In this two part series, we celebrate 5 years in practice for Ascend Health Center and our 50th episode! From the expertise of a chiropractor and a nurse anesthetist, we discuss inflammation and pain, so here’s an extra resource that quoted us recently:
Hello and welcome to the Ascend Health show I’m your host Nick Angelis I’m from Ascend Health Center and I’m here with Dr Bigrigg from Aligned.
thanks for having me
yeah it’s great because we’re both Nicks I’m from Ascend you’re from Aligned this is going to be a great show I’ve always wanted Nick on the show like anytime anyone has my name I’m immediately their best friend like this is great your mom was so wise to give you this wonderful name we must have so much in common
exactly smart smart parents
so you’re a chiropractor and we’re going to talk about your history and uh what brought you to being a chiropractor and uh we’re talking already about mental health and chronic pain in this country I mean some of it though is that we’re so saturated with media that it’s just a really good story for people to tell
it is uh you know I think all those things mental health um physical stress mental stress chemical stress kind of all play into to the person’s wellness and and they all they all play off of each other in a lot of ways right and it’s strange interactions too
like I mentioned well maybe more people need a mental health service like what we provide at Ascend because they’re always on their phones and I was like well wait they’re hunched over on their phones which brings them to Chiropractic Care
exactly we see a lot of uh patients whether it’s a the job or a hobby they have but in recent years even more and more younger patients so so kids phones tablets iPads um you know you have busy parents and it’s easy to hand hand the kid in the iPad for for an hour and and they get get into that so right every parent like I’m not going to do that with my kid right take this exactly that’s really funny because you’re right and and it’s so strange the way that the physical and mental health interacts so definitely there’s a lot of studies actually on uh adolescent people with with postural abnormalities whether that’s being a hunched over kosis or scoliosis um and how that affects their mental health and and there’s some back and forth even about uh different demographics taller people who Maybe conscious of that you know self-conscious of their height or self-conscious of different things and then they start to stand in in postures to kind of compensate compensate for that and how that then plays into their mental health and becomes kind of a a cular cycle for them well it’s interesting because I would assume too if children and adolesence are on their phones and being more sedentary then they’re not moving their bodies because you I’m sure you see that with your with adults that they come and they need a chiropractor because they’re standing behind a desk all day or they have repetitive movements and they’re not doing what kids normally do which just crawl around everywhere right definitely not not out playing out out getting hurt uh um like you had mentioned safer safer physically maybe but uh causing some unintended consequences right yeah I mentioned before we rolled the cameras there was a new study I just read it this morning on CNN that talked about the dangers of cell phone use and one of the statistics was that uh boys aren’t breaking their bones as often which sounds great but the point that the sociologist made was that it’s not great it means they’re not taking any risks they’re just staying inside uh they’re not even interacting with girls because the boys all go to YouTube the girls all go to Pinterest even at a young age like there is this uh separation of interests and Sexes where like these kids won’t know how to relate to anyone and then they come to a sand Health Center for counseling and Psychiatry right I mean I guess in that case maybe they’re not coming to you as often because they’re not well no we already said they’re going to come to you because they’re not moving anything for different reasons yes less less physical injuries but uh postural changes uh uh aches and pains from not being movement movement uh movement is the kind of lubricant of the body so if you’re not moving your your discs in your back aren’t taking on fluid the joints of your your you know arms and legs aren’t aren’t being as healthy so it definitely has some some consequences um I think you know I would argue that they have larger consequences the the injuries that you sustain from being active are much less consequential longterm than the the uh inactivity becomes and really on a molecular level when you have injuries uh for example you can’t really exercise unless you fatigue a muscle because then your body releases substances that help the muscle grow right and I’m not saying that you need to break bones to be healthy but it’s true that when you suffer injuries your body is used to producing uh substances whether it’s endorphins or radicinin or uh what have you and that promotes healing so if you’re in this little bubble where you’re never doing anything your body isn’t used to producing those substances right and you’re not being exposed post environmental factors and things like that we building your body’s tolerance to to adapt to different uh you know situations environments whether that’s physical or or otherwise right just like the FDA was looking at uh making sure that they could have antibacterial soaps in a lot of instances because they realize there so many uh people with poor immunities I mean we saw this during CO as well by the way this is community television so we can say whatever okay we saw that too when everyone was hiding in houses like bathing themselves with antibacterial lotions and then getting Co times exactly so um by the way this is how we do this whole show it’s uh oh this should be the medical disclaimer too we’ll say a lot of things a lot of it will be really smart uh you should listen to it but maybe don’t start taking all sorts of supplements or being exactly what we say without talking to your own provider so that that kind of serves as a medical always good advice yes something about so you can believe it it’s not like don’t believe everything you see on the internet but um maybe also run some things by your own provider who knows you better than I do just talking on the show so we talked a little bit about injuries already and uh how they might be good for you so that’s the lesson so far stand up straight uh don’t be worried to get injured when you’re young like go out there and play