A New Era of Sports Medicine and Patient Recovery with Dr. Matt Thompson

Episode Transcript
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Speaker 1 (00:01):
All right, everyone, welcome to another amazing
episode of the Daria Hamrapodcast.
Today is a very special day andI know you hear it every time I
do this podcast, because everypodcast is special, but this one
is personal, just because whatwe're about to discuss with the
person we're about to discusswas life-changing for me and

(00:26):
will be life-changing for a lotof other people that are
involved in my care, andhopefully you can spread the
word so you can change thepeople's lives that you come
across.
Now we're diving into somethingtoday that's been on my mind a
lot lately.
In particular, I'm talkingabout cognitive bias, group

(00:50):
thinking and a bit of old-schoolpaternalism that are still
affecting how we practicemedicine.
I mean, think about it.
We're in this incredible age ofinformation, right, With new
research and breakthroughshappening all the time, but
sometimes it feels like thefield is still holding on to

(01:13):
outdated habits, almost out ofcomfort or tradition, maybe a
little bit of ego, I'm not sure,but we all know how easy it is
to fall into a routine, right, Imean to keep going and doing
with what's familiar because itfeels safe.
But that's where cognitive biascreeps in and it can really

(01:38):
limit our ability to see thingsclearly and adopt new approaches
.
And let's not forget groupthink.
It's that whole.
Everyone else is doing it, soit must be right mentality which
can make it so hard to pushback against the norm, even when
the data or even your gut tellsyou otherwise.

(02:01):
But the real issue I want toaddress today is this kind of
paternalism we still see withinmedical societies and the
leadership.
It's the way theseorganizations can make it
difficult for members, doctorsand scientists to challenge the
status quo.
It's almost like if you don'tfall in line you're seen as a

(02:24):
troublemaker or someone who'sjust not getting with the
program.
But real progress comes fromasking tough questions,
challenging accepted practicesand not being afraid to stir
things up when we see room forimprovement.
When we see room forimprovement and this isn't a new

(02:47):
struggle, by the way.
Even Dr Claude Bernard, who isreally known as the father of
modern medicine, was onto thisover a century ago, in the early
1800s.
He said the true scientist isone who can resist the
temptation of the firstplausible explanation and is

(03:07):
vigilant against his own biases.
True science is the enemy ofdogma.
That's exactly it.
Real progress in medicine meanswe've got to stay curious, keep
questioning and never settle,even if it means standing up to

(03:29):
the bigger system in place.
So today we're going to unpackall of this, look at how far
we've come and where we stillneed to push forward, push
forward.
Today's guest is a gentleman whoI am proud to call a friend and

(03:49):
colleague, whom I met almost tothe date, exactly a year ago,
when I was not feeling well.
We casually met at a mutualfriend's dinner and as I was
going through a lot of healthissues nothing serious, just the
usual stuff my doctor called itI'm getting older, or I'm

(04:14):
working too hard, or I'mstressed.
You know what I mean yourshoulders are aching, your knees
are popping and hurting.
You go one flight of stairs andyou're huffing and puffing and
you're thinking what's going on?
What happened?
All my life I was an athlete.
All my life I thought I'meating well, I thought I'm doing

(04:38):
well, not least for peopletelling me and complimenting me
all the time how in shape I amand how good I look.
But none of that reallymattered at some point.
So Dr Matt Thompson, who is myguest today, in a very casual
conversation which we're goingto talk about, changed my life.

(05:01):
But before we get to it, I wantto introduce this amazing
physician, an orthopedic surgeon, who grew up in a small town in
Kansas.
He spent his summers working athis dad's tire store, which
instilled him with strong workethics from an early age.
He further went on to graduatewith honors in chemical

(05:23):
engineering from the Universityof Kansas, even becoming a
national champion in thechemical engineering design
contest.
Also, he joined later the trackand field team at Kansas and
spent there a whole year.
He further then went to get hismedical degree at University of

(05:47):
Pennsylvania School of Medicinebefore completing orthopedic
surgery residency right aroundthe corner here at George
Washington University.
He pursued his passion forsports medicine with a
fellowship at the prestigioushospital for special surgery in
New York City, which isconsidered number one in
orthopedic hospital in the world.
While there, he had theincredible opportunity to work

(06:09):
as an assistant team physicianwith the New York Mets, and he
continues to bring thatexpertise to athletes at all
levels today.
But his journey didn't stopthere.
Dr Matt Thompson joined forceswith a fellow resident to build
what is now PrecisionOrthopedics and Sports Medicine,
growing the practice from justtwo doctors to 25 across 15

(06:34):
locations.
Along the way, he also made hismark on the field of surgical
innovation.
Holding a patent on anFDA-approved surgical implant
that's already in use today and,in true forward-thinking
fashion, he is helping toimprove an AI-driven physical
therapy and surgical recoveryapp called my Health Track.

(06:56):
He's passionate about thefuture of medicine, and that's
one of the reasons why he's onmy podcast and always looking
ahead to where we can be in 5,10 or 20 years.
Today, we're going to exploreinsights on the newest frontiers
in healthcare, sports medicineand how technology is

(07:17):
transforming recovery andperformance.
So, Matt, I can't wait to diveinto these hundreds of questions
I have for you.
So for the listeners, stay put,it's going to be a long one.
So, Matt, thank you and welcometo my podcast.

Speaker 2 (07:33):
Thank you so much, Darya.
Thank you so much.
I'm excited to get started onall these questions.
We've got so much fun stuff totalk about.

Speaker 1 (07:40):
Yes, so I have mentioned you on many of my
previous podcasts, which you'rethe one that actually sent me
down this rabbit hole of healthand wellness, for the reasons I
stated above, and I don't knowif you remember, but it was
exactly a year ago when we firstmet at a mutual friends dinner

(08:00):
and I was really contemplatingwhether I should ask you or
bother you, because I hate it.
You know how it is You're adoctor, you're somewhere and
people find out that you're adoctor and start hitting you up
with millions of questions andbecause I'm aware of that, I
usually try not to do that toother people.
But it was something that I wasreally desperate people but it

(08:27):
was something that I was reallydesperate and I had gotten a
steroid shot in my shoulder thatmaybe helped 30%.
I was told I could get up tothree and obviously I know what
the downsides of those are.
So I wasn't very excited aboutit and keen on it and just try
to through persistent andcaution when I do my workouts to
slowly build up the musclesaround my joint.

(08:49):
But then it was kind of like asI was doing it I was
aggravating my joint and,needless to say, I had a labrum
tear, I had previous rotatorcuff injury and I was pretty
much falling apart and, matt, itwas getting into my head Now,

(09:11):
looking back, I was actually alittle bit depressed.
It was affecting my mood.
I felt like it's over now,almost like an athlete that had
to hang up his cleats for goodand was now wondering what's
next.
I was imagining myself with adad bod, which is something that

(09:32):
I just can't see myself ever,but it was happening just
because all these issuesaffected first the level of my
activity and then, eventually,my mental status, and I fell
into that vicious cycle.
And you better than anyoneunderstands, because you do that

(09:54):
for a living every day and nowhave these conversations with
your patients.

Speaker 2 (09:59):
Oh, every day yeah.

Speaker 1 (10:01):
Right.

Speaker 2 (10:05):
I mean, I think we take health for granted.
Um, if you ever get sick, theonly thing on your mind is how
do I get better?
And if you're not thinkingabout it when you're healthy,
you really take it for granted.
But as soon as you have pain,as soon as you have an injury,
that's the only thing thatmatters.
And I feel you there exactlywhen you have that shoulder pain
, and it's always right therenagging on you.
That's the only thing thatmatters.

(10:25):
And I feel you there exactlywhen you have that shoulder pain
, and it's always right therenagging on you.
That's the only thing thatmatters.
You've got to take care of that,if you ever had a pinched nerve
in your neck or your back.
That's the only thing thatmatters, so I'm with you on that
.

Speaker 1 (10:34):
Yeah, and it was even the simple things like washing
my back in the shower or puttingon a coat or my shirt.
It was putting on a coat or myshirt.
It was like a stabbing pain inmy shoulder, to the point that I
became so self-aware andhyper-aware that I was scared to
do certain things because Iknew my brain was conditioned

(10:56):
and it was literally gettinginto my head and psychologically
it really messes with you.
And that's the part that I hadnever experienced and that
really got to me.
And we're going to talk abouthow easily I got over it just

(11:17):
after a conversation with you.
You probably didn't even knowhow much you helped me at that
conversation.
I didn't realize at the time.

Speaker 2 (11:25):
Yeah, you didn't even know how much you helped me at
that conversation.
I didn't realize it at the time.

Speaker 1 (11:27):
Yeah, you didn't realize it.
You really didn't realize it,but what you did?
You made me aware of somethingsimple, which is looking at my
lifestyle and my nutritionalstatus, and introduced me to
some peptides.
That's all you did, really, andthen that night I went home, I

(11:51):
started doing my research andthat took me down this rabbit
hole and the mission I have beenfor the past year, to the point
that it's your fault that I'mnow writing a book.
Okay, so now.
I'm spending my free time towrite a book because of you, so
I'm certainly going to dedicatethe foreword to you on that book

(12:14):
, just because you startedeverything.
So let's start with a bigcontroversy and something that
people talk a lot about onsocial media treatments that are
almost common in othercountries, but not in the US yet

(12:36):
, that seem to have a lot of orshow a lot of promise, and by
that I'm talking about stemcells and peptides.
As you know, they're gaining alot of traction in orthopedics,
yet clinical data is stillemerging on this.
So do you think we're jumpingthe gun or other countries, for

(12:59):
that matter, are jumping the gunby using these therapies
without more robust studies?
Or is the anecdotal evidenceenough to move forward?
And I'm one of the anecdotalstories and evidence, so I feel
like I'm all in, but I'm one ofone, I'm N of one.

(13:19):
So, who knows, maybe it wasother stuff, but God, it was
just so instant, it was sorelated that I truly believe it.
But again, looking at it from ascientific perspective, you
know, because you know, asHippocrates says, you know you

(13:44):
got to make habit of two thingsas a doctor is to help, or at
least to do no harm.
So what is your take on it?
Are we doing harm?
Are we helping?
Is it both, perhaps?

Speaker 2 (13:58):
Yeah, I think we're doing it about right.
To be honest, I really do thinkthere is some promise.
I do think that we do needthose clinical trials, the true
randomized, controlled studiesthat can give us that data we
really want.
I mean, when the academies thatoversee us when they put out a
position statement on peptidesand stem cells, they say there

(14:18):
is promise in this treatment butthe clinical data is still
conflicting.
We need some really big, reallyrobust studies so we can give a
definitive answer.
But at the same time you've gotthe bodybuilding community, the
fitness community.
He doesn't care what they say,they want the best stuff out
there.
The athletes they will tryanything as long as it looks
reasonably safe.

