Episode 256 | Tips For Joint Health and Longevity | Latest Advances in Bone Health | Dr Jason Snibbe - The Aging Well Podcast

Episode Transcript
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(00:09):
Welcome to the Age of Well podcast.
Where we explore the science. Stories and strategies behind
living longer, healthier, and more purposeful life.
In this episode, I'm joined by Doctor Jason Snitty, one of the
country's leading orthopedic surgeons and a pioneer in
robotic joint reconstruction in SPO, Tennessee.
Based at Cedars Sinai Medical Center in Los Angeles, Doctor
Snitty serves as the official orthopedic surgeon from the LA

(00:32):
Clippers and a consultant for teams like the Lakers, Sparks,
Kings and Angels. From elite athletes to Hollywood
celebrities, he's trusted for his innovative, minimally
invasive techniques and his remarkably low complication
rate. But beyond the accolades and
cutting edge technology, what truly sets Doctor Simbi apart is
his patient centered approach. The son of two psychologists, he

(00:56):
brings empathy, clarity, and connection into every
consultation, ensuring patients feel heard, understood, and
supported at every step of theirjourney.
In this conversation, we explorehow to keep joints healthy and
strong as we age, the role of technology in transforming
orthopedic care, and how simple,consistent habits can support

(01:16):
bone health and mobility well into later life.
Whether you're an athlete, an active ager, or someone just
hoping to avoid surgery, this episode offers insight and
inspiration to help you move with strength, confidence, and
joy for years to come. So Doctor Snibby, welcome to the
Aging Well podcast. Let's begin by having you just

(01:39):
tell us about yourself and how you came to be interested in
orthopedic medicine. Thank you very much for having
me. It's a pleasure to be on the the
podcast with you. I, I have kind of a long road
of, of being involved in kind ofmedicine and, and anatomy and
stuff like that. And so I, when I was in high

(01:59):
school, I was 11th grader and I took a Physiology and anatomy
class and I just fell in love with the architecture of the
body. I just every little bone and
tendon and ligament, I just was for me, it was just like a whole
world that I never understood even existed of so much so many

(02:21):
different intricate things that that made-up the human body.
And from that moment, I was always really into sports, but I
didn't really understand what like sports medicine was or what
orthopedic surgery was. But I just knew at that moment
I'm like, I want to be a doctor and I want to do something in
like with athletes, but I don't know what that even means.
And then so I, I went into college, I went to the

(02:42):
University of Southern California.
And there I was at a party, a random party, like literally the
first week of in college and I'mwith, there's, there's a guy
standing in front of me and he goes, what do you want to do?
And I go, I want to be a doctor,but in sports medicine he goes,
well, I'm a a manager on the football team, which means like
the guys that like pump the footballs up and set up the

(03:04):
practice. He says tomorrow he wrote a name
down on a piece of paper with nophones there, right, But wrote a
name down and a number. He goes, go to the training room
and say hi to this guy named Byron.
Go down and talk to him and say you want to be an athletic
trainer. And that, and that one little
meeting and that one little thing I did kind of changed the
course of my life because I became an athletic trainer and

(03:28):
in college, so I, I, I helped rehab athletic injuries.
I got to observe orthopedic surgery.
I got to spend a lot of time with orthopedic surgeons dealing
with all the injuries of the athletes.
And then it was that was it the,the, the, the, my, my, I was my
destiny. And so unlike a lot of what's
interesting is when you go to medical school, most people

(03:49):
don't know what they want to do.Like, I don't know, maybe
cardiology, maybe Pediatrics. I was like from day one,
orthopedic surgery all the way. So I went to medical school in
Wisconsin. Then I did my residency in
Rochester, NY and then I came back to Los Angeles and did a
fellowship at the Kerlin and JobInstitute, which is a very world

(04:09):
renowned sports medicine institute.
And then I've been in practice for 20 years now.
And so it's, it's been a great journey.
That's awesome. I I kind of wish I had gotten
introduced to anatomy and Physiology sooner in life.
I ended up going to geology route until I got to my senior
year and realized it's not what I want to do.
And I got introduced to exercisePhysiology and then in my PhD

(04:32):
program, I I did an anatomy minor and I just fell in love
with anatomy. I taught anatomy for four years
when I was in Michigan and I have nothing but respect for the
orthopedic guys. When you get into dissecting and
it's easy to dissect because you're cutting through the
stuff, you can just cut through it and move it out of the way
you're there. But when I got like, to the hip
and realizing how hard it is to get down to that hip joint, and

(04:56):
then there's people like you that can get in there, replace
the hip, do surgeries and then get everything back and
functional, that just blows. Yeah.
So I'm really excited for this conversation today.
That's cool, that's cool. What you're doing, and so you're
known for your work with elite athletes and high profile
patients. What are some of the most common
orthopedic challenges you see inpeople as they age?

(05:18):
I think the, there's a couple things.
I think the number one thing I think is muscle mass.
I think muscle mass is really, and we're learning that that's
really, you know, a lot of theselongevity doctors are talking
about the more muscle mass you have as you age is better for
you. You know, if you enter in your
60s and 70s and 80s with more muscle mass, you're going to

(05:40):
live longer, you're going to have a better life.
I think that what we see with a lot of patients is that as they
age, one of the number one things that happens, they get a
lot of stenosis in their back, right?
Their spine becomes stenotic andthe nerves that are that are
going down to your legs are not firing as well.
But by stimulating the muscles that stimulates the nerves to

(06:02):
fire better and have better, youknow, neurologic, neurologic
stimulation of the muscle. And so I think that the biggest
challenge is to help patients continue to do resistance
exercises, weight lifting, you know, you know, lots, you know,
squatting, lunging, biking, walking, anything that's
stimulating their legs to get stronger.

(06:24):
Because when you look at your grandfather and he wears a pair
of shorts or, you know, you see him in a swimsuit, his legs are
really, really skinny, like, I mean, almost like to the bone.
And so that's because they've lost muscle mass over time.
A lot of it's related to the, tothe, to the spine, but the more

(06:44):
you maintain your muscle mass, the better.
The second thing I would say would be flexibility.
I think that one of the biggest things that people forget is
that, you know, as you get older, you get stiffer, your
joints get a little more arthritic and you lose that
natural range of motion. So by working on your
flexibility makes a big difference.
It prevents injury. It also helps you walk better

(07:08):
and move better throughout life,you know, but the, the thing
that people don't understand is that you have to stretch every
day. It's not like it's not like you
just stretch like a Monday and the rest of the week you're
great. You got to do it every single
day. And I would say the worst thing
we do in, in, in, in, in as human beings is sleep, right?
When you sleep, you're still. So all your joints get so stiff
and tight, you have to really spend time warming yourself up,

(07:30):
hot shower, sauna, working on your flexibility.
I think those two things are really critical as we age to
focus on. Yeah, I have found that over the
last 30 years of being an exercise physiologist, I've had
to unlearn all the cardiovascular stuff that we
were taught in grad school because it was all cardiac

