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Casey Stumpf is a nurse practitioner and my sister. Years in emergency medicine and hospice, a stretch inside military medicine at Camp Pendleton, and now her own practice in Montana treating hormones full time — perimenopause, menopause, testosterone for men and women. She is one of roughly 4,100 providers in the country holding the MSCP certification. There are 75 million American women in some phase of menopause. The math does not work.
She is back to answer listener questions and to explain why estrogen patches are disappearing. The FDA says there is no shortage. Pharmacists say otherwise. Best estimate on a fix is two to three years.
She lays out what the 2002 Women's Health Initiative did to an entire generation of women, and why the black box warning finally came off. Testosterone for women, prescribed off-label because no FDA-approved formulation exists. GLP-1s and what they pull out of you besides fat. Hormone therapy after breast cancer. Vaginal estrogen, UTIs, and hip fractures. The suicide risk in perimenopause that standard screening misses.
Contact Casey Here: https://theradiantwelltality.com/
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Brandon Spangler did five years in the Marine Corps. He broke his neck, crushed his lower back, and walked out with a VA prescription that turned into eight years of addiction. The last stretch was heroin. He got sober in 2013, started college from zero, and is now a licensed clinical social worker with his own practice for cops and veterans in northwest Montana. Travis Gribble spent 24 years in law enforcement, 16 on SWAT, and retired out of Mesa PD in 2022. He now works for the Boulder Crest Foundation.

He walks through the jump from pharmacy to street, detoxing cold turkey three times, and a month and a half living out of a truck in the Blue Mountains waiting on a bed.

The second half is the system. Why cops are carrying moral injury more than post-traumatic stress. Why a diagnosis turns into a cage. What five days of training did that years of therapy did not, the 400 to 600 traumatic calls a cop absorbs over a career, why the average officer dies seven years after retiring, and the retainer model that put a therapist inside a sheriff's office.

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Four questions this week...
An F-18 simulator is going into the coffee shop sometime in September. I don't know why either. Carrier landing competition to follow.
The opener is about reaching the age where you become the caregiver for your parents. Medical directives, DNRs, wills, trusts, and why the hard conversation needs to happen before you need it.
A 33-year-old sold everything, traveled the world for eight months, and came home with no next goal. I never had a plan either. Not knowing what comes next is fine. Being paralyzed by it is not.
A guy got promoted over his best friend of 22 years and won't have the conversation that could save that man's career and a large payout. What you allow in your presence is your standard.
Someone asked why I haven't covered the killing of Staff Sergeant Logan Melgar. Straight answer on what I make and what I don't.
And a listener found out his wife spent a year with a coworker. He is trying to save the marriage. I could not do what he is doing.
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John Constantine spent almost 23 years in the United States Secret Service. Fifteen of them on the Counter Assault Team — the assaulters who exist for the day everything goes wrong. Team leader. Instructor. Operations supervisor. He stood with a rifle next to four presidential administrations, worked in almost 90 countries, and finished out in the Dignitary Protective Division running foreign heads of state. He wrote a book about the part of it nobody sees. It's called Hallways and Stairwells.
He breaks down what actually happened at the Correspondents' Dinner, why the security plan worked even though the magnetometer checkpoint didn't, and how far that guy really was from the President. Butler gets the same treatment. The layers of security people never see. Why hunkering down has never worked, anywhere, ever.
Then it goes past tactics. Mission, men, then you. Getting swatted at his own house over a function fire and suspended for it. Refusing to send guys and guns overseas as a favor unless somebody put it in writing. Two thousand eight hundred agents doing the work of ten thousand.
And the part that almost killed him. His identity got ripped out with the job. His wife found him on the bathroom floor. He talks about the climb back.
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Michael is moving to Missoula, so this one opens with a resignation and gets worse from there.
A man in a garbage can is polling at 20% against Nigel Farage in Clacton, and his platform makes more sense than it should.
Term limits, and the unelected career staff who actually run the machine.
Early access to Truth Social posts for $60,000 to $100,000 a month. Trading firms have already signed up.
A president clearing north of two billion in his first year back in office, and why the silence around it is deafening.
A California mayor who pleaded guilty to working as an unregistered agent of China.
A former Marine home after four years in a Russian prison.
What prison is actually for. Punishment, incapacitation, rehabilitation, and where the line sits.
A carrier at sea 250 days straight, what that does to 5,000 people with no end date, and the guy I watched grab a fire extinguisher and jump.
Also: a four mile run, PT school, and a second wiener dog named Beans.
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