(14:39):
You know, like anabolic steroids, there's a lot of safety issues
there.
There's a lot of side effects.
But something like peptides andstem cells, especially the
umbilical stem cells, theredoesn't appear to be major
reports of major issues, majorside effects.
With those based on what we'veseen so far, there's just not a

(14:59):
lot of data.
We don't really have a lot ofdata.
When the FDA banned 17 peptidesback in September, I looked at
the reason for each ban on apeptide and it was usually
something pretty minor.
It's like there was one reportof a tumor in a patient one time
, or there is potentially someheart issues, or they always
found something that was a smallsafety signal, but nothing that

(15:22):
was, you know, super alarming.
So I think we're kind of doingit right where you have some
people who are right at theforefront and going out
exploring, experimenting andtrying to find out anecdotally
what works, and then you haveeverybody else, the
organizations that set theguidelines, the governments and
all that the FDA is saying we'regoing to just wait for all the

(15:44):
data to come in.
But I do feel a bit frustratedthat you know, we haven't done
those good studies, especiallysome peptides like the BPC-157.
That's the really hot one rightnow and that's one of the FDA.
Just they banned pharmaciesfrom making it to sell to
patients.
But you can still buy it forresearch purposes.
So it's not like completelybanned, it's just something that
a doctor shouldn't likeprescribe and sell in his office

(16:06):
because it's not FDA approvedand he could get in trouble.
He could kind of get in troublefor that.

Speaker 1 (16:18):
So now on the BPC-157 , because I have to tell you I
took it.
I know you just told me aboutit back then.
You didn't tell me to take it,you just told me actually you
were very careful.
Didn't tell me to take it, youjust told me actually you were
very careful.
You said look into it.
And I appreciate that and I didlook into it and that was part
of the reason why you know and,by the way, I'm not giving any

(16:38):
medical advice, I'm just tellingeveryone what I did.
It helped me and once in awhile, when I feel some twinges
in my shoulder because now Ireally bulked up on muscle, I
mean, by the way, after bulkingup on muscle, within doing that,
I lost 12 pounds just withinfour weeks and people tell me

(17:00):
like you don't look anydifferent, you look the same.
How did you lose 12 pounds?
It was because I lost fat and Ibuilt muscle and so I just look
ripped and my body fat is downto 8% right now.
So that's phenomenal and that'sbecause I've been able to work
out and also I improved mynutrition.

(17:23):
But back to BPC-157.
Is there any randomized,controlled studies that you know
of on this?

Speaker 2 (17:35):
I looked at all the data that I could find, most of
it is animal studies.
There is some very goodcontrolled animal studies where
they would cut the Achillestendon in a rat or they cut both
of them and one they'd give theBPC and one they would not, and
it would heal.
Incredible, it would heal a lotfaster.
It promotes fibroblast growth.
It promotes angiogenesis theblood vessel growth.

(17:56):
So we know in an animal trialthere's multiple trials shown
it's very robust for healing.
The only human trial I foundwas just a group of people 20
patients who got injections intheir knee for knee arthritis
and there wasn't a control groupand they basically said
everybody tolerated it.
80% of the people got a lotbetter.
But that's not the data we needto say this definitely works.

Speaker 1 (18:23):
Were they looking for any safety concerns, or why
didn't they have a?

Speaker 2 (18:25):
control.
Why wouldn't they have acontrol?
It was just a small clinic thatwasn't, you know, affiliated
with a big university.
It was just a guy who's doingit in his office and he says
I'll publish my data, you know.

Speaker 1 (18:34):
Got it.

Speaker 2 (18:35):
Not the study the FDA wants to see.

Speaker 1 (18:37):
Yeah, certainly so, isn't that, by the way?
Isn't that what did I?
I may be wrong, but didn'taaron rogers, you know, remember
he tore his achilles?
Did he do something?
I know he.
He did something off label thatwas not recommended by his team
, uh, doctor, and he just did itanyways.

(18:58):
Do you know anything about that?

Speaker 2 (19:00):
I don't know if he said exactly what he used.
If it was anything, it wasprobably the BPC-157, because
there's a lot of healthinfluencers.

Speaker 1 (19:09):
Yeah, that's what I heard.
Which is interesting that histeam physician a lot of these.
Now you've been a teamphysician, you've worked with
the New York Mets during yourtime in New York.
How was that?
Because we're talking aboutathletes.
Their value is millions ofdollars, hundreds of millions of

(19:30):
dollars, and the loss theseteams get.
When one of their top athletes,for example, we saw Otani, he
had a subluxation of hisshoulder just I watched the game
live.
I mean, there's a lot at stake.
Now, as a team physician, whatdo you do?
Do you go by the book, by therecommendation of your society,

(19:52):
and are you worried aboutrepercussions from your society
because you're not doing thingsbased on their recommendations?
Or when do you decide?
Or how do you decide, to gooff-label Because there is a lot
on the line here?
How do you resolve thatconflict?

Speaker 2 (20:11):
Well, how it works is the team physician has a text
group with every other teamphysician of Major League
Baseball and they all have theirchat group.
They say, hey, I got a toughone here.
What do you guys do?
There's definitely a lot ofdiscussion among the guys in the
same realm.
Like every major leaguebaseball team doc is going to be
talking to the others prettymuch, so they always get dirty

(20:33):
opinions right away forsomething this complex.
But otherwise, as a team doc,you kind of you work for the
organization and you work forthe players.
You know there's a little bitof a conflict there because you
have to do what's right for yourpatients but also you have the
organization saying, hey,there's a lot of money here.
What do you think?
Give me the medical opinion Arewe going to get?

(20:53):
Are we going to cut this guy?
I need your medical truth.
You know not.
You have to tell us what'sgoing on here.
It's in the contract.
So you kind of have to walk afine line.
A lot of the pro athletes willhave their own team, their own
doctor, their own orthopedistback home or they'll use
somebody else and then they'lljust go to the team doc for the
basic regular care so they cando whatever they want, they can

(21:16):
have multiple opinions.

Speaker 1 (21:17):
So team doc is kind of two loyalties the team and
the players Interesting, Iwonder if that affects our
contract if something goessideways, if they accept a
treatment that was notrecommended by the team doctor.
But you know these are issuesand you know, yeah, that can
happen.

Speaker 2 (21:35):
That's definitely happened before where somebody's
gone against a recommendationor gone outside of the treatment
protocol and that gives theteam the ability to void the
contract.
Often, if you don't, you knowyou didn't get your acl fixed or
you didn't do it this way orthere's a lot of things they
could do so I'm sure that goahead now, now.

Speaker 1 (21:55):
So, talking about these challenges, when you
approach these elite athletes,you know, are there instances
where you've had to take a boldor unconventional approach to
achieve an outcome.

Speaker 2 (22:08):
Or you know, at least be in that discussion and you
know, can you kind of like walkus through, um what happened
yeah, yeah, I have a few, uh,professional athletes, some
bodybuilders, some power lifters, um, and we definitely, because
they're in the gym, thateverybody in the gym knows about
all the latest peptides, ofcourse isn't that crazy, you

(22:29):
know it is well, I was, I was.
I was talking to my patientbefore surgery and I said, well,
there is a lot more informationout there about nutrition,
about supplements, and they'relike I know all that you don't
need to tell me.
So you've heard of bpc Yep 157.
You've heard of TB, and she's500.
You know, knew everything.
And then you heard of the NADplus.
Have you heard of that?

(22:50):
Yep, I already got it.
So they are really on top of it.
These are people where that'stheir life, that's their career,
and so this is one of thoseanecdotal examples of somebody
that did well.
A powerlifter had a pec tear inthe pec muscle.
It just ripped off on yourbench press and they had a video
of it.

(23:10):
You can see it.
Pop is like very, very clear.
They probably had severalhundred pounds on there.
Um, well, after the surgery, um, we, I didn't prescribe a
peptide.
I I said, you know, thesethings aren't really FDA
approved formal treatments, butyou can use them if you want to.
There's some evidence they mayhelp and, of course, you know,

(23:30):
on their own.
They went and did the peptidesand did some other, you know,
nutritional supplements.
Nothing that was really odd oranything, just everything that
you can throw at it.
And instead of being back atsix months starting to lift
heavyweight, they were back byfour months already, bench
pressing several hundred pounds.
I was like you shouldn't bedoing that.

(23:53):
Yet it's like no, I feel great,I really do.
You know they were alreadylifting heavy probably, you know
, two months ahead of schedule,and that was just the end of one
.
That's the end of one, and itworked for tendon healing.
And of course, that's not astudy at all.
That's nothing for the FDA, butthat's enough to make me think.

Speaker 1 (24:07):
There surely is something to this, if people are
getting better and I've seensome others do as well too- so I
wonder when you guys sit inyour societies or in your
scientific meetings, you know,like I don't know, you go into a
breakout meeting and you guystalk to each other.
Do you talk about this stuffand what is like the general

(24:29):
consensus, the unofficial one,in your society on this topic?
Just because you know, I know,in my society is stuff like
there's certain things that waspostulated and, as we know, you
know, even the experts wouldadmit it.
Half the stuff that wepracticed is really dogma.
I mean even scientific articlesthat have been published in top

(24:55):
journals like Lancet, newEngland Journal of Medicine,
jama, a lot of thesepublications.
Sometimes they're being revoked, like 10, 20 years later, or
completely debunked.
So it's hard.
So at some point you're like,okay, what should I believe?
And do I just go with my gutfeeling, based on my clinical

(25:20):
appearance, meaning what I seehappen?
So do you guys have thesediscussions like offline?

Speaker 2 (25:29):
A little bit.
I usually check in with all myco-fellows from my fellowship
and, you know, at the meetingsI'll just mention it to some
people and I usually get likethree responses.
One it's as fairly common as no.
I've never heard of that.
No idea what that is, you know,like stem cells, or you know,
I've never heard of that.
Another common response is ohyeah, yeah, I've heard some

(25:50):
people talking about it.
We're going to wait for moredata, but it could be
interesting.
And then the third response isI use it.
Oh yeah, I've got it, I've doneit.
It's amazing.
So it's not formally talkedabout like there's a big podium
presentation on peptides.
You know, that's you know,because there's not data to
present yet.
All you can really say isthere's a lot of anecdotal

(26:12):
evidence, but we need morestudies.
So the societies are all aboutthere has to be research to
present before you can reallytalk about it.
So it's really just an offlinething.

Speaker 1 (26:22):
Yeah, I think that's the frustrating part, not just
for patients who are looking forprogress, but also for
physicians trying to get thebest treatment out there.
You know, we were almosttrained to think that way that
unless there is a double-blindcontrol, placebo-controlled
study with a 10 year um history,that you can't just you can't

(26:50):
recommend it and it's, it's,it's.
It's sometimes so ridiculousthat people ask you to to do a
study on whether or not it hurtsif I kick you in the shin.
I mean, we don't have to do astudy on whether it hurts or not
if I kick you in the shin.
I know some of these.

