a copectomy, you must be continuously aware of the midline. So that's one important thing, so you have to define that, that's the second thing that you need to do. Then the other thing is, where is the oncovertible joint? That's another very important thing, where is the oncovertible joint? So, Zygapophysiologian is simple facet joints, okay. Oncovertible joints are these, you know the edges of the vertebral body and why are they important? Why are they important? So one is that, the second thing is osteophytosis always occurs at this point. Why does osteophytosis actually occur? So in an unstable spine, it's trying to become more stable. The only problem is, either it impinges into the intervertible formula, or it impinges backwards and causes core compression, right? So is that clear? So this is all correlated in your anatomy, right? And the other very important thing is, I mean, when you're actually doing surgery, when you're actually doing surgery, please look at the range of movements. You know, because sometimes what will happen is, there will be bony and chelosis at multiple levels. And along the bony and chelosis of multiple, the point where there is a disc collapse will be the only point which is moving. The postoperatively, the patient says, what is the commonest complaint the patient will make when you fuse such a spine? There's only one movement. There's a bony and chelosis C345, bony and chelosis 12. So you have to prognosticate, you have to tell the person. So you must remember the range of movement. And another is short neck. This is a big mess, because if there's a short neck, there's a big mess, because then you need to give extension and a lot. So these are small practical points which you need to look at. Now, supposing there is, what are the major continuum? When it's a severe osteoporosis, definitely you need to be careful. The second is some trauma, tracheosophial trauma, there is a mild fistula or something, infection. That's what I'm saying. But then you need to also look at the red herrings. What do you mean by red herrings? So these are false. These are false things. You think of something and it's actually not that.  So you think of cervical spondylosis, it's not really cervical spondylosis. So what are those things? If you get fasciculations, if you get disproportionate wasting, then if you're getting weakness much more than tightness, that's a red herring. Then very important thing, hundreds of patients have seen patients make a mistake. Short shuffling steps with less arm clearance and asymmetry. So always look at their arm clearance. A patient with cervical spondylosis will not have any difficulty in arm clearance unless there is weakness of the arms. Decrease arm clearance with short shuffling steps. So gait is not only lower limbs, it's also upper limbs. Very, very important. That's one thing. The second thing is joint pains, red herring. You must make sure there's red. Then step ladder deficits, that's a sign. You will get some osteophyte somewhere, but it might be indicative of, in surgical terms, even an AVM. Some bleed within this. Then some cerebellar or central chord signs, you know that. And sudden weakness with minor trauma, look for what? Sudden weakness with minor trauma, what do you look for? C-rejunction, Atlanta Exile Dislocation. And of course, if there is pain, pain will never happen. That's a red herring. You've not gone with contrast study done. So if you get a contrast study done, you will get enhancement there. That's a tuberculosis or rheumatoid or whatever. So these are red herrings. You must always remember all these when you're diagnosing. Of course, we all know about the usual stuff, so I won't talk about it, but let's talk about the Pavelov's ratio. What is the Pavelov's ratio? Pavelov's ratio, canal body ratio. Not body canal, canal body ratio. So canal body ratio, it's usually one, right? So 0.7 to 0.8, I mean, that's the thing. The other thing is, what you really need to look at whenever there is an osteophytosis is either a static or a dynamic diameter. And what is a static diameter? What's a dynamic diameter? So static diameter is from here to here, from here to here, body to spinal, the minor line or the basic spinous line. This will never change. Never, never change. What will change is the dynamic diameter. What is the dynamic diameter? From here to here. The posterior part, the inferior most part and the posterior part of the border here to the uppermost part of the spinal laminar line of the vertebra below. And this inflection extension will definitely change. So always look at dynamic diameter when you're looking at osteophytosis, right? The other very, very common mistake which everybody makes. So this is the base diameter and this is the facet. So this part in between is the laminar. So the canal extends from here to here. Don't say the canal is narrow by looking at this point and operate wrongly. The canal extends from here to here, right? This other important thing is ishi hara index, which is the curvature, curvature.  