(07:50):
rehab, corporate fitness. Nobody really talked as much
about strength and it was a typical ACSM guidelines, nothing
really emphasizing strength. And as I kind of matured in the
field, and it was a number of years ago, I went to on the
conferences and they were honoring the senior fellows in
the organization. And they all look so frail and
they're kyphotic. And I'm like, something's wrong

(08:11):
here. We shouldn't look like that as
exercise scientists. Yeah, realize it's because we
promoted cardio and we didn't really focus on the weight
training. And so I've shifted a lot more.
Like if you can do the weight training, cardio is going to
come easy. Yeah, I agree.
Now, I don't do as well with stretching and so maybe you can
convince me by the end of tomatodo a little bit more with
stretching. But I do work the weights

(08:32):
through a full range of motion, which is beneficial in terms of
maintaining some level of flexibility, at least a
functional. Yeah.
And I think, I think that the weight train, what people people
used to think, it's like I got to burn calories, you know,
exercising, cardio. And I think it's great.
I think cardio is important. It's important to get on a bike,
important to go for a walk or hike.

(08:53):
Those exercises are very important, the kind of dynamic
movement of your body. But I think that the real weight
training is, is not only increasing your muscle mass or
maintaining your muscle mass, but it's also, especially for
women, creating resistance on your bones, right?
So it's maintaining that, that, that bone density that you need.

(09:15):
And so those things are really, really critical.
And even, you know, they're, they're, you know, they talk
about the farmer's walk where you hold 2 heavy weights in your
hands. And so there's a lot of people
saying that just doing that, youknow, just taking a couple of
heavy weights, like a 30 LB weights in your hands and
walking around your do laps around your pool or laps around

(09:35):
your backyard or laps around your house could be even that
simple thing can be very beneficial to you.
Yeah, when I was a kid, that wascalled carrying the groceries.
Me too, exactly. So what is the difference
between normal aging joints and something that needs medical

(09:55):
attention? So I think that, you know, as
joints age, we know that the cartilage thins a little bit.
There's a little bit of thinningof the cartilage can happen.
There's also some wear and tear that happens.
There are there are structures that exist within joints that
are that there's articular cartilage, which is the
cartilage that covers the bone. Then there's there's, there's a

(10:17):
different type of cartilage, fibro cartilage, which is for
example the meniscus in the kneeor a ring of cartilage around
the hip called the labrum, whichis also fibrocartilage or the
labrum in the shoulder. Those parts, the fibrocartilage
tend to get damaged. They can't tend to get tearing,
fraying damage. And as as we age, damage to the

(10:40):
fibrocartilage can be around 30%, but as you get to 5060
seventy, it could be as high as fifty, 6070%.
So those are kind of natural aging, like if if you if you get
it, I'm 52 years old. If you MRI my knee, I might have
a little tiny meniscus damage, little meniscus injury there.
Where things get significant is when the joint has enough, you

(11:04):
wear down enough articular cartilage, the cartilage that
covers the bone, or you get significant damage to some of
that meniscus or fibro cartilagewhere it starts creating
inflammation in the joint. You get little swelling, you get
a little stiffness in the joint.You lose a little.
Range of motion and that can affect the way you move, the way
you walk, it can affect the way you're able to play tennis with

(11:27):
your arm and those. When we start having pain or
things that are not resolving with typical recovery, that's
when we start saying, you know, maybe you got to see somebody
and take a look. Kind of like my shoulder joints.
Exactly like all of us, right? So are there key habits or
lifestyle changes people can make in their 40s or 50s or

(11:50):
beyond that can help to protect the joint and bone health?
Yes, I think there's a few things.
I think that that there's there's a discussion about
supplements, you know around joint health and I think there's
probably 3 that are the most important.
Number one is turmeric. I think turmeric is the best
natural anti-inflammatory that someone can take.

(12:11):
The second thing is fish oil with omega-3 and then which
really helps decrease inflammation and maintain the
natural kind of environment of the joint.
And then collagen powder, you know collagen powders that
people take enhancing the collagen.
Everything is made of collagen, your cartilage, your bones,
your, your, your ligaments, yourtendons to reinforcing that

(12:34):
collagen is very important. I think that maintaining the
strength around the joint, like we talked about weight training,
for example, I always talked to patients about their quadriceps.
If you lose, if you take 50% of the quadricep muscle away, if
you get atrophy of your quadriceps, you get knee pain,
your knee starts hurting. So that these are the shock

(12:55):
absorbers of your body. If you maintain your core and
work on your glutes, you're going to have, you're going to
eliminate a lot of your hip painand also your back pain.
You're going to really help maintain the.
Core of your body so. Strengthening is really
important for joints and then movement.
You know the Physiology, I mean you.
So this, the Physiology of the cartilage is that water kind of

(13:16):
goes in and out of the cartilageand as you move a joint, you're
compressing the cartilage and water goes in and out.
And that natural ebb and flow ofwater is very healthy.
And so if you take a person, I would say take a person and you
put their arm in a cast, in the elbow in a cast and you don't
let them move their elbow, theirelbow cartilage will

(13:37):
disintegrate because you're not moving the joint.
So the movement is really key tohelp protect.
And I think that, you know, there's always a discussion.
I mean, I'm sure you get this a lot about impact running, right?
Should I run? Should I not run?
I think that running is, is hardon your body.
I think there's people that are physiologically and anatomically

(14:00):
immune to breaking down their joints, which are I think those
are the luckiest people alive. But most of us, the rest of us
mere mortals, you know, it's probably not great to run.
It's probably better to do low, you know, biking, you know,
swimming, elliptical, you know, weight training, that kind of
thing to just maintain your, your exercise and your fitness.

(14:24):
I learned fairly early on, I think it was right after I got
my master's degree, that runningwas not for me at six foot 5200
plus pounds. I was trying to train for the
Pittsburgh Marathon. I went out for a long run, kind
of jumped into training a littlebit late.
I was not too smart in doing this, but went out on a 21 mile
run with a couple friends of mine that were training for the

(14:46):
marathon and I was fine, kept with them.
It was a 7 1/2 minute pace, so Iwas feeling pretty good about
that. I hit mile mile 16, it was like
hitting the wall. And for the next few days it
felt like somebody had taken my hip out of the the joint, rubbed
sandpaper on the head of the femur and put it back in the
acetabulum and I could hardly walk for days.

(15:08):
And it's like Nope, this is not for me. 5 days are about my
limit. That's funny, I, I had a similar
experience. I, I wanted to run a marathon.
I was, I was set on it. I did the Big Sur marathon,
which is like, I didn't realize this until I really got involved
in it. But the, the, the after mile,

(15:28):
like, I don't know, 18 or something like that.
It's, it's all up and down, up and down hills.
And I was the same. I ran 20 miles of it and then by
a mile 20 I was my My legs were dead and I could barely, barely
make it the last few miles, but I made it.
I finished it, but I never ran again after that.