(27:10):
MMA fighters.
They actually have you seenthat they break baseball bats
with their shin?
Have you seen that video?

Speaker 2 (27:18):
It's crazy.
I've not seen that one, butI've seen them get their own way
broken by getting kicked.
I saw.

Speaker 1 (27:24):
One is like back to back.
He broke two baseball bats withthe shin.

Speaker 2 (27:30):
I got to watch that.
It's insane.

Speaker 1 (27:34):
And so, but back to the studies and what we know
anecdotally, or we havewitnessed clinical improvements
on treatments or therapies,whether there's peptides or
other treatments, like now ledlight therapy, which has become

(27:59):
very popular, um which in someof these cases is really hard to
have long-term studies.
But, would you say, it'sfeasible to offer it to patients
as long as you don't see anyharm, or there's no evidence for
harm?
And do you integrate thesetypes of treatments?

Speaker 2 (28:20):
Yeah, I usually will have the discussion with the
patient.
That might be interested.
I'd say, hey, are youinterested in some of the
off-label things I can tell youabout?
And sometimes they're like, ohyeah, I want to hear everything.
I'm really into this, you know.
And then I'll just say, well,here's some things that are out
there.
I have a list of maybe 10supplements that I give them
that do have research behindthem, but that's common.

Speaker 1 (28:43):
Right there there's a lot of doctors that talk about
supplements.
What's the degree of receptionof your patients?
Are they very receptive?
Are they very skeptical?
Are they excited when you?

Speaker 2 (28:59):
offer them these alternative types of treatments.
No, they really appreciate it.
They're like wow, my doctor hasnever really told me a secret
pill to take or a supplement.
They feel like you're givingthem something secret and it's
like you really care about me.
You want me to get better, youwant me to have the best stuff.
And then I'll say there's alsosome off-label things and some
patients they're like nope, notinterested, I don't want to do
anything that's off-label andI'm not providing these

(29:23):
treatments.
I'm not giving peptides.
You know, I stay out of thatyou know, since it's not FDA
approved.
But I will tell patients aboutthe peptides and here's some
things that people are trying.
If you're really interested,you know there could be a small
risk.
They don't seem to be too badbut there might be really good
benefits for healing.
So if people are reallyinterested in that, I'll talk
about it.

(29:43):
We'll talk about diet.
We'll talk about all the otherlifestyle factors too.
So other things.
I mean stem cells.
I'll talk to patients aboutstem cells too, yeah, yeah.
So as far as when is the statusof stem?

Speaker 1 (30:00):
cells.
I I know right now people arejust going to like mexico or, I
don't know, peru or southamerica, somewhere to get stem
columbia to get stem cells.
Uh, can you talk a little bitabout that and kind of give us a
little insight?

Speaker 2 (30:15):
yeah, so well, the two places people are going is,
uh, panama and tijuana.
Those are the big stem cellclinics.
Those are the busiest andbiggest ones.
Those are the big stem cellclinics.
Those are the busiest andbiggest ones that I've heard of.
They've had probably over10,000 people at each one, I
would guess, looking at theirwebsites and everything.
The thing people don'tunderstand about stem cells is
there's two very different types.
There's the stem cells thatcome from your own body, which

(30:37):
would be from fat cells or fromyour bone marrow.
Those would be your own stemcells.
Those are completely fdaapproved.
They're okay.
There's no problem doing that.
Insurance won't pay for itbecause there's well, honestly,
the research on those.
For, say, injecting into yourknee for knee arthritis.
There's conflicting studies.
Not every study shows that theywork amazingly well.

(30:57):
So I have not seen a huge,massive interest in that type of
stem cell.
But it's the umbilical stemcells from a baby's umbilical
cord.
Those are the ones where allthe interest is and those are
the ones that the FDA hasregulated.
They say that you cannotprovide those and sell them in a
medical office.
Anything you do with thosewould have to be completely

(31:19):
off-label and that's why peoplego to Panama and Tijuana for
those, and those are the onesthat have the most potential to
really work.
Well, because it's a morepotent stem cell.
It can differentiate easierinto other tissues, cartilage,
ligament, whatever.
It's not been exposed toenvironmental factors and toxins
like our own cells throughoutour whole life.
It's a pure cell.

(31:40):
It has more growth factors withit.
There's every reason to thinkthat it would be a much more
potent stem cell and there evenare randomized trials on those
for injecting them intravenously.
They did a COVID study wherethey were giving IV umbilical

(32:00):
stem cells in people in the ICUand they actually got better
than the control group fromacute respiratory distress
syndrome.
That's a real randomized trialon umbilical stem cells.
There's also one on, I believe,heart failure.
That they had improvement inheart failure and improvement in
diabetes just by getting an IVinjection, like basically
getting a blood transfusion,except you're getting umbilical
stem cells and they just tend tomake the person healthier,

(32:24):
whatever case it was.
I mean that's three trials.
There's no orthopedicindications for the umbilical
stem cells yet, but they areindicated in some other things,
like for bone cancer, for someother issues.
So I'm really interested in theumbilical stem cells the most.
Those are the ones that youhave to go out of the country to
get.
Those are the ones that all thepodcasters you listen to Joe

(32:46):
Rogan and what he's got, andeverybody that's been on there,
all the UFC fighters all thosepeople are going for the
umbilical stem cells becausethat's the most interesting one,
that seems to be the mostpotent, but we don't have it.

Speaker 1 (33:01):
I'm assuming the reason why we don't have the FDA
clearance for it is because wedon't have enough studies on
this.
Is that correct?

Speaker 2 (33:16):
That's exactly right.

Speaker 1 (33:17):
We don't have that big randomized, controlled trial
of umbilical stem cells.
Do you know of any trials thatare going on currently in the US
or elsewhere?

Speaker 2 (33:24):
I don't know exactly.
I tried to look it up and Iwasn't finding anything great on
that.

Speaker 1 (33:31):
I'm sure we could do a deeper dive.
It's so weird, I mean because,you know, I kind of feel like
whenever it comes to somethingthat can't be a therapeutic,
that can't be monetized, thatcan't put a brand name on it,
because no one is getting apiece of the pie, no one is
getting a cut of the businessother than the patient, which is

(33:55):
their health.
No, one is really keen onspending any money on doing any
trial, not even academicinstitutions, because academic
institutions they get theirfunding either from private
institutions, from privatecompanies or from the NIH, some

(34:17):
NIH grant, and what's bizarre isthat, for something that could
be so groundbreaking andlife-changing, how is it that no
one is putting any effortbecause it could be the cure for
so many different diseases,like you said, beyond
orthopedics, beyond joints andyou know?

(34:41):
And so it's so bizarre thatthese big philanthropists, you
know, like, where is Bill Gatesin all of this?
Like, why doesn't he fund, whydoesn't the Gates Foundation
fund it Foundation fund thisstudy?
Oh wait, I think they're moreinto vaccines, aren't they?

Speaker 2 (35:02):
Because you know the Gates Foundation is more into it
.

Speaker 1 (35:05):
But isn't that bizarre and isn't that a shame?
Because I feel when you.
I just finished reading MarkMcCary's.

Speaker 2 (35:16):
Marty McCary's book.

Speaker 1 (35:17):
Yeah, Marty McCary's book Blind Spots.
He really puts it really.
He put it really well as far ashow the system works and he
didn't call it corruption.
But we all know how tointerpret what's going on.
We all know how the game isplayed and it's very sad.

(35:40):
It's so disheartening that um,science is moving slow because
everything that's powerful andgroundbreaking if it doesn't
bring in money for certainpeople and can't be monetized,
it's literally put aside and umit even demonized um by big

(36:05):
institutions and societies.
If a clinician tried to use itoff, like they're they're, they
ridicule um you for um eventalking about it and shame you
and this paternalism that'sgoing on in in in our medical
societies and these.

(36:26):
It's almost like this big boysclub.
If you're not part of the club,if you're not part of the
editorial board of the newengland journal of medicine or
science or nature, um, no onewants to hear about uh, your,
your research and and it'sreally a shame.

Speaker 2 (36:44):
Absolutely.
And guess how much VPC costs.
You can get a vial of that for$50 and have 10 or 20 doses.
There's just no money in it.
That's exactly it heard onHuberman Lab is that?
Now, I'm not saying this iswhat's going on, but sometimes
big pharma might have pressuredthe FDA.
It was like, hey, can you kindof ban some of those peptides

(37:06):
while we get a proprietaryformulation that's something we
can patent and is just like it,and then we can make a lot of
money.
I mean that's the kind ofconspiracy that's been floated
around.
I'm not saying that's going on.
You know there's reasons theybanned them.
But you know people thinkthere's no money in some of
these peptides.
There's no money in aspirinanymore.
I mean there's no money inexercise.

(37:27):
There's.
You know there's no money inlifestyle changes.
So you know we don't go andpromote that.
You know, what my favorite factis is that you can look at
aspirin is 13 cents a pill andit will reduce the risk of
stroke by 20% in somebody whohas an irregular heartbeat, some

(37:47):
atrial fibrillation.
Eloquist is another bloodthinner that reduces the risk of
stroke 35%.
You know a little better thanaspirin in those people.
And it's $13 a pill.
It's a $13 billion a year drug.
And then get this.
There's one thing that reducesthe risk of stroke 50% in
everybody, not just people withatrial fibrillation and that is

(38:09):
walking 7,000 steps a day, justwalking 7,000 steps a day.
If that was a pill it would bea trillion-dollar pill.
I mean, there's been tons ofresearch on just walking for 45
minutes will reduce your overallmortality by up to 70% and
helps you in so many other ways.
But you can pay for that.

Speaker 1 (38:31):
Imagine that was a multiple choice question on your
USMLE exam and which one ismore effective, and you cross
7,000 steps or more.
You'd fail that exam, wouldn'tyou?

Speaker 2 (38:43):
Absolutely.
They would say well, that's nota randomized trial, that's a
correlation, not a causation,and then you know they pull
something like that.
But we clearly know that, youknow it's good.

Speaker 1 (38:53):
Well, there are studies now that show that
walking more than 7,000 steps aday reduces all-cause mortality
by a significant percentage.
I don't know the exactpercentage, but it's a
significant percentage and Idon't think I've ever, when I
was in training, that I everoverheard any of my attendings

(39:18):
or my professors talking aboutit Ever.

Speaker 2 (39:21):
Yeah, never, it's 50% to 70% was all-cause mortality
yeah, 50, yeah, nobody evermentioned 50 to 70 percent and
it's.
It's phenomenal that we justcompletely ignore that and
usually the excuse is oh, mypatients will never exercise if
I tell them to, it's not worthtalking about.
It's not worth talking aboutdiet people won't listen.
You know, people just like tobrush it off like it's, you know

(39:44):
, not worth worth talking about.
It's not worth talking aboutdiet.
People won't listen.
You know, people just like tobrush it off like it's not worth
even talking about or havingthe conversation when we should
be, like our whole country,should be really focused on.
Like guys, here's a cheap wayto live longer, to be healthier,
to start create a culture likelike they do in Spain.
You go to Spain, you go out todinner after After dinner
everybody goes on a walk for 30minutes.
I mean we got to develop alittle more of that culture here

(40:04):
and we can do that from topdown if we have the right people
saying it.

