May 27, 2025 • 33 mins
The world of podiatric medicine is evolving beyond temporary fixes and Band-Aid solutions. In this enlightening conversation between Dr. Lauren Dabakaroff and guest Dr. Wadehra, we dive deep into the revolutionary field of regenerative medicine for foot and ankle conditions.
"Harnessing the body's ability to heal itself" is how Dr. Wadehra describes this groundbreaking approach. Unlike cortisone injections that merely mask symptoms temporarily, regenerative treatments like Wharton's jelly injections provide the body with essential building blocks for actual repair. As Dr. Wadehra explains with his drywall analogy: "You're going to buy a drywall patch kit that has all the ingredients to fill that hole. That's exactly what Wharton's jelly is—giving the body the ingredients it needs."
We explore the powerful synergy between multiple treatment modalities. MLS laser therapy stimulates cellular energy production, while EPAT/shockwave therapy breaks up scar tissue and improves blood flow. When combined with biologics like Wharton's jelly, these treatments create an optimal environment for healing. The results? Recovery times cut in half compared to conventional approaches.
Both doctors share their unique protocols for conditions ranging from plantar fasciitis to neuropathy, discussing the importance of proper immobilization during treatment and the challenges of navigating insurance coverage for these advanced therapies. Though often not covered by insurance, these treatments offer something invaluable—genuine healing rather than endless symptom management.
Whether you're struggling with chronic foot pain, recovering from surgery, or seeking alternatives to medications for neuropathy, this episode provides a comprehensive look at the future of foot and ankle care. Ready to explore treatments that actually fix problems rather than just masking them? Visit LMDPodiatry.com to learn more about getting back on your feet—for good.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Welcome to the LMD Podiatry Podcast.
Trust us to get back on yourfeet.
Here's your host, Dr LaurenDeBakeroff.
Speaker 2 (00:16):
Hey everyone.
Dr Lauren DeBakeroff here withthe LMD Podiatry Podcast.
We have a special guest todayDr Ashna Madera podcast.
We have a special guest today,dr Ashwin Madera.
He is a colleague of mine andwe do a lot of the same stuff
and we're going to kind of runthrough all that.
Speaker 3 (00:36):
How are you doing, Doc?
Good, good Thanks for having meon this.
Speaker 2 (00:38):
This is great.
All right, so tell us aboutyourself a little bit, so
everybody knows who you are andwhere you're from.
Speaker 3 (00:44):
Yeah, yeah, yeah, I practice in the suburbs of
Detroit, Michigan.
I'm in a city called Birmingham, Michigan.
I started a kind of like ahybrid concierge practice a
couple years ago, reallyspecializing in minimally
invasive foot surgery but alsoregenerative medicine, which I
know you and I are going to talkabout quite a bit here shortly.
Speaker 2 (01:04):
Regenerative medicine , which I know you and I are
going to talk about quite a bithere shortly.
Very exciting.
So why don't we just, like Ilike, to, always open with what
is regenerative medicine and whyis it different than the
conservative approach thateverybody's been used to for the
past many, many decades?
So basically, regenerativemedicine is, I like to call it
(01:31):
like harnessing the body'sability to heal itself.
Like a lot of things becomechronic, like plantar fasciitis
becomes chronic, sometimesAchilles tendonitis, people have
chronic sprains and things likethat, and then there is not
much in the world of traditionalmedicine that gets those areas
to heal.
And that's when regenerativemedicine comes in.
(01:54):
We use things that have specialqualities and properties that
kind of wakes up those cells onthe cellular level to heal.
What do you so, what do you usein your office, dr Bodera?
Those cells on the cellularlevel to heal.
Speaker 3 (02:09):
So what do you use in your office, Dr Badera?
Yeah, I think you put it reallywell.
I like the way you describeregenerative medicine.
That's how I talk to mypatients about it too.
The body is very smart.
If you give the body what itneeds, it truly can heal itself.
But to answer your question, weutilize a you know a variety of
different methodologies.
One is shockwave therapy orEPAT therapy.
We do a lot of laser therapy inthe office too, but my favorite
(02:36):
really is utilizing differentbiological injections not
steroid, but biologicalinjections Right, because
steroid it won't actually healthe area.
Speaker 2 (02:42):
So let's say you take the plantar fascia it's a very
tight band on the bottom of yourfoot and fascia doesn't stretch
.
And then what the steroid does?
It actually just removes someof the inflammation and it
doesn't actually heal thatstructure at all.
In some cases it can help, likeit'll take away a lot of that
(03:04):
inflammation, allowing kind oflike for the environment, a good
environment for the foot toheal, but it doesn't actually
repair anything and then when itcomes to other things like, or
if you inject the steroid aroundtendon, it can be very harmful.
It could actually weaken thetendon, weaken the ligament and
cause other damage and puts youat high risk for tears and
(03:26):
ruptures down the line.
So that's what we kind of wantto avoid, but unfortunately
traditional medicine goes therea lot of times.
So I think you and I use thesame biologic Use the DPMX
injection.
Speaker 3 (03:45):
Yeah, I use a variety of different injections.
Now I do utilize them from timeto time, but I've been kind of
dabbling with different types ofWharton's jelly products along
with the exosomes and actuallyproducts that even contain live
cells.
But yeah, again, to answer yourquestion, dpmx is definitely
one of those that I use quiteoften.
Speaker 2 (04:05):
Yeah, Again to answer your question, DPMX is
definitely one of those that Iuse quite often.
Well, what?
Are the other ones that you use, you've been utilizing
Basically like a Wharton's jelly.
I explain it to patients thatjust say it's the thickest part
of the umbilical cord that's themost rich in native or stem
cells, and that they have allthese properties that are
pro-inflammatory and theybasically tell the body to heal
(04:26):
itself on a cellular level.
Speaker 3 (04:31):
Yeah, no, that's exactly the way that I describe
it to patients as well.
It's almost like you know.
I'll use the analogy sometimes.
You know, and I'll come back tocortisone for just a second.
You know, cortisone, like youdescribed it, all it is is like
a Band-Aid approach.
It turns the pain off for alittle bit, but we haven't,
never we haven't done anythingto actually heal the, the issue
at hand, the root cause.
So what I'll tell patients isyou know, when you inject
(04:51):
something like wharton's jelly,it has all the ingredients that
we need to truly repair theproblem at hand.
So an analogy I'll usesometimes is imagine you have a
hole in the drywall.
You're going to Home Depot orLowe's, you're going to buy a
drywall patch kit that has allthe ingredients it needs to fill
that hole.
That's exactly what Warden'sJelly is is giving the body the
(05:12):
ingredients it needs to patchthe hole, patch the fracture,
whatever it is truly giving theingredients, versus just putting
a Band-Aid on it and thenhoping something happens.
But, as you know, most oftenwhen you do that to patients,
they come right back through thedoor saying doc, it worked for
a little bit, but now I'm evenin more pain yeah, I've, I see
(05:33):
that all the time, all the time.
Speaker 2 (05:35):
Um, so I personally like to use the wharton's jelly
in conjunction with laser and Iactually have higher success
rates with it because most ofthem pay.
Like most patients don't listenin a bad way, but like, like I
(05:56):
had this guy, I gave him theWharton's jelly injection.
He felt for his fascia.
He felt so good.
He started like climbing theCanyon, the Grand Canyon, I
don't know what he was hikingover there.
And then he uses ladders atwork and then I actually do a
lot of diet and mouth imaging inmy office and I have an
ultrasound and I took a look athis ultrasound to see why he was
(06:19):
in so much pain.
It was amazing.
In three, three weeks thefascia actually shrunk in size
the normal way the fascia isabout.
You know, his was bad, his waslike seven millimeters or more
and then it was already down tolike five and a half millimeters
, which was amazing.
But you saw all thisinflammation around it.
It's like great I got.
(06:40):
I gave you this medicine to getyour body to heal itself and
it's doing a good job, butyou're aggravating it.