I won't go into detail, but you must know that there is actually an objective way of assessing spinal curvature. Look it up and I'll, you know. So of course, what you need to do is that when you're looking at an MRI, what are the common mistakes that you make? Common mistakes that you make. Diagnosing cervicals, ponderolotic, myelopathy, when there is a sagittal plane deformity. What do you mean by a sagittal plane deformity? So somebody has a tauticalis, okay? Now what you're seeing is that when you are taking a sagittal section, at some points you have a mid-plane section and at some points you have a paracetal section in the same section. But you think, oh, there is ponderolotic myelopathy without assessing the coronal images which are not there and without actually looking at the patient who has a scoliosis which is less than 30 degrees. So you can't actually see them without their, I mean, unless you remove the clothes, right? Just make sure there is no scoliosis, right? One important point. The second thing is taking two thick sections. That's the second mistake. The radiologist doesn't want to give you too many sections, okay? So you will miss out an osteophyte or a disc. Take thin sections of the area if required. Ask him to make thin sections at that particular level. When you're doing a clinical examination, you must always write your point of suspicion, your clinical level of suspicion. There is the importance of the clinical examination. You say, this is C5 myelopathy. Please look at C56 or look at 4, 5, whatever, right? You must specify this, that then they look at it carefully, right? That's a very important thing. So now, when would you actually go in for a 360 degree fusion? See, sometimes, you know, there is severe osteoporosis. There is significant kyphotic deformity. Significant kyphotic deformity, one-side fusion will not work, right? And then, of course, there are several risk factors for non-union. Somebody is on glucocorticoids. For example, if somebody is on glucocorticoid for rheumatoid arthritis. Severe rheumatoid arthritis. Glucocorticoids for a long time. You need to actually do a complex, long-segment fusion. Otherwise, short-segment fusions don't work for these patients, right? So you must be aware of the fact that, you know, these are segments which will require long-segment. And the other thing is, when would you require a fibular graft rather than an iliac graft? When it's more than three-level long-segment. So there, you know, iliac graft, it will curve, so you will not be able to mold it into place. So, and then, of course, we talk about the incisions. So we all know these levels. These are the classical levels. You have this thyroid trichoid, and of course, you can actually see the upper trichia. You can actually palpate, and you can, so you have these levels. So this is what we are. Now I'll just show you a video of the operative steps and then highlight all the points in the operative steps. So there's a single, there's a copectomy here, right? And there's a compression, right? Two-level compression, because not only one, but two, but you see the cord, it's completely narrowed here. So we just did it. So now a small, very small incision. You don't need a long incision because you can actually undermine the edges, and you get a very good space there. You seldom have to use a vertical incision. Seldom have to use, horizontal is enough. The important thing is that, you know, platysma has to be, you know, excise. You must make sure that you have undermined it adequately. Then you get a huge space there, huge space there, right? So that's the second step. Define the sternocleidomastoid, palpate the carotid artery, you know that, right? So you palpate the carotid artery, and then just medial to that, tracheostefil space. Now here is the importance of an anesthetist. So if he's your friend, then he will give an adequate relaxation. And when you are putting those retractors there, if there is adequate relaxation, then the patient will not develop any dysphagia or hoarseness of voice, you understand? And the second thing is to actually go quite above and below, and create space between these muscles, tracheoesophageal muscles, the paratracheal muscles, and between the sternocleidomastoid and the carotid sheet lactally. Create adequate space, and then open the pre-vertible fascia and see for both longest coli. So now here is the importance of the midline, because if you have an OPLL, you will not do a total job unless you define your midline, right? So here you must actually define the longest coli and just create adequate space for yourself. There's another reason why you need to create adequate space for yourself. If you have adequate space for yourself, when you're putting your retractors, then you don't know how much pressure there is on the tracheonisophagus. And if the relaxation disappears, then there's going to be a significant pressure without your even realizing it. So now you see both these bodies define them, localize them. And once you do that, make sure that you are in the midline and then you start doing