Speaker 1 (40:10):
It's actually amazing .
I wore just to test for a month.
I wore like a glucose monitorand I wanted to see what kind of
foods do to my blood sugarlevel and what they do to my
fasting level of my sugar.

(40:43):
And then also I wanted to seehow walking affects if I walk go
on a brisk walk immediatelyafter I have a meal, whether it
is a high carb meal or just aregular meal, and how that
affects me.
I was amazed how just simplewalking after a meal, like a
dinner, would affect my glucosespike.
So instead of it spiking 30 to40 milligram per deciliter, it
was like in the teens, in thelow teens, like 10, 12.

(41:07):
And it was completely stable.
And the best thing was myfasting glucose at night when I
was sleeping it was below 90 andit was completely steady, as
opposed to if I didn't do it orI had like a late night meal.
My fasting glucose was over 100.
The whole night I had aterrible sleep and my cortisol

(41:32):
levels were actually elevatedbecause I take my blood
biomarkers every three to fourmonths.
So I correlated that with mycortisol levels.
My cortisol level was out ofwhack.
My HSCRP, which is theC-reactive protein, which is a
biomarker for inflammation, thatwent significantly down just by
simply walking after a meal.

(41:53):
So all of these things, believeit or not, got rid of the
inflammation I had.
Shoulder pain.
Pain went away.
Yes, I also took bpc 157.
I uh modified my diet, I andand and I I paid attention to um
more walking, taking 7 000steps minimum, and I always

(42:17):
thought, yeah, at work you knowhow we were uh run around in our
clinic at work a lot.
I thought.
I thought, oh, that's 10,000steps easy, Until I noticed it's
only like 3,000 steps max.
I was shocked.

Speaker 2 (42:32):
It's not that much.
It's not as much as you think.
No no.

Speaker 1 (42:36):
And here I was thinking, I'm running around all
day long, but it's only at best3,000 steps.

Speaker 2 (42:43):
Yeah, you really need those longer walks.
That's where you get the hugebenefit.
You know and I go for a walkalmost every night after dinner.
Late in the evening, me and mywife will go for a walk, walk
the dogs try to do 30 to 45minutes, and I know, man, I feel
so much better If I miss that.
It's like something's missing.

Speaker 1 (43:03):
It really is just a simple.
So this is a simple thing.
Not everybody, yeah.
So so, saying all that, whatare what in sports medicine, you
know, as it's evolving allthese science is evolving?
What emerging trends ortechnologies are you most
excited about?
You know, I know we talked alot about a lot of things, but
personally, what are you mostexcited about?
Like, what do you see in yourlifetime, in your career, really
becoming standard of care?

Speaker 2 (43:26):
I'm excited to see what happens with robotics and
3d printing of things.
I mean, I think that's gonnadefinitely have some benefit.
I don't know what it's going tobe exactly, but it could be
potentially huge are you talkingabout joints?

Speaker 1 (43:40):
are you talking about joints and stuff?

Speaker 2 (43:48):
For 3D printing.
It could be biologic tissue,like a meniscus.
We've always struggled to makea perfect meniscus and you know
I have friends at the topuniversities that are still
trying and you know we'regetting to somewhere but it's
just a very, very tough one todo.
But you know, robotic surgery,that's more for knee
replacements and hipreplacements, not as much for
sports medicine, because we'redoing a lot of soft tissue stuff
.
I think I'm really excitedabout the potential of stem

(44:10):
cells, biologics and thepeptides and the longevity stuff
.
If you listen to David Sinclair, he's a longevity researcher
and there's Michael Levine atTufts University.
He's done some fascinatingregenerative work there that
could be huge implications inthe future.
So they're working on how tosignal your own cells to heal

(44:30):
better.
That's kind of the whole pointof stem cells and peptides.
So I think that the biologicspart is going to come around and
we're going to have betterprotocols, like my dream rotator
cuff surgery five years fromnow.
I do some of this now would beyou come to the office, we're
going to do a rotator cuffsurgery.
It's definitely what we need todo.
It's the right decision, ofcourse first, and then you're

(44:52):
going to get an app on yourphone and that app is going to
have a multitude of things toprepare you for surgery.
It's going to have reallyextensive nutritional
information of like.
Here's exactly the research onwhat kind of diets you should
eat and really what to avoid.
You know.
Basically it's mostly avoidingthe junk food.
Here's how you stay hydrated.
Staying hydrated is moreimportant than you think.
Here is what you should focuson for sleep.

(45:14):
Here's some techniques forgetting that.
Seven to eight hours.
All this stuff is the mostimportant Diet, sleep, hydration
and, of course, the exercise.
Here's some little exercisesyou can do prior to surgery to
prepare you for it, so you cancome out in optimal shape.
And then it's also during thesurgery.
There's a lot of things we'vedone with anesthesia and

(45:36):
perioperative care.
To improve the experience we'vedone, instead of complete
intubation for anesthesia, we dosedation with a nerve block.
It's a little easier on you andwe focus on better pain control
.
Some of that stuff's alreadyhappened, so we do all that.
You go home the same day fromyour arthroscopic surgery to
surgery center and then I hopethat we finally have the

(45:58):
research on all these peptides.
I would expect that in thefuture we're going to inject
probably BPC-157 or somecocktail with some other
peptides right into the repairat the end of the surgery.
And maybe we're going to injectumbilical stem cells right into
the repair site right aftersurgery and then they'll come
back to the office for six weeksand each week do a peptide

(46:20):
injection.
That's what I would hope that weget to at some point, and
that's all dependent on studiesshowing that those work.
If they don't work in a bigrandomized trial, then we found
out we're not going to use them.
But I can see a lot ofbiologics like that.
Those are the ones I want tosee studied the umbilical stem
cells and the peptides in asurgical setting.

(46:42):
Half the patients get them, halfthe people get a placebo.
Who does better?
What does the MRI show a yearout from there?
We look at everything and ifthey truly did help, then
there's 7 million orthopedicsurgeries per year that they
might be useful for and theywould improve healing, reduce
infection, reduce the need forrevision surgery and improve

(47:03):
quality of life in patients.
So if they really do work thatwell, we need to be studying
them ASAP and not just kind ofkeep kicking them on the back
burner and letting thebodybuilders play around with
them.

Speaker 1 (47:15):
That's a very interesting insight, because I
recently integrated the pre andpost-surgical, Because I
recently integrated the pre andpost-surgical recommendations
for my patients protocols whenit comes to nutrition, when it
comes to supplementation, whenit comes to activity All of that
is important.
I always compare surgery topreparing for a 5K or something

(47:38):
like that.
You don't just go and run a 5K,you prepare yourself with diet,
exercise, nutrition,supplementation, weeks,
sometimes months, before you gointo a 5K, and surgery not to
mention orthopedic surgery,which puts more stress on your
body than the facial surgerythat I do but it's all in the

(47:59):
name of not only betterperioperative course but also
post-operative healing andrecovery, which could
significantly change the outcome.
So I love the ways.
What did you or how did you getinto that way of thinking?
Because it's completelyunorthodox.

(48:20):
It's certainly nothing that youwere taught or I was taught.
How did you get, what openedyour mind to this?

Speaker 2 (48:31):
You know I've always, ever since college, kind of
been interested in a little bitof the holistic health and kind
of alternative medicine.
I just keep up on it.
You know I was like, well, Iwant to do what works.
But I'm always interested inwhat could there be.
But I think, just like you,maybe a year before we talked, I
was starting to listen to morepodcasts and read more books
about all of this stuff and Iwas watching the US public

(48:52):
health.
Look at our life expectancy godown.
Look at our obesity rates go up.
In fact, in the last 30 years Ithink 30 years ago the highest
obesity in any state wasmississippi, with like 14.
Now there's not a single statethat is below 14.
Every state is 20 or more andit's maybe in the 40s in some

(49:13):
areas.
It's like it's unbelievable.
So I started to see more aboutthat.
And then I'm like you know what.
Maybe maybe diet, exercise andlifestyle actually does matter
more than we give it credit for.
And you know, maybe for peopleI look at my surgical patients
and some of them that just doreally well and some of them
that don't.
I'm like you know some of themtell me about their diets.

(49:33):
I have one patient and she'slike you know, some days I'll
eat nothing but popsicles.
All day, nothing but popsicles,really, you know I mean it is.
It will surprise you how badsome diets are.
It's like you know we just gotto work on some basics here.
You know if you can just checkout some basic changes.
So I started to get interested,just along with a lot of other

(49:54):
people.
And there's this morediscussion about health, about
the environment, about toxins infood and just about the poor
American diet.
All of that thing kind of comestogether.
You know, making Americahealthy again, all of that stuff
that a lot of those docs andpeople are talking about.
They present research.
Now we have the evidence.
If the evidence is there, thenthat's what we really need.

(50:15):
And we finally got the evidenceabout diet, nutrition and
lifestyle.
So now we can move forward.
And I'm just trying to bring itto my patients and say if
you're having surgery, this isone of the most important things
you're going to be doing.
Let's do everything we can tooptimize the outcome.

Speaker 1 (50:31):
Yeah, I think talking about the popsicles.
That's funny.
It reminds me of a quote byMarcus Aurelius.
He said pleasures, when they gobeyond a certain limit, are but
punishments.
So, it's funny that I havecasual conversations with my
patients about their lifestyleand diet in preparation for

(50:56):
their surgery or sometimes evenminor procedures.
And it amazes me that, eventhough the cat's out of the back
, like you mentioned, just likeI we hear it through word of
mouth, through podcasts, throughthe internet there's nothing,
that there's absolutely nopublic health initiative that

(51:18):
raised our awareness to thesethings.
Like we had to go get thatinformation, either ourselves
online or, like you and I, juststumble upon it and then start
diving into it, because commonsense you can't help but ignore
common sense.
I mean all our lives we havebeen asking questions, we have
been curious, trying to findsolutions to problems.

(51:41):
We were trained to findsolutions to problems.
We were trained to findsolutions to problems but at the
same time, we were urged toconform to a certain norm,
without questioning those thatset or postulate or dictate
certain treatment regimens andprotocols.

(52:04):
And then, when we do, we geteither ridiculed, we get, either
shamed, we get either evennowadays you can easily get
canceled or, like in the stateof California, you know what the
Internal Medicine Society does.
If you don't do a treatmentthat's basically standard of
care, If it's not recommended bythe Internal Medicine Society.

(52:27):
They can strip you of yourboard certification in the state
of California.