So once I like forced him tokind of go in a boot and I had
him do six.
I used the MLS laser.
We did six sessions of the MLS.
I never saw him again.
He was fixed.
(07:01):
He gave me a testimonial andeverything.
And ever since that I don't letpatients get the injection
without it, because I love theMLS laser.
It tells the mitochondria andyour cells to make more energy
and it takes away a lot of theinflammation.
And I actually have found a lotof studies that it actually
(07:24):
enhances the ability of theWharton's jelly injection and
all those type of biologicinjections to work better.
So do you use that inconjunction or you do it
separately?
Speaker 3 (07:37):
No, I very routinely will package it with Wharton's
jelly with a combination of MLS,laser and shockwave therapy.
I find the two, especially withheel pain, I find that, uh, the
MLS plus shockwave actuallycompliment each other very well.
And then you throw theinjection on top of it.
You create a really nice sounduh environment for some really
good healing.
Speaker 2 (07:57):
So in what cases do you do the shockwave for?
Or you just use all threemodalities for?
Speaker 3 (08:05):
it really primarily my like uh soft tissue type of
uh tendinopathy, so achillestendinosis or plantar fasciosis
will utilize the combination ofthe two.
Um, I mean very rarely am Idoing just shockwave alone or
just laser alone.
Um, I mean, of course,neuropathy patients, those are
probably just getting a laseralone.
I mean, of course neuropathypatients, those are probably
(08:26):
just getting a laser alone.
Or post-surgical patients.
We do lots of MLS.
But again, for these chronicconditions that patients are
dealing with again softtissue-wise, I like the
combination of the two, theshockwave plus the MLS laser.
Speaker 2 (08:41):
Well, what is the?
I know you use the E-PAT right.
Speaker 3 (08:45):
Yeah, I use E-PAT.
I don't have that machine.
Speaker 2 (08:47):
Okay, so how like?
How is it different than theextracorporeal shockwave?
Speaker 3 (08:54):
It's under the same family.
You know, essentially there'sno sound waves that are being
pushed into the patient withoutthe use of any sort of
electromagnetic again type ofproduct, but the idea is the
same.
The idea is that we'restimulating you know, I call it
(09:16):
exogenous inflammation, if youwill.
You're creating inflammation onpurpose to jumpstart the body
with the shockwave there or EPATtherapy, and so we're bringing
good blood flow to the area.
We're breaking up scar tissue,we're bringing the body's own
natural stem cells to the area.
I find that you pair with mlsmls, similar.
It'll bring good blood flow tothe area, but it'll then flush
out all the bad cells.
The histamine releases that.
(09:38):
We get the bad.
You mentioned mitochondria,right?
Uh, we basically recycle thebad mitochondria, bring fresh
mitochondria to the area and themitochondria releases ATP.
So I found that the two togetherreally created a really great
environment, and then you hit itwith some Morton jelly on top
of all that.
Speaker 2 (09:55):
So how do you separate them?
You do the shockwave first andthen MLS, and then how long do
you like separate it?
Speaker 3 (10:06):
So it's a good question.
I've been playing around withdifferent type of protocols and
talking to colleagues, but whatI found work that works really
good in my hands.
If you were to just you know.
If you do like utilize thesethree types of modalities, let's
use plantar fasciitis orfasciosis for a second.
I typically will start themwith.
I'll start with plus EPAT firstand that same.
(10:28):
As soon as we finish the EPATround, I'll hit them with MLS
laser and I'll do two to threeof those and then have them on
the third visit.
Speaker 2 (10:36):
In the same time that they're there.
Speaker 3 (10:38):
Same time they're there.
Oh, Same time they're there.
And third visit we'll have themcome back and we'll just do the
injection that day.
We won't do anything else.
I'll wait two weeks and thenstart the process back over
again so you do the epat and themls the mls in the same setting
(11:01):
.
Speaker 2 (11:03):
And you do what?
Speaker 3 (11:04):
three in a row, each one a week apart yeah, I'll do
two to three first, and then twoor three.
First two to three weeks, uh,and then, and then back in for
the injection, wait two weeksand then give them three more
rounds of that I spoke to uh drspear he's also one of our
colleagues.
Speaker 2 (11:22):
He said that he does the uh epat, uh three in a row,
and then he does the wharton'sjelly and then he does another
three epats and he gets reallygood response from that.
Speaker 3 (11:38):
Yeah yeah, I've heard some people just do three
rounds of epat and then whartonjelly and call it today.
So we don't really have any.
You know, quote unquote goodprotocol protocols, yet it's all
anecdotal.
Speaker 2 (11:49):
I know, I know Cause regenerative medicine.
It's a brand new field, thewhole point is is, like we said,
just to get the body to healitself.
Speaker 3 (11:56):
Do you?
Speaker 2 (11:56):
so I'm very I'm a stickler for immobilizing the
patient.
Do you put them in a booth?
Speaker 3 (12:01):
Yeah, do you put them in a boot?
Yeah, I do, I do, I recommendit.
I mean, do patients listen tome?
That's the other, you know,that's the other half, Right?
So you just, you know, I tellthem this.
I said, look, the boot is to dotwo things.
It's number one to give thatfoot just a break from life so
that we can truly allow it tojust start healing.
(12:21):
But it allows you to staymobile.
The second reason I like theboot is because you know, it
keeps that injection pretty muchwhere I want it to be, versus
spreading out.
Now, the foot's a smallstructure, so, you know, would
it actually spread out and it'lllose the area?
I don't really think so.
But I like the boot because ittruly just gives them, it
reminds them that they hadsomething done recently too.
(12:43):
So they should just take iteasy.
But again, like your patients,my patients sometimes will
listen to me they want to getback to life.
You can only educate, right?
Speaker 2 (12:54):
Yeah, yeah, I mean I think I always make the analogy.
I tell patients like all right,this is the problem with your
foot.
I tell patients like all right,this is the problem with your
foot.
And then I tell them you know,if you sprained your wrist or
dislocated your shoulder orsomething, you'd stop using it
for a couple weeks and you'dfeel better.
And then the problem with you,know us, our field, you know
(13:17):
foot and ankle specialistsnobody stops using their foot.
And then I just keep kind ofreinforcing, like how do you
expect your body to heal itselfif you keep using your foot?
All the time.
Time like your foot, like thepain, is the signal.
It's a blessing from your body.
It's your body telling youplease stop using me.
(13:38):
So you have to listen to yourbody, like you can't just walk
this off, um, and then you know,with the regenerative medicine,
healing time is pretty muchhalf of what most people expect.
Like Like I do it a lot forsports medicine injuries and
I've had really good results.
(13:58):
Like some people that have areally bad ankle sprain, whether
it's the ATFL or the deltoid, Iconfirm it with MRI and give
them the injection, put them ina boot and then I actually see.
You could actually on theultrasound see only three weeks
later that everything is fillingin, whereas traditional
(14:20):
immobilization for ankle screensmaybe in six weeks it'll close.
Yeah, yeah, that's pretty coolthat's cool.
Speaker 3 (14:30):
You can see that on ultrasound.
Um, I agree with you on thatthat acute injuries, injuries.
It works really, really well.
Are you utilizing WardenShelley for post-surgical
patients?
Speaker 2 (14:40):
That I'm not there yet because, it's funny, down
here in Florida patients don'twant surgery, they don't want
time off, they don't want a boot, they would rather live with
their pain or I don't know itshould.
I mean, I know you do minimallyinvasive surgery in your office
I do.
The surgeries that I do aremostly like I do some like
(15:04):
bunions and hammer toes andthings like that at the surgery
center.
But yeah, I have been.
The only thing I encouragepost-op is is the MLS laser,
because it does help theincision heal a lot better and a
lot of patients have a lot lesspain after surgery and they
heal a lot faster.
Speaker 3 (15:23):
If you started to add yeah, I saw I had a lot.