yeah be active and really that’s that’s a lesson for adults too uh so usually we try not to date these shows so we can you know put this out there 3 years from now pret endos yesterday but the eclipse was last week and so we closed down our entire Clinic cuz we were like well what can you do on a m M day for your mental health go look at something Cosmic and beautiful outside with your family that’s going to be a lot better than anything that we can provide for you that day so we just shut it all down and sometimes we miss those moments because we’re doing something silly like oh I have to work so hard to afford this or I need to we kind of lose track of right what do we want long term in our lives yeah you get caught in in the rat race of of chasing that but we did the same we shut down so our staff and our staff and patients could you know either enjoy time outside or with their family of see this once in a lifetime opportunity yeah and it’s a little bit of hypocritical for me to say that cuz I also worked that morning doing some anesthesia work somewhere else but that’s where I realized this was a good really good idea to shut down the clinic because everyone was like oh we got to get out on time and there’s a lot of frustration I was like none of us should be here right oh that’s great so uh I should start asking you about the things we’re supposed to talk about like how do you become a chiropractor what influenced you all that sort of thing um but just to finish that point so so a lot of what we’re saying is people need to be active and uh the point I made about like thinking longterm past well how do I feel right this moment can I withstand some discomfort do you see that a lot in Chiropractic Care CU I know when I’ve gone to the chiropractor which I go to chiropractors all the time but I’m still a bad patient they’ll say you need to come back in 3 weeks and I’ll think no no this this adjustment will be great I won’t have pain for four weeks or something but you’re thinking more like longterm how can we get you better yes there’s a I think our medical model at times is focused so so much around symptoms so um whether it’s uh this drug correlates to this symptom or this uh this pain to you know to this drug where we’re not looking at holistically like what is uh how is this person’s body functioning and that’s an approach that we try to take uh or that we do take at aligned and that um while we may while your pain is important to us and we can hopefully help resolve that through some natural ways in the short term how is your body functioning and how can we keep you healthy 10 15 20 years from now so you’re able to be active you’re able to play with your kids with your grandkids and and and do the activities that you’d like to I get so it’s more of let’s get you out of pain so that you can form new habits without discomfort and then keep doing that yes and if you choose not to come see us more often so that way it’s a clear choice right correct and it actually makes sense I I uh went to see my doctor recently and she was like you can do whatever you want just do so consciously like don’t rationalize it like if you’re going to eat a bad meal that has no nutritional value say I’m going to eat this and it’s bad for me and I’m going to enjoy it and then do so none of this like well look that pizza’s pepperoni that’s meat you can look at you know some diet that says a carnivore diet’s great for you like no just accept what you’re doing right I think I think there’s a lot of that there has to be some balance and you have to have fun and you have to enjoy yourself so take that moment enjoy it for everything it is and then and then get back to you know what what healthy habits you’re forming yeah absolutely whatever is sustainable yes because even if you look at Fitness we’ve already talked about play the the greatest change uh in a person’s physiology is if they go from doing nothing to starting to walk a little bit so at the very least like let’s take those steps that will make the biggest difference exactly uh kind of shocks the system I suppose like even um even leite athletes it’s time periods of time after rest where then you start to train again uh where someone’s been inactive and they start to to just walk they’ll see the biggest gains the biggest improvements in those in those early months uh early early Lifestyle Changes um which becomes the challenge too because then uh the maintaining that lifestyle becomes uh you don’t have the biggest reward the the huge reward or the immediate change the DraStic change I suppose U but to maintain it as this is the new normal and you’ll see that with athletes too because obviously uh so my brother’s in operations research went to this uh Sports business uh seminar in Boston it was crazy how many millions of dollars it spent on each athlete like they’re looking at their CO2 levels like basic on the molecular level because they’re an investment almost like a racehorse it is what it is and at the same time you’ll see some athletes recover from injury and be better than ever and others like their career is never quite the same and some of that is the mental and the willingness and the discipline and all those things that we forget about you know we take it down to bones and muscles it’s like no you have to have the willingness to get better exactly W that’s really neat so uh speaking of willingness to get better what was what’s your story of how you got interested in chiropractic care and what drove you to doing that um it it wasn’t a very direct path I it’s not something I knew I wanted to do necessarily or was exposed to at a young age I um I was fortunate enough to play football in college uh at Kent State not too far from here and then uh Arena Football as well um professionally afterwards so uh in Arena Football um to much like the point you just made we are less of a valued commodity I suppose if you play really well you’re going to leave and and play at a higher place you know potentially NFL or wherever and if you don’t play really well you’re unemployed anyway so your lifespan or your time with each individual organization is very much shorter so you’re treated a little bit differently than what you may say a Nick chub is for the Cleveland Browns or something along those lines um so I had some pretty severe back injuries um and they were able to get me through you know their their means through through through a season and um but at the end of the year in 2007 I was recommended for for a spinal surgery mhm um and likely would have pursued that uh due to the severity of the symptoms I was having um but they had told me that the surgery would essentially you know end your playing days and and it’s just going to be so you can be a functioning adult and kind of move on um you put on a suit
