The Untethered Podcast™

Maxillary expansion isn't just an orthodontic intervention - for adults navigating narrow palates, compromised airways, and chronic TMJ dysfunction, it can be a total health transformation.

In this episode, Hallie Bulkin sits down with Jeannie Nelson, MS, CCC-SLP, to share an unfiltered, first-hand account of their personal experiences undergoing MARPE (Minimally Invasive Micro-Implant Assisted Rapid Palatal Expansion). Together, they pull back the curtain on the procedure itself, comparing their treatment approaches, pain management strategies, and the physical and emotional realities of the recovery process.

Hallie and Jeannie dive into the profound functional benefits that go far beyond aesthetics—including drastic improvements in nasal breathing, sleep quality, reduced systemic inflammation, and even unexpected shifts in vision. They also discuss navigating speech challenges, dietary changes, lymphatic support, and essential tools to prepare if you or your patients are considering advanced expansion.

About the Guest: Jeannie Nelson, MS, CCC-SLP

Jeannie Nelson, MS, CCC-SLP, is a licensed Speech-Language Pathologist, certified myofunctional therapist, and pediatric feeding specialist. With an extensive clinical background in evaluating and treating complex orofacial myofunctional disorders, pediatric feeding difficulties, and airway-centric cases, Jeannie brings both high-level clinical expertise and personal patient experience to the conversation. In this episode, she joins Hallie to share her first-hand journey navigating adult maxillary expansion (MARPE), shedding light on the intersection of structural anatomy, speech clarity, and whole-body functional recovery.

Key Topics & Takeaways

The Functional Power of the Maxilla: Understanding why expanding the maxillary bone directly impacts nasal vault volume, airway capacity, and structural posture.
Comparing Expansion Approaches: Exploring how individual anatomy influences protocol choices, appliance designs, and overall treatment timelines.

Soundbites

"Opening up my nose has been completely life-changing. You don't realize how much energy you spend fighting to breathe until that restriction is lifted."
"Breathing properly has drastically improved my sleep architecture, nervous system regulation, and daily recovery."
"The maxillary bone impacts everything—from your nasal airway and posture to how your vision, jaw, and neck organize."

Timestamps

00:00 – Introduction to MARPE and Personal Treatment Backgrounds
02:49 – Comparing Treatment Approaches, Protocols, and Individual Experiences
05:41 – Pain Management Realities and Practical Recovery Insights
11:36 – Navigating TMJ Issues, Jaw Alignment, and Airway Stabilization
21:21 – The Interconnectedness of Maxillary Structure, Oral Health, and Whole-Body Function
39:09 – Speech Clarity, Articulation, and Communication Challenges
42:47 – Pain Perception, Nervous System Response, and Emotional Recovery
51:43 – Preparing for Advanced Expansion: Essential Preparation Tools and Protocols
57:32 – Final Thoughts and Resources for Patients and Clinicians

Links & Resources

Fast Myo Screening Tool: Identify structural and airway red flags in your clinical practice at FastMyoScreening.com.
Connect with Jeannie Nelson: Learn more about her practice, clinical services, and myofunctional expertise at Breathe Eat Sleep Talk.

WORTH A LISTEN: CONTINUE YOUR JOURNEY
Episode 137: The Evidence Based Research Behind Tethered Oral Tissues with Richard Baxter, DMD, MS.
Don't Ignore the Snore: The Hidden Link Between Airway, Sleep, and ADHD.

STAY CONNECTED
💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on Instagram | Facebook | LinkedIn.

If Hallie and Jeannie's personal MARPE journey gave you a clearer understanding of structural airway expansion, please take a moment to leave a review! Your support helps us bring these vital, transparent conversations to clinicians and patients everywhere.
Hosted on Acast. See acast.com/privacy for more information.

Taking a weekend course can make you see tongue posture, restricted movement, and mouth breathing everywhere you look. But recognizing a pattern is vastly different from truly understanding it.

In this solo episode, Hallie Bulkin addresses "The Myo Gap" - the space between noticing an isolated anatomical finding and developing the clinical depth to understand how it fits into a child's connected, multi-system picture. She unpacks why a restricted frenulum or forward resting tongue is merely a data point rather than an automatic diagnosis or treatment plan, and explains how shallow understanding leads clinicians to jump directly to conclusions, quick referrals, or "cookbook" exercises.

Hallie breaks down how to conduct a deeper assessment by analyzing real-time compensations, motor coordination, sensory processing, and overall physical development. You'll learn why true clinical competence often leads to making fewer but far more valuable referrals, how to navigate honest parent conversations without false certainty, and why real clinical judgment requires mentored practice over quick information.