I do a lot of wort and jellypost-surgery for my patients.
So after I put my last stitch,instead of hitting them with,
you know the common cocktail weall used in residency.
Or you know other practices.
You know a little lidocaine orwith some Dax at the end.
You know I just do orange jellyat the end and I have found
(15:45):
that I mean the patients thatsign up for that versus don't.
It's a night and day differencebecause you know, even with
minimally invasive surgeryyou're still dealing with pain
and swelling.
That never goes away regardless, but it really does decrease
the edema I see with patients.
Also, just overall, pain-wisepain is substantially decreased.
I'm seeing unionization onx-rays faster with these
(16:05):
patients too.
And then, of course, I use MLSall the time for post-surgical
patients.
So again, the two really createa great environment for for
patients to heal fast.
I think mls alone is phenomenal.
I I love mls laser.
It's a great.
It's a great modality I love it.
Speaker 2 (16:23):
My patients are so happy.
It's like, especially theneuropathy patients, they it's
like it's like a gift becauseyou, there's this new technology
, there's this technology.
The technology has been aroundfor a while, like I remember,
yeah, laser from when I was incollege, when I was in podiatry
school.
They were like they had themshow us how to use that laser
and what it does yeah, yeah, Iwish they would show it more.
Speaker 3 (16:46):
You know, back then we were all skeptics, you know,
uh, but, but we're not in thefield practicing, talking,
talking badly about low-levellaser therapy.
Speaker 2 (16:55):
And then the MLS is different because it's like it's
a double beam.
It's a double laser beam, soit's a healing laser as opposed
to the other lasers out there.
Speaker 3 (17:06):
Yeah, it's definitely the premier laser.
And you know?
Here's another thing I tellpatients because sometimes we're
skeptical, and I go thiscompany, cutting Edge and we're
not sponsored by Cutting Edge,by the way, just FYI.
If your patrons have seen this,I want them to know.
We're not getting paid to saythis.
I'm just saying this because Itruly believe in the laser, but
if Cutting Edge wants to pay us,I'm sure we're here for that
(17:28):
too.
Anyways, that company wasactually designed for
veterinarians.
I don't know if you know thatfor six years, I've heard about
that.
Yeah, I heard.
You cannot fool an animal.
There's no such thing asplacebo in animals.
Uh, if your dog had just an aclsurgery or something you know,
a fracture, etc.
(17:48):
That, or if production fixationor they just are having bad
arthritis because animals do.
This laser really helped a lotof these animals.
Now finally, six years later,they bring it to human medicine.
You can't trick an animal, andI'm you know.
My patients who go through italso just swear by it too well,
when do you not use thewharton's jelly injection?
(18:11):
honestly, I, you, I try to useit for everything.
I don't I, I do.
I don't use cortisone in myoffice.
If I have a patient that isasking me for cortisone, I
actually will just refer themout because I don't believe in
cortisone.
I truly don't.
No, I don't, I don't believe init.
I can count on one hand howmany times I've used it since I
started my practice here.
But ortho group, I use it allthe time.
Speaker 2 (18:37):
But I saw a lot of bad reactions with it, so I
refer people out.
So I still use it, mostlybecause I don't have the hybrid
concierge model that you have.
Yet I see a lot of insurancesand people want what is covered
by insurance and that I tellthem you know wardens, jelly
fixes your.
The only thing that's coveredby insurance is talking to me a
(18:57):
prescription for medication,physical therapy and a steroid
injection.
Speaker 3 (19:03):
Well, it may be, we don't even know.
Nowadays, with insurance,they're cutting everything.
Now, you know, sometimes evenphysical therapy is not covered
by insurance anymore.
It's actually kind ofridiculous.
Speaker 2 (19:13):
They limit it like per year.
Yeah, even physical therapy isnot covered by insurance anymore
, it's, it's actually kind oflimited like per year.
Uh, yeah, it's, it's sad, butyou know that's I tell patients
it's kind of sad that likemedicine is advanced and there's
actually evidence-basedmedicine to support all the
things that we are doing,especially um the, the wharton's
jelly injections.
I've seen a lot of studies onit, but but you know, these
(19:35):
Medicare guidelines are notkeeping up.
They're like, oh, they're sobackwards.
Speaker 3 (19:39):
Don't ever expect a regenerative medicine to ever be
covered by insurance.
It's never going to be.
It's it's you and I.
I can have a whole differenttalk with you about insurance,
but I, I hate health insurance.
I have health insurance, buthealth insurance in our country
nowadays, I truly.
By 2030, the average deductiblewill be $10,000.
That's what we found out.
So your health insurance istruly for catastrophic reasons
(20:02):
at this point.
God forbid.
You're a life-threateningaccident, you need to go to the
hospital, you have alife-threatening illness, you
have a baby those are reasons tohave it but to come see you and
myself, your health insurancereally is not going to be
applicable.
You're going to be paying ahigh deductible a deductible to
see us anyways.
So why not use that money anduse it towards something that's
(20:23):
actually going to help yourhealth, versus something that's
going to put a bandaid on itversus something that's going to
keep you coming through my doorover and over again.
You're going to get frustratedwith me.
Speaker 2 (20:38):
Doc, you keep giving the same injection over and over
again.
Why am I not healing?
Mrs jones, remember what I toldyou steroid is only a band-aid.
It's not to me.
It's truly going to help you.
You know, I actually use.
There's an example I use onmyself.
It's like a sad example.
I don't like to talk about mypersonal life too much but uh
like I need a fertility doctorto help make babies right and
according to blue cross bluesheet, like I have, I have
insurance.
And according to Blue Cross BlueShield, like I have, I have
insurance.
And according to the insuranceguidelines of my insurance
(20:59):
company, it's not medicallynecessary to have children, so
they refuse any fertility.
And like that's, that's where,that's where this, that's where
society is going, and it's likeyou're in a birth rate decline.
I hate talking about it.
It's sad.
You know what?
I took out my credit card.
Speaker 3 (21:21):
You paid for it.
Speaker 2 (21:23):
I paid for it.
Sometimes it was successful.
Thank God I have a beautifulthree-year-old daughter.
I had lots of failures beforeher.
I had a couple after her, butyou know it is what it is and I
paid for it because it'ssomething I want.
So, like I tell my patients, ifyou want, you don't expect your
insurance to pay for everything.
(21:44):
You know it's patients.
There's like this mentalitythat they want insurance to pay
for absolutely everything andit's not reality.
It's not reality so I I first ofall thank you for being
vulnerable and appreciating thestory.
Speaker 3 (21:59):
That's, uh, you know that's not easy to share, um,
but to your point, right, um,you paid out of pocket for
something that you trulybelieved in and you, you, you
have a daughter, right,three-year-old daughter.
That's amazing, that.
That's a blessing.
So you know, if you trulybelieve in something, you're
gonna do whatever it takes toget.
That's amazing, that's ablessing.
So you know, if you trulybelieve in something, you're
going to do whatever it takes toget it.
That's how I, that's my you know, that's how I, my personality
(22:20):
is.
So you know, I think, I thinkthat's you know the way the
message is to our patients too.
It's, it's that, look, there'sa lot of great modalities that
are healthier for you, right,that's.
The other thing is we don'ttalk about side effects.
These insurance companies willcover the blood pressure
medication, the statin, whatever, okay, but there's no talk
(22:42):
about the side effects, theillnesses that come and follow
this medication, just becauseit's covered by insurance.
Let me take it Right, but letme now educate you on all the
bad things that can come with itand you let me know if you
still want this medication.
Speaker 2 (22:59):
Yeah, I tell patients with neuropathy like I tell my
patients all those likegabapentin and Lyrica it doesn't
fix your neuropathy.
We have to do things to wake upyour nerves right, because
that's the whole point ofregenerating the nerves,
regenerative medicine.
So for neuropathy I do do acombination of vitamins, cbd
cream and the laser patientsfeel better with like the third
(23:21):
or fourth session.
