Hello, everyone. Welcome to another episode of Dr. Jill live. So happy to have you here today and excited to introduce our guest. I know it'll be a fascinating conversation on Dr. Jill live. So happy to have you here today and excited to introduce our guest. I know it'll be okay. Sorry about that. They're changing how they do the live. And so I have this echo. So everybody bear with me. We're going to get all settled here again. And hopefully you can hear me online. Put your name and comments in the comment section.  Today I want to introduce a special guest who I haven't known for very long, but we already found out we have something in common. We both come from a farm background. And interestingly, I think that frames not only the work ethic and what we do, but the understanding how the environment and the soils and the gut microbiome really frame our health and our illness and what we see in the clinical practice. So super excited to learn that about you Dr. Derby. Dr. Derby is a board certified colon rectal surgeon who now dedicates a large part of his practice to treating gastrointestinal conditions and from a functional medicine approach. And we're both saying we're eventually trained, but we've really expanded that view of root cause and everything. And functional medicine is my passion as well. He's particularly interested in expertise and gut microbiome, dysbiosis, small and large intestinal bacterial overgrowth, constipation, fecal incontinence and cancer, which is all connected while still performing surgery when necessary. Dr. Derby has been very successful in treating and preventing surgery, treating and preventing surgery for those with ulcerative colitis, Crohn's disease, diverticulitis, gallbladder disease and more, offering anal menometry and biofeedback for incontinence and pelvic floor disorders as well as abdominal massage or abdominal pelvic adhesions. I am absolutely honored and excited to have you here and to talk to you. I love to start with a little bit about your background. How did you go from the farm into medicine and then into colorectal surgery? Tell us a little about your journey and then we'll go to how'd you find functional medicine? Yeah, well, thanks for so much for having me. And I'm super excited to to meet you and talk to you. And so to answer your question, I grew up on working on a farm in Kansas. And I guess my journey started when I had as a little kid, I had an auto immune, a transient autoimmune GI disorder, which required surgical intervention. And that GI surgery that I had was one of my, you know, impotences for, for going into medicine. And, you know, looking back on it, how, you know, I was being set up for, for what I do now was the fact that I did a lot of work on a Kansas wheat farm as a boy. And one of my jobs during wheat harvest was to drive this big wheat truck full of freshly harvested wheat to where we wanted to take it to a grain bin and store it until the market was right for selling it.  I was 12 or 13 years old. But you know how that works. I do like 12 as well.  And I was like, I, because I expect it at that age that you know how to drive. Exactly. Yeah. Yeah. So it was one of those that you had to do it. Yeah. So I would back the truck up to this auger and I would lift the bed of the truck and start emptying out the wheat. But before I started auguring wheat into the grain bin, I turned on this humongous 20 gallon jug of malathion. And it sprayed malathion, which is a pesticide all over this wheat because we wanted to keep the insects out of the wheat. Well, this was, this was hard red winter wheat, which went directly to a flour mill to be processed into flour to become bread. And I can guarantee you that the wheat was never washed because it would ruin it. And so this malathion that I was spraying on there was being also, you know, introduced into people's bread. And so I didn't realize it then. But that was one of the things that really got me thinking. When I became a colon rectal surgeon, I had been practicing for a number of years, and I was seeing more and more and younger and younger patients with surgical GI diseases. So I was cutting out colons and small bowel and all kinds of things. And I said, What, I mean, isn't there something that's causing this?   And so the big question was, what in the world is causing this? And so that started me on my journey to think, Wow, it's got to be something in our food. And and that also helped me remember back to when I was a kid. And what I did to the wheat that was transformed into flour, which was transformed into people's bread. And so that got me started on this functional medicine journey and, you know, has gotten me ended up to where I am now. So I hope that answers your question. Amazing story. No, because it's so relevant to me to grow on a farm, solve this stuff. And at 25, I got breast cancer. And I have no doubt well water, atrazine, some of these same things contributed. And I don't know if you know my story, and we don't need to talk a lot about it, but just to frame this at 26, right after the chemotherapy, the breast cancer on the treatment, I was diagnosed with Crohn's disease. So no surprise, right? And again, you know how this goes. The doctor said diet has nothing to do with it. He said, you're going to need surgery, you're going to need lifelong immune modulating drugs is incurable. Well, guess what? I didn't need any of that. I'm off meds. I've been I consider myself cured because I have no evidence for 20 years. That's fantastic. Right? So I get this so deeply and I'm so passionate and so excited to have someone like you sitting here. I mean, truly I could almost cry with gratitude to have someone who has that surgical background and understanding but also knows this bigger world because I'm living like proof of the power of diet nutrition, the microbiome, and fixing that. And as you so well know, my story goes with the chemotherapy clearly caused in a permeable gut situation. I have NOD2, which is a high risk gene that causes immune reaction to a neuro microbiome. And so of course, you know the story, but what's powerful is that my story and many of your patients, we can heal without surgery and without drugs. And I never did take I think I took a short course of steroids for a few weeks. And that's the only immune kind of drug I've ever had in my life. So it's pretty amazing that it's possible. Yeah, that's fantastic.  And yeah, the gut is is the root of all kinds of diseases. And and that's where it really starts. And and you know, that's where it was kind of a really natural transition for me, from going to seeing the the end disease, which is like terrible intestines all riddled with inflammation and strictures and and the whole mass and then, you know, going to the point where I thought that wow, we can actually prevent this from getting to this degree and prevent surgery. And so I still do some surgery, but I'm really have devoted my time to preventing the need for surgery. And it's really been super satisfying for me.  And then what you did that not everybody does is ask the question, well, why why? Because for me, too, it's like, when we start to ask the questions, we went into medicine to help people heal, right? And then we go down these paths and similarly forget our beginnings. And the true beginning is like, why does disease happen? What happened here? How can we reverse it? And granted, surgery has its place. It's a lifesaver. But then again, some of these cases. So you mentioned something that I found fascinating. And again, with my knowledge of function, missing that permeability, we call intestinal hyper permeability. It's been called leaky gut in the layman's terms. But for a long time, especially in your field, it was kind of set, you know, there wasn't a lot of respect for that term, or even acknowledgement that it existed. Do you feel like that's shifting a little among your colleagues like analogy, acknowledging that it actually does exist and does contribute to disease? Tell me a little about your journey, because again, that's been a hard sell for conventional medicine with how Yeah, no, I totally am with you there. It was one of those terms that was like, yeah, leaky gut. Yeah, like that right, right, right. But interestingly, when I was a resident in the 90s, you know, I did a lot of work in the trauma ICUs.  And three days later, we they spike a fever, we do blood cultures and their GI bacteria are now in their blood. So we were calling that bacterial translocation. Of course, that's to the nth degree. But what we didn't embrace was the fact that this happens at varying degrees. I mean, obviously, when you're in the intensive care unit, and whole bacteria shows up in your blood, that's kind of the worst possible scenario. But to a lesser degree, that sort of thing is going on in people walking around on the street. But it's more like translocation of bacterial pieces and parts, activating the immune system and causing this inflammatory response. And the whole big picture is what's commonly known as as leaky gut, or what we like to call as increased intestinal permeability, because it sounds more medical. Yeah, exactly. But it's the same idea. And, you know, we were seeing it back then, but we didn't put two and two together. And because we only thought it happened with severely traumatized people. But with lesser traumas, like some of the stuff we're being exposed to in our environment, those things are going on to a lesser degree. And it's kind of like a yes, the same thing's happening, but it's not putting you in the intensive care unit. It's just slowly. And can I use this term is slowly killing you and not quickly like it could happen in the ICU. So inflammation starts and then as you as you know, inflammation is the root of all kinds of evil. And those are the kinds of things that we're seeing as chronic diseases in our society today. And that's what we're kind of out to stop. Yeah, and you mentioned, first of all, love that analogy. And you're right, I've always thought, you know, like same thing as sepsis, not always, but many times in the ICU, someone's severely ill, especially like you said with head trauma, but even post surgical if they're really ill, that sepsis is coming from the gut, it actually literally is. So same as you, I've been like, wait a second, we've known this from residency, we've seen it, it's not new, but we just haven't thought about it in the realm. And I think as our world gets more toxic and as the soils change and the microbiome changes, we're getting more and more changes that affect that permeability, and then cause dumping and immune activation. And we know now that lipopolysaccharide and that endotoxic effect is the root with obesity, diabetes, heart disease, like it's way further than just the gut. Talk a little bit about say someone like myself would come in in their 20s or 30s with Crohn's and maybe they're stable, maybe they're not. Clearly, probably like you, if needed, I use medications to stabilize, but how would you look at them from a functional perspective that might be different from just meds and surgery? Would you look at their gut microbiome? What would you do with a patient with inflammatory bowel in the beginning? Yeah, that's a great question because that's one of the things that I really have focused on. We see a lot of inflammatory bowel disease patients, and what I tell them is that in conventional medicine, they have one tool in the toolbox. And of course, if you've got one tool in the toolbox, if there's a problem, what tool are you going to use? You're going to use the one tool, which is some sort of anti-inflammatory pharmaceutical. And that's all well and good. Those things can be very helpful, but they don't address all of the other needs when it comes to inflammatory bowel disease. So when I see an inflammatory bowel disease patient, whether or not they're on steroids or a biologic or whatever they might be on, I tell them, look, we need to cover all these other bases, which includes, hey, let's look at your