it. When you're drilling, you don't worry about the bleeding. All you have to do is to have to create a gutter which is a minimum of 1.8 to 2.5. That's the range of the gutter. And make sure that you have pillars on opposite sides. This is very important. And make sure that you are beyond the disk spaces on both sides. This is very, very important because you might leave a little bit of osteophyte or a disk above and below. And then, of course, and the depth, there are two ways of assessing depth. One is go on doing a dyssectomy. When you're doing a dyssectomy, you know your depth. You know your depth. Every time you reach a point, go do a little more dyssectomy. Go to the next step. The other way, what is the other way of doing it? As soon as the trabicular bone disappears, you will get an absolutely white cortical bone and the bleeding disappears. So then you know you are almost reached the dura. And then, of course, you just put in a graft and the plates. And the principles of putting the plates I'll just explain in a minute. So then the whole thing has to look absolutely bloodless later on. And please, please, please, I mean, I'm very conservative about this, but put in a drain. Because you don't know that one patient who develops a small collection here and develops certain respiratory distress. And if your resident is not sharp enough, he's going to miss it. And you might lose that patient. And especially with a long segment of equipment, it's always better to put in a drain and just take it out the next day. Now, there are two issues associated with just putting a graft without putting in a plate. One is that there is graft subsidence over a period of time. Now what is graft subsidence? What happens is that the edges, when you remove the cortical bones, then it kind of compresses itself on the graft. And the graft goes into the vertebral body. So that's known as graft subsidence. And that takes place over a period of time. Now the problem is that this plate helps in load sharing, which means that a part of the load is transmitted from the graft that you have in the center. And part of the load is transmitted through the plate that you have on the side. So that helps in load sharing. And that is why, even when you have done a very good grafting there, you need some kind of load sharing equipment by putting in a plate. The second very important thing is that try and not put rigid constructs, which means what is a rigid construct? Rigid means you put in a screw and it stays in place. It doesn't move out. Now the problem with that is that if this is not wide enough, this is not wide enough, many of the local companies will make those rigid ones which do not move up and down. When there is graft subsidence, what will happen is that the screw does not have the ability to go up and down with the subsidence. So what happens is it loosens.  Then of course, what are the complication avoidance methods of the problems that you face? Of course, tracheo, you see the recurrent laryngeal nerve and superior laryngeal nerve. What is the best way to avoid this complication? Don't see the nerve. Don't see the nerve. So you don't see the nerve. So you know where it is, but don't see it. So that's the best way to. And then, of course, vertebral artery, I've already told you. So two places where the vertebral artery can get injured are here. So it's actually quite in the middle, not quite lateral. Not deep down. It's quite in the middle. And then neurological injury. One is as soon as the trabicular bone is over and the cortical bone becomes old shiny. So that's when you need to change to a diamond drill, plenty of irrigation so that that's where you shouldn't cause an injury. And usually there'll be a posterior longitudinal ligament behind, but still you need to make sure that you don't injure the bone. The second is, of course, at the last part, when it's a thin bone, use a kerosene sponge. Now, two common mistakes. One is I've seen people, they don't make the bone thin enough, and they use a larger kerosene sponge. The head of the kerosene sponge has to be the smallest possible. So what you're doing is only removing a very, very thin transparent shallow bone without any effort and you're not putting the foot of the kerosene sponge deep into it, because that's where you cause injury, especially the nerve root injury. That's where, you know, there's a sudden monopyrus or something is because of that. The other very important thing is, this is a very, very important point. This is not a usual disk situation where it's a soft disk and you can just remove it. But if there's an ossified posterior longitudinal ligament and there is an asymmetrical ossified posterior longitudinal ligament, what happens is that at one point, there's a lot of compression and on the other point, there's less compression. And if you're drilling uniformly, if you're drilling uniformly, what will happen is that soon at the point of less compression, the dura will prolapse out. Once that prolapses out, then it is impossible to reach the point of maximum compression. So