exactly unfortunately at that point I had never given that much thought so I didn’t know what the next plan was right so I saw out uh someone to help me I was fairly skeptical at first like maybe many people out there with P um and frustrated cuz you’re you’re not able to perform or or function the way you’d like to so uh this doctor was able to help me uh was able to get me back to to playing which I did for one more year um but during that time he also kind of Meed me way of of saying you know what is your plan after this like do you have a plan after this and and uh kind of encouraged me to go back to school at that point for for chiropracting oh wow that’s really cool yeah it’s it’s really valuable and and I think it’s something experience I still use today because you can understand what the SP patients are going through right when a patient is having a frustrating day or when their symptoms aren’t changing quite as fast as as they would like them to um or they you know you get some very severe cases that come in and you know it’s going to be kind of a long journey um being able to relate to the to the day-to-day experience that they have is is is helpful and in getting them through that yeah and you’re saying too that there’s rarely a quick fix it’s nice when there is um but you know unfortunately uh our our we’ve been trained through our medical system to be very reactive um so we’ll address something when it’s a problem um and if we can get the symptom to go away we might not address it again for you know 10 more years right uh but so a lot of times our patients will have chronic issues chronic pains uh degenerative arthritis that they’ve developed over the course of a lifetime and we’re very successful at treating that but um it’s not an overnight fix or a pill or a medication right so uh relatively I think it’s pretty fast but let’s say for example a patient uh needed to be treated for a couple months two 3 months something like that that might not be perceived as a quick fix when Advil or you know a pain medication is much faster but the if you look at it in the perspective of you took 40 years to do this to yourself and I’m going to or we can correct it together in about 3 months it’s really not that long so it’s kind of a matter of perspective but yeah there are days where especially when you’re not feeling well if a patient is not feeling well if you’re not feeling well there’s frustration there’s you know doubt things that can creep in and having that experience helps me relate to them and get them through that that makes sense and also you could probably talk with the patient like hey this could be a quick fix it might not be let’s start the process and I’ll keep letting you know because we see that a lot with the the camine infusions for example at a send where sometimes it’s a quick fix uh like your brain just changes and there you go it’s nice meeting you see you later we fixed you and other times it’s not and so quickly I mean sometimes it’s to the point where it’s like nope don’t give me any more of your money you’ve gotten better I don’t feel it’s worth it for you to invest more into this you’re at a good spot like just take it because that’s something in our culture that we don’t know how to do either like when am I fixed what does it mean to be fixed am I normal you know because especially with what you see with pain people are like no it it doesn’t hurt at all like when I go to the caropractor I’m like nope haven’t had any pain and then they’ll start moving something like oh okay I guess I wasn’t 100% like I thought I was so pain is often not a great indicator of of how how well your body is functioning um fortunately the type of work we do Chiropractic biop physics able to quantify uh without pain is very important that’s what’s affecting your day-to-day life that means you’re willing to do something are you able to go to work are you able to play with your kids are you able to do these things but there’s some quantifying factors that we can measure and and um that allows us to actually maybe predict better what is your life going to be like in 10 years if if we do something or if we don’t do something about this and then and then remeasure those same uh measures post treatment to great our success um and also predict future health for that person um and one of those metrics would be like uh more in the CH practic aspect of our practice is is posture so we can take a a load bearing or a standing x-ray where you’re supporting your own body weight MH and a neutral position and measure measure the shape of the posture and there’s actually a shape that your posture should have and right there’s some variance from person to person there’s some U math and physics that goes into figuring out what should your posture be versus mine versus the next person but we can quantify that and much like an orthodontist straightens your teeth we could rebuild your posture back to the right shape and that is usually a better prediction of degenerative changes degenerative arthritis um right and just body function from a physical standpoint down the road then do you have pain today well that makes sense because a lot of times uh we don’t treat pain as often as we used to even though I’m a nurse anesthetist just because we were mainly Psy a psychiatric practice but a lot of times when we come is when the pain doesn’t match the X-ray the CT the MRI uh because you know I’ve worked with a lot of neurosurgeons spine surgeons being a nesus and they’ll say that too like okay this is a really bad x-ray but actually like they’re doing fine there’s no need for me to go in there and carve something up right or other times they’re like look I know it doesn’t look that good but look at their loss of function we have to do something exactly so you’re saying the biophysics is a better way to tell here’s what we need to do yes it’s a better metric there A lot of times patients and we recommend adults get getting exam once every two years you know regardless of whether they’ve need it or not whether they have one or not but most people don’t realize that the the profession probably hasn’t done as good of a job as maybe like the dental profession of telling you what should you do on a day six month basis or year basis or how often should you have these checkups um uh and that hopefully gets better but um people find that out from us going out doing show like this going out maybe speaking to someone’s