Key Topics & Takeaways

The "Sensitization" Trap: How new clinical learning creates pattern-recognition bias where every finding looks like the primary root cause.
Observation vs. Diagnosis: Why a restricted frenulum or forward tongue posture is an initial observation point, not an immediate reason to prescribe exercises or surgical releases.
Reading the Connected System: How to evaluate tongue function relative to jaw mechanics, lip seals, nasal breathing, overall muscle tone, sensory processing, and motor coordination.
Selective, Value-Driven Referrals: Why advanced clinical discernment leads to fewer automatic referrals for releases and results in clearer, function-based communication with ENTs, dentists, and surgeons.
Honest Parent Conversations: The shift from presenting false certainty ("Your child has a tie, so they need a release") to leading transparent, nuanced clinical discussions.

Soundbites

"Recognizing a pattern can feel a lot like understanding it before the depth is actually there. An observation is not a diagnosis, and it's definitely not a treatment plan."
"Structure matters, but function matters more. Context determines what the structure actually means."
"Confidence isn't giving parents a quick, simple answer—it's being able to separate what you know from what you suspect."

Timestamps

001:04 - The Gap Between Knowing and Understanding Myo
02:50 - Clinical Sensitization & Pattern Recognition
04:23 - Case Study: 3-Year-Old with Low Tone
06:23 - What Deeper Assessment Looks Like
07:35 - Assessing a 2-Year-Old for Feeding Concerns
09:04 - Myo Does Not Replace the Rest of the Child
10:20 - Structure vs. Function & Better Referrals 12:03 - Assessing Infants & The Feeding Dyad
13:28 - Communicating Honestly with Parents 15:20 - Myo vs. Feeding Therapy & Multi-Disciplinary Care
16:26 - How to Build True Clinical Competence
18:21 - The Myo Method & Closing Thoughts

Links & Resources
The MYO Method: Elevate your clinical reasoning, bridge assessment gaps, and master orofacial patterns at TheMyoMethod.com.
Fast Myo Screening Tool: Stop guessing during your intakes and download the checklist at FastMyoScreening.com.

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Episode 132: Feeding With A Twist of Myo with Hallie Bulkin, MA, CCC-SLP, COM.
Episode 150: Where To Start And End With TOTS?.

STAY CONNECTED

💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on Instagram | Facebook | LinkedIn.

If this episode challenged you to look deeper at the whole connected system on your caseload, please take a second to leave a review! Your support helps us share these critical clinical perspectives with the therapists who need them most.
Hosted on Acast. See acast.com/privacy for more information.

When we think about core stability, digestive efficiency, or functional breathing patterns, we rarely consider the foundational muscle group resting at the base of our pelvis. Yet, pelvic floor health directly dictates everything from diaphragmatic excursion to bowel regularity, posture, and systemic stress management.

In this episode, Hallie sits down with Dr. Svetlana Mehlman, a physical therapist specializing in pelvic health, back pain, and lymphatic drainage. Dr. Svetlana breaks down the complex anatomy and mechanics of the pelvic floor, explaining why a tight, tense pelvic muscle is often a hypertonic, weakened one rather than a strong one.

About the Guest: Svetlana Mehlman, PT, DPT, MLD-C

Dr. Svetlana Mehlman is a physical therapist specializing in pelvic health, back pain, and lymphatic drainage. She earned her Bachelor's degree in Human Development from Cornell University and completed her Doctorate of Physical Therapy at New York University. Her passion for pelvic floor physical therapy was ignited early in her career while treating pregnant and postpartum patients suffering from pain and pelvic dysfunction.

Key Topics & Takeaways

The Pelvic Core Connection: Understanding how the pelvic floor acts as the true base of your deep stabilization system, working in tandem with the diaphragm and abdominal wall.
Tightness vs. Strength: Demystifying the myth that a tight pelvic floor is a strong one, and why muscle hypertonicity restricts blood flow, movement, and functional length.
Breathing and Digestive Motility: Exploring how diaphragmatic movement mechanically massages internal organs, directly impacting gut motility, constipation, and bowel transit time.

Soundbites

"The pelvic floor is an integral part of your deep core system. It cannot function in isolation from how you breathe or sit."
"Muscles need to move through a full range of motion. A tight pelvic floor is not a strong pelvic floor—it’s a fatigued, restricted one."
"When we fix the breathing mechanics at the top, we relieve the mechanical pressure on the pelvic floor at the bottom."