Yeah, no, that's phenomenal Anymedications and I encourage
patients to exercise more.
It really helps stimulate thenerve to wake up.
But all those other pills theyjust put band-aids on it and
they have.
Speaker 3 (23:41):
Even today.
Why did they put me on anantidepressant for my neurosis?
Yeah, that's, but they do that.
No, they do that, they do that.
Uh, that that's.
That's actually a very commonpractice nowadays.
Uh, you know again these docsand again I'm not.
I respect all all ourcolleagues, okay, okay, yes, so
do I, but people like you and me.
Speaker 2 (23:55):
We're in this for I guess we're out-of-box thinkers
and that's why I started thewhole regenerative medicine game
, because I really want, I liketo fix the root of the issue,
the root cause, the root cause.
Even with pancreatitis.
You know if patients, if theircalves are extremely tight.
Speaker 3 (24:20):
Actually it is.
Speaker 2 (24:21):
You know if patients if their calves are extremely
tight.
I actually use my shockwavemachine to loosen up their
calves and break up all theadhesions in the abdomen.
You told me too.
That's why I started using itas part of my protocol, because
if they're tight and they didphysical therapy or they're too
lazy to stretch at home, one ortwo sessions of the shockwave
(24:43):
just on the leg, the back of theleg, loosens everything up and
it takes so much pressure offthe fascia.
So that's why every patient,case by case, I have to see
what's causing the tendonitis,what's causing the fasciitis.
Speaker 3 (24:59):
Are you doing?
Are you so, if you the patientthat comes in with a fascia, a
plantar fasciitis, are you doingthe, the calf or the
aponeurosis first and then theheel at the same time?
Speaker 2 (25:22):
Yes, I am.
I am doing it at the same time,like if it's like I was just
thinking, I had someone onFriday.
We just did the legs cause shejust had the tendonitis, the
Achilles tendonitis but forfasciitis I do both the calf and
the fascia okay when I do theshock wave, the patient.
Most people sign up forshockwave because there's no
downtime versus getting thewharton's jelly yeah, yeah so.
(25:45):
So that's like they actuallyfeel better right away.
The shock wave, uh, it breaksup all that.
So the adhesions, uh brings newinflammation to the area.
I also tell patients not totake anti-inflammatories.
I tell them you know you wantthe inflammation.
It's good for you, it'll helpheal.
But that's the and.
(26:06):
Every time I tell patients thatwith the Wharton's jelly
injection they need the boot,they kind of they deviate from
that.
I know, I know, I know what youmean.
There's something I don't knowwhat it is there's something
about wearing a cam walker fortwo weeks.
Speaker 3 (26:19):
It's just.
It's just like you know it'salmost like I don't understand
that.
Speaker 2 (26:25):
Especially the driving foot, it kills them.
You know people don't want tobe limited.
Speaker 3 (26:30):
I guess it's inconvenient it's inconvenient,
but but then you got to paintpicture right.
It's like look, it's two weeksof your life versus.
Two weeks of your life is adrop in the bucket compared to
how long we live as human beings.
So two weeks to truly try andget you out of pain, I think, is
something you can do foryourself.
Speaker 2 (26:49):
I actually have a patient.
She has.
Have you ever seen these likepeg leg walkers?
Speaker 3 (26:54):
Yeah, yeah, I've seen them.
Speaker 2 (26:55):
It's like you put your knee in and like you have a
peg leg and then your foot'shanging up in the air.
Speaker 3 (27:01):
I've seen that.
Speaker 2 (27:03):
She's like I get a lot of looks at the store but it
works.
She finally, like kept off herfoot and her fasciitis went away
.
She's so happy.
Speaker 3 (27:12):
That's great.
Speaker 2 (27:14):
Yeah, any other nuances before we sign off?
Speaker 3 (27:19):
I was actually going to ask you what's your
neuropathy protocol for MLS.
Speaker 2 (27:26):
Okay, so I do 12 sessions of MLS to start with,
first three sessions in thefirst week to create the buildup
effect in the cells because youhave to wake them up.
And then I do the EBN6 vitaminfrom the EBM company.
It's a great vitamin.
(27:46):
It helps glycosylation andrenewal of the nerves.
And then I encourage patients Ialso started physical therapy,
especially the older populationphysical therapy to just do like
gait training and balancingjust to try to get them more
mobile um, and then if and then.
The other thing is I really likethe cbd cream and if the
(28:10):
patient doesn't want to pay forit, then they go get some over
the counter capsaicin cream thatworks as well.
Speaker 3 (28:16):
I see.
No, that's very similar to whatwe do.
Speaker 2 (28:21):
There's also a machine that sometimes I
prescribe if the patients haveinsurance.
It's called the Zynex machineand it has an inter.
It's like a tent unit but ithas an interferential currents
on it and it stimulates the.
It's like a 10 unit but it hasan interferential current on it
and it stimulates the nerves towake up and heal and it helps a
lot with the symptoms ofneuropathy as well oh, that's
interesting, so you do.
Speaker 3 (28:42):
So.
You do the, you do three.
You do three sessions of mlsthe first week, and then you do
one session per week after thatno two two per week, I do two,
yeah.
Speaker 2 (28:53):
So I tell patients, the more they do it closer
together, the faster the nerveswake up.
I actually had one neuropathypatient that did five in a row
and felt like a million bucks.
Speaker 3 (29:06):
Awesome, awesome.
And are you doing theirprotocol where you let the robot
go over the dorsum of the footand then you use the trigger
point laser to hit the legs?
Is that your protocol?
Speaker 2 (29:16):
no, I actually just I do each leg.
I do the right leg, from thecommon fibular nerve all the way
to the dorsum of the foot, andthen I do nine minutes on each
leg like that, and then I do,and then I put their feet the
bottom of their feet togetherand I do nine minutes on each
leg like that, and then I do,and then I put their feet the
bottom of their feet togetherand I do another nine minutes
(29:38):
with the bottom of feet together.
Speaker 3 (29:41):
Okay, and you're using the roller as a robot.
Speaker 2 (29:46):
Yeah, it's a robot, like it's.
I didn't hear you what.
Speaker 3 (29:52):
What I think you said M7.
You got the M7, the robotic.
Speaker 2 (30:00):
Yeah, I have the robotic one, so it has the
handheld piece and it also has.
So we just do the setting.
We do the whole entire leg,both legs.
It runs for nine minutes.
We scan it and we run each legfor nine minutes and then the
bottom of the feet togetheranother nine minutes.
The patients are here for abouthalf an hour but, it really
(30:20):
does work.
And I always crank it up, Ialways double power it because I
want to do right by my patientsand get them the most relief.
And, um, my patients, I also dothat for chronic arthritis.
I have someone I actually treatknees down here.
Sometimes I have like a mailmanwith bone on bone knees and he
(30:43):
really doesn't have time to havea knee replacement and he just
comes in, gets a couple he didthe initial like six in a row
and he comes in about once aweek for maintenance and he
feels a lot better.
He doesn't have any scoots inand out of his mail truck and
(31:04):
you found a way to get his painunder control, without surgery,
without injections, withoutpills, and he's very that's
great, so I use it for a lot ofthings that's really nice.
Speaker 3 (31:14):
Knees are great any arthritic condition.
Speaker 2 (31:16):
Great for it and end up using less pills, cause it's
amazing.
And then it's just interestinghow all my colleagues use them
differently and how like.
What I do is.
I just give the injection firstand then I do 10 or 12 MLS in a
(31:41):
row with the boot for aboutthree weeks.
That's my protocol, but it'snot.
I could see where doing theshockwave and the MLS at the
same time works a lot better.
I didn't even think of thatbefore, so it's really cool,
very interesting.
Speaker 3 (31:55):
Yeah, it's just.
You know, like I said, there'sa million ways to skin a cat
right.
So that's the same thing here.