uh work or their Church group or their social group or whatever kind of P you know uh setting that they have and as we spread that message then people hopefully are more proactive on on having an exam even without having pain sure more often than that someone will come in with pain will address that situation and then have this metric to measure a prediction of like what future degeneration would look like or what your future health so the biophysics is more like software then seeing what’s wrong or um it is now it used to not be I I used so I used to do you with a tape meesh I used to do it with plain films and you know chemicals and drawing with a protractor and now now we do have pretty fancy software it’s nice where you can plot points and and can get the information much quicker than than what we used to be able to it’s a little bit like when I go get my oil change they’re like look this area is yellow you really need an alignment and like well it’s not really red though you’re just saying it’s yellow exactly that’s a that is uh that is something we deal with so we give people an honest assessment of maybe you’re in the yellow or you’re in the red and yellow we would like you to fix it I think you should fix it uh but it’s you can make your own decision on how you approach your health right we try to encourage you or educate you the consequences of that it’s much easier to fix in the yellow than when it’s in the red and other times patients come in and it’s in the red and you have to say like if you don’t do this now then your next step is going to be with a neurosurgeon not with me um sometimes it comes in in the green and we say that’s awesome we’ll see you in two years so it’s kind of all over that spectrum and and that makes sense because you know a lot of times I’ll be the same way where I did pain treatments on a patient and their pain kept on coming back and I was like look if you have a nurse and athetist looking at you every week or two and you’re still having pain issues you need surgery there’s nothing more that we can do you don’t need to go back to the chiropractor like it’s time for surgery uh and so I think sometimes people need to know like what are my options and I think you and I would be in agreement that it’s really important to try the least risky options as much as you can cuz surgery you are trusting somebody you might wake up and it’s that quick fix we talked about although obviously seeing patients in rehab it’s easy for us to say we’re not the ones you know recovering from surgery or what not it it sounds like a quick fix in a lot of ways and and and there are great surgeons out there but um even within the services offered within our Clinic we always try to start least in least invasive um and then progress from there so and do you often have the issue of like what you said with the biophysics where you’re in the green like no I need to see you every week like how do you handle those type of if someone is in the green and there they postures within normal values then uh what it is is a prediction of essentially your body should act like a suspension bridge so the way your spine is structured and shaped it disperses Force if it disperses Force appropriately then all of your joints will age at relatively the same speed right so if it’s in the wrong shape some areas are doing too much work and they’re going to age faster so if someone’s in the green they may come in occasionally to get adjust it or to do something like that massage adjustment uh uh kind of maintenance uh of their spine sure or maybe they had an acute thing where they tweaked it at the gym or you know at the picking up their kid or at the grocery store whatever that that is uh they don’t need to really see us all the time um a more intense treatment plan where we’ see the person multiple times potentially a week or or or every other week or frequently where we’re trying to remold their spine is definitely going to be someone who’s like you said in the yellow their posture is not correct we need to do something to get it back towards the green um and then you know obviously the red is is another situation where we’re trying to help but um once it is fixed it should be you can obviously hurt yourself again so you know um our staff always is conscious of me saying it’s relatively permanent it’s not permanent because you can go fall down when you walk outside but it it should be stable in the sense of normal living conditions it doesn’t change well and the normal living conditions is important too cuz uh a lot of times it’s like well let’s get you back so you have the quality of life that you did before meaning that you can still do some of the things you did so sometimes we’ll even rehab a patient for deer hunting season so they can stand again in a tree stand until they get their Buck or dough and then like okay I’m fine for a while or they’re going on vacation or they’re going to a wedding because usually with chronic pain and even to some extent with mental health that’s where some of the uh challenges are that I can’t do this thing that I want to do right so it’s like well you know the old model was that out of pills and opioids and let’s get you painfree all the time and then just sitting on your couch all day long so I think sometimes it does make sense like look we need you to be active let’s do some uh in your case let’s do some adjustments so you can be active in our parts using infusions or something um and then you can still do the things because otherwise like we mentioned earlier you’re just in this I can’t move a muscle I’ve got to protect everything and uh even if that helps your physical health in the short term in the long term both your mental health and your physical health EX recip toly declin for sure and then what is the long-term plan too like with the whether it was opioids or whatever pain you know like pain management essentially pain management has a great place if we’re managing your if the maybe like another professional is managing our patients’s pain while we fix the prom so when we have a plan to eventually get off of this pain management cycle uh having that be like a permanent plan doesn’t isn’t really that good yeah we made an adjustment too where we only take referrals now for patients so we’re not going at this alone it can be your chiropractor your therapist your psychiatrist but we’re not fixing all the things right uh for one thing because as Healthcare Providers that’s something I’ve struggled with like I’m a hero look what I did well let’s let’s share my expertise with other people who know things that I know exactly um