Speaker 2 (52:32):
That's crazy.

Speaker 1 (52:33):
It's crazy, that's I mean.
So what happened to science?
The whole basis of science isto ask questions, to be curious,
to question and challenge thestatus quo.
I mean, how else is going toscience advance?
So I think politics is reallyspilling into medicine.

(52:57):
Yeah, absolutely I think youknow it's, I don't know.
You know, to me nothingstrengthens authority so much as
silence.
And if we don't speak up Idon't know who said that, I

(53:18):
think it was Da Vinci, leonardoda Vinci, who said that but if
we don't ask questions, nothingis going to change.
And those people in theirauthoritarian positions, they're
so comfortable, they just don'twant to give up their position,
and they will defend it at nocost, even if the cost is the

(53:41):
demise of the health of a nation.
And so I think theseconversations are important.
That's why I was so excited totalk to you, because I feel that
type of mindset.

Speaker 2 (53:55):
Mindset yeah.

Speaker 1 (53:56):
I think people like you are important, at least to
initiate a conversation, tobring awareness, and then it's
up to the individual physician,scientist, whoever or clinician
to let their his or hercuriosity lead down that rabbit

(54:17):
hole just like it did with me.
And now it's not surprising withthe internet, with the advent
of all this information nowbeing out there, all these
executive health clinics andpreventative care clinics
becoming more and more popular.
I just had a full body MRI Ithink the name of the company is

(54:39):
Prenuvo and I literally wentthere for 45 minutes.
I was under MRI I think thename of the company is Prenuvo
and I literally went there for45 minutes.
I was under MRI.
I got a full body MRIfunctional brain, cardiac,
everything.
I could even check my prostate.
I mean, it's amazing.
Within 45 minutes I kneweverything about my body.
I had that peace of mind.
And, as you know, mri there isno risk of radiation.

(55:02):
You can do it as much as youwant if you can afford it, but
first of all it shouldn't bethat expensive.
Secondly, if the insurancecompanies really care about our
health, if it's truly calledhealthcare as opposed to what it
really is, which is sick carethey should pay for an MRI, why
wouldn't you?
And one would think that if wedon't have chronic illnesses,

(55:24):
that the insurance companieswould save money.
Right, I mean, but it's not.
It's not like that.
It's not like that.
And I don't know if you wereaware.
For example, uh the um, a lotof the money insurance companies
make is off of the pharmacies,for, for example, aetna owns CVS
.
So you don't think that's aconflict of interest?

Speaker 2 (55:48):
Oh, absolutely yeah, the pharmacy benefit managers.
They have kind of someaccounting tricks where they
really profit a lot on the drugs.

Speaker 1 (55:56):
And they don't want anybody to know about it.
I think it was Brett Buehlerwho talked about it on the Joe
Rogan podcast.

Speaker 2 (56:03):
Yeah, Brigham Buehler went over that whole scheme.
I was like is that true?
Somebody should really thegovernment.

Speaker 1 (56:11):
Dude, it blew my mind .
I was like, yeah, Do theuniversities, the medical, like
the hospitals?
Are they aware of that?
Or are they putting their headin the sand?

Speaker 2 (56:27):
Yeah, Apparently it's legal, but it's kind of tricky
and I just think that somebodyshould put a stop to something
obvious like that.

Speaker 1 (56:35):
No, if it's really going on like that.
What is you have your?
Do you work for a, a system?
Do you work for corporate, oris the business yours?
Are you basically the?

Speaker 2 (56:48):
um, we're private.
Yeah, so the practice isprivate.
Yeah, we're not working for ahospital.
We go to the hospitals and theycall up the hospitals and work
with them, but they don't, youknow, pay us a salary or
anything, anything.

Speaker 1 (57:00):
Did you make a conscious decision to go private
versus working for a hospitalsystem or one of those big
orthopedic companies?

Speaker 2 (57:11):
I always find myself leaning towards, yes, going
private.
I mean, I would, of course,maybe coming out if there's a
really good academic positionthat was available and you know
I would consider something likethat and absolutely there could
be perks with that.
But I definitely was more of aprivate practice guy to kind of
do things my own way and I don'tlike to have bureaucracy and

(57:35):
inefficiencies telling us youknow what way we have to do
something and you know we wantto run a clinic.
We want to run a clinic our wayin our practice and do
everything our way, run oursurgery center in an efficient
way.
So I think it's you could be.
Doctors are much better andmore efficient when they have to
do it themselves versus justrelying on a hospital and a

(57:55):
bunch of administrators to runthe whole ship.

Speaker 1 (57:58):
But it's sad that the trend is going the other way.
With all these, you know, um,even even our specialty, a lot
of my colleagues have sell, soldto uh, these companies big
groups, big hospitals.
Yeah, yes, and and just becausethey're tired of running um the

(58:20):
companies privately, becausethere's a lot of work associated
with it.
I mean, like I wear a CEO hat,cfo hat, cmo hat in addition to
being in the operating room andin addition to seeing patients
in the clinic.
But you know what?
I would never give it up forthis one reason, which is I

(58:40):
don't want a hospital systemthat is based on some arbitrary
reward or a reward system thatbenefits them, not me or the
patient to dictate how I shouldtreat my patients, what the
protocol should be, what thealgorithm should be.
I want to have conversationswith my patients, I want to make

(59:02):
them better, I want to makethem happier.
And in your specialty it's evenmore so difficult because
you're actually the firstorthopedic surgeon that I know
that is not part of a big systemthat is actually private,
because I think all of thisstarted a lot with orthopedics,
at least in our area here in theDMV, where these private

(59:23):
clinics have been gobbled up.

Speaker 2 (59:26):
Yeah, all the small groups kind of joined into one
massive group and you know youjust have these big 200 doctor
groups and it's a lot ofbureaucracy and they kind of
tell you how you're going to dothings and they're probably
somewhat efficient.
They're not the hospital.
But you know, the bigger youget, the more you lose your
autonomy.
Of course you know you kind ofget told you're going to do this
clinic and that clinic.

(59:47):
Here's your days, you're goingto operate.
If you want vacation, tell ustwo months in advance.
You know all those sort ofrules where you kind of don't
have the control that you wantanymore.

Speaker 1 (59:55):
Yeah, I mean, I hope that you keep staying private,
because I'm sure you know how doyou?
I'm curious when it comes toyour own health, how do you go
by that?
Do you have like a primary care?
Do you take things in your ownhands through like

(01:00:15):
direct-to-consumer lab testing?
One of these companies?
What do you do exactly?

Speaker 2 (01:00:25):
one of these companies.
What do you do exactly?
I've, of course I've gone to mydoctor's visit to get all my
labs drawn, all the basics, andI added on a couple to check for
some you're talking about the21.
You're talking about the 21biomarkers that they take, which
is like our cake I yeah, I dothat, of course, you know just
check your cholesterol and askthem to check for the mthfr gene
to see if I was in a doublepositive there.

(01:00:47):
You know some little things.

Speaker 1 (01:00:48):
I look up.

Speaker 2 (01:00:50):
I've done.
I've done some hormone tests,just, you know, not with my
primary doctor.
There's can you check the tlevels and all the basic stuff,
um and I.
But I really just go by, kindof what I know and how I feel
and I'm like, ultimately, I cantest as many things as I want
and I am going to get one ofthose whole body mris, by the
way, but I just haven't set thatup yet.
I have a friend that's going todo it.

(01:01:11):
I I really focus on what I knowabout nutrition.
I'm super, super, um, carefulabout eating a lot of junk food.
I used to be bad, you know, I'dalways have a bag of Doritos or
cheese that's around, and nowit's like you know, I've got to
cut that stuff out.

Speaker 1 (01:01:26):
I cut that shit.
I cut it out.
Cold turkey man I never thoughtI would be able to do that cold
turkey.
I thought it's like a processFirst I'm going to cut the
Cheetos, then I'm going to cutthe Cheetos, then I'm going to
cut the Twizzlers, then I'mgoing to cut the chocolate.

(01:01:49):
I was obsessed with chocolateand M&Ms and I never thought
that it was possible, and let metell you in a secret how it was
possible because it wasn'twillpower.
It was not Most people thinkit's willpower, it's
determination.
It wasn't willpower.
It was not Most people thinkit's willpower, it's
determination.
It wasn't.
The only thing I did was Iliterally cut the carbs and I

(01:02:12):
ate nutrient-dense whole foodsmeat like beef, chicken, fish,
eggs, beans, leafy greens likespinach, fruits, nuts, berries,

(01:02:36):
yogurt.
The most processed food I atewas Greek yogurt.
That was the most processedfood.
And so what happened is becauseI did that, I felt so satiated.
My body didn't crave.
I didn't have these sugarspikes and insulin spikes, so I
didn't have these huge sugardrops, so I wasn't craving
anything.
So I was surprising myself thatI hadn't had anything to eat

(01:02:58):
for eight hours and I wasn'thungry and I was full of energy
and I used to have like brainfog.
I would like get tired, I wouldget jittery, literally, like
you know, ringing in my ears, Iwould get hangry.
Everything went away just bydoing that and it amazed me and

(01:03:19):
I actually didn't, even my braindidn't crave it Like the food
noise.
I call it the food noise.
It completely went away.

Speaker 2 (01:03:28):
I'm with you.
Same exact thing.
Once we went hardcore on lotsof organic whole foods, a little
bit carnivore.
I would eat a little morehealthy meats and just cut out a
lot of the sides and carbs andeverything you said the fruits
and nuts, the berries, theyogurt Yet suddenly I didn't
really want to get a lot of thesides and carbs and everything
you said the fruits and nuts,the berries, the yogurt yet

(01:03:49):
suddenly I didn't really want toget a bag of burritos at the
quick shop anymore, or cheeses.
I even had them the other dayonce.
I was like I just have a few ofthem.
I felt like crap, you really,you really don't feel good, I
know you don't feel good yeahand you know what the funny
thing is.

Speaker 1 (01:03:58):
You know the funny thing is it's actually not funny
, it's sad.
When I talk to my patientsabout it, or friends, I tell
them everything.
I just told you.
You know what happens, what?
They don't buy it.
They don't believe it.
I don't know if they don't wantto believe, but they don't

(01:04:21):
believe it.
They're like I'd rather dieeating Cheetos or a muffin or a
croissant than eating spinach.
That's how they look at it.
That's their mindset.
So they don't even givethemselves the chance.

Speaker 2 (01:04:38):
You're right.
Yeah, you don't miss it onceyou're off of it.
Our foods are terrible inAmerica our junk foods and fast
foods.

Speaker 1 (01:04:45):
I mean it's almost like denial, because I was a
little bit of denial, because Iactually convinced myself that
I'm doing well, I'm eating well,and it wasn't until I was
hurting like I told you in thebeginning of the podcast that I
went down that spiral of to thepoint that was getting me
depressed.
I said I've got to that Ithought I could never give up.