Is that there's so many ways toachieve the same results, if
you will.
Speaker 2 (32:06):
Yeah, all right.
Well, thank you so much forcoming on my podcast today.
I love collaborating with othercolleagues and seeing what
they're doing and, uh, you're.
We're doing great thingstogether.
We're just helping other peopleall the patients with pain and
dr wadera.
Thank you so much for your timeand for all the people in
(32:26):
michigan.
Hopefully they'll get around tohearing us together thanks for
having me on.
I appreciate it thank you somuch.
Have a great, have a great daySee you next time.
Speaker 3 (32:35):
You too See you next time, bye.
Speaker 1 (32:42):
Thank you for listening to the LMD podiatry
podcast.
For more information, visitLMDPodiatrycom.
That's L M D P O D I ATiatrycom.
That's lmdpodiatrycom, or call954-680-7133.
Welcome to the LMD Podiatry Podcast.
Trust us to get back on yourfeet.
Here's your host, Dr LaurenDeBakeroff.
Speaker 2 (00:16):
Hey everyone.
Dr Lauren DeBakeroff here withthe LMD Podiatry Podcast.
We have a special guest todayDr Ashna Madera podcast.
We have a special guest today,dr Ashwin Madera.
He is a colleague of mine andwe do a lot of the same stuff
and we're going to kind of runthrough all that.
Speaker 3 (00:36):
How are you doing, Doc?
Good, good Thanks for having meon this.
Speaker 2 (00:38):
This is great.
All right, so tell us aboutyourself a little bit, so
everybody knows who you are andwhere you're from.
Speaker 3 (00:44):
Yeah, yeah, yeah, I practice in the suburbs of
Detroit, Michigan.
I'm in a city called Birmingham, Michigan.
I started a kind of like ahybrid concierge practice a
couple years ago, reallyspecializing in minimally
invasive foot surgery but alsoregenerative medicine, which I
know you and I are going to talkabout quite a bit here shortly.
Speaker 2 (01:04):
Regenerative medicine , which I know you and I are
going to talk about quite a bithere shortly.
Very exciting.
So why don't we just, like Ilike, to, always open with what
is regenerative medicine and whyis it different than the
conservative approach thateverybody's been used to for the
past many, many decades?
So basically, regenerativemedicine is, I like to call it
(01:31):
like harnessing the body'sability to heal itself.
Like a lot of things becomechronic, like plantar fasciitis
becomes chronic, sometimesAchilles tendonitis, people have
chronic sprains and things likethat, and then there is not
much in the world of traditionalmedicine that gets those areas
to heal.
And that's when regenerativemedicine comes in.
(01:54):
We use things that have specialqualities and properties that
kind of wakes up those cells onthe cellular level to heal.
What do you so, what do you usein your office, dr Bodera?
Those cells on the cellularlevel to heal.
Speaker 3 (02:09):
So what do you use in your office, Dr Badera?
Yeah, I think you put it reallywell.
I like the way you describeregenerative medicine.
That's how I talk to mypatients about it too.
The body is very smart.
If you give the body what itneeds, it truly can heal itself.
But to answer your question, weutilize a you know a variety of
different methodologies.
One is shockwave therapy orEPAT therapy.
We do a lot of laser therapy inthe office too, but my favorite
(02:36):
really is utilizing differentbiological injections not
steroid, but biologicalinjections Right, because
steroid it won't actually healthe area.
Speaker 2 (02:42):
So let's say you take the plantar fascia it's a very
tight band on the bottom of yourfoot and fascia doesn't stretch
.
And then what the steroid does?
It actually just removes someof the inflammation and it
doesn't actually heal thatstructure at all.
In some cases it can help, likeit'll take away a lot of that
(03:04):
inflammation, allowing kind oflike for the environment, a good
environment for the foot toheal, but it doesn't actually
repair anything and then when itcomes to other things like, or
if you inject the steroid aroundtendon, it can be very harmful.
It could actually weaken thetendon, weaken the ligament and
cause other damage and puts youat high risk for tears and
(03:26):
ruptures down the line.
So that's what we kind of wantto avoid, but unfortunately
traditional medicine goes therea lot of times.
So I think you and I use thesame biologic Use the DPMX
injection.
Speaker 3 (03:45):
Yeah, I use a variety of different injections.
Now I do utilize them from timeto time, but I've been kind of
dabbling with different types ofWharton's jelly products along
with the exosomes and actuallyproducts that even contain live
cells.
But yeah, again, to answer yourquestion, dpmx is definitely
one of those that I use quiteoften.
Speaker 2 (04:05):
Yeah, Again to answer your question, DPMX is
definitely one of those that Iuse quite often.
Well, what?
Are the other ones that you use, you've been utilizing
Basically like a Wharton's jelly.
I explain it to patients thatjust say it's the thickest part
of the umbilical cord that's themost rich in native or stem
cells, and that they have allthese properties that are
pro-inflammatory and theybasically tell the body to heal
(04:26):
itself on a cellular level.
Speaker 3 (04:31):
Yeah, no, that's exactly the way that I describe
it to patients as well.
It's almost like you know.
I'll use the analogy sometimes.
You know, and I'll come back tocortisone for just a second.
You know, cortisone, like youdescribed it, all it is is like
a Band-Aid approach.
It turns the pain off for alittle bit, but we haven't,
never we haven't done anythingto actually heal the, the issue
at hand, the root cause.
So what I'll tell patients isyou know, when you inject
(04:51):
something like wharton's jelly,it has all the ingredients that
we need to truly repair theproblem at hand.
So an analogy I'll usesometimes is imagine you have a
hole in the drywall.
You're going to Home Depot orLowe's, you're going to buy a
drywall patch kit that has allthe ingredients it needs to fill
that hole.
That's exactly what Warden'sJelly is is giving the body the
(05:12):
ingredients it needs to patchthe hole, patch the fracture,
whatever it is truly giving theingredients, versus just putting
a Band-Aid on it and thenhoping something happens.
But, as you know, most oftenwhen you do that to patients,
they come right back through thedoor saying doc, it worked for
a little bit, but now I'm evenin more pain yeah, I've, I see
(05:33):
that all the time, all the time.
Speaker 2 (05:35):
Um, so I personally like to use the wharton's jelly
in conjunction with laser and Iactually have higher success
rates with it because most ofthem pay.
Like most patients don't listenin a bad way, but like, like I
(05:56):
had this guy, I gave him theWharton's jelly injection.
He felt for his fascia.
He felt so good.
He started like climbing theCanyon, the Grand Canyon, I
don't know what he was hikingover there.
And then he uses ladders atwork and then I actually do a
lot of diet and mouth imaging inmy office and I have an
ultrasound and I took a look athis ultrasound to see why he was
(06:19):
in so much pain.
It was amazing.
In three, three weeks thefascia actually shrunk in size
the normal way the fascia isabout.
You know, his was bad, his waslike seven millimeters or more
and then it was already down tolike five and a half millimeters
, which was amazing.
But you saw all thisinflammation around it.
It's like great I got.
(06:40):
I gave you this medicine to getyour body to heal itself and
it's doing a good job, butyou're aggravating it.
So once I like forced him tokind of go in a boot and I had
him do six.
I used the MLS laser.
We did six sessions of the MLS.
I never saw him again.
He was fixed.
(07:01):
He gave me a testimonial andeverything.
And ever since that I don't letpatients get the injection
without it, because I love theMLS laser.
It tells the mitochondria andyour cells to make more energy
and it takes away a lot of theinflammation.
And I actually have found a lotof studies that it actually
(07:24):
enhances the ability of theWharton's jelly injection and
all those type of biologicinjections to work better.
So do you use that inconjunction or you do it
separately?
Speaker 3 (07:37):
No, I very routinely will package it with Wharton's
jelly with a combination of MLS,laser and shockwave therapy.
I find the two, especially withheel pain, I find that, uh, the
MLS plus shockwave actuallycompliment each other very well.