and communicating you know like that we do I think we do a good job of that and we kind of find providers that do the same that that can communicate uh about the patient so that they’re getting the best possible care from all the eyes that are looking at them and not kind of getting uh sharing information I think it’s important absolutely so do you have any events coming up or anything else interesting that’s coming down the pike for you guys out of mind um we we have a pretty we generally do quite a few events as far as like like I mentioned before um lunch and learns is what we call them but whether that is uh patients of ours who who would like us to come speak to a group they’re involved or their workplace um usually makes people more popular when they’re they’re responsible for the food so I try to give our whoever whoever invites us all the credit for we’ll bring in lunch and and and give a short presentation uh to them maybe about stress or the services that we offer each place is you know a little bit different maybe try to make it applicable to the group if they’re having a group that has a high stress job we talk about stress in the workplace and how physical stress can maybe manifest itself in different ways um so those are something that we can always um that we can schedule if people are at home and would like us to come talk at at their any event that they have uh we have uh on our website um has a a a location to request information regarding that um and you guys are in Westlake we are in West Lake okay so about like what’s your radius usually for what you normally see patients that is a little bit different than what you probably expect uh the Chiropractic biophysics is um there’s a limited number of people in the area doing it so I think it’s getting better um I know for sure that there is a really good doctor in Columbus area another one in the Dayton area um before we opened this practice I had worked for someone in Chicago and it’s kind of an interesting Dynamic we had chiropractic biophysics clinics on every street corner every neighborhood right right so and we all knew had good relationships with people who knew were doing good work so if someone came from Ravenswood to where we were in the South Lop we’ be like listen there’s a great doctor like right down the street from you and need to take this train across the city to do that and we don’t have TR the transportation issue in Ohio but the I guess to my point was there’s not there’s not an awareness that this is really even available or this is a different thing because there’s not enough people practicing it so while you kind of have from a business perspective I know people say well that must be great you have like a monopoly on this Market I’m like yeah but no one knows it exists so it’s kind of a you know a double-edged sword that way but um so our to our radius of people to come see us is is probably bigger geographically than what it should be uh um most of the time probably anywhere from like akan K South this area all the way west we have patients that come from Toledo too to like uh um like past Menor kind of that area really sometimes it is like a west side east side cuz being in Fon you know we’re on 77 so that’s a west side of town so Canon to Southern kago County a lot it is you don’t have to get your passport out there cross the river well why don’t we have another show we’ll talk about more of the things that you guys provide and some of these other topics that as our viewers know just come up randomly but uh I’m Nick from asend Health Center we provide Psychiatry counseling transcom magnetic simulation ketamine therapy and sprado and having the two Nicks together this has been great so let’s do it oh wait I almost forgot to mention we we’re the runners up for a Clapper award and uh I’m doing several shows today but I’m calling all of them our 50 show so it’s quite an accomplishment for uh this piece of cardboard here yes congratulations thank you all for joining us hello and welcome to the Ascend Health show I’m your host Nick Angelus I’m the owner of Ascend Health Center in Fon and I’m here with Dr Nick big rig from aligned over there in Lakewood thanks for having us I say no West Lake West Lake I always get those suburbs wrong you think because I lived in Ohio most of my life I know each one but honestly I can’t even drive around my neighborhood without being like wait do I turn left here I and I realized like this is my house I got that part down but that’s a good start yeah so we’re going to talk about geography today and why I’m so impaired in this particular field or I guess we could talk about regenerative medicine it’s a tossup those are both very important topics both important things so this is our second show of the day so if you missed the other one none of this will make sense to you just kidding it doesn’t really matter what order you see it although you did tell your life story in the first one that was pretty cool we did um some laughter some tears yes a lot of injuries which kind of leads us back to right back to this yeah cuz I think our main point was that uh if you’re a kid you need to go out there and play you if you injure yourself your body will heal you’re an adult uh quit being behind the desk 95 you also need to move your body yeah get out there and play your body’s trying to heal itself um it just the ability it has to heal itself uh becomes a little bit less and less you know as we progress through life and and that’s where regenerative medicine comes in and kind of helps us make up some of that ground absolutely and a lot of times on the show too uh I bring guests like you who know things I don’t and we talk about some of these words that have been so hyped up for example at a send we do ketamine infusions and we rarely do any sort of marketing because we have all sorts of patients like what this sounds like great it’s a trip of some sort and then I’m Healed from everything sign me up and it gets well wait you might not be the appropriate patient or we got to do this first or it’s a stepwise process or a lot of times it’s like well we’re not this isn’t the first line uh treatment for whatever you’ve got going on is your generative medicine sort of the same thing because I hear about it all the time it’s a little bit almost like holistic ha where it’s like what does that really mean yeah it’s uh it’s using it’s using a donor tissue to help your body um your body is already trying to to repair and um repair parts of your body especially parts of your body with uh less of a blood supply so if with an avascular cartilage where there’s no blood