Hot Topics in Kidney Health

High blood pressure can have a major impact on both your heart and kidneys—but understanding your risk can help you take steps to protect your health. In this episode, we break down the connection between blood pressure, kidney disease, and heart disease, including the key tests that can help detect problems early. You’ll also learn practical ways to support your kidney and cardiovascular health and how to prepare for more informed conversations with your healthcare team. This episode is supported by Boehringer Ingelheim. In this episode we heard from: Daniel Edmonston, MD, MHS, is a board-certified nephrologist and Assistant Professor of Medicine at Duke University School of Medicine, where he is also a faculty member at the Duke Clinical Research Institute. He cares for adults with chronic kidney disease, hypertension, and related cardiovascular conditions, and his research focuses on the close connection between kidney and heart health. Dr. Edmonston leads clinical trials and large real-world studies aimed at detecting kidney disease earlier and helping patients receive evidence-based treatments that protect both the kidneys and heart. His work has examined gaps in kidney disease screening, the use of newer kidney-protective medications, and the cardiovascular complications of kidney disease. Rory Pace has dedicated her career to nephrology nutrition, a field in which she is a leader, educator, and patient advocate. Rory earned a bachelor’s degree in Dietetics from the University of California, Davis and a Master’s in Public Health from UCLA. She has been a board-certified specialist in renal nutrition for 20 years, providing expert nutrition care for people with kidney disease. Rory has published and presented on numerous nephrology nutrition topics and is a strong advocate for the role of nutrition in the care of people with kidney disease. Bob Sheridan is a 55 year old heart attack survivor from Michigan. He is passionate about sharing his journey to encourage and support others living with heart disease. Following his heart attack in 2016, Bob was diagnosed with heart failure with an ejection fraction of 26% and received an implantable cardioverter-defibrillator (ICD) in 2017. He also has a history of hypertension. Through his experience, Bob offers a personal perspective on navigating recovery, adapting to life and living well with heart disease. Additional Resources Learn more about high blood pressure and your kidneysLearn more about our collaborating partner, The Mended Heart. Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

The transplant system in America is evolving. And you deserve to know what that means. Today, we unpack the Securing the U.S. Organ Procurement and Transplantation Network (OPTN) Act with experts Miriam Godwin and Jullie Hoggan. Learn why this legislation was introduced, how it could improve the organ transplant system, and what it means for people waiting for or living with a transplant. In this episode we heard from: Miriam Godwin is a kidney donor and Vice President of Health Policy and Clinical Outcomes at the National Kidney Foundation. She previously led transformative initiatives at CMS, including the ESRD Treatment Choices Model, and supported groundbreaking programs like Kidney Care Choices. With a strong foundation in health policy, clinical trials, and drug development, Miriam has dedicated her career to advancing kidney care and increasing access to transplants. She holds a master’s degree in public policy from George Washington University. Jullie Hoggan is the Transplant Director at patients.app and previously co-founded Square Knot Health, where she helped develop a peer-led transplant navigation program alongside a transplant nephrologist. She is also a kidney transplant recipient, bringing both lived experience and professional expertise to her work. Jullie provides peer mentoring, education, and support to patients, living donors, and care partners through Kidney Solutions. She serves on the OPTN Patient Affairs Committee, the National Kidney Foundation Public Policy Committee, and several other national committees and advisory groups focused on improving transplantation and living donation. Additional Resources NKF Advocacy Transplantation Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