(15:49):
All it takes is a marathon to tell you there's no need to run.
Exactly. Exactly.
The collagen I have not done, and I'm a bit skeptical on
collagen because, you know, yeah, much of it's digested.
It breaks down into amino acids.If I'm getting all my amino
acids, is it really necessary? Yeah, it's great.
It's a great question. I don't think I don't think we

(16:11):
really know, you know, I think that I know that I I personally
take I we there's a big the amino acids are are become very,
very popular now to for people taking amino acids for for
building up their their skeletalmuscle and and maintaining it.
And I think that we in our world, there's been a huge push

(16:32):
of actually using amino acids inthe perioperative period.
And so I think that, yeah, I, I,I don't know actually whether
collagen versus just taking amino acids or should you do
both? I don't think the, the, the, the
jury's out on that discussion. I do think that amino taking
amino acids or taking collagen or both are helpful, but we're

(16:55):
using it a lot now in the perioperative period because,
you know, they're, we, we're nowgiving patients amino acids in a
drink, you know, a week before surgery and then three weeks
after surgery to help maintain muscle mass, to help them build,
to help them have a better recovery.
And there's some data to say that by taking amino acids, you

(17:16):
can actually prevent infection because you're, you're, you're,
you're helping maintain kind of the, the natural nutrients of
your body. And so I think that I think
you're absolutely right. I think that there's a, you
know, I'm not sure the jury's out without with that
discussion. That's one of those things I
think you're not harming yourself and you're just
providing the amino acids. Whether they're going directly

(17:38):
as collagen or not doesn't matter.
You're getting amino acids. But that's really fascinating
about doing it during the operations or around the
operations because I've never heard that before and it it
makes perfect sense. Yeah, there's a new there's, it
happened a lot because of some studies with NASA, because they

(17:59):
were doing, they were looking atthe astronauts going up into
space and losing so much muscle mass because they're in a
gravity free environment. And so they NASA worked with
some physiologists to help understand what's a good thing
for them to take. And it was basically a lot of
these complex amino acids. And so some of us in the in the
medical world said what how do we maintain that?

(18:20):
How do we use that to help us with patients?
And we do that. And also when you have surgery,
you know, you don't eat or drinkafter midnight.
So you, you know, you think I tell patients all that you come
and tell patients us all the time.
You come into the surgery and you have any, you haven't had
anything to drink, you're dehydrated, you're, you're

(18:41):
hypoglycemic, you know, you're, you're maybe ketotic.
You know, you just, you're not in a good physiological state.
Then we do surgery on you and then you go to the recovery room
and now it's, you have surgery at 7:00 AM.
By the time you're eating, it's like 2 in the afternoon.
So there's also work that's being done where people are
like, like you would when you run a marathon to carbo load.

(19:03):
So basically you have amino acids, but then the night right
before surgery, around like 10:00 at night, you have a
special carbohydrate drink. Something that like maybe you
would take with you're running amarathon or doing a long, you're
cycling 50 miles, you would takea carbohydrate kind of thing,
have a carbohydrate drink. So you're carbo loading your
body to try and get your body tohave something inside to help,

(19:28):
to help with the natural Physiology of your body to help
heal. That's fascinating.
I mean it, it's common sense it would seem, but it's it's not
and it's not what we tend typically do.
Yeah, exactly. And and I think that you, you
know, you're putting your patients kind of as a, as a term
says behind the 8 ball when you're bringing them in and
they're getting dehydrated and they feel horrible, you know, I

(19:50):
mean, if you don't eat or drink anything for, you know, for all
day long, you know, I mean, somepeople intermittent fast, but if
you fast all day long and you'renot even drinking water, you're
just getting it through your IV,that's not the natural
Physiology of your body. And so you just, you're put you
in a bad way. So I think that really working
on that and I think that that those principles also as a, as a

(20:15):
maintenance is also important. You know, like if you're trying
to maintain your muscle mass andyou're not getting enough
protein and you're not getting enough amino acids, it's going
to be hard to maintain and buildand your, your muscle mass.
So I think that's, that spills into life too.
And so a lot of our patients sayI'm going to keep taking these
amino acids because I want to get stronger.

(20:35):
I want to get fit, you know? Are there specific amino acids
that you kind of involve in thatperiod around the operation?
Not really. I mean, I don't know the
specific ones that are in it, but if there's a, there's
several different kind of brandsthat we use that are, I don't,
there's not one brand that we specifically use, but there's a
couple companies that we use that, you know, one of them is

(20:57):
perfect Amino, I think it's called.
It's a brand, you know that thatwe we've been using just because
it's, you know, whatever is easyto, to get, you know this for,
for the patient and it's not difficult for them to access it.
We use that one for for them. So it's not necessarily a
specific compilation of essential amino acids or
anything. I'm sure leucine is probably one

(21:19):
of the key. Yes, Amino.
Acids yeah, leucine is is definitely in there.
I'd have to look at the the concoction.
I don't know the specific ones, but that that it's it's it's
becoming an important thing. And and who knows, you know,
maybe it's something that we we should take forever, you know,
like just as even into our into our late eight 80s, you know, to

(21:39):
help maintain that that muscle mass.
As I get older, the more I feel brand like taking some branched
chain amino acids on a regular basis, just kind of having that
in my, you know, my hydration drink that I'm drinking
throughout the day just right, branched chain amino acids
create in there and it's really helpful.
Yeah, exactly. Yeah, I think that's that's very
important. And I I do the same.

(22:00):
But I what I don't know is that it, you know, should, should
everybody take that? It's like almost like, you know,
the cardiovascular people say you should to everyone should be
on Lipitor, it should be in the drinking water.
Yeah, maybe I don't know about that, but I think amino acids is
definitely something that we should all take.
Yeah, I'm fighting the whole Lipitor thing.

(22:21):
My cholesterol is high and they're trying to put me on
statins. And it's like, no, I'm not going
to do the statins because, you know, the detriment it could do
to my muscles. And there's all the kind of
downsides to it. It's like, let's look at the
lifestyle things that we can change to improve that.
But when you're talking about improving lifestyle, taking in
amino acids is far different than taking a statin, right?