supply to it or or or parts of your body with a um less quality blood supply regenerative medicine kind of helps heal you know uh cartilage damage degenerative arthritis ligament tears um muscle injuries even um okay and your body’s already trying to do it it just as we age uh the number of cells of this type of undifferentiated cell or regenerative type cell goes down um and in a way oversimplified uh statement it’s kind of why we stop growing and why we start aging um there’s a lot more detail and complicating factors to that but it’s it’s an oversimplification of these number of cells decrease and then our body can kind of begins to break down and how fast that breaks down depends on a lot of things our overall health injuries things like that uh but regenerative medicine is an Avenue that allows us to to repair these things or at least help your body repair these things um right um in more natural setting maybe than what traditional medicine had okay cuz we talked uh on our last show about how U and we didn’t get into great detail of it probably because you’re more polite than I am um but the American model is that oh I have a problem I go to the doctor it gets fixed I never address this problem again until it’s unfixed and then I go back yes so um because we take insurance uh at a cent Health Center so we know that’s what the game is you come in we build your insurance we fix the thing you leave we didn’t really fix the thing so you come back and then we build your insurance again then we fix the thing and then you leave so what we’re all trying to do here as uh I guess the experts here in Northeast Ohio is like well wait it doesn’t have to be this way like let’s have these sincere conversations with patients of what is our goal what do we actually want to fix what are we looking for and make sure we’re on the same page right and our our medical director uh is our over seeeing prescribing doctor in this field I handle um a lot more of the the rehab post post the procedure uh but inin of medicine um essentially the patients evaluated for for a a damaged uh cartilage or degeneration a damaged ligament um partial tears things of that nature um and then there’s some factors as far as how healthy is their joint how healthy are they how much um uh what is their expectation of the procedure and and giving them realistic expectations of that but uh it seems to have been very valuable in a lot of settings whether that’s uh an athlet trying to come back and be uh perform at the level they would like to or whether it is you know um someone who may not be healthy enough for knee replacement or or a joint replacement surgery uh or an advanced age but would like to um stay in their own home and not go into assisted living so uh I guess how you grade success in those two scenarios might be different but uh important nonetheless in both both to those people and it’s important because we’ve been talking talking of at length now about how you can repair your body uh but it is important to note that you know we’re all dying we we’re all degenerating there once you get to a certain age you’re not looking to get better you’re looking to maintain the quality of life and to be realistic when doing so because as we said before sometimes wait this therapy isn’t worth it and that’s perfectly fine so a lot of it is going along with the patient like what’s worth it to you what do we need to do what are we looking for exactly um setting realistic expectations for this type of treatment is is very important um and having um some of your own tissue for the regenerative uh um donor tissue to work with is as important as well there’s certainly times where it’s unfortunate but you have to give people you know news of maybe the joint replacement is the correct absolutely procedure so but then they can also go into that joint replacement it’s time to do this you know uh I do a lot of anesthesia for joint Replacements and the patients do better when they’re like you know what I work this need to death it’s time to get a titanium one it is what it is and they’re fine with it as opposed to well I could have done this or do I really need this I you know so that attitude of like oh I’ve exhausted reasonable options it’s time to do this because you have to realize that this field it’s not something we can really use pills for there are huge losses years ago because one of the toenail fungus medicines uh was causing liver damage because when you’re trying to get medicine into a place that has poor blood flow or when you’re trying to heal a ligament a joint these are places where yeah the body will heal itself it’s not in a hurry about it at all it’s like listen we our heart needs nutrients our brain needs nutrients ligaments you’re last place yes exactly we’re going to keep you alive first and we’ll worry about you running later right right ligaments are right up there with like nose hairs about how much the body cares about getting them better if you are not getting any Oxygen maybe we’ll give you a nutrient every third Thursday exactly um so this is a way to take yeah donor tissue and kind of supercharge that that process um and because we’re so hopefully as more and more people know that this is available because we’re so traditionally reactive right um and it’s not just reactive of like now I have pain I’m going to do it it’s now I have pain and I’m going to go to work for 10 more years and and and see how far I can push this pain or or culturally and there’s some value in this we are uh we’re hard workers so we’re designed to get through the next job the next task if I can just get through this we work then I’ll get you know deal with it next Monday and then I’ll get through another week of work and then before you know you’ve done that for 10 years but now that we know we have some of these tools available to us hopefully it will encourage the public or people who may have like a less severe joint pain or an nagging joint pain to get an exam address it sooner and maybe figure out what my options are um before I just wear it down to where it has to be a titanium or or replacement and then the question I have and this is just because the majority reason for the show is to pick each other’s brain is where do you find that line where a patient’s doing better and they can be more active but they can also overextend themselves because I struggle with this all the time we’ll uh for example do a a sprado dose or a Kine infusion and then the patient says I felt so good my fatigue was gone my pain was gone I cleaned my whole house now I’m as bad as I was before because we you do need to be more active