Starting dialysis often means rethinking your relationship with food—and that includes eating out. But dining out doesn’t have to be off-limits. In this episode, we’re talking about the emotional and practical sides of dining out, from advocating for yourself at restaurants to balancing dietary needs with quality of life. In today's episode we heard from: Lauren Levy is the practice owner and principal dietitian in an insurance based private practice that focuses on kidney health. Lauren bills insurance companies, works with CKD patients and nephrologists on a daily basis to prevent progression of CKD. Melissa Bensouda was diagnosed with chronic kidney disease after giving birth to her second daughter. After her third child, she had lost all functionality of her kidneys. She was placed on the transplant wait list in June of 2002. Although Melissa initially began dialysis treatments in-center, she was selected to participate in a nocturnal home hemodialysis program. After 6 weeks of extensive training, Melissa set up a machine in her bedroom and dialyzed on her own every other night for 8 hours while she slept. She received the gift of freedom from a deceased donor in April of 2012. Nearly five years post-transplant, Melissa’s transplant kidney rejected, causing her to resume dialysis at home. Melissa’s passion and commitment to awareness has been revived following such an extensive journey. Despite working full-time and raising three children, Melissa is determined to continue advocating for technology, education, and research to improve outcomes of those affected by kidney disease. Additional Resources Nutrition for Kidney Patients Dining Out With Confidence Info Cronometer Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

Behind every kidney cancer diagnosis is a person navigating difficult decisions about treatment and care. Today, we’re diving into how to navigate the side effects of kidney cancer treatments and how to tell the difference between side effects and warning signs. This episode is supported by Exelixis. In this episode we heard from: Andrew Allers was diagnosed incidentally with clear-cell Renal Cell Carcinoma (RCC) in 2015 after a soccer injury. After a radical nephrectomy and four years of monitoring, Andrew's stage IV diagnosis was made in 2019 with metastases in his rib, hip, lungs and lymph nodes. The bone tumors were radiated, and after two rounds of an immunotherapy combination, a serious auto-immune reaction necessitated a pause in treatment while Andrew's care team figured out a solution. With regular IVIG infusions to manage the adverse reactions, a single-agent immunotherapy was restarted in early 2020 and within a few months a set of scans showed remarkable improvement -- tumors still visible, but "clinically unmeasurable" in the words of his oncologist. Just over a month later, a vision issue took Andrew to the local ER where he was diagnosed with two brain metastases, one of which was in the occipital lobe. The following day an emergency craniotomy was performed, followed by a round of brain radiation. Over the next 18 months, a series of 4 more brain tumors were discovered, radiated and added to the monitoring schedule. Since beginning a TKI in 2022 Andrew has been free of new brain metastases, and the immunotherapy continues to keep the lung and lymph node tumors at bay. After retiring in 2023, Andrew has become active in the Kidney Cancer community, participating in the research grant review process in the CDMRP & KCRP and as a Legislative Advocate for KidneyCAN, an advocacy group that campaigns for federally funded research into Kidney Cancer treatments. Julia Stevens, PharmD, BCOP is a Clinical Pharmacy Specialist in Ambulatory Oncology at Beth Israel Deaconess Medical Center in Boston, MA. She collaborates with medical oncologists to care for patients with kidney cancer. Her primary clinical responsibilities include educating patients and caregivers, monitoring and supporting those on oral therapies, minimizing the financial toxicity of treatment, and providing drug information and treatment recommendations to her team. Dr. Stevens is also a member of the Kidney Cancer Association Clinical Advisory Board. Rimda Wanchoo, MD is a Professor of Medicine at the Zucker School of Medicine and full time nephrologist at Northwell Health in NY. She graduated from medical school in India followed by residency at St. Barnabas in New Jersey and fellowship at NY Presbyterian at Weill Cornell. Her interests are taking care of patients with cancer and kidney diseases, glomerular disease and end stage kidney disease. She has been at Northwell for the last 14 years . She also serves as director of quality for the division and medical director of the largest joint venture dialysis unit in the health system. She has published and spoken on several onconephrology topics internationally. She serves as an associate editor for JON and CKJ. She is one of the founding members of American Society of Onconephrology (ASON). Additional Resources Kidney Cancer Kidney Cancer: Treatment and Living Well Voices for Kidney Health Kidney Cancer Association (KCA) KidneyCAN Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