microbiome. Let's make sure you don't have pathogenic bacteria that are causing part of your problem. Let's make sure that your commensal bacteria we're working on getting them back into balance because typically in inflammatory bowel disease, the immune system attacks the good bacteria and leaves the bad or the pathogenic bacteria to have their way in a person's gut. So we definitely want to look at the microbiome and there's not a perfect way of doing that just for our listeners, but we take what we can get and that's the best way to do that with the least invasive method is do a comprehensive stool analysis. And that can tell us a lot of things because not only do we want to know about the balance of the good bacteria versus the quote-unquote bad bacteria, but we also want to know how well a person is digesting and absorbing because if they're not digesting and absorbing, then they're going to be losing out nutrients which can make them sicker. They're going to be leaving nutrients in the lumen or the space of the gut, which is just more food for the bad bacteria. And plus undigested food can also cause worsening diarrhea, abdominal pain, bloating, etc. So we look at that. We look at inflammatory markers to make sure that we know what the levels are because we can follow that to see if people's inflammation is getting better. We want to make sure they don't have parasites. It's rare, but every once in a while we see one and it can make a difference in some cases. Then we also want to know, let's say you have good gut bacteria. Well, one of the jobs of good gut bacteria is to make things like short-chain fatty acids. And short-chain fatty acids, of course, are super important to the health of the gut lining. So we want to know what the short-chain fatty acid levels are. And that's a great thing about some of the functional medicine testing is that there's one test that can tell us just about everything that we want to know about what's going on, at least in the colon. And it's not perfect for the small bowel, but it gives us a pretty good idea. And there is no perfect test, so we take the clues, the information, the evidence, and we put it all together. And we come up with a more comprehensive approach to inflammatory bowel disease. And we try to help people. We come alongside them if they want to stay on their biologic or their steroid. We obviously don't want to get them off their steroid because you don't want to be on that long term. But let's say a person wants to stay on their biologic. Well, fine. We'll come in, pull alongside, drive parallel with the conventional medicine approach and help that to work better. If they want to try to get off of their biologic, we can help facilitate that. If they come in and they haven't been on a biologic yet and they're trying to prevent going on one, we can help them do that. So we try to meet them where they are and cover all the bases that conventional medicine really doesn't address, including diet. Like you said, your doctor said, oh yeah, doesn't matter what you eat. Food has no difference. Well, wrong. Right. And it's funny now, I can pull studies at show Crohn's and diet do. For me, back 20 years ago, a specific carbohydrate diet was what I ran into. And for me, it helped. And then Benos, you'll get this. It's funny. I'll just tell you a few of my little things that he helped me to heal all that you just said. So this is clinical case, real life. I had hypochlorhydria, probably from a very young age, zinc deficiency, and pretty severe pancreatic insufficiency. So that was all contributing to overgrowth in the small bowel of both fungus, saccharomyces, survey CI, and bacteria. So I had to treat that CIVO and CIVO, the bacteria and fungal load. I had a little dysbiosis, club C.L.O. was there. And then I had to add back pancreatic enzyme and hydrochloric acid. And then same thing, short chain fatty acids were low. So I took butyrate as a supplement and ate foods with butyrate. But that diet was probably the biggest change because I went from a vegetarian not knowing any better. I was more of a carbitarian and I had gluten in my diet and I have high-risk genes. I was never formally diagnosed with celiac. I may or may not have had it, but either way, the gluten out of my diet made a big difference. So kind of like just what you said, I went through all those in my own body. Now, you mentioned the comprehensive stool. I love that. I do that the same way. Are you doing much breath testing for small intestinal bacterial overgrowth or any thoughts on that? Yeah, in the context of IBD or just really any any patient that comes in with gut issues and symptoms I know just so come with like IBS actually more, right? Yeah, so I mean in IBD studies show that maybe one in five people with IBD also have bacterial overgrowth. But more often the people that I see, you know, are trying to function. They're struggling with bloating every day, bowel movement irregularities. And so yeah, just about every one of those with that scenario is going to get a breath test. And again, breath tests aren't perfect, but breath tests are important because not only does it tell you which gas is being overproduced, but it also can give you an idea how much treatment a person is going to need. So different gases get different treatments. As you know, I'm not telling you anything you don't know, but just for the listener's sake. But you don't know, otherwise you're just guessing. And I can't tell you how many people come into me that have been treated with Zyphaxin or whatever without a breath test. And then we do a breath test and we find out that it was the exact wrong treatment or an incomplete treatment.  But yes, that's a long answer to your short question. We do a lot of breath testing. We see a lot of SIBO and we offer a more comprehensive approach than standard maybe conventional medicine does, because not only do we treat the bacterial overgrowth, but we also offer kind of a comprehensive approach to try to prevent it from coming back by addressing the root cause and optimizing the microbiome and all those things that are necessary in a comprehensive approach. And I'm sure you see a good bit of that in your practice too. I do. Yeah, I still do a lot of good. So I love what you said because it really is that. And what we see, same thing, a lot of conventional docs might do a breath test or might not and just gives a vaccine. But if you don't address the root cause, which you mentioned, the pancreas, the stomach acid, the motility is huge and then all of those things have to be addressed. And then as you mentioned, most breath tests do both hydrogen and methane. There's newer tests that now just hydrogen sulfide, but those are the big three and super common to have something like the methane and then just like vaccine alone won't treat it. Right. Typically use ice meds as well. But do you use all meds or some herbs or do you use some of both when you're treating SIBO or what's your preference? Yeah, that's why I tell my patients, I say, you know, the great thing about what I do, at least in my opinion, is that we have all options available. So we use pharmaceuticals. I love refaxmen. I think it's just this amazing antibiotic because it's not absorbed to it as, you know, a significant degree. It only works in the gut and the studies show that it actually supports the commensal bacteria while it knocks down the overgrowth, which is just outstanding. Yeah, we didn't have that years ago. Like when I went to medical school, that wasn't it. So it is a very, and I agree with you, I want to say this because a lot of you are free to have antibiotics. I feel very different about refaxmen and I use it just like you frequently because I feel like we get a great result without a lot of harm to the microbiome. Exactly, yeah. And so we have all the pharmaceutical, you know, availability as well as herbal. So I use a lot of herbals. And then we'll do elemental diet. Sometimes it's not, you know, people aren't crazy about it even though some others have said, hey, be more positive about the elemental diet, but I just think of myself trying to do an elemental diet. I would only do it if something else hadn't worked. And so that's what I do for my patients is if I only kind of bring that in as an option, if let's say my herbal protocol or my pharmaceutical protocol hasn't been as effective as I wanted, but also do a hybrid kind of as you were implicating or implying that you can also use a pharmaceutical plus an herbal. And so that's what's so great about what we do is that we've got all the options. Conventional pretty much just does pharmaceutical, naturopaths, well not all of them, but a lot of them just do herbals, you know, nutritional practices just do elemental, but we do all. So I think I couldn't agree more. I love that because often I'll do it and usually the antibiotic is no more than two weeks. So although you did mention allude to you probably like me if the hydrogen's really high, I sometimes go 30 days. I have kind of a cutoff. I'd love to get your opinion. I think around 20 or 30 units of hydrogen, whatever that unit is, is a good, if it's say it's 60, would you go longer than two weeks? Yeah, I'm not opposed to going three weeks with refactionment if the hydrogen's super high. Studies suggest that you can drop it by 30 to 40 points with a two-week course, but I go a lot on how the patient's feeling. So if they hit like 80 or 90 percent improvement in symptoms, then I move on. But if they haven't hit that, I either repeat the breath test or go a little bit longer with the treatment or even sometimes change it up to from a pharmaceutical to an herbal because I kind of say you know what, the pharmaceutical is like a right jab and the herbal's like a left hook. So we're hitting it from both directions and if we hit it from all directions then we'll knock it out. Love it and I couldn't agree more. And often like you said, or sometimes I'll do the antibiotic refactionment plus right after then I'll start an eight-week herbal course or something like that. And like I said, I kind of check them with the patient. What do you prefer? How do we do this? Are you improving? And what's great, fungus and yeast is hard to detect and that can be co-existent. And if that's there, the herbals tend to by far do it a better job because often those herbs, berberine and caprylic acid, oregano, etc, they cover both. And I'm sure you found that as well. Exactly. Yeah, yeah. And there's a, you know, like you say, there's a significant percentage of folks that have those co-existing, both CBO and CFO, which for the listeners is small intestinal fungal overgrowth. And that that can be a bad combination. It can be really tough and it's really hard to nail down CFO.  But it can get both of them. And so I do like to come back with an herbal protocol, just in case you've got a little bit more bacterial work to do, but still haven't addressed fungus. I love that you mentioned that because that's what I've been talking about for years. Like, I think the suspicion of fungus has to be high because, again, in medical school, we're not, we're almost taught that it doesn't exist except we know better. And even if it's not systemic, you know, sepsis from fungus, it can be there and be very significant in the patient's lives. But like you said, whether it's the antibodies in the blood or the stool test or organic acids, you can do a lot of tests and still not find it. But if there's a massive symptoms I've seen as the yeast, the cravings for sugar, brain fog. It's interesting, yeast produces a product called acetylaldehyde. It's the same thing from alcohol after a hangover. So it's almost like a hungover. And I love that you said that, though, because it is hard to detect. And that's why conventionally we're not taught because it's hard to find.  