yes uh for both physical and mental health your brain needs to form new habits or it won’t stick I’m a firm believer and unless you do something different it doesn’t matter how we treat you nothing will change long term right but where do we find that line of okay you can do more activity but let’s not like take this to the brink uh I think we’ve we’ve addressed that as we run across that same issue so we’ve done like let’s say a regenerative medicine injection to someone’s uh knee joint and as it heals and they do they’re doing the rehab they they feel great and then uh we’ve gone from that walking very much minimal to avoid pain to uh I went on a cruise and walk 10 m a day and now my knee hurts or now my muscles are sore well we haven’t used them uh in a long time so uh it’s cool to see them do things see patients do things they haven’t been able to do in many many years um but but coming up with a good plan I think a good plan to to rehab and we we do that we rehab everyone post um procedure post injection so okay we kind of monitor their their activity levels but sometimes they feel good and they don’t listen so they just go crazy um but I think having a good plan and good communication of how how do we gradually increase your activity so that you can do it in a safe way and and kind of not set yourself back and maybe the same as like stretching warm up even though it may sound silly like I’m just going to walk around the cruise ship like no you have not been active take a few steps stretch those muscles maybe not take the Excursion that involves climbing a mountain for sure like for one example uh cuz uh I’m gungho about let’s get you back to the same quality of life so I treat a patient and then let them go snowboarding right but it’s like well you’ve been snowboarding many times would completely be inapproiate was like oh you want to try snowboarding now that you’re better let’s do it so at least have the muscle memory of something you’ve done before as opposed to I’m going to take up rock climbing because now Dr Nick fixed me right that makes a lot of sense so um the other question about is uh so we’ve talked a little B about regenerative medicine but stem cells were really huge issue to uh maybe like even a decade or two ago so how does it use that technology um and how’s it changed since because it’s not so what we’re talking about regenerate medicine it is uh at the Forefront of medicine but it’s not quite as much of a buzzword as it was maybe five or 10 years ago so what kind of advancments have they made or or is there any types of it that don’t work because I know at one point there are a few different types of these Technologies and some of them didn’t really pan out as well as they wanted them I think I think there’s different uh technologies that are appropriate in different scenarios potentially um and some of them are still experimental as far as like they can take cells from your own body um from your adapost tissue or from your bone marrow um are two examples uh but generally our cells kind of get recycled and they age with us so they’re less viable for certain things as we get older now uh Leukemia treatment is a type of stem cell treatment you’re finding adult bone marrow to adult bone marrow there’s some spinal cord injuries that are are done with um adapost or fat tissue which makes sense because your nerves and your spinal cord are kind of covered in a sheath of of fat so those cells adapt good in those scenarios um that’s not necessar what we do in our our Clinic uh but for joint repair and cartilage or ligament damage um a donor tissue is is become the uh the best technology and it’s is it tissue or do they just like spin down PL with no this is a donor tissue from actually um when a planned C-section is uh occurred um and the mother meets certain Health requirements to uh to become qualify as a donor uh then they’ll contact her and see if she was interested and then the um American Association tissue bank would be present because it’s planned they’re not just hanging out at the hospital all day so there’s a scheduled time and and when that birth happens as long as uh mother and baby are okay and they both survive they the birth and everyone’s good they’ll collect the umbil cor and placental tissue so uh the inter lining of the umbilical cord has the highest density of undifferentiated type cells which are the kind of the main workers in this process but um there’s also placental tissue included in the injection uh one way to think of it is the placental tissu is providing nutrients but it’s things like cetto kindes growth factors scaffold things that kind of Aid the umbilical cord tissue in doing its job better so this is much different than like PRP or some of those other Technologies just spinning down and PRP is another type of regenerative medicine where we draw where someone would draw your own blood spin it in a cuge and then re-inject it into a joint or to a muscle or a tendon um in those scenarios uh at least in our experience the PRP works really better in like acute injuries maybe like you did it yesterday or you’re young you’re you’re healthy 25y old and you had like a muscle small muscle pool or things like that will help speed up your recovery but for degenerative arthritis uh um for meniscus tear laum tear in your shoulder things of that nature where a more maybe a um more chronic injury something spend there a little bit longer or more severe injury then the most effective way it’s been through the the donor and there really isn’t any reactivity because we’ve already mentioned these are areas of the body where there isn’t blood flow it’s not like I mean it’s very different it’s not like oh if somebody else’s kidney have to be on these medicines or this could happen no the the actual um it’s a universal donor so the the tissue and in that’s donated from Bor and placental tissue is a universal donor it doesn’t have biomarkers to the mother or to the baby so it’s kind of unique in that sense which makes it a pretty special tissue that it is able to um you don’t have to have matching um with the donor to the recipient there’s no risk of your body rejecting it or anything like that okay great that makes a lot of sense so um I want to talk a little bit about knee pain since that’s one of the joints that uh and honestly I’ve had a lot of chiropractors on the show and we’ve talked about sciatica and we’ve talked about migraines but we’ve never talked about knee pain that knees just left out and that’s the one that you know I’ve mentioned I I work in anesthesia we do eight nine 10 knees in a day just like all these people just