And then you throw theinjection on top of it.
You create a really nice sounduh environment for some really
good healing.
Speaker 2 (07:57):
So in what cases do you do the shockwave for?
Or you just use all threemodalities for?
Speaker 3 (08:05):
it really primarily my like uh soft tissue type of
uh tendinopathy, so achillestendinosis or plantar fasciosis
will utilize the combination ofthe two.
Um, I mean very rarely am Idoing just shockwave alone or
just laser alone.
Um, I mean, of course,neuropathy patients, those are
probably just getting a laseralone.
I mean, of course neuropathypatients, those are probably
(08:26):
just getting a laser alone.
Or post-surgical patients.
We do lots of MLS.
But again, for these chronicconditions that patients are
dealing with again softtissue-wise, I like the
combination of the two, theshockwave plus the MLS laser.
Speaker 2 (08:41):
Well, what is the?
I know you use the E-PAT right.
Speaker 3 (08:45):
Yeah, I use E-PAT.
I don't have that machine.
Speaker 2 (08:47):
Okay, so how like?
How is it different than theextracorporeal shockwave?
Speaker 3 (08:54):
It's under the same family.
You know, essentially there'sno sound waves that are being
pushed into the patient withoutthe use of any sort of
electromagnetic again type ofproduct, but the idea is the
same.
The idea is that we'restimulating you know, I call it
(09:16):
exogenous inflammation, if youwill.
You're creating inflammation onpurpose to jumpstart the body
with the shockwave there or EPATtherapy, and so we're bringing
good blood flow to the area.
We're breaking up scar tissue,we're bringing the body's own
natural stem cells to the area.
I find that you pair with mlsmls, similar.
It'll bring good blood flow tothe area, but it'll then flush
out all the bad cells.
The histamine releases that.
(09:38):
We get the bad.
You mentioned mitochondria,right?
Uh, we basically recycle thebad mitochondria, bring fresh
mitochondria to the area and themitochondria releases ATP.
So I found that the two togetherreally created a really great
environment, and then you hit itwith some Morton jelly on top
of all that.
Speaker 2 (09:55):
So how do you separate them?
You do the shockwave first andthen MLS, and then how long do
you like separate it?
Speaker 3 (10:06):
So it's a good question.
I've been playing around withdifferent type of protocols and
talking to colleagues, but whatI found work that works really
good in my hands.
If you were to just you know.
If you do like utilize thesethree types of modalities, let's
use plantar fasciitis orfasciosis for a second.
I typically will start themwith.
I'll start with plus EPAT firstand that same.
(10:28):
As soon as we finish the EPATround, I'll hit them with MLS
laser and I'll do two to threeof those and then have them on
the third visit.
Speaker 2 (10:36):
In the same time that they're there.
Speaker 3 (10:38):
Same time they're there.
Oh, Same time they're there.
And third visit we'll have themcome back and we'll just do the
injection that day.
We won't do anything else.
I'll wait two weeks and thenstart the process back over
again so you do the epat and themls the mls in the same setting
(11:01):
.
Speaker 2 (11:03):
And you do what?
Speaker 3 (11:04):
three in a row, each one a week apart yeah, I'll do
two to three first, and then twoor three.
First two to three weeks, uh,and then, and then back in for
the injection, wait two weeksand then give them three more
rounds of that I spoke to uh drspear he's also one of our
colleagues.
Speaker 2 (11:22):
He said that he does the uh epat, uh three in a row,
and then he does the wharton'sjelly and then he does another
three epats and he gets reallygood response from that.
Speaker 3 (11:38):
Yeah yeah, I've heard some people just do three
rounds of epat and then whartonjelly and call it today.
So we don't really have any.
You know, quote unquote goodprotocol protocols, yet it's all
anecdotal.
Speaker 2 (11:49):
I know, I know Cause regenerative medicine.
It's a brand new field, thewhole point is is, like we said,
just to get the body to healitself.
Speaker 3 (11:56):
Do you?
Speaker 2 (11:56):
so I'm very I'm a stickler for immobilizing the
patient.
Do you put them in a booth?
Speaker 3 (12:01):
Yeah, do you put them in a boot?
Yeah, I do, I do, I recommendit.
I mean, do patients listen tome?
That's the other, you know,that's the other half, Right?
So you just, you know, I tellthem this.
I said, look, the boot is to dotwo things.
It's number one to give thatfoot just a break from life so
that we can truly allow it tojust start healing.
(12:21):
But it allows you to staymobile.
The second reason I like theboot is because you know, it
keeps that injection pretty muchwhere I want it to be, versus
spreading out.
Now, the foot's a smallstructure, so, you know, would
it actually spread out and it'lllose the area?
I don't really think so.
But I like the boot because ittruly just gives them, it
reminds them that they hadsomething done recently too.
(12:43):
So they should just take iteasy.
But again, like your patients,my patients sometimes will
listen to me they want to getback to life.
You can only educate, right?
Speaker 2 (12:54):
Yeah, yeah, I mean I think I always make the analogy.
I tell patients like all right,this is the problem with your
foot.
I tell patients like all right,this is the problem with your
foot.
And then I tell them you know,if you sprained your wrist or
dislocated your shoulder orsomething, you'd stop using it
for a couple weeks and you'dfeel better.
And then the problem with you,know us, our field, you know
(13:17):
foot and ankle specialistsnobody stops using their foot.
And then I just keep kind ofreinforcing, like how do you
expect your body to heal itselfif you keep using your foot?
All the time.
Time like your foot, like thepain, is the signal.
It's a blessing from your body.
It's your body telling youplease stop using me.
(13:38):
So you have to listen to yourbody, like you can't just walk
this off, um, and then you know,with the regenerative medicine,
healing time is pretty muchhalf of what most people expect.
Like Like I do it a lot forsports medicine injuries and
I've had really good results.
(13:58):
Like some people that have areally bad ankle sprain, whether
it's the ATFL or the deltoid, Iconfirm it with MRI and give
them the injection, put them ina boot and then I actually see.
You could actually on theultrasound see only three weeks
later that everything is fillingin, whereas traditional
(14:20):
immobilization for ankle screensmaybe in six weeks it'll close.
Yeah, yeah, that's pretty coolthat's cool.
Speaker 3 (14:30):
You can see that on ultrasound.
Um, I agree with you on thatthat acute injuries, injuries.
It works really, really well.
Are you utilizing WardenShelley for post-surgical
patients?
Speaker 2 (14:40):
That I'm not there yet because, it's funny, down
here in Florida patients don'twant surgery, they don't want
time off, they don't want a boot, they would rather live with
their pain or I don't know itshould.
I mean, I know you do minimallyinvasive surgery in your office
I do.
The surgeries that I do aremostly like I do some like
(15:04):
bunions and hammer toes andthings like that at the surgery
center.
But yeah, I have been.
The only thing I encouragepost-op is is the MLS laser,
because it does help theincision heal a lot better and a
lot of patients have a lot lesspain after surgery and they
heal a lot faster.
Speaker 3 (15:23):
If you started to add yeah, I saw I had a lot.
I do a lot of wort and jellypost-surgery for my patients.
So after I put my last stitch,instead of hitting them with,
you know the common cocktail weall used in residency.
Or you know other practices.
You know a little lidocaine orwith some Dax at the end.
You know I just do orange jellyat the end and I have found
(15:45):
that I mean the patients thatsign up for that versus don't.
It's a night and day differencebecause you know, even with
minimally invasive surgeryyou're still dealing with pain
and swelling.
That never goes away regardless, but it really does decrease
the edema I see with patients.
Also, just overall, pain-wisepain is substantially decreased.
I'm seeing unionization onx-rays faster with these
(16:05):
patients too.
And then, of course, I use MLSall the time for post-surgical
patients.
So again, the two really createa great environment for for
patients to heal fast.
I think mls alone is phenomenal.
I I love mls laser.