For people living with kidney disease, clinical trials can offer hope—but not without questions or concerns. Today, we talk with Dr. Nadine Barrett, Glenda Roberts, and Luz Baqueiro about lived experience, community trust, and the power of being asked. In this episode we heard from: Dr. Nadine J. Barrett is a Professor in the Department of Social Sciences and Health Policy in the Division of Public Health Sciences and the inaugural Senior Associate Dean of Community Engagement and Equity in Research at Wake Forest School of Medicine, she is Associate Director of Community Outreach and Engagement for Wake Forest Comprehensive Cancer Center, the Clinical Translational Science Institute and the Maya Angelou Center for Health Equity. Prior to joining Wake Forest, Dr. Barrett served 13 years in senior leadership roles at Duke University, as the Founding Director of both the Duke Center for Equity in Research and the nationally awarded, Duke Cancer Institute's Office of Health Equity. She is also President of the national Association of Cancer Care Centers, in Washington DC. A medical sociologist by training, Dr. Barrett is a health disparities researcher, expert equity strategist, and a nationally recognized leader in facilitating authentic community, healthcare, and academic partnerships to advance health equity. She develops multi-level interventions to address implicit bias, structural and systemic racism, and inequities that limit access to quality research and trustworthy health care among underserved and marginalized populations. Dr. Barrett brings an equity lens to her work and collaborations to enhance healthcare systems, close the disparities gap in health outcomes, and increase diverse and broad representation in research participation and the research workforce. Glenda Roberts: Prior to joining the Mount Sinai Center for Kidney Disease Innovation as the Director of Communications and Patient Engagement, Glenda V. Roberts was an Information Technology executive with over 35 years of experience with top-caliber corporations, including General Electric, Microsoft and Johnson & Johnson. She was also the Executive Director of the Seattle Transplant House, and the Director of External Relations & Patient Engagement at the University of Washington Center for Dialysis Innovation (CDI) and the Kidney Research Institute (KRI). Before going on dialysis, Glenda managed the progression of her disease for over 40 years using diet and exercise. Since her transplant in 2010, she’s completed nine half marathons. Based upon her personal experience with kidney disease, Glenda is a passionate activist for kidney research and patients living with kidney disease. She’s involved in myriad patient-centered national and international health care transformation initiatives. All are focused on addressing patient preferences and improving patient-reported outcomes. Glenda brings the patient voice to several NIH/NIDDK government and industry research efforts (Kidney Precision Medicine Project, APOLLO), as well as the American Society of Nephrology’s Current & Emerging Threats (C-ET) Steering Committee. She’s the inaugural co-chair of the Critical Path Institute’s Biomarker Data Repository Governance Committee, and a member of the Kidney Health Initiative (KHI) Board of Directors. Additionally, she contributes to the Advisory Boards of LifeCenter Northwest and Home Dialyzors United, and over 15 other industry and academic research advisory committees/boards focused on transplantation, kidney, cardiovascular, and metabolic health. As an ambassador for the National Kidney Foundation, the American Kidney Fund, and the American Association of Kidney Patients, Glenda’s advocacy tirelessly advances the voices, needs, and aspirations of the kidney community worldwide. Luz Baqueiro serves as a patient advocate with the National Kidney Foundation (NKF), providing feedback and helping develop new initiatives to better support the La

History is often made through science, but it is lived through people. Today, only four living people in the US have received a xenotransplant or a transplant using a gene-edited pig kidney. Two of these pioneers are here to share in their own words what it means to be part of medical history. Their stories remind us that behind every breakthrough is a person waiting, hoping, and choosing to move forward even when the path ahead is uncertain. This episode is supported by eGenesis and United Therapeutics In this episode we heard from: Tim Andrews is a pioneering kidney patient whose experience has helped shape the emerging field of xenotransplantation. A longtime resident of Concord, New Hampshire, Tim lived with end‑stage kidney disease and endured more than two years on dialysis before stepping into the unknown and signing up for a kidney xenotransplant. On January 25, 2025, he became one of the earliest recipients of a pig kidney and went on to live with the organ for a record 271 days before it was removed due to declining function, an achievement that provided valuable data for researchers around the world. After returning to dialysis, Tim continued his transplant journey and recently received a human kidney transplant, becoming the first person in this group of xenotransplant pioneers to transition from an animal organ to a human donor organ. His courage, resilience, and willingness to participate in cutting‑edge medical research have offered hope to patients facing long transplant wait times and contributed meaningful insights to the scientific community. Towana Looney is a trailblazing kidney patient whose journey has now made history. After donating a kidney to her mother in 2000 and later developing chronic kidney disease herself, Towana began dialysis in 2016. As a highly sensitized patient with 100% antibodies, she was told she would never qualify for a human kidney transplant. In 2024, Towana was offered a rare and groundbreaking opportunity: to receive a genetically modified pig kidney. She bravely said yes, becoming one of the earliest recipients of a kidney xenotransplant and helping open the door to a new era in transplantation. Towana lived with the xenokidney for 130 days before it was removed. While she has returned to dialysis, her courage has given hope to patients everywhere and invaluable scientific knowledge to the researchers advancing xenotransplantation. Additional Resources Xenotransplantation Information Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