(22:41):
Absolutely, Absolutely. Yeah.
That's a a prescription medication is very different.
Yeah. I think, you know, the statins,
you know, we see a lot of physiological problems with
patients from the statins. You know, the stiffness, body
aches. Some people get it so bad they
can't move. They're like in bed, you know.
So it's just. It's crazy.
So let's keep on kind of some ofthese technological advances and

(23:04):
things going on in orthopedic medicine.
You've been a leader in robotic joint reconstruction.
How has that technology changed the game in terms of the
outcomes and recovery? Yeah, great question.
You know, it's, it's something that I the, the simple
description I described to patients is that you when you

(23:25):
have a map, right? You, you, you have a map in your
car and you're trying to figure,you have a paper map and you're
trying to figure out where you want to go as opposed to having
Google Maps or like a navigationsystem in your car.
The level of detail that you getis on the highest level.
And what robotics has done for us is it's taken the anatomy of

(23:46):
the patient, the three-dimensional anatomy of the
patient and allowed us to do theoperation before we do the
operation. Meaning that a patient comes in
and gets we'll talk about a knee, they get a CAT scan of
their knee from their hip all the way to their ankle.
So we know the the three-dimensional anatomy of
their bones. We know the alignment of their

(24:08):
entire extremity and when we when we take them to surgery, we
test their ligaments. We feel where their ligaments
are tight, where the ligaments are loose.
And remember, your ligaments aredifferent than my ligaments,
then different than my wife's ligaments.
We all have our own ligaments. We all have a certain bow to our
femur. We have a certain alignment of

(24:29):
our bone that it's all different.
But what the robot does, it allows us to understand where,
where that is like where, how isthe bow?
Your femur has a bow and how does your the end of your thigh
bone have a relationship to the rest of the femur?
How does the alignment of your whole leg translate into the way

(24:51):
you have arthritis and how? We want to correct the arthritis
and then balancing the ligaments, making sure the
ligaments are balanced. So we test the ligaments and
then we get a set of numbers andI literally on a computer screen
and instructing a person in the operating room to adjust the
implant, move it up a millimeter, rotate it a
millimeter, move it back and forth, basically positioning the

(25:14):
implants to be at the perfect location for that knee to
function perfectly. And then when I say yes, that's
perfect, the robot comes in, it knows where the hip, where the
knee is in space, and the robot will cut.
I control it, but the robot willcut the bone in the perfect way
to accept that implant in the perfect position based on what

(25:37):
we decided intraoperatively. So if the technology of that,
the advancement of that is so dramatic because now you're
considering so many different things you never could
understand. And, and I would say the sad
part about the way we used to doa knee replacement is we used to
just do the same knee replacement for everybody.
We would say you the the femur should be rotated this much, the

(25:59):
tibia should be cut here and then you would put the implant,
the sample implant in and you would have to say it's not that
great and you'd have to cut someof the tissue to accept the
implant. Now we put the implant in based
on what the how the tissue behaves.
So what, what happens, we end upcutting less tissue.
We end up not damaging cutting ligaments or releasing, doing

(26:23):
all these releases that create scar tissue and bleeding.
Also, the robot works on a thingcalled haptic technology.
So the saw does not exit the bone.
It never, it knows where the bone is.
It never leaves the bone. And so when you're doing a
manual knee, you're, you don't you, you can't control where the
saw is going. So the saw can inadvertently

(26:45):
damage tissues and cut things. And so that makes it very, very
minimally invasive and it gives you a confidence that you can
perform that operation at the highest level.
So what do we see? We see less bleeding, quicker
recovery times. As far as getting rid of
assisted devices, we see very easy range of motion.

(27:07):
You know, my patients will, will, will achieve 90 to 100° of
flexion in a knee at two weeks without a doubt.
It's we never get any issues with stiffness or problems like
that. And I have patients of my own
that I did a manual neon and I did a, a robotic neon and I
asked every single one of them, what do you think?

(27:28):
And they're like, the robot is far easier.
I recovered much faster. I had less pain, I took less
pain meds. And so we're just seeing a, a
very advanced technique of, of how we can do this operation on
the highest level. So you've just taken my already
high level of respect for orthopedic surgery, an even

(27:48):
higher level? I'm glad.
I'm glad you're, you're I'm gladwe're educating you.
That's fantastic. I love that.
Yeah, it's, it's amazing. I mean, it's just like, you know
exactly where you are at all times.
You know, you, there's no guessing game, you know, like
like if someone has a little bone spur in the back of their
hip or a little bone loss or thethe coolest thing, I think the

(28:10):
coolest surgery is, you know, when someone has a pelvic
fracture and they have screws and plates in their pelvis and
they need then they need a hip replacement.
We used to go in there blind. We should just kind of ream and
say if we run into a screw, we'll take it out.
But now with the robot, we get aCAT scan of the pelvis and we
look at the CAT scan, we say, oh, see this one screw?

(28:32):
You just take this one screw out.
Then you put the acetabular component in and you're done.
So you know exactly the screw. That's the problem.
You're putting it in so perfectly.
It just, it's, it is amazing. And we, we joke about it because
we say the X-rays are boring because our X-rays are so
perfect every single time. It's just like it's it's, you

(28:53):
know, we used to look at the X-ray, say, ah, you know, the,
the cuts a little off or this isnow it's just like absolutely
perfect. Right, blowing me away.
So what are some of the key advances in orthopaedic care
that you think every aging adultshould know about?
I think some of the key advancesare some of the non, non

(29:13):
surgical stuff. I think that there's a, there's
a huge world of, you know, I hate to say, give that say the
term stem cells, you know, because that's a kind of a very
broad kind of, you know, term that people use.
But one of the simplest things that's being used quite
frequently in an orthopedic practice is platelet rich
plasma. You know, you know what that is?

(29:35):
It's taking your blood, spinningit down, removing the red blood
cells, the white blood cells andthose platelets have growth
factors in them. And I think that the biggest
thing we see when people age is blood flow, right?
The blood supply to your tendons, the blood supply to
your joints, the blood supply toyour cartilage diminishes.
And what platelets do is they stimulate, they have growth

(29:55):
factors. That part of the growth factors
is to stimulate blood flow to the area angiogenesis.
And so I think that that's a common thing used to kind of
help tendonitis, help treat inflammation, arthritis.
You know, in my practice, if youtear your labrum in your hip and
you're in your in, you're in themiddle-aged person, you're going

(30:18):
to get PRP. If you tear your meniscus,
you're going to get PRP. We really try to be non surgical
with these people because those surgeries, sometimes the
arthroscopic surgeries aren't always successful and so that's
a big thing. The other thing that I do
frequently is a bone marrow injection.
It's kind of similar to PRP where we take a little bit of

(30:39):
bone marrow and we spin that down to concentrate the cells
and we inject that into areas. Of the body.
I usually use bone marrow for people that fail PRP, that kind
of don't get a good response from PRP.
So and then there's a lot of technology that's coming down
the line. I'm a believer in using your own
tissue. I think that when you're taking

(31:02):
somebody else's tissue, somebodyelse's umbilical cord tissue and
somebody else's placental tissueand you inject it into yourself,
we don't know how it's going to react.
And probably most of the time your immune system just eats it
up. I think that where, where we're
really starting to advance is inyou trying to figure out how we
can, you know, replicate a, a type of stem cell or control

(31:25):
your cells to do certain things.There's a, there's an
interesting company that, that I've gotten involved in called
Acorn, which is out of Canada, out of Toronto, where they're,
they take 50 hairs out of the back of your head and that
they've found it within the follicle.
There's, there's lots of very immature stem cells and they