And it is relevant because they don't get better if you just treat the one side and they have both. Exactly. Yeah. And you know, in this day of not doing physical exams, I still think physical exam is important because I can't tell you how many times that just the physical exam itself greatly raised the suspicion of having coexisting CFO or even CFO by itself. And I see some kids and there's a number of times in the recent past where I'm talking to the mom and I'm not thinking, you know, a bacterial overgrowth. And then I examine the child and, you know, tap around on their tummy and there's a good bit of gas in there.  And sure enough, they've got a bacterial overgrowth. So physical exam is an important part. You know, I try to do at least one exam on people and I encourage them to drive to see me if they're coming from long distances. Sometimes that's not possible. But then I say, look, go to your primary care physician and have them lay hands on your belly. So those, you know, it's a, you collect, I tell people I'm kind of like a medical detective. I'm trying to, I'm going to a crime scene, which is the medical condition. I'm trying to gather clues from all these different areas. And then I put all the clues together and kind of come up with a who done it sort of thing. And sometimes fungus is the who done it. Sometimes it's not, but you got to have a high index. I love that you said that because again, it's really, conventionally, we aren't taught to look very far for that. And just very, very specific. I find white coating on the tongue. So if you're listening, look in the mirror, you have a real white white coating on tongue could be fungus. If you're hypothyroid and untreated, that can contribute to SIBO or fungal overgrowth because just that slight bit of decrease of temperature in your body will allow for the proliferation of yeast and fungus and also the motility is lacking and you need good motility in the small bowel to prevent this from happening. I always joke about it like hockey, the Zamboni that goes between the periods on the ice. That's kind of like the migrating motor complex in the gut. And if that's not working, you're going to have this stagnation overgrowth of bacteria or yeast in the gut, which is why you mentioned all these other things that we think about. We talked a little about Crohn's and your approach, which again, look at the microbiome. Is there anything different with ulcerative colitis because they're very similar. They're in the same IBD, but they do present a little differently. Is there anything different you would do with the ulcerative colitis patient versus the Crohn's? Yeah, and ulcerative colitis, I'm always looking for hydrogen sulfide because it's a big player in ulcerative colitis and that's where I think, again, the comprehensive stool analysis comes in because this is the stool analysis is going to tell you about the microbiome mainly of the colon. Let's face it. But I can't tell you how many times that I look at the microbiome of a person who I either suspect has ulcerative colitis or it's been definitively diagnosed and they have an overgrowth of a particular species. It's a sulfate reducing bacteria called desulfobibrio pyger and you know that one on the on the stool analysis and that one really makes hydrogen sulfide and hydrogen sulfide, if it if the concentration is high enough, it is pro inflammatory. It creates inflammation and just with controlling that particular organism when it's overgrown can make a huge difference in you know how the clinical setting of how people are doing and their symptoms. So I definitely always look for that. Don't see it so much in Crohn's but with ulcerative colitis that's a big difference and of course with both Crohn's and you see we're we're instituting you know dietary precautions and sometimes even putting them if they have a flair sometimes even an elemental diet for two or three weeks if they're willing to do that can make a huge difference as well and cooling down that flair and that's been corroborated by a number of clinical studies mainly coming out of Europe. So not so much done. Right and like you said the evidence is actually really good for elemental diets it's just that it's inconvenient to patients they don't always like it so it's not that they don't that they're lacking evidence on that. I love that you mentioned that because it is a great option and for those of you listening there's commercial formulas out there but there's also a couple of like pharmaceutical nutritional companies that make them and there is on the web a naturopath C. Becker who has created a homemade elemental diet so that's a place to look I think it's cboinfo.com or.org. Yeah I think that's ours right. You know Allison probably too. I've been on a few board like listening to some of the people who know a lot more than me on the hydrogen treatments. I'd love to hear your thoughts and I can share some of the things I've heard as far as because I feel like it's a harder thing to treat than the methane or the hydrogen. Any successes on kind of meds or herbs that you use for hydrogen sulfide? Yeah you're right it's a toughie and let's face it we don't have a whole lot of clinical data. It's it's kind of it's kind of one of those things that we've known it's been around but we haven't studied it as much as probably need be and you know there is a hydrogen sulfide study group that is collecting data and the data shows that the clinical scenario is all over the place. It's not just diarrhea but for the ones that I've done like a trio of smart which you know tests all three of the gases that you mentioned and I have a definitive elevation of hydrogen sulfide. The things that I found effective are I have treated it with refaxmen but I add I add bismuth which it's pepto-bismol essentially or you can get a compounded version of bismuth as well which is probably more effective but anyway it's expensive and pepto-bismol is a lot cheaper yeah but the combination of those two I've had success with on the herbal side I've had success with kind of high dose oregano where you really hit it with high doses. Some people don't tolerate that very well so you got to be careful but I have had some success clinical success with that as well so and there are other you know treatments out there you could use the elemental diet I haven't done that yet because in my practice hydrogen sulfide is a is a fraction of hydrogen cebo and intestinal methanogen overgrowth so I don't see it that much but when I do see it those are the things that worked so refaxmen and and pepto-bismol or bismuth and high dose oregano which you're talking you know I use ADP which is an emulsified tablet and so you're talking you know five tablets which is 250 milligrams three times a day which is a ton I mean you you probably smell like a pizza shop you know you know I love that you say that because it's exactly my experience and there are some studies out there with blastocystis which is a protozoa that probably the most common if we do see parasites that's the one that we do and it's that exact brand that was studied and it was three to four three times a day and that was back 10 years ago I used to think that was so high but same as you that stuff is really effective if you go high enough and because it's enteric coated people not always tolerate it but better than at least like the oil if you were doing drops that would be right you would definitely smell like pizza I've heard a little bit about uva ursi and silver I don't use a lot of silver in clinical practice so who knows but the and the uva ursi I sometimes will just add to the regimen I don't feel like alone it's enough but love that you're saying that is bismuth is really a key to I think and interesting if sometimes we'll see on the stool someone who has H pylori then hydrogen cebo and bismuth tends to be real good to prevent bacterial from H H pylori from adhering to the stomach so that's a nice thing if you have two things to be able to use that for both combination this is fantastic so you also talked about motility disorders like constipation what's some other pearls because that's a big deal and I'm sure that you treat a lot of methane cebo that's constipation and that's a root cause but say you've treated methane cebo or you you know having trouble getting that level down what other tips or tricks or things do you do for the chronic constipation so you're saying you you they either don't have methane cebo or you they had it and you treated it it's gone but they still have constipation yeah and maybe just because our listeners maybe don't know this but methane cebo clearly is related to constipation so let's start there what would you do to treat the methane cebo and then if it doesn't resolve what would you do for constipation yeah see see methane all the time and you know one of the things that methane does is causes constipation but it also in my experience causes a lot of neurologic symptoms people are just miserable they have a fair amount of pain usually on the right side not that's not you know hard and fast rule but that's my experience and a lot of them also have coexisting fungal overgrowth because there's some evidence that the fungus and the methane producing organisms kind of have a symbiotic relationship and so whenever I've well to go back to your question um again the methane producing organisms are not technically bacteria they're they're they're more primitive organisms and antibiotics and I'm not telling Dr. Jill anything she doesn't already know I'm telling this for you the listeners out there but antibiotics are designed for bacteria but if we've got a more primitive organism antibiotics will work but you've just got to pound it hard or you know for a hydrogen producing organism you might just have to flick it yeah but with a methane producing organism you got to take a sledge hammer and beat it to death to get rid of it so that's why we use generally use two agents instead of just one and and so we're Faxman plus neomycin those are two pharmaceutical antibiotics or on the herbal side I'll use of like you've already mentioned I'll use a fair amount of berberine or oregano because I can use those in high doses and add allicin to that which is an extract out of garlic and people that have SIBO like garlic you're going to treat me with garlic and I tell them look it it's a it's the antibiotic extract out of garlic it has none of the carbohydrates that cause you know uh gut disruption with with in the presence of SIBO so it's not going to have the same effects and it doesn't make you smell like garlic or anything like that if the if the extract is pure and the one that I use is pure but it's expensive but it works and it'd be better to use something that works and pay a little extra more than get something that doesn't work and and you know then you're in the same place but anyway then I'll also use um combo you know um kind of hybrids so I'll use I just prescribe today for a 19 year old young person um a combination of refaxamen and allicin because I didn't think that they would do well neomycin neomycin can be a little hard to tolerate for some people um but those are my go-tos um and there's other regimens but um you know when you found something that works you want to stick with it and only switch if it's not working and I'm sure that's your experience too yeah I love that and I couldn't agree more everything you said totally would do the same as um and then that constipation you know whether you you've treated the methane SIBO you've looked at things what else do you do for chronic constipation sure yeah um when I'm looking at chronic constipation you know it might there's there's kind of three things to think about um number one uh the colon doesn't propel the waste material along the its path and so we you know we call that um you know dysmotility slow transit constipation or or even uh you know colonic at me um so no motility is one thing and then let's say the motility is fine but everything gets kind of jammed up at the outlet that's called uh you know uh pelvic out pelvic floor disorder or or outlet obstruction so the colon might be working fine but once it gets over to the rectum the muscles of the pelvic floor don't work right and you can't