It's a great.
It's a great modality I love it.
Speaker 2 (16:23):
My patients are so happy.
It's like, especially theneuropathy patients, they it's
like it's like a gift becauseyou, there's this new technology
, there's this technology.
The technology has been aroundfor a while, like I remember,
yeah, laser from when I was incollege, when I was in podiatry
school.
They were like they had themshow us how to use that laser
and what it does yeah, yeah, Iwish they would show it more.
Speaker 3 (16:46):
You know, back then we were all skeptics, you know,
uh, but, but we're not in thefield practicing, talking,
talking badly about low-levellaser therapy.
Speaker 2 (16:55):
And then the MLS is different because it's like it's
a double beam.
It's a double laser beam, soit's a healing laser as opposed
to the other lasers out there.
Speaker 3 (17:06):
Yeah, it's definitely the premier laser.
And you know?
Here's another thing I tellpatients because sometimes we're
skeptical, and I go thiscompany, cutting Edge and we're
not sponsored by Cutting Edge,by the way, just FYI.
If your patrons have seen this,I want them to know.
We're not getting paid to saythis.
I'm just saying this because Itruly believe in the laser, but
if Cutting Edge wants to pay us,I'm sure we're here for that
(17:28):
too.
Anyways, that company wasactually designed for
veterinarians.
I don't know if you know thatfor six years, I've heard about
that.
Yeah, I heard.
You cannot fool an animal.
There's no such thing asplacebo in animals.
Uh, if your dog had just an aclsurgery or something you know,
a fracture, etc.
(17:48):
That, or if production fixationor they just are having bad
arthritis because animals do.
This laser really helped a lotof these animals.
Now finally, six years later,they bring it to human medicine.
You can't trick an animal, andI'm you know.
My patients who go through italso just swear by it too well,
when do you not use thewharton's jelly injection?
(18:11):
honestly, I, you, I try to useit for everything.
I don't I, I do.
I don't use cortisone in myoffice.
If I have a patient that isasking me for cortisone, I
actually will just refer themout because I don't believe in
cortisone.
I truly don't.
No, I don't, I don't believe init.
I can count on one hand howmany times I've used it since I
started my practice here.
But ortho group, I use it allthe time.
Speaker 2 (18:37):
But I saw a lot of bad reactions with it, so I
refer people out.
So I still use it, mostlybecause I don't have the hybrid
concierge model that you have.
Yet I see a lot of insurancesand people want what is covered
by insurance and that I tellthem you know wardens, jelly
fixes your.
The only thing that's coveredby insurance is talking to me a
(18:57):
prescription for medication,physical therapy and a steroid
injection.
Speaker 3 (19:03):
Well, it may be, we don't even know.
Nowadays, with insurance,they're cutting everything.
Now, you know, sometimes evenphysical therapy is not covered
by insurance anymore.
It's actually kind ofridiculous.
Speaker 2 (19:13):
They limit it like per year.
Yeah, even physical therapy isnot covered by insurance anymore
, it's, it's actually kind oflimited like per year.
Uh, yeah, it's, it's sad, butyou know that's I tell patients
it's kind of sad that likemedicine is advanced and there's
actually evidence-basedmedicine to support all the
things that we are doing,especially um the, the wharton's
jelly injections.
I've seen a lot of studies onit, but but you know, these
(19:35):
Medicare guidelines are notkeeping up.
They're like, oh, they're sobackwards.
Speaker 3 (19:39):
Don't ever expect a regenerative medicine to ever be
covered by insurance.
It's never going to be.
It's it's you and I.
I can have a whole differenttalk with you about insurance,
but I, I hate health insurance.
I have health insurance, buthealth insurance in our country
nowadays, I truly.
By 2030, the average deductiblewill be $10,000.
That's what we found out.
So your health insurance istruly for catastrophic reasons
(20:02):
at this point.
God forbid.
You're a life-threateningaccident, you need to go to the
hospital, you have alife-threatening illness, you
have a baby those are reasons tohave it but to come see you and
myself, your health insurancereally is not going to be
applicable.
You're going to be paying ahigh deductible a deductible to
see us anyways.
So why not use that money anduse it towards something that's
(20:23):
actually going to help yourhealth, versus something that's
going to put a bandaid on itversus something that's going to
keep you coming through my doorover and over again.
You're going to get frustratedwith me.
Speaker 2 (20:38):
Doc, you keep giving the same injection over and over
again.
Why am I not healing?
Mrs jones, remember what I toldyou steroid is only a band-aid.
It's not to me.
It's truly going to help you.
You know, I actually use.
There's an example I use onmyself.
It's like a sad example.
I don't like to talk about mypersonal life too much but uh
like I need a fertility doctorto help make babies right and
according to blue cross bluesheet, like I have, I have
insurance.
And according to Blue Cross BlueShield, like I have, I have
insurance.
And according to the insuranceguidelines of my insurance
(20:59):
company, it's not medicallynecessary to have children, so
they refuse any fertility.
And like that's, that's where,that's where this, that's where
society is going, and it's likeyou're in a birth rate decline.
I hate talking about it.
It's sad.
You know what?
I took out my credit card.
Speaker 3 (21:21):
You paid for it.
Speaker 2 (21:23):
I paid for it.
Sometimes it was successful.
Thank God I have a beautifulthree-year-old daughter.
I had lots of failures beforeher.
I had a couple after her, butyou know it is what it is and I
paid for it because it'ssomething I want.
So, like I tell my patients, ifyou want, you don't expect your
insurance to pay for everything.
(21:44):
You know it's patients.
There's like this mentalitythat they want insurance to pay
for absolutely everything andit's not reality.
It's not reality so I I first ofall thank you for being
vulnerable and appreciating thestory.
Speaker 3 (21:59):
That's, uh, you know that's not easy to share, um,
but to your point, right, um,you paid out of pocket for
something that you trulybelieved in and you, you, you
have a daughter, right,three-year-old daughter.
That's amazing, that.
That's a blessing.
So you know, if you trulybelieve in something, you're
gonna do whatever it takes toget.
That's amazing, that's ablessing.
So you know, if you trulybelieve in something, you're
going to do whatever it takes toget it.
That's how I, that's my you know, that's how I, my personality
(22:20):
is.
So you know, I think, I thinkthat's you know the way the
message is to our patients too.
It's, it's that, look, there'sa lot of great modalities that
are healthier for you, right,that's.
The other thing is we don'ttalk about side effects.
These insurance companies willcover the blood pressure
medication, the statin, whatever, okay, but there's no talk
(22:42):
about the side effects, theillnesses that come and follow
this medication, just becauseit's covered by insurance.
Let me take it Right, but letme now educate you on all the
bad things that can come with itand you let me know if you
still want this medication.
Speaker 2 (22:59):
Yeah, I tell patients with neuropathy like I tell my
patients all those likegabapentin and Lyrica it doesn't
fix your neuropathy.
We have to do things to wake upyour nerves right, because
that's the whole point ofregenerating the nerves,
regenerative medicine.
So for neuropathy I do do acombination of vitamins, cbd
cream and the laser patientsfeel better with like the third
(23:21):
or fourth session.
Yeah, no, that's phenomenal Anymedications and I encourage
patients to exercise more.
It really helps stimulate thenerve to wake up.
But all those other pills theyjust put band-aids on it and
they have.
Speaker 3 (23:41):
Even today.
Why did they put me on anantidepressant for my neurosis?
Yeah, that's, but they do that.
No, they do that, they do that.
Uh, that that's.
That's actually a very commonpractice nowadays.
Uh, you know again these docsand again I'm not.
I respect all all ourcolleagues, okay, okay, yes, so
do I, but people like you and me.
Speaker 2 (23:55):
We're in this for I guess we're out-of-box thinkers
and that's why I started thewhole regenerative medicine game
, because I really want, I liketo fix the root of the issue,
the root cause, the root cause.
Even with pancreatitis.