(31:46):
want to kind of see that maybe you could pluck your hair and
then grow these these cells and then we can modulate these cells
to treat arthritis or treat meniscus or treat tendonitis.
You know, so I think that that'swhere the world's going to go.
You know, maybe one day you cometo my office and we draw your
blood and we can manipulate the cells of your blood or your bone

(32:08):
marrow or or whatever and try tolike get those cells to work in
a way to help heal. And I think that's where we're
moving towards. But right now the plasma is
really commonly used and you know, in my in a day in clinic,
I'll do 5 or 6 PRP injections and and we get a lot of great
results with it. So I might be a little too far

(32:29):
gone for the the hair follicle treatment.
Oh yeah. We could take it off your face.
OK, well, I'll do that then. I'll, I'll save the beards so
that I can save myself down the road.
I was going to bring up PRP withyou and I initially hadn't
really planned on it, but I havea student, he's a football

(32:50):
player at Western Oregon where I, I teach.
And he had some hip issues, had hip surgery.
And he, you know, he was talkingto me the other day about, you
know, contemplating what he should do treatment wise that,
you know, the the physicians trying to get him to do more of
a corticosteroid injection. And he's also been weighing PRP

(33:13):
and, you know, knowing that PRP is expensive and it's not
covered by his healthcare insurance, but he's like, yeah,
I still think I'm leaning into doing the PRP, even the cost of
money. What would be your
recommendation on that? Because I have limitations to
doing the corticosteroid injections.
I mean, it, it screwed up my shoulder.
I had an orthopedic Doctor Who wouldn't listen to me about a

(33:35):
bicep tendon issue and ended up injecting A corticosteroid.
And I leaned in there thinking, OK, he's, he's the MD.
I'm just a PhD. I'm not the right kind of
doctor. But within a couple weeks, I'd
ruptured my bicep going to pick up my my toddler son.
And you know, PRP really wasn't as much of an option back then.

(33:56):
But it would seem like for an athlete in his situation, even
though he's probably not likely to GoPro or anything like that.
The longevity benefits of doing PRP in your early 20s as opposed
to a Cortico steroid injection. What what would be your
recommendation to I know this iswe got to probably put the
disclaimers on there. This is not medical advice, but

(34:18):
what are your thoughts? Yeah, it's a great question.
I think, you know, in in young athletes, we really don't do
steroids really much at all. I mean, it's very, very rare.
I think that corticosteroids aregreat for someone in a lot of
pain. Like you have acute, acute pain,

(34:39):
you're, you're having trouble even taking a step.
You're, you're just, you're having just your, your knee is
just on fire, right? That's a reason to do
corticosteroids. The other reason the
corticosteroids is beneficial issometimes in tightness, like a
frozen shoulder. If like, or if this athlete had
a stiff hip, like his hip wasn'this, his hip just he just had

(35:00):
laid down too much scar tissue and you want to soften up that
scar tissue. That's a reason to do it.
I really have a, you know, I really limit the amount of
corticosteroid. I do.
Absolutely. I mean, I would never, we never
inject around the biceps for theexact reason that you said,
because you get a rupture in an athlete like that for sure.

(35:22):
If they are, if they are gettingcoming back and they're having
inflammation and a little bit ofirritation of the joint, PRP is
highly effective. There's a lot of data out there,
a lot of research articles showing that in patients that
have labral tears in their hip, in young athletes, that cortico
steroids is ineffective. It just doesn't do anything.

(35:42):
And then also that that even after the surgery, it doesn't do
much. So we try, we don't really do
much. But I think I would tell that
athletes, my patient for sure todo PRP and sometimes it takes a
couple to get them to kind of cross the finish line.
And it's also a wonderful way tohelp an athlete in season.

(36:03):
So like, let's say an athlete has a labral tear in the hip and
they're like, I know I need surgery, but I want to finish up
my season. We would do PRP in season.
And because because the PRP not only helps angiogenesis and
blood flow, but it's a, it's a huge anti-inflammatory because
you give it to a patient within a week, they say why I already
feel better when we know it takes much longer than that for

(36:25):
it to really work. But the anti-inflammatory effect
could be very powerful. That's really good stuff to take
back to my classroom, so. Yeah, yeah, absolutely.
So I'm going to kind of switch gears a little bit here and go
back to your kind of life growing up with psychologist or
psychiatrist pair. Psychologist.
Yes. You've spoken about the

(36:46):
importance of empathy and communication in medicine.
How does that philosophy play out in your practice?
And I would expect that it has even more importance dealing
with high level athletes as wellas aging population.
Yeah, You know, I, I never realized how great of a
upbringing am I had with my parents until I kind of became a

(37:08):
doctor and I was in practice andworking with people where I
learned, you know, a lot of patients would say, you know,
you're, you're not a typical surgeon.
Like you spend time with me, youtalk to me, you listen to me,
you don't interrupt my, my, my questions that I'm asking you.
I also think that I have a, a level of understanding of kind

(37:29):
of human behavior and kind of like how they, how people are.
And I think I, you know, one of the things I always say is that,
you know, when you're a patient,you call my office and you make
an appointment and you, you havea knee, you have knee pain and
you have a story that you want to tell.
You. You there's.
Something that that patient wants to tell me and get it off

(37:50):
their chest, right? It's, it's, it's kind of the
natural like, like you have yourbest friend and you're about to
go have lunch with your best friend.
You may have like 3 stories likeI got to tell my buddy Jim,
there's these three great stories.
And it's, it's, it's part of like human experience and kind
of like what you, what makes youfeel whole as a person.
And so if a person comes to youroffice and they start telling

(38:11):
the story and you're like, okay,okay, just tell me about your
pain. Where's your pain?
You know, and you just kind of really, you know, cut into them.
They really, I think as a patient, you feel like you're
not being heard. And I think even though in the
end, like I know within 5 seconds kind of what I'm going
to, I'm thinking about doing with this patient, you know, I
kind of have a sense of like what they done it for so long.

(38:34):
I kind of sense like this guy's going to need a PRP shot.
This guy's ready to have his hipreplace.
I kind of sense it, right? I let them tell their story
because I know that's what they want and they want to tell me
the story about how it's affecting their life and how
it's affecting their, their, their relationship with their
family and all those type of things.
I also think that there's certain things that patients

(38:56):
want to understand. And I think that spending time,
even though they've never seen ahip MRI before, going through it
with them and showing them what it looks like and what are the
anatomical parts of it and really explaining it to them in
a very simple, simple way. You know, this is the ball, this
is the socket, you know, this islike a gasket, like just really

(39:17):
explaining simple way, mechanical ways of what the, the
how the body works really helps patients.
And then I also ask a lot of questions.
I think a lot of orthopedic surgeons don't ask like who's
your support at home? Like who's helping you at home
when you after you have surgery?Like what's your environment?
Like? What do you do for a living?
Like is there travelling? Is there not travelling to try

(39:40):
and just get an understanding oflike what makes this person
tick? You know, like some people are
like, they're like I, I'm a, I'ma gym rat.
Like I have to work out. If I don't work out, I go crazy.
I'll say, listen, when we replace your hip within a week,
you can go and lift weights, upper body, you can do that.
And they go, oh, thank God. I thought I wouldn't have to.
I could, I couldn't work out forlike 3 months, you know?