When it comes to kidney health, taking care of your mind is just as important as taking care of your body. Today, we’re exploring how mental health support can improve your overall well-being and breaking the stigma around therapy and medications. In this episode we heard from: Lydia Johnson, MSW -Lydia is a social worker based in Massachusetts. They previously worked in direct care as a dialysis social worker and now serve at the national level as a leader in support of home dialysis social workers and the growth of home dialysis in the kidney care community. Malkia White -Malkia was diagnosed with IgA Nephropathy when she was only 6 years old. In 2017, she began doing nocturnal dialysis for 3 years, 3 nights a week from 9pm – 3am while maintaining a full-time job. In November of 2021 she received a kidney transplant. She celebrates life by continuing to advocate for kidney health and shares her story to encourage people and give others hope. Shannon Glynn -Shannon Glynn is committed to having face-to-face conversations and dialogue to champion the issues central to the National Kidney Foundation mission. She received her life-saving kidney from her friend Molly in March of 2009 after being on peritoneal dialysis for seven months. And while Shannon thinks that petitions championing the issues are important, she wants to meet with representatives to discuss the concerns surrounding kidney issues today so that they can take action. Shannon believes that care and coverage are essential for transplant patients. She is passionate about the intersection of mental health, kidney disease, and overall wellness. Additional Resources NKF Cares NKF Peers Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

According to a 2024 World Health Organization study, over the last 50 years vaccines have saved over 154 million lives worldwide from over 20 life threatening diseases. As vaccines are facing skepticism, we are here to cut through the noise and lay out the facts as to why staying up-to-date on vaccinations is especially important for kidney patients. This episode is supported by Moderna. In today's episode we heard from: Mary Baliker has been a dedicated healthcare advocate for the past 40 years, and is involved in several kidney initiatives regionally, nationally and globally. Mary was diagnosed with a rare kidney disease at the age of nine and since then has undergone hemodialysis and received four kidney transplants. As a result of this life-long journey, Mary cherishes her life and possesses a strong desire to help improve the healthcare experience, health outcomes and quality of life for patients with kidney disease. In addition to publishing multiple peer reviewed articles related to the kidney patient experience, Mary is the author of Maria Never Gives Up, a story written to help children and families facing chronic illnesses. Her book is distributed across transplant and dialysis centers nationwide and is available for purchase online William Werbel, MD, PhD is a transplant infectious diseases physician and scientist at Johns Hopkins focused on optimizing protection against infections in immunocompromised persons. He completed clinical and research fellowship in infectious diseases at Johns Hopkins following MD training at the University of Michigan and internal medicine residency and chief residency at the Northwestern Feinberg School of Medicine. He is the current Associate Director for Epidemiology and Quantitative Sciences in the Johns Hopkins Transplant Research Center and principal investigator of the national Emerging Pathogens of Concern in Immunocompromised Persons (EPOC) cohort study. He receives NIH funding to study the landscape of infections in transplant recipients and evaluate the real-world impact of vaccination using a combination of epidemiological and laboratory approaches. Additional Resources: Vaccines for CKD Patients Vaccine Integrity Project IDSA Immunization Resources Emerging Pathogens of Concern in Immunocompromised Persons (EPOC) Study Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