read the radiology, go to the point of maximum compression first, make it uniform, and then come to the dura. This is very, very important because with OPLL, this is a big problem. You know, all those people who are experiencing OPLL will immediately identify with what I'm saying. The other very important thing is you make the gutter too narrow. This is a very, very important problem. You make the gutter too narrow and the bone doesn't fit and you can't go in. Make sure your gutter is wide enough. A wide gutter is very, very good. It's very easy to do work with a wide gutter. Never work with a very narrow gutter. And the third point is that if in an OPLL, you find that the bone is not getting removed from the dura. Either you can remove it with the dura and then put in a fat with a febrile glue and put a bone graft over it that is one way, or the other is you just leave a little floating bone there. Just leave a floating bone there and that works very well. But usually you remove the bone because sometimes it gets ossified again. So it's much better to remove it than not to remove it. But if it is not getting removed, just leave the floating bone there. It works very well. Now, what are the communist problems which cause plate extrusion? One is that you keep the plate away from the vertebral body. This is the communist. Because what happens is as soon as you keep it away, the screw loosens and this comes out. This is a very, very common problem.  It's always a compressive force there. So that plate is providing a compressive force. So they have to go up and they have to go down. Is that clear? These are two very, very important reasons why the plate. And the third is that the length of the screw is not adequate. So it has to be of adequate length that it reaches up to nearly the posterior mass. So you have to measure all these things beforehand. The other thing is graft extrusion. Common problem. In your mind, what do you think are the common causes of graft extrusion? So one important thing is, see one very, very important thing why it comes out is that you try to take a very long length. Just don't do that because what will happen is you artificially try to force it into. And as soon as the patient flexes a little, it kind of comes out. So the very important thing is that the length has to be just right. So that you put it in place. Just snugly fix it into place. That's a very common problem. And the second is the width is not enough. When the width is not enough, then it's a very narrow thing and you try to either it breaks or it slips out. These are two very, very common problems by way. These are very simple problems but they are very common. And the third very common problem is that it's not a trichortical graft because it will not providing strength. So it will break. It will get fractured. So these are three very common problems which are responsible for this. So you see that this is an OPLL here, right? And this is how we went. And we left this, okay? Yeah, we left this huge thing there, right? And this is a classical point. So you must know where the midline is and if you're working from one side, you will naturally drill on the opposite side. You'll naturally drill on the opposite side. Another very important thing is disphase your hoarseness. Your anesthetics is not your friend. You know, proper relaxation. You won't know because you know the thing is under the tractors, the whole trachea isophagus on one side and on the other side. So that is fun. You must make sure that they're adequate relaxation. The second is adequate exposure because what happens is sometimes you have not exposed vertically adequately and then you're trying to pull. So just dissecting between facial planes makes a lot of difference to reach the point. And like I told you, you need a trichortical graft there. Finally, the last two points that I'd like to mention.  It's very, very important for you to understand that there's a disproportion between the head and the torso. And the head is larger than the torso when a child is less than nine years of age. So even when you're putting a child supine, there is flexion of the head. And so what you need to do is to elevate the body a little so that the child is actually in extension. This is one important point. Any craniovertebral junction, any cervical spine, you must remember this fact, especially in a child, right? The second very important thing is immobilization. I'm sorry for this slide, but this is a very, very precious slide for me. So in 1977, there was this guy called Jackson who actually looked at all the external orthosis and the degree and the freedoms of movement which is provided by each of them despite placement. And you will be surprised to know that with a Philadelphia collar that you put place, it's almost 45 degrees of movement are still permissible by a Philadelphia collar. An external occipitomandubular brace still provides 40% of movement. And a four-pose brace still provides this movement. So the only two...


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