empty so that's a another kind of constipation that needs to be addressed and then the worst is a combination of both of those which would be um bad motility the colon doesn't propel things through but when it finally does get it down there you can't empty it very well and that's a bad combination so let's just say we've done a test and we found out that the colon motility is is um not uh where it should be well that opens a whole can of worms because that could be um a number of different root causes not the least of which is autonomic disorder um vagus nerve dysfunction um you know uh even a intrinsic um dysfunction of the colon excels not um contracting properly so uh it's hard to distinguish between all those so i will um if i'm suspicious of that then i will kind of come at it from all angles i'll i'll do some um you know vagal uh vagus nerve stimulation i'll try to promote motility which we can promote with either pharmaceuticals or herbals um and some pharmaceuticals work great for some people and um some they don't and some herbals work great for people and some they don't so you just got to kind of find which one works um i like um i like ginger based um you know uh prokinetics but some people can't tolerate those from an herbal standpoint i also like pukela pride um which is a pharmaceutical um that's fortunately available once again in the u.s. yeah the past couple of years use a lot um so i'll use that uh you know and i'll use um abdominal massage um you know uh i don't use a whole lot of um say like amethysia uh uh or um true lance or some of those agents because i found that they either give people diarrhea which is just going from out of the frying pan into the fire sort of thing or they work for a little while and then they totally lose their effectiveness and you've got to just keep going through all these different medications and then you're out of uh you know you're out of options so i don't really usually use those too much they can be okay in the short term but um so uh those are kind of the different approaches but then let's say a person has pelvic floor disorder then um uh we'll do anorectal monometry to prove that that their their muscles are not relaxing when they're supposed to relax and they're they're um they're uh relaxing when they're not supposed to relax so they're totally backwards or paradoxical um and that those people will greatly benefit from biofeedback which we do in our office and we do some retraining of the pelvic floor muscles which studies have shown again um that that's a that's a big um a big winner for for um outlet obstruction constipation um and then when you got a combination of the two then uh it makes it more complicated but you do both got it yeah that's super helpful because again this is i think becoming more of more of an issue as we're less mobile or we have more toxic load or more dysbiosis the people who have and again from a toxicity perspective if you're retaining stool you're just a reabsorbing massive amounts of toxins um i want to let you go and honor your time but one last thing i want to talk about and we can make a brief gallbladder disease this is opening a whole can of worms but obviously super common to have issues with the gallbladder and infection inflammation and all that you did mention that sometimes you can prevent um surgery i'm assuming if it's not you know totally inflamed and infected there's just some dysfunction what's some little tips about what do you think about with gallbladder issues and where do you go with that um uh and again i'm maybe opening a can of worms but i'd love to just touch on it briefly yeah um well i'm going to give you my suspicion i would love to do a study sometime and prove it yeah but i think that many gallbladders could be saved if we would control methane producing organisms in the gut because not only does methane slow down the gut but it also slows down gallbladder anything and um for all the people that have their gall bladders out because they they had um gallbladder dyskinesis which means that the gallbladder doesn't squeeze efficiently and empty the the bile out of the gallbladder those people probably had methane and so if somebody comes to me and says a they're they're wanting me to get my gallbladder out because it's not contracting right i said before you do that let's make sure we know your methane status so um that is my first go to if we're trying to save somebody's gallbladder and um so yeah there's other things to do yeah that makes so much sense and and just for the listeners the bile that's produced without produced but stored in the gallbladder and excreted is a sterilization way to help the small bile stay healthy so part of this is actually contributing to the overgrowth of bacteria if your gallbladder is not working it's and from my perspective with mold and toxins it's also storage for cholesterol and toxins and so that a lot happens in the gallbladder that we don't acknowledge it's such a piece of the puzzle um wow this has been absolutely great wealth and knowledge i know people are commenting and already saying they appreciate this um where can people find you and are you taking new patients tell us a little about where to find you yeah um we're taking new patients and you can find me at drjerby that's d r j e r b y dot com perfect and um you know folks are interested they can set up a phone consultation to see if if they feel like our practice is a good fit for them and i i find that to be very helpful um but yeah feel free to check that out and and if you want a phone consultation you can set that up too fantastic um we i am like i said i'm truly honored because i always feel like someone with your expertise and then you've expanded this toolbox you're a rarity and you're a gift because it's so important to give the root cause and yet you know a lot of docs go in straight surgery there's nothing wrong with surgery but i love love love that you've expanded your toolbox and that you've shared your wisdom with us today so thank you so much for coming on yeah thanks so much for having me it's been great


The mysteries of Islam fascinate us time and time again This is no different from the life story of the Prophet Who was Muhammad sallallahu alaihi wa alihi wasallam? An illiterate doesn't merchant who one day stumbled upon amazing Arabic rhetoric Or was he the creation of Allah's greatest light? Sent down to earth to pull man out of ignorance and bring them to the purest of truths I I Ali Burji I'm on a journey to discover the real story behind the Prophet The real story behind our religion the roots the beginning the cradle of civilization I seek refuge with Allah from Satan, the accursed, in the name of Allah, the Merciful, the Merciful May peace and blessings of Allah be upon our master and beloved Muhammad sallallahu alaihi wa alihi wasallam May peace and blessings of Allah be upon his family, the righteous, the righteous, the righteous, and may Allah be pleased with their enemies May Allah be pleased with Muhammad and his family, in the name of Allah, the Merciful, the Merciful Dr. Al-Azeez So we're continuing now to the phase where the Quraish have run out of options They've had enough, they're noticing that the holy Prophet sallallahu alaihi wa sallam is gaining power And they need to act fast, they want to get rid of him, ASAP So what happens? Quraish were very angry, probably the anger was the highest it had ever reached during the stay of the Prophet sallallahu alaihi wa alihi in Mecca And they said, they called for a meeting in a meeting house, Darin-Nadwa, a conference center if you like A kind of place where they meet and discuss The top chiefs of the clans and the wealthy The chiefs and the nobles, the chiefs of Quraish, different clans of Quraish met there It is said that there were 40 who attended that meeting, and it is said As this is given in Tafsir-Ruqomi if you like Iblis also came in the shape, in the form of an old man And at the door, they said to him, who are you? He said, I'm a sheikh from Najd, from the people of Najd And I would like to advise the people here and have some advice for them and some opinion After a bit of haggling, they said, okay, Allahumma, let me And Abu Jal started speaking and they said This Muhammad was a nice guy, he was trustworthy, he was called Al-Amin And we called him Al-Amin because of his conduct, because of his honesty and truthfulness And he was very trustworthy because we could trust him with our Precious things and he would turn them to us But now he's got this interest, he claims that he's a prophet, he's a messenger of Allah And he is criticizing our beliefs and Ridiculing our gods And not only that, now he's forming a base in Medina And he's getting more and more people And I'm very concerned that the only thing which is left is some of the chiefs of Quraish to embrace Islam To accept him And this will be disastrous for Quraish, and for the standing of Quraish The fact that people from all around the land, they come for pilgrimage And we are responsible for the Kaaba And we're losing authority And I see that we have no choice but to kill him And they said, how do you suggest we do that? He said that we'll send one of our warriors to kill him And if Bani Hashem asks for blood money, then for Dea, then we'll give them 10 times What is required for blood money for one person, we'll give them for 10 times What do you think?   Because they will not stop at that, they will not stop at accepting the Dea, the 10 times the Dea Valid point Valid point Someone else said, I have a different opinion Is that we detain him in the house, we give him food and water until he dies So we haven't killed him and we can put a stop to all these activities of Muhammad Ablis again said this wouldn't work either, this is even worse the other one, he said why? He said they will, Bani Hashem, while he is being detained, they will go and seek support from other Arabs Either from those who come and visit us during the two high seasons Or they go outside and seek support from the other Arabs And to come and fight us because they would have to excuse, we have detained one of their sons So even that wouldn't work A third person came and said I have another opinion And they said what? And he said that we send him into exile, we can rid him, we don't want him here And Ablis again, this old man from Najd, who is Ablis, he said that they will, this is even, this is worse than the other two Because he will personally be active, seeking support All the people of those who will support him, when he gathers them, he will come and take over Mecca And they were really speechless, they couldn't, he said what do you suggest? Now you keep saying this is wrong and this is wrong, but what do you suggest? And he gave his famous suggestion that What you should do is, you are 40 chiefs of 40 clans, so from each clan, one warrior comes Okay, and they attack the house or attack him simultaneously With a single blow, so each of them give them so that they don't say This was the first one, this warrior was the last one No, simultaneously they strike at Muhammad and kill him With a single blow, so that, and if Ben Yashim decides to fight The tribes or the clans of the killers, they will have to fight 40 clans And that would be something impossible for them to do And they all liked that idea Of course They said, this was a genius idea, so they decided for that And it was that, that an aya was revealed So those who disbelieved are plotting So basically this aya is revealing this Allah is informing what they're doing What they're doing, this conference This meeting that they are plotting to either detain you Or kill you, or send you into exile Now they are doing plots and Allah will advise something contrary to that Of course, the advice of Allah SWT was Jibrail informed the Prophet SAW that he has to leave for Medina Because they are going to kill you tonight So this was, and in fact some of the narration give the names of the individuals Some of the individuals, if you like the 40 so-called warriors Who