This NKF Live crossover episode features a discussion on shared decision making on medical treatment options for people with atypical hemolytic uremic syndrome (aHUS). Our faculty includes a patient expert and advocate -- the actor and Substack author, Taylor Coffman, as well as two nephrologists, Holly Koncicki, MD and Ramy Hanna, MD, an expert on aHUS. They’ll cover a range of topics, with a focus on how to work with your medical team to achieve the best outcomes in aHUS. This discussion provides valuable tips and information not only for people with aHUS, but for all others who wish to gain insight into how to work with the most effectively with their medical team. In today's episode we heard from: Taylor Coffman is an actor, writer, podcast-maker, and mother with pregnancy-triggered aHUS. As a performer, she can be seen in Silicon Valley, Feud: Bette and Joan, and Life In Pieces, among others. Following her remission, Taylor also started work as a patient advocate helping those with life-changing diagnoses. She’s a patient expert and the author of Rare Disease Girl substack, sharing her journey and life-navigation tools weekly Dr. Ramy Hanna ia an Associate Professor of Medicine and Nephrology at the University of California Irvine. He’s a clinician-educator who’s devoted to patient education and research on kidney diseases like aHUS. Dr. Hanna is focused on working with underserved communities, as well as improving the diagnostic process and treatment outcomes for patients. Dr. Holly Koncicki graduated from the Rutgers New Jersey Medical School and completed her Internal Medicine Residency and Fellowship training at the Icahn School of Medicine at Mount Sinai. She is triple board certified in Internal Medicine, Nephrology and Palliative Medicine and Hospice. She is one of a few physicians who has trained in an integrated program of Nephrology and Palliative Medicine and is part of a small group of experts in this field. Though she cares for patients with all types of kidney problems, her specialty is caring for older patients with kidney impairment. She is widely published and has spoken nationally on topics including decision making in advanced kidney disease and symptom management. Her research focuses on communication tools to improve communication between patients and providers around discussion of treatment options for kidney disease. In 2020, she was honored by receiving the Cullman Family Physician Communication Award. She prides herself in learning each patient’s narrative that she treats, so she can best understand how to care for them. Additional Resources: Learn More About aHUS Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

Imagine you’ve been on the kidney transplant waitlist for years, hoping for a second chance at life. Then, one day, you find out that your estimated wait time was longer than it should have been—not because of your health, but because your kidney function was calculated using a race coefficient. That was the reality Black kidney patients faced. Now, that’s changing. Dr. Vinay Nair, the Medical Director at North Shore University Hospital and Northwell Health, Morgan Reid, NKF’s former Senior Transplant Policy and Strategy Director, and two kidney warriors Michele Bibby and Brittany Dickerson are here to break down the impact of removing race from eGFR and what that means for transplant patients In today's episode we spoke to: Dr. Vinay Nair, is an Associate Professor of Medicine at the Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell and the medical director of kidney transplantation for Northwell Health. Dr. Nair’s clinical and research interests include novel immunosuppressive protocols, kidney paired exchange and infectious and malignant complications after transplantation. He serves as part of CERCA (coalition to end racism in clinical algorithms), the editorial board and reviewer of several nephrology and transplant journals, and has served in the UNOS kidney transplantation committee. Dr. Nair has published on various transplant related topics and co-authored book chapters on immunosuppression and post-transplant malignancy. He is an advocate for equality in medicine and has spoken at several community outreach events on the importance of chronic kidney disease recognition and kidney transplantation. Michele Bibby is President of MAB Consulting Services. Michele provides mental health education, advocacy, and policy analysis to public and private entities. Michele designs and delivers mental health workshops and training. Michele delivers public speeches and presentations on mental health topics. Michele Bibby previously enjoyed a successful career in Human Resources Management in the Private and Public Sector. Michele has a Professional in Human Resources (PHR) Certification. Michele is a Certified Peer Specialist and a Certified Mediator. Michele serves as Board Chair for Via Hope a Texas Mental Health Nonprofit. Michele also serves on the National Kidney Foundation “Kidney Advocacy Committee” and the “Health Equity Sub Committee”. Michele holds a B.A. in Government from The University of Texas at Austin (1984). Morgan Reid is the Regional Patient Advocacy Manager for Ardelyx, Inc. Previously, she worked at the National Kidney Foundation as the Senior Director of Healthcare Policy and Strategy. She is a tireless patient advocate and also a kidney recipient herself. Brittany Dickerson- I am a dedicated mother, motivational speaker, and compassionate life coach living with Polycystic Kidney Disease (PKD). I use my kidney failure battle to educate and help others regarding kidney disease and transplantation. My personal journey has fueled my passion for helping others navigate life's challenges with courage and grace. Through partnership with the National Kidney Foundation, I have had the opportunity to mentor others and to be a guest for the National Kidney Foundation Podcast channel. My dedication to kidney awareness has led me to pursue becoming a National Kidney Foundation Advocate. I use my voice to spread my powerful message of perseverance and hope. My goal is to continue making an impact on individuals facing adversity, offering guidance, support, and being a shining example of strength in the face of hardship. Additional Resources: Removing Race-Based eGFR Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