(40:02):
And then you say you can drive after a week or two and they're
like a week or two really because they're like they felt
they're going to be in jail. I think that with patients, you
know, it's, it's a lot of it is about, you know, relating to
them and having the, and having a great experience.
And I think, you know, a lot of people think of a doctor's
office as a very, you know, sterile and, and very formal.

(40:25):
And we, we try to make it more like, like I always tell
patients, never my, my staff, excuse me.
I try to tell my staff like I wanted this like a hotel.
Like when you walk into a hotel,you have a smiling face and you
have someone that's like welcoming you.
We don't want to make the experience for them, you know,
and so I try to make it welcoming.
I try to make them like they're part of a family and they're

(40:48):
part of the experience and understanding about their lives
and about tell me, question things about their trip.
And I tried to also relate to them on what they do for a
living, you know, So for example, you came into my
office, I'd ask you some questions about what you do and
like you know, your experience with athletes and understanding

(41:08):
about the. The the the.
Experiment, you know, some of the research you do in
Physiology and like really understanding stuff like that to
kind of figure out what makes you tick.
And by understanding that, I think you really understand who
the human is and who and, and what they're all about.
And that makes us have more moreempathy for what they do and

(41:30):
where they need to get back to. So I'm going to ask you, what
was your undergrad in? My undergrad was in was in
biology with a, but I also did alot of exercise Physiology
classes I didn't make. I didn't have a minor in it, but
I did do a lot of exercise Physiology classes.

(41:51):
Because I'm always curious with medicine, I tend to really push
for more of our students to go into medicine.
And I'm of a mindset that all physicians should come from an I
don't know, I'm biased, but all physicians should come from an
exercise science background because they get a little bit
different perspective than you get from biology.
And I didn't know if. Maybe you know, you had a little

(42:12):
bit more of a psychology background in there or what?
Or it's just your parental influence?
Yeah, it was, it was my parentalinfluence.
But I, but I, I think that from my standpoint, you know, I came
from a athletic training, I was around, AT CS, I was around
physical therapists, I was around orthopedic surgeons.

(42:33):
I was, I was learning about, youknow, body fat, VO2 Max.
I was learning about all this kind of exercise Physiology
stuff to understand and you know, because you make a great
point, you know, when you learn anatomy in medical school, it's
one thing, but orthopedic anatomy and orthopedic
dissection and learning how to where the planes are that you

(42:54):
have to get in to, to, to understand where you're at.
And I think to be a great orthopaedic surgeon, you have to
really have an understanding of three-dimensional anatomy.
It's like, OK, this muscle's here, but what's behind that
muscle? What's to the left of it?
What's to the right of it? If I put AI, put a pin through
this bone, what's it going to hit on the other side?

(43:14):
You know, understanding life. It's not just what's in front of
you, it's all what's behind you,you know, and it's, it's, it's
almost like like a door. You open a door, but there's a
whole world behind it. You have to be very aware of
where you are with that because it can be very dangerous if you
don't have an understanding of that three-dimensional anatomy.

(43:36):
And one of the things that I've adopted in in really stressing
to my students and I picked it up from other physicians that
talked about medicine needs to be biopsychosocial.
And you're talking a lot about that psychosocial piece.
But I had a bio mechanics colleague who said, oh, no, but
it's biomechanical. And like, wow, you're absolutely

(43:56):
right. And I think that's a lot of what
you're talking about as well as an orthopedic, you're bringing
in that mechanical piece in addition to just simply the
biology, the Physiology and the psychological piece.
And so I think it's important for people to understand that
when you're looking for a physical physician, look for one
that's understanding that it's at biomechanical psychosocial
piece. They're not just treating the

(44:17):
the biology, you know, they're not just giving you a drug to
treat a symptom. They're looking at the root
cause. They're understanding the root
cause, but they're also understanding that you are human
being and this disease is injury.
Whatever it's going to be is going to have an impact on you,
you know, in your social life, in your psychology, especially
dealing with athletes. I mean, you're, you're
definitely dealing with some psychological issues when you're

(44:40):
talking about, well, you're not going to be able to play for the
rest of the season or whatever it might be.
It's it's really critical to have that approach.
Yeah. And I, I think that like when
you're dealing with athletes, there's so many aspects to it.
I mean, there's, there's, you know.
Especially on the. Professional side, I mean,
they're getting paid huge money to play these sports and, and

(45:00):
you know, when you look at an athlete, you know, they may have
an injury and they may ultimately need an operation,
but you have to look at where are they in their contract?
Like is this their last this year?
They just signed a contract. Like how are they, how are they
doing with the team and how how are they performing?
All those things play a role. You know, sometimes an athlete's

(45:21):
like he's like, I don't like this team I'm playing for.
I don't care about this season. I want to just get fixed and
move on. Sometimes that happens.
Some athletes say, just patch meup, get give me some PRP, give
me some physical therapy and letme get through the season.
Then we'll talk at the end of the season or they'll say
there's no way I'm having a surgery right now because I'm up

(45:42):
for a new contract. If I have surgery, I'm never
going to get a new contract. So it's just you have to
understand where they are in that whole thing.
And also a lot of these injuriesare overuse.
And so you try to, you know, kind of keep them going with
these injuries before and try toprevent the joints from breaking
down and, and keeping them going.

(46:02):
So it's not just as simple as like a person comes in your
office and they they need a surgery and you're going to have
an operation. It's just there's some things
that they have to like if someone tears your ACL, they
have to get fixed there. There's certain things that we
can do to kind of keep them going, but a lot of it depends
on who they are as an athlete and kind of where their mindset
is. And the older adult is probably

(46:24):
a different beast. What do you wish more doctors
understood about caring for older adults?
I think that for older adults, you know, the, the understanding
that they are still important, you know, that their, their,
their exercise and their, their,their life, living a, a full

(46:44):
life is very, very important. And not diminishing that, you
know, this guy's just, he's 78, he's an old guy.
He's never going to go anywhere,never going to, he's not going
to walk that much. He's just, he's just kind of a
sedentary person. I think that, you know, throwing
them into this kind of big bag of just an older person is
probably very, you know, very biased.

(47:08):
And I think that we have to really look at them as vibrant,
active people and doing whateverwe can as orthopedic surgeons to
keep them going, whether it's a surgery, whether it's
injections, whether it's, you know, recommending all kinds of
treatments. And I think it's very important
to understand that, like, we don't work on an island.