wanted to come and kill And amongst those names, there are various other names Among those names is Khalid Nualid Is one of the people who was amongst those 40 Who wanted to come and kill the Prophet SAW While he was sleeping in his bed So this how it was revealed to the Prophet SAW And then the Prophet SAW asked Informed Imam Ali SAW That Jibrail has informed me of the revealed this aya to me And I have to, I'm instructed by Allah SWT to leave for Medina And on my way to Medina, I have to stay in the cave called Ghar Thor And will you stay in my bed while I leave so that they don't realize I've left, they don't realize that the house is empty Imam Ali SAW immediately said Will you be safe? And the Prophet SAW He was concerned about the safety and well-being of the Prophet SAW He said, Allah informs me that I will be safe And then it is said that he was, Imam Ali was smiling He was only too pleased that he would do that And out of his joy he, he prostrated on the ground To say thank you to Allah SWT, Sayjid al-Shukr And it is said that this was he, Imam Ali was the first one to do Sayjid al-Shukr Really? Imam Ali SAW was the first one to prostrate On the ground to Allah SWT Thanking Allah SWT that Allah has said that he will be safe And he was honored, Imam Ali He was honored that he will stay in the place of Prophet SAW Even though that meant, of course he didn't talk about this in this conversation Even though that meant that he will be killed Forty men are coming with their swords and going to attack To strike him as a single blow And Imam Ali didn't even hesitate What about my well-being? What's going to happen to that? And the Prophet SAW said, it's a very interesting comparison That Allah SWT says that Allah SWT tests individuals And the awliyaa, those who are devout And the greater your iman, the greater the test And Allah SWT, and the greatest tests are for the Prophet SAW And the messengers of Allah SWT And he said Allah has tested both of us, you and me Just as Allah SWT tested Ibrahim Alayhi salam and Ismail Because what happened, Allah SWT said to Ibrahim That to slaughter his son Ismail To sacrifice his son And Ibrahim accepted And he informed Ismail that I'm instructed That I do this to you and Ismail accepted Now, of course it's very hard for Ismail to accept For this to happen to him And it's probably even harder for Ismail, for Ibrahim to do that to his son To his beloved son But it shows the amount of iman, faith they had to do It shows the iman, but it was this In the same way, the Prophet SAW has been asked To place Imam Ali in his bed And Imam Ali was the most dear to him Among all his relatives I love Of course The most beloved of all people is Ali SAW Now he's instructed by Allah SWT to expose Ali In such a danger So it's a test for the Prophet SAW And a test for Imam Ali to accept that But of course he eagerly and happily accepted And as I said, he was smiling When he heard that the Prophet would be okay And he was honored that he would do that So, of course I want to say that There is a On this occasion when Imam Ali accepted that Allah SWT revealed this Aya from the Quran And there are those who would sell their souls Sell themselves Seeking the pleasure and content of Allah SWT And it is said that in Hadith And it's given in Amal At-Tulsi page 469 That Allah SWT Said to Jibrail and Mikael If I want to give a longer life to one of you Over the other, who would favor his brother? And they remain silent That means they wanted to live the longer life And Allah SWT said You go and congratulate Ali Who has stayed For the safety of the Prophet SAW Has stayed in his bed And he is in imminent danger And they descended to Imam Ali SAW And they congratulated him on this And they informed the Prophet SAW Of the revelation of this Aya Omin and Nasi Mayashri Nafsahu Ibtugha Amar Zatillah And of course this is also given In various Sunni references And Sunni Tafsir Like Thalabi Like Al-Ghazali Wil-Ahya And also in Al-Ghazali Kimya Al-Sa'ada And various other scholars Sunni scholars As well as Shi'a scholars And in here There are numerous references Which are given Al-Mussasjid Al-Ibn Jareel Al-Tabari Shawwad Al-Tanzeel Al-Sa'alabi For his Tafsir Osd Al-Ghaba Fadal Amir Al-Mu'mineen Sa'ad Al-Saud And so on So there are numerous Tafasir And references to say that This Aya was revealed Ibad Imam Ali Ali SAW Okay so So Imam Ali Eventually sleeps In the bed of Rasulullah Sallallahu Alaihi Wasallam Rasulullah escapes by himself Does he leave Mecca alone? He leaves Mecca with Abu Bakr With Abu Bakr Yes He There is also someone else Who was the guide He's called Hind Ibn Abi Hala Okay He takes them to the It is said that I take them to this And he instructs them to go back To inform Ali that They've arrived at the cave So this is one narration Almost all narrations say And it's almost universal acceptance On both Sunni and Shi'a scholars That the person Who was in the cave With the Prophet Sallallahu Alaihi Wasallam Was Abu Bakr And of course they stayed there Before they left For Medina when If you like the dust settles When they were Quraish were seeking them They tried to How long did they stay in the cave? It is said that they stayed there For three days and three nights That's quite a long time All along Allah is talking about Don't you support him Which is the Prophet Allah gave him the victory Which is the Prophet While the disbelievers forced him out Forced him being the Prophet Sallallahu Alaihi Wasallam And the point is He doesn't say Allah only descended the Sakeena on the Prophet Sallallahu Alaihi Wasallam And not Abu Bakr And whereas in other verses of the Quraam States that Allah Allah descends His Sakeena his Tranquility Upon his Messenger And upon the Mu'mineen But not in here


Hey everybody, this is Brett and just wanted to give a huge shout out to all of our subscribers on the YouTube channel This past week on Sunday, we hit 25,000 subscribers, which is really mind-blowing Really exciting as well. I'm really hoping that we can get the subscriber count up to a hundred thousand within the next year or so We got a lot of great Jeep inventory coming in as you can see behind me It's another Willis Eco diesel that we have Here today, so I'm going to be doing that video in just a minute But I just wanted to take a second to thank all the subscribers out there who are watching I've got a handful of subscribers that are constantly Commenting on the videos Adding their input and that's what I want. I want to bring more conversation to what colors you like what Really drives the Jeep fans whether it's Jeep fans or if you like the truck videos or if you like the how-to videos on The Fords and and everything like that and on the Jeeps, especially the hardtop removal and everything We just want to make the channel better. We want to make our information more accurate and better for the Viewers out there, but I just wanted to thank everybody. We had our 25,000th subscriber on Sunday And actually I sent a sweatshirt to that person. Paul patient was our 25,000th subscriber so thank you for that and just wanted to say we're going to keep up the videos and Hope you enjoy them Share with your friends the more subscribers we get the the more views we get the more I can spend time doing these videos and less time doing other things so thanks again to everybody out there and Hope you enjoy the videos and keep the comments coming and thanks again


Good morning. I'm Mary Ellen and today I'm going to show you some things that I love that are $30 and under that are Available on Amazon. I am not going to be filming an Amazon Prime video because I want it But I want to let you know that July 12th and 13th is What's called Amazon Prime Day? And it's the two days a year that you can get some very special deals at times if you are a Prime member Well, you can also get a 30-day trial membership And the only thing that's important about that is that you mark on your calendar a Couple of days before your Prime membership is due again because you will be charged I think it's like $8.99 a month or something like that. I do the yearly. I've just I've done it for years But it would be a good opportunity if there was some bigger ticket items you're looking for what I've done I'm looking for another one of the ring Doorbells. I love it. You have to have a smartphone That I love it and I want one for out back Well, I think they're around a hundred dollars and there's a chance they'll be on for 50 There's also a 55 inch TV that Jim is interested in and there was something else I can't remember but anyway what I do is I find what I'm interested in and I either put it in my Car or just take the screenshot of it. So when it's Amazon Prime day, I look and see what what the cost is Sometimes I haven't gotten a good deal, but like my Alexa the little round Alexa I got it for $25 last year and also one thing I want to ask is if you all recommend any type of a Kindle type Reading device I can read on my phone I can read on my iPad and on on my laptop But I kind of like to read in bed and I know they have some ones that are special But I don't know anything about it. So if you have a favorite Kindle type device, let me know So I'm gonna go ahead and get started. I'm gonna look up and see how long I have been buying the Sheldon Leather phone cases the first one was sent to me and I think I had an iPhone 6 and it was many years ago Well, your phone just snaps in right here. It snaps in and it stays and I always put a screen protector and Then there are there's plenty of room for like my driver's license. I have my healthcare spending account Card in there. I have two debit cards my triple a And a regular credit card and in here. I don't even know what's in here. We'll just see together. I have 10 $15 $35 that's just in case you go someplace and your debit card doesn't work and a few other things in here I have my medication list My son's business card and and my Medicare Part D. Anyway, it holds a lot when I want to go any place I've got everything I need and I can just stick this in my pocket and go It's really not good if you're somebody that wants to take a lot of selfies But I don't take selfies so because you have to you have to open this up But I love it and I paid $29.95 for it and it's been a game-changer for me I think I heard about this from Ellis for living But it's we've had it about three years and it is an extra large heating pad It doesn't have straps on it, but like if it's lower back pain I just use a robe when a gym uses a robe a belt on a robe and puts it around them I'll type in the dimensions and link it below, but it has been a wonderful wonderful heating pad I don't believe it's washable, but I always put a towel between myself and a heating pad just because I'm extra careful The next item is for winter and I know it's been so hot here It has been terribly hot but these might be on sale and sometimes you get the very best price when you buy it off season and it's It's underwear long underwear for women. I bought this last winter. I Can't read the brand if they still have it. I'll link it below if they don't have it I'll just say not available, but it is so soft and it feels so good And the pants I love They don't they're not too super skinny at the bottom but if you need to wear something underneath your clothing or Like to go for a walk or if you just want to lower your thermostat I can highly recommend these and I think I paid around Less than 30 dollars for them. The next item is something that is really honestly important It is a freestanding toilet paper holder And I'll either take a picture of mine in the bathroom or I will put a screenshot in years and years ago an orthopedic Surgeon said to me so many people Jar their back when they're reaching back for toilet paper And if you have room for a freestanding one, I can highly recommend this. I think it was around 25 dollars. It is Never turns over the the bottom. It's it's stainless steel And it's just perfect It really is in fact when I made my bathroom into a bathroom. It used to be like