Potassium is an essential mineral, but it is important to make sure you have the right amount. Tune in and hear from experts on how high potassium (hyperkalemia) can impact health and it’s risk in people with advanced chronic kidney disease. In this episode we heard from: Briana Douglas is currently a Peer Mentor for the National Kidney Foundation. At 17 yrs old, she was diagnosed with Lupus Nephritis. She was then diagnosed with end stage 5 kidney disease, in 2016, and immediately had to start dialysis. After starting hemo dialysis, she remained on treatment for 7 years, experiencing home hemo, peritoneal, nocturnal and in center-hemo dialysis. In 2024, she received a kidney transplant and is now living really well with her new transplant. She also takes pride in being a peer Mentor for NKF to help others with similar experiences. Dr. Pascale Khairallah, MD, MS, is an Assistant Professor of Medicine in the Division of Nephrology at the University of California, San Francisco (UCSF). She specializes in chronic kidney disease and kidney transplantation. Dr. Khairallah has been recognized with multiple awards for excellence in patient care and teaching. She has multiple publications in the field of chronic kidney disease mineral and bone disorders and kidney transplant outcomes. Annabel Biruete is an Assistant Professor and Registered Dietitian in the Department of Nutrition Science at Purdue University and an Affiliate in the Division of Nephrology at the Indiana University School of Medicine. Her broad clinical interest is nutrition in kidney diseases. Her research aims to study the effects of nutritional and pharmacological therapies for chronic kidney disease on the gastrointestinal tract and gut microbiome. Additionally, she is interested in improving outcomes in the Hispanic/Latine community living with chronic kidney disease, primarily through language- and culturally-concordant interventions. Additional Resources: High Potassium Information Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

In a time when the hope of surviving kidney failure was rare, one family refused to give up. Pulitzer prize winning journalist, Maura Casey recounts her sister's fight for life in the 1960s and the legacy of hope it left behind. In today's episode we heard from: Maura Casey grew up in an Irish-American family in Buffalo, New York, the youngest of six children. For more than 30 years, Casey was an opinion writer for three New England newspapers and The New York Times, where she had a seat on the exalted Times editorial board. Over the course of her career, Casey won 45 state, regional and national awards for her writing. She and her husband Pete have two adult children and two grandchildren. They live on a small Connecticut farm with their two dogs and a barn cat. Casey writes a weekly column, Casey’s Catch, and when the breeze is right, she coasts on Long Island Sound in her sailboat, Second Wind. “Saving Ellen” (Skyhorse Publishing, April 1, 2025) is her first book. Additional Resources: Saving Ellen; A Memoir of Hope and Recovery Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.

In celebration of Donate Life month, we are sharing a special crossover episode from NKF’s Life as a Nephrology Professional podcast. Tune in and hear from three living kidney donors as they discuss the power of living donation and kidney advocacy. Host: Anna Gaddy, MD, FASN, FNKF Guests: Lauren Drew, JD, Beth Burbridge Additional Resources: Becoming a Living Donor NKF Advocacy Do you have comments, questions, or suggestions? Email us at [email protected]. Also, make sure to rate and review us wherever you listen to podcasts.