Timestamps
000:01:04 — Hallie Bulkin introduces guest Svetlana Mehlman (DPT, CSCS).
00:02:41 — What is the pelvic floor and how does it function as part of the core?
00:05:00 — The role and mechanics of using a Squatty Potty.
00:08:08 — The link between chronic constipation, bladder issues, and incontinence.
00:10:46 — Practical tips: The "I Love You" abdominal massage.
00:12:00 — How diaphragmatic breathing regulates the pelvic floor and nervous system.
00:15:16 — Why travel and routine changes trigger constipation.
00:22:30 — Common symptoms of pelvic floor dysfunction (and why tight doesn't mean strong).
00:29:31 — Why you should never "hover" or rely on "just-in-case" peeing.
00:32:14 — Postural Restoration Institute (PRI) principles and how posture connects to pelvic health.

Links & Resources

Connect with Dr. Svetlana: Explore specialized care programs, resources, and consultation details at Pelvic Harmony.
If this episode changed how you see the body, that's just one case. Inside The Integrated Therapist™, you grow the clinical reasoning to spot the root cause, think past your own discipline, and feel sure about what to assess, treat, refer, and co-treat. Come join us at: https://theintegratedtherapist.com/

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Episode 233: Understanding Your Pelvic Floor with Britnie Hornsby, PT, DPT, Cert DIN, Cert VRS, PCES.
Episode 185: Laura Glazebrook, DPT The Pelvic Floor and Jaw Connection.

STAY CONNECTED

💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on Instagram | Facebook | LinkedIn.

If Dr. Svetlana's whole-body approach reframed how you look at the connection between breathing, posture, and pelvic health, please take a quick second to leave a review!

Your support helps us bring these essential clinical conversations to more providers and families.
Hosted on Acast. See acast.com/privacy for more information.

When a child walks into your clinic presenting with a tongue thrust, a high-arched palate, or a complex feeding delay, what is your immediate clinical instinct? Is it to reach for a specific exercise in your toolkit, or is it to zoom out and analyze how the entire system is functioning together?

In this solo episode, Hallie Bulkin dives into the powerful paradigm shift of becoming an integrated therapist. She challenges the common trap of relying on isolated techniques and instead lays out a roadmap for evaluating children holistically.

Hallie breaks down how to run multiple clinical lenses simultaneously - from airway and breathing considerations to structural vs. functional anatomy, neurological diagnoses, and the sensory-motor layers of feeding.

Key Topics & Takeaways

The Integrated Mindset: Why focusing too closely on a single tool or therapy protocol creates clinical blind spots, and how to zoom out to assess the whole child.
Running the Airway Lens First: How structural issues (like mouth breathing and palate shape) directly impact downstream oral motor habits like a tongue thrust.
Deconstructing the Feeding Layers: Organizing feeding challenges into clear mechanical, sensory, and behavioral tiers to know exactly where to begin treatment.

Soundbites

"Look at the whole connected system. If you only look at the mouth in a vacuum, you miss the structural foundation driving the compensation."
"We have to ask: what is the whole system doing? When you treat a symptom without treating the root cause, you're just chasing shadows."
"Find the fire, not just the smoke. Clinical discernment is about finding exactly where the dysfunction originates so we can intervene with precision."

Timestamps

00:00:00 – Intro Hook: The Feeding Lens vs. The Loudest Voice in the Room
00:00:29 – Welcome to the Untethered Podcast & Host Introduction
00:01:05 – What Separates a Good Clinician? Introducing the "Integrated Therapist"
00:01:48 – The Shiny New Tool Trap: Single-Lens vs. Whole-System Thinking
00:04:50 – Lens 1: The Airway Picture (Mouth Breathing & Tongue Thrust)
00:07:15 – Lens 2: Pediatric Feeding (Mechanical, Sensory-Motor, & Behavioral Layers)
00:08:03 – Case Study: 8-Month-Old Bottle Refusal & Cleft Lip Repair
00:09:56 – The Pain Differential (Reflux, Thrush, Torticollis)
00:11:53 – Lens 3: Neurological Frameworks (Apraxia, Dystonia, Dysarthria)
00:15:06 – Lens 4: Anatomy & Structure (High Narrow Palate Constraints)
00:17:49 – Mastering the Referral: How to Communicate Cross-Discipline
00:20:38 – Summary: The 6 Key Pillars of an Integrated Approach
00:22:31 – Outro: Join The Integrated Therapist Community & Disclaimer

Links & Resources

Become the clinician who finally sees the whole picture https://theintegratedtherapist.com/.
Our Digital Home: Catch past episodes, resources, and show notes anytime over at The Untethered Podcast.
Fast Myo Screening Tool: Stop guessing during your intakes and download the checklist at FastMyoScreening.com.