(01:05:08):
I literally believed that I cannever give it up and I
convinced myself I can outrun abad diet in the gym.

(01:05:30):
So I just hit the gym a littlebit harder whenever I was a bad
boy eating junk eating, uh, junk, and.
But that kind of led me to thisdemise that the only way out was
just to eat healthier food,nutrition, dense food and also
organic foods, no pesticides, um, um, no chemicals.

(01:05:54):
I mean it was a combination ofa lot of things and, yeah you,
you get a little bit annoying topeople.
I know I'm annoying my wife alittle bit with my new dietary
lifestyle because you know she'salways like it's healthy and
it's all about that.
But I think in her mind, I, orin her eyes, I, I'm, I'm taking

(01:06:17):
it to another level, which issometimes it can be annoying,
and I can totally see that, ohyeah.

Speaker 2 (01:06:22):
Yeah, you have to be careful with it, like always
being a doer, because I'll gettalking about microplastics and
fluoride and all these things,and I could go on for a while.
I'm like you know what?
Let's talk about positive stuffbut it's good to talk about it
once, make the changes and thenforget about it.

Speaker 1 (01:06:42):
You know there's a lot of things.
Yeah, I mean, I want to talkabout your practice and
innovations.
You know you mentioned the appthat you're helping out with
developing and kind of tell me alittle bit about that, because
I feel that's going to be thefuture in healthcare.
I feel that's going to be thefuture in healthcare.
I think that's going to be thefuture in how we communicate

(01:07:05):
with our patients beyond thembeing in our office, meaning
when the patient leaves ouroffice, it's almost like there
is no communication.
But I feel like with this app,it's a way of continuing that
conversation, communication,accountability, almost like

(01:07:27):
helping patients beyond themspending time in our office and
talking to us when they're ontheir own and their own homes
and kind of like taking thingsin their own hands and holding
themselves accountable and youbeing able to help them beyond

(01:07:49):
that visit in your office.

Speaker 2 (01:07:51):
Oh yeah.

Speaker 1 (01:07:52):
Well, the app started just as physical therapy after
orthopedic surgery.

Speaker 2 (01:07:56):
That was the simple goal for the start of it and I
didn't develop it, but I do workwith the company that makes the
app.
The most amazing thing has beenhow much better it's got just in
the last year.
It's getting so much betterwith AI and with all the things
that are being added to it thatit's going to grow to more.

(01:08:17):
It starts out just as a littlephysical therapy app.
It's going to be so much moreand, you're right, it's going to
be the way we communicate withpatients in the future.
So what it is is you see apatient in the office and now
it's not just for surgery, butit can be for anything for
patellar tendonitis, for kneearthritis, for rotator cuff
tendonitis.
I send them the app, they get atext message, they download it

(01:08:38):
and the main thing it has isdaily physical therapy exercises
with videos, with instructionsand exactly what to do, and you
check off the boxes when you doit.
It's exactly what you would doif you went to physical therapy
no different, except you don'thave a person physically there
watching you do it, but you dohave to check it off on the app.

(01:08:58):
And the other good thing aboutthe app it has a whole section
on nutrition.
It says here are the bestthings to eat, here are the best
diets to follow.
Focus on whole foods.
It doesn't matter if you'revegan or carnivore, if it's
whole foods, if it's organic.
That's the goal.
The main thing is what youdon't eat.
Don't eat the junk food, don'teat all the fast food and trash

(01:09:22):
that the main thing.
Don't drink sugars, don't eatall the candies.
So it tells you all that and ithas inspirational psychological
advice.
It has the quarterback alexsmith is on there, who went
through a really bad injury, ofcourse, and so did the owner of
the company.
He went through a bad injuryand he's like you know this.
We need something to help withtherapy.
And they give a lot ofpsychological, motivational
advice, because that's a hardpart of recovering from an
injury is the psychological partof it.

Speaker 1 (01:09:43):
Yes, and then yeah, that's true.

Speaker 2 (01:09:46):
And then it gives some nutritional, and then it
gives some supplement advice,and it gives some advice on
sleep, because we know thatsleep is one of the absolute
most crucial things to healing.
It's when all your growthhormones are excreted and it's
so crucial to healing.
So it really hits all of thoselifestyle factors and pushes
those as well, and it's almostsomething that's good for just

(01:10:07):
everybody in general.
If you could just follow theapp and it gives you some daily
advice like did you drink, didyou stay hydrated today?
Did you get your steps in?
Did you eat a healthy meal?
You know just very basic thingsDid you get your eight hours of
sleep?
So?
And I can check on the app andI can look up all my patients
that are on it and see ifthey're doing everything you
know I could just click, oneclick, and I was like well,
everybody who's on here are they?

(01:10:29):
did they check off their boxes,or did they have they not been
using it?
Um, so I think it's.
It's.
It is a little bit extracommunication, for sure too.
No, but no, the next generationwill be amazing yeah, even the
next generation of the app isgoing to be even more yeah, I.

Speaker 1 (01:10:46):
I so is available now to to patients or is it only
available?

Speaker 2 (01:10:50):
to your patients in your clinic no, no, any patient
any a doctor that signs up.
There's hundreds of doctorsthat use this orthopedic app
right now and and anybody that Isee in the office can use it.
I think you probably.
If you tried to download it you, you probably could sign up for
it without a doctor sending itto you.
Um, it basically acts as aphysical therapy.

(01:11:12):
There might be like a smallphysical therapy visit fee or
something to use it.
I'm not sure how they would doit um, but so as of now it has
to be almost prescribed by adoctor for a patient to be able
to utilize it and participateyeah, if you want the actual
physical therapy exercises andall those details that are

(01:11:34):
personalized to you or apost-surgical protocol, I have
all my post-surgical protocolson there and, uh, those are
personalized to me and thepatients.
But if you want just a generalapp, there are a lot of general
health apps.
It's like get your steps, getyour hydration.
Here's some basic meals, thoseare out there.
But for the personalizedsurgical and post-operative
protocols, and specific injuryprotocols and there's also a lot

(01:11:56):
of injury education.
If you get the app on, say,rotator cuff tears, you can
learn all about them.
There's a lot of resources, soit's really kind of like an AI
doctor for you.
It's telling you all you needto know what you should do, what
the treatments are, and it'ssort of replacing us a little
bit, or it's a compliment.
It's complimenting us Amazing.

Speaker 1 (01:12:14):
I think that's the future and it's funny.
I just had this conversation aweek ago with someone who asked
me why I don't have an app,because I was talking to that
person about my perioperativeprotocol almost like functional
health protocol and he was asoftware developer himself.
He's like, do you have an app?

(01:12:34):
I'm like, no, should I?
Should I?
And he's like, well, it wouldbe very helpful if you have an
app, because then a patient cancontinue, um, to follow your
recommendation, um, as opposedto just you telling them here or
giving them a piece of paperthat they're probably not going
to read or throw away or lose ina car or somewhere so I think,

(01:12:57):
I think that is going to be thefuture.
uh, the way we communicate, kindof like telemedicine.
Telemedicine 10 years agopeople would laugh at you when
you just brought up the concept,and now we're having a podcast
through television.
But I want to address theelephant in the room here.

(01:13:19):
A lot of people, includingmyself, were very skeptical and
cynical when it came tosupplements, because it's not
something that you're taught inmedical school, it's not
something that is advocated as amatter of fact, it's something
that's made fun of, that it'snot real science, that if it's
not a medication or aprescription it doesn't work.

(01:13:40):
Otherwise it would be aprescription, and the reasoning
was kind of like with diet thatthere's no real science, no
evidence-based science behind itand there's so many
controversies around it.
Some people say it works,others say it doesn't work, some
say it's actually bad for you,some people are saying it's

(01:14:01):
great for you and so, becausethere is no consensus, it's
really not discussed and notpart of a physician's training,
similar with nutrition.
What are some of yourrecommendations when it comes to
supplementations, as itparticularly pertains to an

(01:14:23):
orthopedic surgery patient,whether it is a surgical patient
or a non-surgical patient?

Speaker 2 (01:14:31):
Well, I struggle with the same thing you're saying.
Every time I hear about a newsupplement, I always want to
read the study, like was it abig study?
Was it a small study?
Has it been repeated multipletimes?
It is so hard.
I'm always skeptical of a lotof supplements that are out
there.
You go to GNC.
I'm sure that a lot of stuff inthere doesn't really work, you
know, and there's just a lot ofmoney to be made though.
So if there's money to be made,people are going to market and

(01:14:53):
advertise and push it.
Really, looking into all thesupplements I could find, I
looked at other people who werelooking into all the supplements
, and one place I started was,well, you know, brian Johnson,
the blueprint.
He's trying to live forever.
He's the most studied man inthe world.
You know.
He went out and found 75supplements that actually had

(01:15:15):
clinical data for longevity, andhe put them together into his
stacks the blueprint stack andhe sells it for something like
$400 a month.
So I tell some patients like ifyou want to be the luxury, high
end executive supplementprotocol.
Here's 75 supplements.
I'll put together for you thatall of them have some clinical
benefit in a research study andit has things like creatine and

(01:15:37):
vitamin D and a lot of stuffthat we hear about, but there's
also a few other ones that Ihadn't really thought about and
so like that is your your mostextreme, if you want to go that
way.
You know, I kind of in themiddle, I'll do athletic greens.
You know that's athletic greensis one of those where, um, I
think they do have someliterature that's just coming
out more but it's, you know,kind of a newer thing.
But it makes obvious sense.

(01:15:58):
It's like.
It's like a really goodmultivitamin basically um
probiotics.
I love the probiotic, yesthat's one of my favorite things
about that.
I still do athletic greens, ofcourse.
Yes and uh yeah and then uh,look at the supplements are the
most studied?
The behind behind a caffeinecreatine is the number one or
number two, most studiedsupplement.

(01:16:18):
Tons of research, not just forphysical health but for mental
energy, for elderly people.
I put my parents on creatine.
I tell everybody over 60, oranybody really over 40, I guess
say get on creatine Five grams aday, you'll feel better.
You'll think better.
It's even been shown to improvetest performance for kids.

(01:16:39):
I believe there's a study onthat.
So creatine is a pretty obviousone.
Vitamin D is a pretty obviousone.
50% of us are low in vitamin D.
They've shown that in multiplestudies.
A lot of people are criticallylow and we know critically low
vitamin D has terrible outcomesfor all sorts of diseases.
I mean for COVID, for illness,for anything, for your hormones.
So I'm a huge fan of vitamin D,of creatine.

(01:17:02):
They have a lot of data behindthem and there is a lot of other
ones that are in that mid-tierwhere there's some decent
research like they might helpwith mental function or mental
health not something thateverybody needs all the time,
but something.
I usually give people a list ofabout a dozen supplements and I
say pick and choose from thesewhat you're really looking for.
They're the ones that havepretty good data behind them.
One of my favorites is the NADPlus booster.