(47:31):
I have a world around me of chiropractors, physical
therapists, body working people,you know, a specific athletic
physical therapy versus balance physical therapy, you know, all
different kinds of things that we can kind of dial in a
treatment protocol for people. We have nutritionists, you know,

(47:51):
we have, we have home programs that we have for patients.
We have so many different thingsto help these people get
through. And that's part of what I do is
I connect people. And so someone comes in and
says, you know, my dad is not walking that much.
So I say, hey, listen, we're going to get a therapist.
I call that say, hey, you got toget Jim up every day and make

(48:11):
him walk, you know, 2 miles a day and until he gets the habit
of it, then you can let him go. But like, how do we make this
person, you know, as physically active and have a rich, healthy
life for for everybody? And you've touched on a few
things already, but I'm going tohave you kind of narrow it all
down into just top three recommendations for people who

(48:32):
want to maintain joint health and mobility as they age.
Well, I think 1 is resistance exercise.
That's a key thing to resistanceexercise.
Two, I would say daily stretching, working on
flexibility, movement, range of motion.
And I think 3 is protein, like just maintaining a level of

(48:56):
protein in your diet. We talked about amino acids and
stuff like that, but just make, well, however you like to get
protein in your body, whether it's supplements combined with
food, but really maintaining theprotein in your body.
So when you do your exercises, you maintain your muscle mass
and you have those building blocks.
Great recommendations and we've talked about resistance

(49:16):
training. Can you under score again?
Why? For any age, resistance training
and movement can be safe and support one's orthopedic health.
Because I think a lot of older people start thinking, well, I'm
too old to start lifting weights.
All right, right. I, I think I, I, that's a great
comment. I think a lot of older people
say I'm going to go to the gym and I'm going to, you know, I

(49:38):
had a guy in the office yesterday goes I went to this
trainer. He he thinks the guy thinks I'm,
I want to be Muhammad Ali. You know, I want to be this big
boxer fighter. I go no, we, you know, I think
it's very, very important to do resistance training and like we
always that the classic comet, higher reps, lower weights,
lower weights, but resistance, you know, it can be a 5 LB

(50:01):
weight. It doesn't have to be 30 LB
weight because we obviously don't want people to get injured
and tear tendons or damaged joints.
But having some resistance against your body on your upper
body, on your core, on your lower legs is very important.
That's how the muscle builds. And so you may not build a lot

(50:21):
of muscle as you get very older,but you're gonna maintain what
you have. And so maintaining what you have
or trying to build a little bit is very, very important.
And it's safe to lift weights. It's very, very safe.
And it's actually, like we said earlier, very healthy for your
bone density. And so having resistance is
probably the most important thing that you can do for to

(50:43):
have a healthy lifestyle and be very strong.
And you know that they, they, you know, if you read a lot of
these longevity books or listen to some podcasts, you know, they
talk about getting up off the floor, you know, someone should
be able to get on the floor and get up, you know, And so if you
think about that, it sounds verysimple, but a lot of people

(51:04):
can't do it. You know, a lot of people cannot
do that. And I, and I, I myself self do
that with my, with my trainer, do a lot of up and down off the
floor exercises to really work on that balance and strength.
And it really, really helps to to do some simple exercises to
help build that muscle and keep your body strong as you age.

(51:25):
So in your opinion, what does itreally mean to age well?
I think to age well is being able to be, there's a freedom
in, in, in, in aging well in that being able to travel, being
able to, you know, be independent, drive a car, being
able to go for a nice long walk at the beach or, or down the

(51:47):
street or in on a, on a trail. I think aging well is, is being
able to maintain a level of activity where you can enjoy the
world around. I think that's the most
important thing because we get alot of joy from that.
You know, you go on a nice hike and you smell the fresh air and
you smell the trees and have great, you know, views of a

(52:09):
Vista that's that's therapeutic to people.
And then I think that being ableto do those things are
wonderful. And I think also being able to,
you know, you have grandkids, being able to take your
grandkids to the park and walk around with them, being able to
travel with your children, whether it's going like in
California, going to Disneyland or, you know, going, you know,

(52:31):
going to the beach. I think that being able to be
active with your your grandchildren and your children,
I think is very, very important for not only your your physical
health, but your mental health. OK.
So next question is, when I ask of all my guests on this show,
what are you doing personally toage well?
You talked about lifting weights.
Yeah, so I, I work out with a trainer two to three days a

(52:53):
week. And I also recently, I hadn't
been doing it for a long time, but I recently got into cycling.
I've been doing Roads Rd. biking.
We had a group of friends that we've been doing some cycling a
lot. So I've been doing, I just rode
40 miles last Saturday and 50 miles on Sunday.
So I'm getting some long cyclingand which I'm loving.

(53:17):
I love the wind on my face. I mean, in, in California, I can
go all the way up and down the beach.
You know, they have a nice trailup and down the beach.
So you know, the ocean is there.You get the breeze, you smell
the ocean, which is wonderful. And then I'm also, I'm, I'm also
an obsessive golfer. So I love to golf.
So it's, I walk the course. So, you know, when you walk, our

(53:40):
course is probably about 7 mileswalking, you know, maybe a
little longer. So it's so, so I walked the
course and that, that's part of my exercise.
But I just love being outside. And, and I also love golf for
the, for the mental health, because it's nice to talk with
your friends and tell stories and, and catch up with people.

(54:02):
So that's that's that's nice forme.
So golf. They teach in Med school, right?
But they don't really teach enough about nutrition and
exercise science. Exactly.
Yeah, I mean, I so much of what we learn, you know, all the, you
know, what's crazy is that everysingle operation that I do now,
I never did as a resident. It's the approaches are the
same, but the technology that weuse and the things that we do

(54:25):
are completely different now. And the things that we talk
about about, you know, supplementation and exercise and
and maintaining muscle mass and bone density, these are all new
concepts that we really didn't really understand back then.
And I think that are the information is going at a high
speed rate. And now with AI, it's going even

(54:47):
faster. And I think that you, you know,
it's a, it's a wonderful time tobe a physician.
It's, it's exciting. It's, it's so many breakthrough
ideas and it's, it's, it's, it's, it's a pleasure to keep up
with it because it's so fun and,and, and fresh and new.
So I, you know, after 20 years in practice, I'm still having

(55:07):
fun and still enjoying every, everything I do.
And I, I wait, wake up, I tell my wife all the time she goes,
are you ever going to get tired of being a doctor?
I go, no, I wake up every day happy.
I love going to work and I enjoyit.
And you kind of answered my lastquestion, but what gives you
hope about the future of orthopedic medicine and how we
care for aging bodies? I think the hope is that you

(55:28):
know, as we, as we, you know, wetalked about robotic technology,
there is, we are robotic technology is just the cusp on
the cusp of where we're going. And I think one thing that's
going to happen is AI, you know,we're going to be able to make
decisions in the OR and understand the ramifications of
our decisions based on AI and outcomes, stuff like that.