need their knee replaced yes it’s a very complex joint I think they found a new ligament a few weeks ago it’s like how many of these have you done and you just now notice or something new there yeah the knee is uh is unique I mean a lot of sports you know we have people who being active you get hurt um and if you have wear and tear from work or sports or or activity throughout your life then then it can certainly um cause the joint to to age abnormally or inappropriately or at a faster rate potentially um but another thing that happens actually is that your as we get older our the arch of our foot will will um decrease okay uh which will load the the medial miniscus or the inside of your knee more so you’ll see more commonly that the medial or the inside part of the knee we faster than the outside I’m there right now cuz I’ve got flat feet like a penguin and now that I’m 41 and you know my doctor said well I can get you X-rays and I was like well would I do anything different than whether I do these exercises you gave me or not she’s like it doesn’t really make that much of a difference like all right let’s skip the x-rays CU I know what I’m supposed to do I just have chosen not to exactly if we’re there’s no reason to do more testing if the testing doesn’t provide a different path right right so um yeah generally the best way to diagnose degenerative arthritis uh is is through or the least invasive way is through an x-ray um occasionally you’ll need more advanced imaging like MRI but a lot of times you can kind of get a good grasp between between a physical examination Orthopedic tests and an x-ray okay um well that’s great because again there’s a lot of options there for pain management topical PT Chiropractic Care um but I guess in each case it is the patient would come to you get it evaluated and kind of go from there yeah our our Clinic actually offers a wide range of services whether it be um medical massage mile fasal release uh Active Release therapy dry needling cupping which are all kind of based around like lengthening or shortening different muscles and and tendons and trying to get the joint to to move and function properly and and if it’s a situation where the joint’s already degenerated and the the person is a good candidate then regenerative medicine kind of fills that Gap and makes the rehab all that much more valuable because the joint uh can repair itself yeah for us the most that we do with knee is there’s a few of the surgeons and anesthesiologists around here that do a lot of knees and so every so often after there’s a pain pump inserted or some sort of uh anesthesia Block in about 4% of patients there’s this neuralgia of the knee that just doesn’t go away and all the Imaging shows it’s fine so that’s where something like a ketamine infusion would come in but again like I said it’s not at all a first line it’s more of the surgeon the anesthesiologist say look we’ve tried a few things why why does the patient come this way uh because for what we do we’ve also notice if you’re using a ketamine infusion for example for pain and there’s no mental health component a lot of times it’s more difficult for the patient just the way that these medicines work where um it’s more of like a a functional medicine approach where you’re trying to regenerate the whole body and so a lot of times when uh the patient has some physical pain but it’s actually a manifestation of what’s really going on in their head and they’re not admitting that it can be a difficult experience definitely and it sounds really silly to people I’m sure like wait I’ve got knee pain that’s all there is to this my knee hurts but just surprising some sometimes a little bit what you said about the scaffolding of the spine how know sometimes uh I’m not saying that your anxiety is locked up in your knee but we’re we’re it’s almost like medicine’s gone a full circle yeah where they used to be like nope this is hysteria that’s what’s going on and then we’re like no absolutely not this is a chemical imbalance your body desperately needs serotonin or endorphins or en keyins or whatever and now we’re like no actually there is a mental health component to this they definitely all tie together you know we talk about that a lot in our Clinic chemical stress physical stress stress emotional stress and how how all three work together to kind of help not to help but to to affect the total health of the person so and I would say too if someone thinks that’s ludicrous well look the other option is that we C open on your knee and put something titanium in there so maybe consider a less invasive option and once that fails we can look into that but certainly it’s uh you know going to therapy and talking to someone is uh a lot cheaper than getting your KNE cut open definitely which which would bring me to the point also of uh Community because uh this was another article I read earlier today where parents are so anxious they’re like are you sure you’re okay kid go talk to a therapist it’s like no they kids just need to talk to their parents like a lot of this is when we’re in community we see a lot of these uh Health factors get better I think even the Surgeon General mentioned that loneliness is worse than smoking right now so and back to get outside and do stuff get outside and play find your peers and and go you know run around and not be glued to a electronic device is is a big part of that probably yeah and and and I’m not above that either like again like I think I’m I’m coaching a soccer team for the fifth time and each time I try not to do it I’m like oh I’ll find some other parent to do it’ll be fine but it is still the thing that if you as you stay active as you stay in community and relationship with people uh it’s surprising what that does for your health so great well um I think we discussed all the things we want to talk about today it really great having you on the show thanks for us for our 50th show which again I’m saying all day long so um so how if people want to reach you or come to the clinic uh what’s the best way for them to do that uh we can accept appointments online so through our website okay um and also our phone number would be 44385 7357 um either one of those ways is easy to uh reach out there’s always someone there to kind of answer any questions or help you make an appointment or if you already are aware that you want one uh you can easily make it online if that’s more convenient great and for us it’s at Ascend healthc center.com we can go to the website uh Phil out a form and all of our contact information is always on these videos as well so thanks for joining us today