(01:17:24):
So that's kind of a newer onethat's come out recently.
But the NAD Plus boosters Ibelieve we talked about that.
You got some of those too.
They do have a lot of studieson those that are pretty
positive and I know that PeterTien and Hubert Mann have had a
big discussion like a wholepodcast on them and it's

(01:17:45):
definitely something that, uh,that I do promote.
I tell my patients you know,look into this.
If the price point is not toobad for you, I'd consider doing
it, at least perioperatively foryour surgery, because I don't
know that it's something youneed every day.
But if you're doing surgery andit's going to help you heal
better, you know there's somegood data.

Speaker 1 (01:18:01):
I mean, um, I want to talk about the nad plus, which
is nad booster.
It's just too different.
You know people always get itconfused.
There is the actual nad thatyou, that people take, are
actually infused, because it's avery large molecule so you
can't absorb it through your giso you have to take it IV Very
expensive, it's like.

(01:18:21):
I think for one IV session it'slike $1,500.
And no study has yet shown itsbenefits.
And I know Peter Atiyahactually talked about it.
And the other one is the NADbooster, because NAD is a
coenzyme that your body canregenerate through a pathway and

(01:18:46):
that pathway kind of slows downand that, by the way, happens
in your mitochondria.
So that pathway slows down aswe get older, get distracted

(01:19:09):
elsewhere to repair a lot ofother DNA damage stuff, general
aging of the cells, liketelomere shortening and stuff
like that.
All of that affects to takeaway or lower the function and
the reproduction of the NAD, ournatural NAD, so that slows down

(01:19:34):
.
So the other philosophy or theother strategy is to boost our
natural NAD production.
Those are the NAD boosters,which is basically niacinamide
or vitamin B3, vitamin C and NRnicotinamide riboside and NR

(01:20:02):
nicotinamide riboside, and sothe supplement that I'm taking
has the NAD booster, but I alsotake the precursor of NAD, which
is NMN, which is nicotinamidemononucleotide, which is
actually you introduced me tothat which I take.
It in powder form.
I take, I think, one gram now Iused to take just 500 milligram

(01:20:28):
, now I take one to one and ahalf grams sublingual and that's
like it's kind of like the rawmaterial.
It's a precursor of NAD,because that's more easily
absorbable as opposed to takingthe actual NAD, which one way to
get over the poor absorption isto get it IV, which is very

(01:20:51):
expensive.
But here's the thing, here's thethings.
When it comes to NAD and NMNand all of that and NMN and all
of that, we don't even know theamount to take that would show a
clinical significance orrelevance.
And if you, because we don'thave human studies, the studies

(01:21:13):
that we have are in mice and Ithink David Sinclair did a lot
of these studies on mice.
If you take the dosages inthose studies, they were given
the mice and Peter Attiamentioned it several months ago
on a podcast at the Huberman Labwhere he said if you
extrapolate the dosage of theNMN or NAD you would take.

(01:21:38):
That's equivalent to what theygave the mice where they saw it
improves their longevity.
It would be 10, 20-fold what weare taking, or recommended to
take with the one gram of NMNthat I'm taking, which is way
below that dose.
So it's this long leap thatwe're taking and thinking that

(01:22:02):
that would help.
So what I am focusing now moreof because of that, I mean it
doesn't harm and if you havemoney to spend, yeah, you might
do it.
You don't know if it works.
So it's not something Irecommend, unless you have extra
money sitting around and youwant to feel like you're
contributing to your health, butwith the NAD booster to boost

(01:22:27):
your own natural pathway.
That we have evidence and forthat I actually I'm focusing
more on the NAD boosters becauseit's also very cheap.
I mean, if you look at thedownside, there's no downside,
it's only upside.
So that's how I try to reasonit for myself when I do these

(01:22:49):
things for myself and when Italk to my patients about it.
And the other thing is thecreatine.
The creatine monohydrate istraditionally bodybuilders used
to take it.
I remember my uncle was abodybuilder in the 80s and I saw
him coming out of gym buffedand he would take this creatine.
I thought he was doing cocaine.

(01:23:10):
I'm like what is this?

Speaker 2 (01:23:11):
He said it's creatine .
It's good for your muscle.

Speaker 1 (01:23:14):
He's like sure it is looked at creatine as for
bodybuilders, but there's a lotof studies that show its effects
on um neuroplasticity andmental acuity, not just for all
the patients.
You know, I've been taking, uh,creatine monohydrate now, um, I

(01:23:35):
put it just, and I mix it withmy athletic greens.
I just put a scoop in there andthen just take a concoction and
just literally chug it with myathletic greens I just put a
scoop in there and then justtake a concoction and just
literally chug it with mysupplements.
I'm much sharper.
I'm much sharper.
Actually.
I had a hard time remembering aphone number, like if you gave
me a phone number, I was like703, uh, can you repeat the

(01:23:55):
number again?

Speaker 2 (01:23:56):
and then I could only get three numbers at a time.

Speaker 1 (01:24:00):
Now it's like bam and I thought I'm getting old,
which I was.
My mitochondria obviously werenot producing as much ATP as
they used to, so all of that isthe effects to me of the NAD
booster.
I see direct effect, andcreatine is also one of the
factors, and I love the factthat you're encouraging your

(01:24:21):
parents to take that, because Ifeel everybody above the age of
60 should be on it.
It's the cheapest supplementyou can get and there's a lot of
science actually emerging inthat.
And then, lastly, vitamin D isthe one you mentioned, and
vitamin D I take it routinely onmy patients.
On my pre-op labs I includevitamin D I never used to how

(01:24:43):
smart.
Because I want to know.
You know it says so much aboutthe immune system and so much
about their healing ability, andso for me, that's one thing I
look at, and you want to hearsomething crazy.
You know what the highestvitamin d level was.
The whole entire year I've beendoing that.

(01:25:05):
What 38 that's the highest thatyou saw, the highest on my
patients to date, and I've beendoing it for just this year and
you know the ideal is.
What was the maximum?
That was the maximum.

Speaker 2 (01:25:23):
What was the?

Speaker 1 (01:25:23):
top.
The top was 38.

Speaker 2 (01:25:26):
Oh yeah, On your panel.
What was the top to be abovehigh level.

Speaker 1 (01:25:31):
What was the range?
The range is 30 to 80.

Speaker 2 (01:25:38):
And the highest range was at 38?
.

Speaker 1 (01:25:40):
The highest was 38.
And so my patient was like yeahmy doctor said my vitamin D
level is normal and I look at it, I'm like it's 38.
You should be in the 50s.
You should be in the 50 range.
Yeah do you want to be?

Speaker 2 (01:25:54):
lowest 10th percentile.

Speaker 1 (01:25:57):
So, thank you.
So these are things.
So I include vitamin D and you,as you know, you have to take
it with vitamin k, becauseotherwise, yeah, it doesn't, uh,
transport the calcium into thebones, right?
So can?
You talk, talk to.
I mean, I'm talking to anorthopedic surgeon here.

Speaker 2 (01:26:14):
So I want you to tell us that oh man, I haven't
looked at that for years.
Pardon, but no, d3 plus k2 isthe best way to to do it.

Speaker 1 (01:26:24):
Um, but I mean the so does it work when you just take
the vitamin b?
Vitamin d, does it work ordoesn't it?

Speaker 2 (01:26:31):
yeah, it does, but it doesn't absorb quite as well.
I think you just want optimalabsorption, um, but yeah, all
the biochemistry of of all ofthat you know I haven't looked
at all the details for a while,for quite a while, but we know,
obviously vitamin D is veryimportant for bone health and
just for overall health ingeneral.
There's so many things thataffects.
So, yeah, that's a big one forme and I will often just

(01:26:56):
prescribe it to patients becausesometimes they're like, oh, I
don't want to go get actualblood drawn right now.
I just see them in the office.
They have an injury, a fractureor something.
It's like just start vitamin D,you're not going to overdose on
it.
You know I'll start them off ona fairly reasonable dose and
then about, and then they comeback three months later.
It's like oh yeah, my primarycare check my vitamin D, I was
really low.

(01:27:16):
There's so many times wheretheir primary care half my
patients at least say that ohyeah, I'm on my primary care,
check me, I'm way low.
So no, that's one of those justno-brainers.
Vitamin d, for sure.
Omega-3, omega-3 fish oils too,that's another one, and
magnesium is the other onemagnesium right, absolutely
magnesium.
There's a lot of data onmagnesium.

(01:27:37):
You know so um, again, um lotof data on magnesium.
You know so um again, um, I,you probably have a.
You have a.
You have a very good specificprotocol that you give everybody
, or do you kind of give them alist of?
Yeah, so that's a good so, so Idon't.

Speaker 1 (01:27:50):
I don't do the shotgun approach like, um, you
know, give them everything underthe sun and I mean you could do
it.
Uh, like, yeah, you want totake brian johnson's for like
400 a month.
If you have that type of money,that's great.
I I do it very targeted.
I take roughly about 100 bloodbiomarkers and I look I.

(01:28:14):
And then I tell them to record afood diary for two weeks.
That's great.
And then so I look at the fooddiary for two weeks, that's
great.
And so I look at the food diarytogether with the blood
biomarkers, the labs, and then Ilook what their deficiencies
are and then I haveconversations about how they can
improve that with, simply, dietand nutrition and sleep and the

(01:28:39):
four horsemen of longevity.
And then I add supplementationto get them to where they need
to be, at least preoperatively,because you can't teach an old
dog new tricks in four weeks,right, but I can optimize them.

(01:28:59):
But I can optimize them.
And then I let their owntransformation speak for itself
and motivate them, because theycome to me and say, oh my God, I
feel so much better, I'm nottired anymore, I'm not craving.
Essentially, everything I wentthrough, I see my patients go
through, and thenpostoperatively, when they look

(01:29:22):
better, let's say I do afacelift or something.
They already look better Now,they feel better.
Now, matt, they're all in.
Not only it transforms theirlifestyle.
I called it the longevityfacelift.
Part of it is the facelift, butyou don't have to have a
facelift.
You can just have a simple Idon't know eyelid surgery or
brow lift, something reallysimple, something that you look

(01:29:45):
in a mirror.
You're like, oh, I love the wayI look, I'm happy now, and then
I combine it with just physicalhealth and wellbeing, and that
really gets them on thebandwagon of the longevity
bandwagon, and so I look at itas a complete transformation,
and whether you want to call ita holistic approach, which

(01:30:06):
people like roll their eyes onit as soon as they hear the word
holistic or functional.
I call it really functionalaesthetic medicine because it's
functional health combined withaesthetics, which is all about
self-esteem, self-confidence,self-worth and, ultimately,
one's happiness.
And so I'm so happy that yousent me down this rabbit hole

(01:30:30):
that I'm able now to transformmy patient's life, and I feel
good about it because I feel I'mdoing the right thing.
I'm doing what we're supposedto do.
I'm doing what patients deserveand they come to us and trust
us for it.
And it shouldn't be someinfluencer on Instagram that

(01:30:51):
doesn't even have a sciencedegree giving health advice or
recommendations on this, whichthere's so many of them out
there confusing the consumerbecause they don't even know how
to interpret a scientificarticle, not to mention they
don't even look at it.
They just read a headline in anews article.
That misinterpreted an article,because they just read an

(01:31:15):
abstract and they didn't evenknow how to interpret it, and
that's how rumors develop andconfuse the public.
And then you listen to it orread it.
You're like what are theytalking about?
And then you go read the study.
Did they even read the study?
The conclusion is completelyopposite of what the study's
conclusion was.
How could you be so blatantlyeither ignorant or lying?