(55:51):
I think also there's going to besome automation like, you know,
we have to now look inside of a joint.
There's going to be a time wherewe can maybe make even smaller
incisions that we make or maybe less dissection and the robot
will be able to go in and prepare things on its own by
itself. And so that's there's a lot of
technology in where we are. And also when you have a doctor

(56:14):
that just comes out of residency, they're not
experienced. But the robot can be kind of a
leveling thing where we basically people can do
surgeries at the highest level, but may not have the most
experience. So access to high level medical
care, I think will be will be very broad.
You know, we'll be able to, you know, do remote surgeries or be

(56:35):
even even participate in operations or care remotely
through robotics and AI. So somebody like in you know,
Saudi Arabia or someone in, you know, China wants to have a
robotic hip replacement, we can help guide that surgery robot
robotically and remotely. And so that that's going to

(56:56):
happen and I think that it's very exciting.
Yeah, It seems like AI can gain that level of experience that a
single physician can't gain in residency and even over a career
of medicine. I mean, there's always going to
be somebody, some remotely did something a little bit different
than what you normally do that would benefit in the situation
that you're in. That's right.

(57:17):
That's really exciting to think about medicine from that
standpoint. Yeah, it is very exciting.
And I think it's, it's, it's exciting to think about how you
can have access to things, you know, like, I mean, you know,
we're not far away from having a, you know, imagine you have
something even in your house, you know, or something, or
something you connect to your computer that like, you get a

(57:39):
cold, you get sick. You could have a robot draw your
blood, you know, run some physiological tests on you.
And they say, you know, you probably have strep throat, you
know, and then, and then that day an Amazon delivery person
delivers you some AZ pack and you take it or, or delivers you
some, you know, over the countermedication.
You know, just, there's a lot ofthings that we do that we see a

(58:02):
doctor for and have to make an appointment and drive over there
that a lot of that stuff's goingto come in house or, or locally
to your local Walmart or your CVS or whatever place that you
go to. It's, it's just going to change
a lot. And I think things are going to
get smaller. They're going to get more
efficient and more more more sleek.
As far as. Access to medicine.

(58:24):
You got me flashing back to my childhood growing up with The
Jetsons and Star Trek. Yeah, exactly.
I know, I mean, I was, I'm, I'm,I'm a little bit of the other
thing I love to do at home is I'm, I'm a big, I'm a chef.
I love to cook a lot. And so I, you know, there's a
robot now that you put the flourand the water.
And the ingredients and it can make you just.

(58:45):
Push a button, it can make a Neapolitan pizza that's like the
best pizza you've ever had all by itself, you know?
So it's like it, we're not far from, you know, think about it
like having a robot in the housesaying like, I want to have
steak and potatoes tonight or I want to have, you know, you
know, spaghetti Bolognese and itwill just cook it for you.
You know, it's, it's, it's, it'sreally amazing where, where all

(59:07):
this is going. And it's, it's some of it's
scary. It's you know, to have all these
like robots and things around you controlling your life, but
some of it's just incredible. And then and and.
It blows your mind. Yeah, the, the question I guess
remains, what are we going to dowith the time that the robots
free us, free us up to do, you know, it's like.
Exactly. As long as we replace it with

(59:28):
healthy behaviors, then it's great.
But it's just going to get us. I think of the movie Wally, you
know, you know, scrolling aroundon those little scooter things
with their computers in front ofnot being active.
And I always tell my students that the show freaks me out
because when they get off the the rocket and they they get up
and they walk down on the earth,it's like there is no way that

(59:50):
they have never walked in their life.
They would be crushed under their body weight.
Exactly. That's funny you say that.
Yeah, you're absolutely right. No, I think, I think that, you
know, as human beings, we still need human connections.
And I think that that's very, very important.
And I think one of the things I think is negative about

(01:00:11):
technology is that if you go to a hospital and you walk down the
hall, you know, in the old days we used to have paper charts and
it was right by the door of the patient.
And you would basically like go in and talk to the patient, walk
out and write a little a quick note in the chart, you know now.
Everything's on a computer and when you walk down the hall of a
hospital, all the nurses and everyone are in front of the

(01:00:32):
computer just typing away, typing away, doing all these,
you know, check, checking boxes and doing all these things.
And nobody's with the patient. Nobody's talking to the patient.
And also when you look at the digital chart, there's so many
things that get auto populated. It's very, very difficult to
figure out what exactly is goingon because the notes are kind of

(01:00:53):
in these weird ways and there's so much, the notes are like
every, you know, it's like 5 pages.
So it's like this big, the documentation is just almost
oppressive. So we lose a little bit of that
human aspect to, to medicine. And so I think that as doctors,
we have to really put our foot down and say this is still a

(01:01:14):
human experience. You know, like for myself, like
when I see patients in the office, I, I'm not in front of a
computer. I have, I have a computer that
shows the imaging, but I have a scribe in the room and she types
all, everything I say to the patient and everything, all my
physical exam, she enters it in the computer.
So I am 100% locked into the patient.

(01:01:34):
They have, my eyes are on them. I, I'm not leaving that, that
I'm, we're in front of each other talking, explaining
things, answering questions. So they have a 100% of me.
And so I think it's important for doctors to really maintain
that because that's we can't lose that because that will that
will change the world if we do that.

(01:01:54):
And that's another opportunity for AI, although that could take
away that job of the scribe, But, you know, being able to
record the audio and transcribe what's going on in that room and
in the same process be drawing in other information to help
make the decision. That's that's the kind of cool
thing to think about. Yeah, all.
Right. Well, you've really excited me

(01:02:15):
for the the future of at least orthopedic medicine.
Any last words for our listenersand our viewers?
I just think is is stay active and enjoy the world.
Get outside and enjoy this beautiful country that we have
with all the mountains and lakesand oceans and everything like
that. Just and be as active as you

(01:02:36):
possibly can be and, and encourage your children and your
grandchildren to be active. You know, to the more I, I've
noticed it in my life, the more active I am, the more active my
kids are. And so it's just, it's have
physical things in your life that may be an active person and
encourage your whole family to be active.
Keep moving. That sounds good.

(01:02:57):
It's great advice and talking tome.
I just I really enjoyed your time today.
This was a great conversation. Appreciate what you're doing.
Just keep doing it and just keepaging well.
Thank you and thank you. Thank you for having me on the
podcast. I really enjoyed it and amazing
conversation. Thank you for having me.
Thank you for listening. Hope you benefited from today's

(01:03:18):
podcast and until next time, keep aging well.

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Episode 256 | Tips For Joint Health and Longevity | Latest Advances in Bone Health | Dr Jason Snibbe

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Episode 256 | Tips For Joint Health and Longevity | Latest Advances in Bone Health | Dr Jason Snibbe