a little library I didn't even have him put a recessed Toilet paper holder because I'd already heard that and I probably did that bathroom 17 years ago It was before I met Jim I had done that bathroom and something I have enjoyed so much And if you ever see these if you have those kind of corner cabinets that are lacy seasons that are round I bought two That were stackable one for either side I they have worked out so well. I'll put a picture of them here I don't have a ton of cabinet space anyway So these have been really helpful and they've held up really well And I think I paid about 25 dollars for one And I only needed two I love my corral pasta dishes They happen to match the set of corral I have but I just love them. We both love them I've got two sets of four and they make a good if you'd like a small vegetable dish If it's just for Jim for just the two of us I use them for a lot of things, but I think you all helped me find these The Sonya cashew brush I heard about from Laura from Laura raised beauty used to be shake-up makeup My grandmother always used to bore bristle brush and my oldest sister Swore by mason Pearson hair brushes and they are like super expensive anywhere from like 120 dollars To 275 dollars and Sonya cash have quit making them and I wanted a brush that was this size Well, it is bore bristle and rubber and it just brushes through your hair So nicely it's easy to clean Like I can see if I have any hair loss But I love these and I think I paid 21 dollars for this I was told about these from not another youtuber, but somebody that left a comment under my comment I was wanting some good shoulder pads. Well, these are a pair that I got this past year But I think they're called like invisible bras. This was the first set I ordered And I mean you can use them and use them and use them You can wash them in cold water and soap if you need to But you just have to keep the plastic to put over them and they work so well for shoulder pads These work really well with heavier sweaters This is a d cup here is a c cup and And I really like it but last year I was wanting just something a little bit smaller And I found the invisible bra And it had a clasp in the middle So you could just like put it on if you're kind of not real busty And wear it as a bra, but I just cut that little clasp on and you could see me putting them on I think they make a world world of difference for me It makes my shirts look like they fit better It just leaves a nicer line under a jacket Like drop shoulders do not do me any favors and I used to take them and sew them and bring them up But I haven't used my sewing machine in a long time. So these are working very well I think these were 1599 or 16 dollars Ice is a big part of my life and I would freeze cups in my freezer To get ice and you know if they were plastic sometimes eventually they would split And I found these on amazon, of course And they were 1499 for a set of six And I just put as much ice as I want to and I put them in one of those bino Organizers and put them in my freezer and I just run a little water underneath the faucet And the ice plops out and it lasts forever because I I drink a lot of water So these were a good deal and then you could also use them as cups But the nurse and me liked stainless steel I came I like glass and stainless steel and I found these just by luck And I know you all have seen them before so many of you have purchased them I hadn't mentioned them in my other two videos I did one ten dollars and under one twenty dollars and under and I didn't mention them That they stack and they're magnetic and they're measuring spins and it has two ends one is elongated And one is bow like this will go down in those little tiny jars real well I usually use the round side for liquid and this for dry But they're just perfect and they have a little level on them and I love them I bought these for about 13 dollars or should I say this? This is a chef's grade cut resistant glove And I usually use it on just one hand and it'll work on either hand And when I am chopping I have to you know, I've got really thin blood So I have not had any cut since I use these and what I do I don't know about the washing instructions But when I'm done chopping whatever I'm wanting to chop and I don't chop meat with it I mean, it's usually vegetables or fruit I will just put it on my hand put detergent on it and I'll wash it and then I'll just hang it to dry If you're somebody that is prone to accidents with a knife These might be really good and I just thought I just needed one glove and I've had them for a few years This I heard about on somebody's channel and for the life of me I don't know But these are a multi charger This charge is absolutely everything I needed to it has the usb port on this end And then you just it has three different. I guess these are ports. I'm not sure what they are But you can use this size or This size and take this off or this size And I've gotten rid of all of my other chargers except for a couple from apple and it even works on my apple phone So they stretch. I don't know how many of these I purchased for people and they just go right back in And I know I paid less than $15 This what I'm going to show you I mean, you can probably find all these things so many different places But something that has been really important to me and I use As often as I can remember is a perpetual calendar I have to admit this year. I have missed some birthdays But you know, you just look every year you've got like january february march april may june I put Birth dates. I put dates that people passed away I put the year somebody was born when you get so many grandchildren. Sometimes you forget it You remember how old they are and then you think well, anyway, if you're good, you never will miss a birthday But like I said this past year, I have not been as good But if you see these anywhere, they are so helpful And you don't have to worry about transferring birthdays or putting them on your iphone The one they showed on amazon was like 1199 and I did not buy this on amazon I used to use the erin conjun planners and it came with that But I wanted I did want you to know that they are available and they're really good These are one of my very favorite finds ever and I've talked about them a long time ago And I know a lot of you bought them and you loved them too And I'm not sure if they're available or not, but I was looking for a belt That stretched that didn't have a buckle So if I wore jeans and I wore a sweater that was out that there wouldn't be a buckle that showed Well, I found this and it is really nice. It clips, but it's not the best part of it This is gems and I'll show you mine I took that clasp off And what I do is like any type of slacks that have the belt loops You just put the snap this on a belt loop And then bring it around through your other belt loops and snap this on the other side So there is nothing in the middle of your where your zipper and your button is And if you have a pair of slacks that are too A little bit too big in the waist Jim likes to wear them too with jeans jeans if he's wearing his shirt out But I think these were probably 11 or 12 dollars and I bought mine and Jim liked it so much I bought him one, but it's been a favorite I should have washed these before I showed these next ones I found these from Dolores from the baking diva and they are a pair of pot I mean, it's just some pot holders But I have washed these and I don't I don't dry them in the dryer But they have silicone and they are very resistant to slipping But I like the way your hand goes in here and they're just a perfect amount And I've got to show you I've got a bad burn there and that's it had nothing to do with pot holders I was showing Jim something I was browning and in butter and I don't know what I did I kind of Hit the pan and just big grease on my inner arm So the last thing I'm going to talk about I heard about from O'Carroll And it's grandma's secret spot remover if I have like an oil spot like I did on my blouse when I Top when I was cooking I'll just go ahead and put dawn on it immediately But this is I've used for stains that I did not see when I washed them the first time And so far everything that I've used it on has worked And carol found them and I just got two small bottles I keep one in my dressing room and one in my laundry room And I don't know what it's made of but it works. My mom would have sworn by Feltsnapa soap. That's what she used for everything But it may have Feltsnapa soap in it So those are my items that are $30 or under if they're available I will put them in the description below if they're not available I'll just put an NA And if you're still here, this is going to be a giveaway And what I want to do is I want to give three of my viewers either a $75 amazon gift card Or a $75 deposit in your PayPal account One or the other PayPal is very very easy and so are e-gift cards. This is international You don't have to be subscribed. All you have to do is be 18 years old or older Since this is a giveaway. I cannot reply to comments But if you ask go to any video whether it says I can or can't reply any video If you want to ask me something if you want to tell me something I will definitely get back with you. I get messages on videos from eight years ago They show up. So and the only thing you need to do is Use the word favorite in a sentence in your comment below It'd be great if you told me your favorite find from amazon or your favorite find anywhere It has been hot as heck and the humidity has been sky high But the sun has been really bright and that's a good thing It is all good appreciate you all and uh, I'll see you in my next video.  They're called bra to keep his pants They're so resistant to sleeping slip You know, it's just one of those things and one up


d that the you know the just transition elements in a lot of the conversations around the climate transition the net zero transition is still not always strong enough EU is I think pretty good at this but there's always more work to do in terms of thinking through as we move from targets to implementation how do we put the people and communities that we all serve whether as business or as political leaders at the heart of what we're thinking about trying to do so look it will come as no surprise that Unilever is super supportive of everything the EU's done to get this 55 percent emissions reduction target and you know we should extend our thanks to those in the room today who've worked really hard to get that through that's been a you know big effort by the community to make that happen but we've got to now see that translated into hard policy measures it's the easy bit really is having the is having the target and the hard bit is when the rubber hits the road on things like carbon pricing on where you set the renewable energy targets just transition measures to see coal phased out in the remaining places that we still have that and even repurposing agricultural subsidies so they really work to deliver the Paris agreement and not against it so so you know we love the target it's a brilliant step in the right direction I think if you run the numbers Europe will need something more like a 58 to 70 percent reduction if it was to truly be in line with the Paris agreement so there's you know I think it's important that we hold on to that target and see it as a floor not a ceiling of ambition whilst also grappling with the really you know tricky policy measures that will need to implement it so just a polite reminder there that you know there's always more to do on this on this subject and but that's all I wanted to say by way of a few quick remarks thank you thank you Thomas excellent and a really important reminder about the the fact that we should always look to go further this is not an agenda that we should be under delivering on okay so next up I have Safi Punt who is managing director of policy for women business coalition the coalition that sealed Europe is a proud and active founding partner of Safi