You know if patients, if theircalves are extremely tight.
Speaker 3 (24:20):
Actually it is.
Speaker 2 (24:21):
You know if patients if their calves are extremely
tight.
I actually use my shockwavemachine to loosen up their
calves and break up all theadhesions in the abdomen.
You told me too.
That's why I started using itas part of my protocol, because
if they're tight and they didphysical therapy or they're too
lazy to stretch at home, one ortwo sessions of the shockwave
(24:43):
just on the leg, the back of theleg, loosens everything up and
it takes so much pressure offthe fascia.
So that's why every patient,case by case, I have to see
what's causing the tendonitis,what's causing the fasciitis.
Speaker 3 (24:59):
Are you doing?
Are you so, if you the patientthat comes in with a fascia, a
plantar fasciitis, are you doingthe, the calf or the
aponeurosis first and then theheel at the same time?
Speaker 2 (25:22):
Yes, I am.
I am doing it at the same time,like if it's like I was just
thinking, I had someone onFriday.
We just did the legs cause shejust had the tendonitis, the
Achilles tendonitis but forfasciitis I do both the calf and
the fascia okay when I do theshock wave, the patient.
Most people sign up forshockwave because there's no
downtime versus getting thewharton's jelly yeah, yeah so.
(25:45):
So that's like they actuallyfeel better right away.
The shock wave, uh, it breaksup all that.
So the adhesions, uh brings newinflammation to the area.
I also tell patients not totake anti-inflammatories.
I tell them you know you wantthe inflammation.
It's good for you, it'll helpheal.
But that's the and.
(26:06):
Every time I tell patients thatwith the Wharton's jelly
injection they need the boot,they kind of they deviate from
that.
I know, I know, I know what youmean.
There's something I don't knowwhat it is there's something
about wearing a cam walker fortwo weeks.
Speaker 3 (26:19):
It's just.
It's just like you know it'salmost like I don't understand
that.
Speaker 2 (26:25):
Especially the driving foot, it kills them.
You know people don't want tobe limited.
Speaker 3 (26:30):
I guess it's inconvenient it's inconvenient,
but but then you got to paintpicture right.
It's like look, it's two weeksof your life versus.
Two weeks of your life is adrop in the bucket compared to
how long we live as human beings.
So two weeks to truly try andget you out of pain, I think, is
something you can do foryourself.
Speaker 2 (26:49):
I actually have a patient.
She has.
Have you ever seen these likepeg leg walkers?
Speaker 3 (26:54):
Yeah, yeah, I've seen them.
Speaker 2 (26:55):
It's like you put your knee in and like you have a
peg leg and then your foot'shanging up in the air.
Speaker 3 (27:01):
I've seen that.
Speaker 2 (27:03):
She's like I get a lot of looks at the store but it
works.
She finally, like kept off herfoot and her fasciitis went away
.
She's so happy.
Speaker 3 (27:12):
That's great.
Speaker 2 (27:14):
Yeah, any other nuances before we sign off?
Speaker 3 (27:19):
I was actually going to ask you what's your
neuropathy protocol for MLS.
Speaker 2 (27:26):
Okay, so I do 12 sessions of MLS to start with,
first three sessions in thefirst week to create the buildup
effect in the cells because youhave to wake them up.
And then I do the EBN6 vitaminfrom the EBM company.
It's a great vitamin.
(27:46):
It helps glycosylation andrenewal of the nerves.
And then I encourage patients Ialso started physical therapy,
especially the older populationphysical therapy to just do like
gait training and balancingjust to try to get them more
mobile um, and then if and then.
The other thing is I really likethe cbd cream and if the
(28:10):
patient doesn't want to pay forit, then they go get some over
the counter capsaicin cream thatworks as well.
Speaker 3 (28:16):
I see.
No, that's very similar to whatwe do.
Speaker 2 (28:21):
There's also a machine that sometimes I
prescribe if the patients haveinsurance.
It's called the Zynex machineand it has an inter.
It's like a tent unit but ithas an interferential currents
on it and it stimulates the.
It's like a 10 unit but it hasan interferential current on it
and it stimulates the nerves towake up and heal and it helps a
lot with the symptoms ofneuropathy as well oh, that's
interesting, so you do.
Speaker 3 (28:42):
So.
You do the, you do three.
You do three sessions of mlsthe first week, and then you do
one session per week after thatno two two per week, I do two,
yeah.
Speaker 2 (28:53):
So I tell patients, the more they do it closer
together, the faster the nerveswake up.
I actually had one neuropathypatient that did five in a row
and felt like a million bucks.
Speaker 3 (29:06):
Awesome, awesome.
And are you doing theirprotocol where you let the robot
go over the dorsum of the footand then you use the trigger
point laser to hit the legs?
Is that your protocol?
Speaker 2 (29:16):
no, I actually just I do each leg.
I do the right leg, from thecommon fibular nerve all the way
to the dorsum of the foot, andthen I do nine minutes on each
leg like that, and then I do,and then I put their feet the
bottom of their feet togetherand I do nine minutes on each
leg like that, and then I do,and then I put their feet the
bottom of their feet togetherand I do another nine minutes
(29:38):
with the bottom of feet together.
Speaker 3 (29:41):
Okay, and you're using the roller as a robot.
Speaker 2 (29:46):
Yeah, it's a robot, like it's.
I didn't hear you what.
Speaker 3 (29:52):
What I think you said M7.
You got the M7, the robotic.
Speaker 2 (30:00):
Yeah, I have the robotic one, so it has the
handheld piece and it also has.
So we just do the setting.
We do the whole entire leg,both legs.
It runs for nine minutes.
We scan it and we run each legfor nine minutes and then the
bottom of the feet togetheranother nine minutes.
The patients are here for abouthalf an hour but, it really
(30:20):
does work.
And I always crank it up, Ialways double power it because I
want to do right by my patientsand get them the most relief.
And, um, my patients, I also dothat for chronic arthritis.
I have someone I actually treatknees down here.
Sometimes I have like a mailmanwith bone on bone knees and he
(30:43):
really doesn't have time to havea knee replacement and he just
comes in, gets a couple he didthe initial like six in a row
and he comes in about once aweek for maintenance and he
feels a lot better.
He doesn't have any scoots inand out of his mail truck and
(31:04):
you found a way to get his painunder control, without surgery,
without injections, withoutpills, and he's very that's
great, so I use it for a lot ofthings that's really nice.
Speaker 3 (31:14):
Knees are great any arthritic condition.
Speaker 2 (31:16):
Great for it and end up using less pills, cause it's
amazing.
And then it's just interestinghow all my colleagues use them
differently and how like.
What I do is.
I just give the injection firstand then I do 10 or 12 MLS in a
(31:41):
row with the boot for aboutthree weeks.
That's my protocol, but it'snot.
I could see where doing theshockwave and the MLS at the
same time works a lot better.
I didn't even think of thatbefore, so it's really cool,
very interesting.
Speaker 3 (31:55):
Yeah, it's just.
You know, like I said, there'sa million ways to skin a cat
right.
So that's the same thing here.
Is that there's so many ways toachieve the same results, if
you will.
Speaker 2 (32:06):
Yeah, all right.
Well, thank you so much forcoming on my podcast today.
I love collaborating with othercolleagues and seeing what
they're doing and, uh, you're.
We're doing great thingstogether.
We're just helping other peopleall the patients with pain and
dr wadera.
Thank you so much for your timeand for all the people in
(32:26):
michigan.
Hopefully they'll get around tohearing us together thanks for
having me on.
I appreciate it thank you somuch.
Have a great, have a great daySee you next time.
Speaker 3 (32:35):
You too See you next time, bye.
Speaker 1 (32:42):
Thank you for listening to the LMD podiatry
podcast.
For more information, visitLMDPodiatrycom.
That's L M D P O D I ATiatrycom.
That's lmdpodiatrycom, or call954-680-7133.
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