RELATED EPISODES YOU MIGHT LOVE

Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
Screening vs. Assessment vs. Treatment: Why Every Clinician Needs to Know the Difference

STAY CONNECTED
💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on
Instagram | Facebook | LinkedIn

⭐ Love the show? Leave a quick review — it means the world to me!

If this episode inspired you to step into an integrated mindset and analyze the whole connected system for your patients, please take a quick moment to leave a review!
Your support keeps us climbing the charts to help pediatric therapists think more critically.
Hosted on Acast. See acast.com/privacy for more information.

When a child exhibits behavioral challenges, facial recession, or struggles with sleep, the root cause is frequently hiding in plain sight: their breathing habits. Unfortunately, these vital signs of compromised airway health are often overlooked by traditional medical models.

In this episode, Hallie sits down with Dr. Leslie Pasco, an expert in airway health, pediatric development, and the author of The Great Contraction. Dr. Pasco breaks down the profound impact that mouth breathing, poor jaw development, and tongue-ties have on a child’s long-term physical and neurological growth.

About the Guest: Dr. Leslie Pasco, DMD, OFM, CBBI

Dr. Leslie Pasco is the visionary founder and President of MyoWay Centers for Kids. With almost three decades of experience in dentistry, Dr. Pasco has dedicated her career to understanding how airway health and muscle function deeply influence growth, sleep, learning, and overall health in children.

Rather than simply addressing surface symptoms, she emphasizes early screening, thorough functional assessments, and close collaboration with other healthcare professionals to ensure her young patients receive truly comprehensive care. Her clear, driving mission is to help children grow right, breathe right, and live better.

Key Topics & Takeaways

Mouth Breathing as a Danger Signal: Why mouth breathing should never be dismissed as a "phase," and how it actively derails midface growth, jaw position, and dental alignment.
The ADHD & Sleep Link: How sleep-disordered breathing frequently mimics or exacerbates symptoms of ADHD, leading to misdiagnoses that could be resolved with airway support.
A Call for Holistic Care: Understanding the environmental stressors driving facial recession and contraction, and why true patient healing requires organic, multidisciplinary collaboration.

Soundbites

"Mouth breathing is a danger signal. It is your body’s emergency backup system, not a functional way for a growing child to live and develop."
"Breathing therapy can change lives. When you restore nasal breathing and correct sleep architecture, you aren't just changing a habit—you're shifting a child's entire behavioral and developmental trajectory."
"Holistic care requires collaboration. No single provider can fix a contracted airway or a system-wide dysfunction completely on their own."

Timestamps

00:00 - The Impact of Airway Health on Families
01:12 - Introducing Dr. Leslie Pasco
02:20 - Shifting from General Dentistry to Airway Care
07:23 - The Dangers of Chronic Mouth Breathing
12:04 - ADHD Misdiagnosis vs. Sleep Disordered Breathing
19:02 - The Connection Between Palatal Expansion and Myofunctional Therapy
28:44 - Functional Assessments for Tethered Oral Tissues (Tongue & Lip Ties)
30:53 - The Critical Role of Pre-Op and Post-Op Preparation for Releases
44:00 - What is the Buteyko Breathing Method? (Form, Function, Fuel)
52:39 - Breaking Down Medical Silos: A Holistic Approach
54:16 - The Great Contraction Book Overview
58:52 - Medical Disclaimer & Outro

Links & Resources

Connect with Dr. Leslie Pasco: Learn more about her clinical work at https://buteykoclinic.com/pages/instructors/dr-leslie-pasco?srsltid=AfmBOoqEmYjR8y3SzFHFpgr-JpFWFgfyViaOItLvpazcPnDMqwDwd7w0.
Facebook : https://www.facebook.com/DrLesliePasco/
Linkedin:https://www.linkedin.com/in/dr-leslie-pasco-03a096a1/?isSelfProfile=false

RELATED EPISODES YOU MIGHT LOVE

Dr. Richard Baxter on How to Know If a Tongue Tie Is Really the Problem
Don’t Ignore the Snore: The Hidden Link Between Airway, Sleep, and ADHD

STAY CONNECTED
💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on
Instagram | Facebook | LinkedIn

⭐ Love the show? Leave a quick review — it means the world to me!

If Dr. Pasco's insights on pediatric breathing reframed how you analyze your complex developmental cases, please take a brief moment to leave a review! Your support helps us share these crucial airway answers with the clinicians and families who need them most.
Hosted on Acast. See acast.com/privacy for more information.