over to you well thanks very much for Elliot for inviting me and for the green growth group of ministers for inviting me to this important event building on on what Thomas just said you can translate those shifts for the EU to intervene at three levels before the COP during the COP and after the COP and I'd like to give some suggestions from a business perspective to that the first one is about before the COP the G summit is right before it on the 30th and 31st of October and it's really important because G20 are representing the biggest economies in the world and together represent 80 percent of greenhouse gas emissions so whatever is achieved there can set the ground for COP and beyond and what we have done as a women business coalition we coordinated an open letter that was signed by hundreds of companies that were looking for G20 leaders to go all in for 1.5 and to looking if you're looking at the fundamentals of what's really at play there are three things that we highlighted in the letter the first one is that the strengthening of the NDC so now the Paris agreements have been said we really need to get down to national plans and policies and making sure that those NDCs and their supporting policies and plans stay within within the 1.5 scenarios we need to keep that within reach and then we added two core systems that need most fundamentally changed and the first one is energy and what we've done is companies are asking for G20 leaders to commit to phasing out coal-fired power generation by 2030 for the advanced economies that's pretty much the entire EU and 2040 for others so that means that other countries should quicker move away from coal that they might have otherwise planned and second is then to end new coal power development and coal financing immediately and what we're seeing now for example with China having said we're no longer going to invest in new coal-fired power abroad that sets the way it's a matter of when the shift is happening the G20 leaders can together accelerate that and then the other part is finance and finance is about removing fossil fuel subsidies by 2025 delivering on the 100 billion finance commitments to developing countries making sure that climate-related financial disclosures for cooperation has become mandatory and finally to put a meaningful price on carbon combined with other policies to make sure that the full cost of climate change is reflected if we're able to do these three things strengthen NDCs and the energy system and the finance system that supports all the other systems that need changing industry transport built environments and even nature because of course finance we need to not just protect nature but also invest in it now this letter was signed by more than 600 companies covering all having operation all G20 countries of which more than 250 have operations in the EU and 150 of those companies have headquarters in the EU so the EU is really well represented there 2.15 trillion euros in revenue and employing more than 8.5 million people worldwide so the EU has an opportunity to leverage the voice of these businesses have signed this letter and use that as encouragement to set a stronger ambition for the EU both at the G20 as well as leading into the COP now at COP it will be key for the EU to protect the integrity of the Paris Agreement and that's again three things keeping the 1.5 goal within reach as I mentioned and with the EU has with its green deal ambition and plans the credibility and the legitimacy to take that leadership role and protect that 1.5 goal it's also important for them to align climate finance with 1.5 and making sure that adaptation and developing countries are included this in earnest so it's not just about financing the wealthy countries it's also about bringing the rest on board and it's not only anymore about mitigation but about adaptation and then there's a third area to make sure that the article 6 which several of the previous people have mentioned um retains its environmental integrity so we don't get any leakage or double counting um and again emphasizes the role of carbon pricing and that article 6 is actually possibly the most critical piece on the table at the COP negotiations simply because if the financing is organized well and the clear rules then that allows um the private financing to be unleashed and everybody understands public and financing is important also send a signal but without private finance we won't get there and with that it's also then important to make sure that the businesses are considered in the global stock take because it's a collective process and uh business make a contribution to that and then finally post COP so um people are looking at COP I think everybody will have a week's sleep after that but where we're looking already be ahead of that G7 is going to be hosted by Germany so again the EU will have a pretty important role to play in in the next year too now within with the fit for 55 package the EU is the first major economy with detailed plans on how to implement this NDC and recognizing what's good for the climate is good for the environment and the economy and if successfully delivered it will do will bring those economic opportunities as we also heard Franz Timmermans say in renewable energy energy efficiency rollout electric vehicles net zero technologies so a success story in the EU will encourage other countries including those developing countries to take a similar transport transformation and many companies in the EU including those that have signed that G20 letter have various operations not only in the EU but also in those other countries that the EU could influence so I encourage the EU to make use of those businesses and with their support try and and leverage or encourage other countries to follow suits and by doing so they cannot just encourage other countries but they can also work together policymakers and business to create harmonized policies and business environment to decarbonize the value change increase the investments in the green economy and decent jobs so the EU has ample opportunities before the COP through the G20 summit during the COP and particularly protecting the integrity of the Paris Agreement and after the COP by continuing with his leadership role and working with business for ambition and action elsewhere in the world and making sure that whatever is introduced is standardized and harmonized and that will benefit global business thank you for the opportunity to speak today thank you so much Saifi a really important contribution and now we've heard lots of European voices and we've had lots of commentary on the role of Europe in this international space but I'm very pleased to bring in a perspective from outside Europe so we have Joanne Jawicz for the CEO of the National Business Initiative of South Africa Joanne we'd love to hear from you and hear your thoughts about COP 36 and the opportunity of advice okay thank you thank you very much Elliot and it's a great great pleasure to be speaking at this event I've been listening in and have learned a lot today about the the detail and the approach and where the EU is at and I thought I would do two things I think the first thing is to really talk about where South Africa is at in relation to our preparation as a country for COP 26 and specifically to talk a little bit about what business is doing and then secondly to talk about how I would see the relationship between the EU and the developing world moving forward in relation to both sustaining keeping as as people in this conversation have spoken of keeping 1.5 degrees alive as well as net zero 2050 set of targets okay so so I think that South Africa as you all know is a energy intensive and high emitting country over the last few years there has been a huge amount of work done in order to try and build national consensus around the need for a fairly radical decarbonization pathways to be put in place in South Africa and really the issue of climate like for the rest of the developing world is is critical in our context because of the impacts of of climate change as well as all of the issues around climate risk and trade risk if we if we keep on the kind of current development path that we are on what that has resulted in is firstly in an NDC that has been put forward by the South African government that is 1.5 degree aligned and that in putting that forward that has had intensive public engagement and has had business pushing government at some points and supporting walking alongside government at others in order to be able to put this ambitious NDC on the table so I think that that has been a really really important thing the conversation around an ambitious NDC has resulted in major movement I would argue in the kind of development path that the country sees for itself secondly there has been significant work done within the business community in South Africa over the last year headed by both my organization as well as by Business Unity South Africa which is our apex business organization and what we've done is to put together a set of 2050 transition pathways for different sectors of the economy for the power sector for petrochemicals for the folio sector for transport for mining for for gas and for green hydrogen that sets out for business how these different sectors could start moving towards the net zero 2050 and that work has been led by a grouping of around 30 CEOs from the country's largest companies and from the country's largest emitting companies and what that has brought us to is a situation where we can go into the cop as business aligned with government on the need for a net zero 2050 and where we believe that we in our inner situation as a developing country to really demonstrate in a very fundamental way our commitment to be able to stand alongside the rest of the globe in terms of addressing climate change and reaching reaching our goals and in relation to the kind of partnerships and issues that we then go into the cop with in relation to the developed world I think it's been said a number of times in this conversation that clearly this is being seen as a finance cop I think the time has come after years and years of negotiation post Copenhagen initially and then post Paris to be able to say that the money is on the table and there is a very serious commitment to support the developing world both in relation to accelerated decarbonisation as well as in relation to being able to put serious money into addressing the impacts of climate change and the issues of adaptation and resilience I think secondly if you look at a country like South Africa we are going to the cop with a decarbonisation plan for our power sector with a plan that we have we believe that we are very well positioned to start working on the establishment of green hydrogen industry in South Africa and so what we would see ourselves wanting to engage with the EU on are the establishment of a set of partnerships and not a not a kind of donor recipient set of partnerships but a set of mutual investments around issues of trade of technology of R&D and of the need for us to be able to start working together in a much more fundamental partnership where we recognise our strengths and our capacities to support each other in what is going to be a very very difficult road that we all have to walk I don't think that we can pretend that this is an easy road certainly in our country it not only demands huge levels of leadership and political will but it demands enormous levels of mobilisation and building of social consensus including being able to address the issues of a just transition in order to be able to ensure that once we get on this path that we don't get offered and so I think the COP26 is a critically important moment I think that my sense is that a lot of African countries and many developing countries are going to be coming to the COP with commitments and intentions to act that go far beyond what has been on the table before and I think it would be really important that in the relationship between the