(01:31:41):
Could you be so blatantlyeither ignorant or lying?
So I think we have to be theones to be at the forefront and
not just some tiktok influenceror instagram influencer.

Speaker 2 (01:31:50):
But there are a lot of good, uh, good, uh, there's a
lot of people out there, butthere's something you know just
wanting the clicks when it comesto orthopedic surgery and
sports medicine, I want to hearyou talk.

Speaker 1 (01:32:02):
I don't want to hear someone that has a degree in
physiology talk about giving meorthopedic or sports medicine
advice, even though they mightknow a lot about it.
But it's different that itcomes from a clinician, someone
that actually treats patientsand sees results and is able to
contextualize everything.

Speaker 2 (01:32:23):
Yeah, absolutely, you said it perfectly.
There We've got a doctor.
We can't just be techniciansthat are surgeons, that all
we're doing is a technical thingand, hey, let somebody else
worry about your health.
It's very important for us tobe guiding them through that
perioperative journey, and Ilove what you say about the
lifestyle factors of yourpatients.
They buy all in on it, and I'venoticed that with some of mine

(01:32:45):
too, where they've really takento the diet, the protocols,
everything, all of that stuff,especially with the app as well.

Speaker 1 (01:32:54):
So I was wondering if that's the way to go.
For you weight loss.
What impact does weight losshave on your patients?
I mean that must be huge.

Speaker 2 (01:33:01):
That's the biggest thing in my clinic.
All the time I have patientsthat come in and they have knee
pain and they're also 100 poundsoverweight, and we all know,
from the moment they walk in,the real cause of their knee
pain, and I can give themcortisone shots until the end of
time.
You know, it'd be a band-aidthough, and it's not that great
form, and so I really have tohave the conversation.

(01:33:26):
Like you know, we're going tohave to address the real issue
here at some point.
We have some strategies.
It's not just people don't wantto be told, hey lose some
weight, why not?

Speaker 1 (01:33:33):
What is wrong with that?
What is wrong?
I thought that and I actuallyyou know how I ended up
including weight loss or weightmanagement in my practice Like I
would be the last person.
I couldn't take patients to theoperating room if they were
above a certain BMI because myanesthesiologist would say it's

(01:33:54):
not safe, right, which I agree.
So, then I had to tell thepatient I'm like, look, you need
to lose weight.
I mean, I don't want to do afacelift and kill you, so you
need to.
And, by the way, if you arelike 40 pounds or 50 pounds
overweight, you havemetabolically you're not

(01:34:18):
optimized.
There's no way you'remetabolically optimized.
You know there's some degree ofinsulin resistance.
There is, you know, all thisadipose tissue that causes
inflammation, and then not onlyI will have to deal with all
that stuff post-operatively, butyou'll be frustrated.
So I don't want to send you on ajourney, um, that is doomed for

(01:34:38):
failure.
Um, you come to me, you.
You came to me for me to helpyou, so let me help you.
And so first thing is first, weneed to lose weight.
And patients were like well,I've tried, I've been doing
exercise.
It's almost like helpless.
They don't even know what to doand no one ever told them that
it's their diet.
No one even gave them healthadvice.

(01:34:59):
So that's how I started then,getting involved in it.
So are you integrating weightloss and management in your
practice?
Have you considered it perhaps?

Speaker 2 (01:35:11):
Oh yeah, I always anybody that will listen.
I mean some of the patientsthey want to lose weight they
say I'm trying, I need help.
Some people there's always anexcuse, it's like I can't, you
know.
And the people that really wanthelp, I definitely integrate it
in.
I do have a colleague who doesa telemedicine weight loss and
they'll do all the Ozempex andmy gluteus and all that stuff.

(01:35:32):
Yeah, so I mean there'sprobably a role for that.
I mean it seems like it'sgetting you know pretty hard
right now and I mean there'sdefinitely some benefits to it,
but there's also some concernslong term.
So but I think it's probably agood thing right now, you know
we can have a whole discussionover oz and peck and all that.

Speaker 1 (01:35:51):
But I know like the craziest thing is.
The craziest thing I heard isabout.
Sorry to disrupt you, butbecause you mentioned you know
there's two sides of it.
I mean, um, yeah, did you toldme about the recent
recommendation of the um umamerican?

Speaker 2 (01:36:05):
they had me pediatrics.

Speaker 1 (01:36:06):
Yeah, can you can you tell my, tell us about that.
What was that about?

Speaker 2 (01:36:12):
yeah, I think it's for for kids.
They're obese, they basicallyabove a certain age I can't
remember the exact age.
They basically recommendOzempac for life.
They say that is ourrecommendation for children with
obesity that maybe tried alittle bit of nutritional stuff.
I don't remember the exactwording of the recommendation,

(01:36:32):
but I've heard that it basicallysays above a certain age, say
maybe 12 or so, we recommendOzempac in kids as a primary
treatment for obesity, not likechanging the diet or doing all
the conservative things, butthat's for life, basically, as
long as they're overweight, forlife.

Speaker 1 (01:36:50):
That's the American Academy of Pediatrics.

Speaker 2 (01:36:53):
Yeah, it's kind of wild.
It is kind of wild, but that'sjust what they say.
Yeah, I mean $1,000 a month forlife.

Speaker 1 (01:37:04):
Yeah, and you know, as we know, most of the
population are not the affluentpopulation and the population
that can't really afford.
But I assume they are pushingthat so that insurances start
covering it.

Speaker 2 (01:37:17):
Oh exactly, there's a special bill in Congress, I
think, for Medicare to cover itor Medicaid to cover it.

Speaker 1 (01:37:24):
See, that's incredible, that's like almost
abusing the power of a peptide,instead of doing the right thing
teaching them what to eat andhow about getting rid of all
these ultra-processed foods?
How about putting pressure onthe food industry?
Uh, instead they'rerecommending um medications for

(01:37:47):
life, whether it is peptides ormedication for children age 12.
That is crazy, you know, uh notany different than pushing
vaccines like covid vaccines orflu vaccines for children.

Speaker 2 (01:38:03):
Yeah, we're the only country that does that, and all
the European countries are likeno, kids don't need all these
COVID boosters.
But here we'll be, recommendingevery kid six months, if not
forever.
Look at the money he's makingmoney on that.

Speaker 1 (01:38:17):
But that's where the medical paternalism from our
societies is trickling down andputting pressure on us and I
think, something has to reallychange at the higher level.
Either that or the patients haveto just get smarter, and I
think already a lot of patientshave lost trust in the medical

(01:38:41):
system, in doctors trying toself-diagnose themselves on
Google and not followingdoctors' recommendations when
they should.
And it's important to go toyour doctor.
If you have a traumatic injury,if you have cancer, I mean, for
those things you need, we havetherapies that can help.

(01:39:05):
But the thing is, becausepatients don't trust us anymore
or lost trust because of allthis controversial and
ridiculous recommendations, it'snot surprising that they don't
trust us anymore, and I thinkfor us to regain their trust, I
think we can't treat them likeI'm sorry idiots anymore.

(01:39:27):
I mean we have to treat themwith respect and we can't insult
people's intelligence anymore.
I mean, the cat's out the back.

Speaker 2 (01:39:34):
Yeah, our leadership needs to.
You know, admit when they getthings wrong and say, hey, you
know, this was definitely wronghere.
You, you know the way we didsome certain things during the
pandemic and you know if therewas ever a recommendation that
got reversed.
Like you know, medicalreversals there's so many
medical reversals that havehappened and like one was
estrogen.

(01:39:54):
I think that marty mccary wastalking about that, or peter.
Yeah, yeah, no, it's marty,yeah, no, that was Marty and
Kerry about.

Speaker 1 (01:40:02):
HRT and that the study was the Women's Health
Initiative, the WHI study in2002, where the study itself
concluded there's no significantsignificant risk risk for

(01:40:22):
breast cancer.
And then they said the oppositeand the media ran with it and
all the authors, the co-authorsthat were involved.
They weren't even asked for theopinion, they didn't get a
chance to review it.
Some of them were so pissedthat they actually left and
others that raised theirconcerns they were literally

(01:40:44):
fired.
All because of ego andpolitical power to send a
generation a devoid generationof women from hormone therapy.
And not only that, increasedtheir risk of getting stroke and
heart attack by up to 40%because they didn't get their
hormone replacement therapywithin the 10 years in their

(01:41:06):
post-menopausal period, where itactually yields any matters and
yields benefits.
So you see this stuff, you'relike who do you trust these days
?
So I really hope that I'm sohappy that we have the platform
of podcast where we can openlydiscuss, without any political
or financial incentive, justtransparently discuss where we

(01:41:32):
are, where we should be andwhere we think we're going to go
.
And I want to thank you reallyso much again, uh, for uh
opening my eyes and now comingonto my podcast and just uh
chatting for um, almost, yeah,an hour and 42 minutes already.

(01:41:53):
Uh not including our pregameshow, oh yeah, which makes it
two hours Um Monday nightmissing Monday night football.
So I really appreciate that andI hope to just talk to you on a
personal level on a lot of thethings that you're doing and we
can kind of share ideas and I'mreally excited to one day

(01:42:17):
perhaps work together on some ofthis stuff.

Speaker 2 (01:42:21):
Absolutely.
It's been a pleasure being onwith you.
I love what you do.
You really work hard at thisand it's amazing how well you've
done with this podcast.

Speaker 1 (01:42:30):
Thank you.
Thank you, my brother, and Iwant to thank Dr Matt Thompson
for coming on to my show.
I hope you enjoyed the show asmuch as I did.
I hope it was as eye-opening.
His insights were aseye-opening as they were for me
and if you have any questions,where's the best place for my
audience to reach you, Matt?

Speaker 2 (01:42:52):
Oh, precision Orthopedics
wwwprecisionorthopedicsmdcom.
That's our main website.
That's how to get in touch withus.
I also have a LinkedIn profile,matthewthompsonmd, for any work
stuff.

Speaker 1 (01:43:06):
All right, guys, you heard it.
Have a great night and pleasedon't forget to leave me a
review on Apple iTunes and putyour comments and questions in
on Spotify, and hope to see younext time.
Bye-bye, bye, thank you.

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