EU and the developing world that we use the opportunity of the COP to bid those down. Thanks. Thank you Joanne, some immensely useful comments there and I think you know really helpful to open up that dialogue in terms of the any EU South Africa conversation and I couldn't have picked a better theme to finish on some ways than that one about partnerships I think if we had a bit more time we would have more of a dialogue or a discussion about you know the role of partnerships in COP26 with all of the panelists but unfortunately we've we've essentially basically run out of time we've had a number of really good good questions that we haven't had a chance to get to on things like aviation and shipping on other kind of key parts of the energy transition the rise of energy prices, role of electrification but hopefully everybody has found it a useful conversation and I certainly have and I will kind of remind people that the recording of this will be up on our website but to bring us all to a close and to kind of neatly tie all these threads together in a knot if that's not too too big an ask I want to hand over to CISL, Cambridge Institute for Sustainability and Leadership CEO Claire Shine for a summary and closing remarks and reflections. Thanks Elliot, it makes it sound like I'm in a cat's cradle with a real tangle of threads and thank you all to the speakers for the great questions it's a total to try and pull some of those strands together I will humbly try recognising it's very imperfect and I've tried to pull things together from both the panels around three hooks the first is about realism about the starting point humility actually and what we will really need to achieve this paradigm shift so Sharon emphasised right from the start what in my language is the just transition that you need buy in from and benefit to the entire society and that is an absolute bedrock for moving forward for a just transition one speaker said a status quo can never be a just transition someone else said no transition without just transition and as Carol said we have to go both deep and broad in an audience like this although we come at it with different experience fundamentally it's possible to say the economy and climate are 100 aligned but we also have to remember as I think Duro said that there are as less visible dragging power that may hold back in some countries or in some sectors that there are there is much deeper political division than what we may want to think and that need for an overarching social agreement and shared understanding is something that we have to build and so messaging matters and coming at the messaging with fresh eyes and understanding that some of the language we may use or the assumptions we may bring may simply not be valid for some constituencies perhaps particularly in that post-COVID collectively bruised society that many of us around the world are inhabiting and therefore to think about how creatively you prepare a household as Sophie said how do you bring others on board how do you build social acceptance of an entire package I think that's a really interesting challenge and as Elliot will know I will often think about new types of voices and agency that may help us in that space for example cultural innovators and new kinds of mediators the second package was around leadership and legitimacy we had a lot of emphasis which I warmly welcome around accountability around due diligence that transparency is fundamental to move the transition in the right direction as I myself said we can't just do the wrong thing better or appear to advise others to do the wrong thing better and Kaya talked about the improvement of national data management capacities a Tiorna talked about climate determination and there was a loud agreement that we must keep that 1.5 degrees alive and kicking at COP26 several of you including Thomas Lingard spoke to this need for a higher level ambition we're talking here about floor not ceiling and there was the nice metaphor of moving beyond thinking like do no harm as used to be said in the field of medicine to becoming proactively net positive and advancing regenerative models of business we heard some issues about some tensions particularly from Pascal Confin the tension on the time frame that 2030 is too soon for true industrial transformation but it's too slow for climate so that issue of being able to talk openly about urgency and quality how we get it right but understand the perfection may not be within our grasp straight away that was another key point there was also the again I will use the word humility that understanding that stringency is critical but we are also in post COVID recovery and therefore the way we talk to these issues must also pass that legitimacy test with many constituencies the ring the raising the bar the higher ambition came out strongly with a call for smart co-working between progressive businesses many of whom are on this call and ministers and MEPs and also the need for clarity how are we going to change how are we going to show the world that we are willing to do what it takes and in that context we heard that feeling about the critical mass that a litmus test is where the companies will sign up to the raised to zero to really demonstrate that commitment and Joanne gave some great examples of the sector specific transition pathways and the way in which we can think about bolder policy pivots that can help some of those sectors and make quicker progress and the last point under the leadership and legitimacy related to getting the right mix of tools and instruments and there was several comments in the chat box about the need for better alignment of incentives to enable corporates for example to adapt to clean energy and the importance of policy not lagging behind business many of you are signatories to the letter which is actually showing that if business is going to go far further faster and more boldly then we need that right playing field to encourage the legal certainty and the incentive mix and finally very briefly my third hook was obviously around opportunity as France Timmermans highlighted I like the way that we think of fit 455 there you are Elliot I tried to say it more as a mission it's not jargon it's a mission it's a forward pathway that we can really use together as a stake in the ground a green deal is a growth strategy it's something to improve life and life chances for the millions for the hundreds of millions and that's a very important frame to the messaging and it can truly act as a springboard for transformative investment in new infrastructure new sectors new products and so on and wrapping up the EU in this in this context is beautifully positioned to make a real difference it has taken the risk it is embarked on the journey of plotting this multi-year pathway and that can really inspire businesses across sectors and also other countries and regions worldwide and again to close on Joanne's words that is not something that is Europe looking in it is Europe looking out and giving out but also learning from without so that we have really constructive feedback loops and sharing of innovation for the global public good so I'm now breathless I hope that that was coherent in terms of pulling some of my can take away takeaways together and I just want to thank again all of you for giving us your very valuable time to share your inputs hope to meet lots of you in Glasgow and I want to thank Elliot and the whole of the CISL team the CLG Europe team and everybody involved in the green growth partnership for bringing together everything that went into making today happen so thank you very much and good luck with all your work going forward bye bye for now


My name is Sam Vakny, and I am the author of Malignan self-lover, Narcissism Revival. The Narcissist existence, his life, his vicarious, he lives through others. He inhabits their memories of him. Beats and pieces of the Narcissists are strewn across continents, among hundreds of casual acquaintances, friends, lovers, teachers, admirers, and despisers. He lives by proxy, through the eyes of others. Narcissists exist by reflection.  Witnessing the Narcissist's glory dates. Secure knowledge that the Narcissist is replicated in the minds of many. The Narcissist wants to be remembered, because without being remembered, he is not. He does not exist without memories of him. The Narcissist needs to be discussed, because he has no being except as a topic of conversation. So passive memory is not enough. It needs to be active. The Narcissist needs to be actively reminded of his achievements, of his moments of glory, of past adjuminations, of applause. The constancy of these streams of memories smooths the inevitable fluctuations in primary Narcissistic supply. In lean moments, in lean times, when the Narcissist is all but forgotten, or ignored, or when the Narcissist feels humiliated by the gap between his reality and his grandiose self-perception, his fantasies. In these moments, memories of past grandeur related to him by outside observers, these memories lift his spirits, sustain him. It's like the drip line, like transfusion. The Narcissist needs these memories when he is not getting active, constant, repetitive Narcissistic supply. They substitute for Narcissistic supply. This is the main function, actually, of people in the Narcissist's life. Their function is to tell the Narcissist how great he is, because of how great he was. So, Narcissists subsist of other people's reiteration of their accomplishments, achievements, breakthroughs, applause, affirmation, confirmation. In this sense, Narcissists are vampiric.  Consider the cerebral Narcissists. Cerebral Narcissists are usually precautious children, gifted children. They are the Wunderkind, kinder. They are the child with the oversized spectacles, the freak, the geek. Such Narcissists, even at an early age, befriend only people many years they are senior. At the age of 20, the youngest of their best friends, among which there's a variety of professions and vocations and so on, the youngest would be 40. The age, experience and social standing of the Narcissists, so-called friends, make them renders them ideal sources of Narcissistic supply. Such friends feed the Narcissists, host them in their homes, bring them books, introduce them to each other, interview them, take them on expensive trips to foreign lands, and in general sustain the Narcissist's grandiosity. The Narcissist becomes the darling of these people, the subject of much awe and adulation. As a Wunderkind, as a Wunderer boy, the Narcissist becomes a phenomenon. To some, a circus freak, to others, a genius. Exactly the source of Narcissistic supply for a cerebrum. But decades later, these, his erstwhile sources of supply, are by now old people, and they die off one by one. Their kids are in their 20s, but they are out of the loop, they are not in the know, they don't recall the Narcissist hating. And when his friends die, their memories of him die with them. They take to their grave his secondary Narcissistic supply. They are unable to regulate the Narcissist's flow of Narcissistic supply, unable to support a stable sense of self-worth based on this supply. So, with the disappearance of these witnesses, the Narcissist slightly fails with every passing of one of them.  The only ones who are able to tell the Narcissist, to confirm to me, that the Israel has been real, and therefore will be real. His existence is so ephemeral, that the Narcissist requires this constant input from the outside, just to be sure, just to ascertain his own existence. They are the witnesses of who the Narcissist was back then, and why. They are the Narcissist's only chance at ever getting to know himself at all. Therefore, when the last of them is in turn, in the ground, the Narcissist will be no more. The Narcissist will have lost his tab at proper self-introduction. It feels so sad, that the Narcissist is incapable of ever knowing himself, except via and through other people. It feels so lonely, like a child's grave in autumn.