Nick, CRNA joins Angela, NP and Dr. Krkic to discuss Medicine 3.0–innovative therapies to treat the root cause of illness. They also offer practical tips in case 5 minute appointments to renew a prescription covers your healthcare needs.

We discuss peptides, acupuncture, and ways to tell if a healthcare practice is right for you. Are they just treating surface symptoms, drilling down to the root cause of your disease, and do you actually feel better with their interventions? One example is IV vitamin therapy, which both Ascend and Zel offer: in many cases, patients absorb nutrients just fine orally, so building trust with your provider is absolutely necessary to get the care you need. Transcript below.

Hello and welcome to the Ascend Health Show. I’m your host Nick Angelis. I’m a nurse anesthetist and the owner of Ascend Health Center. And I’m here from the folks from Zeal. Angela the nurse practitioner and Dr. Kirk the chiropractor. How are you guys?

I’m doing well. Yeah, we’re doing really good. Yeah, we’re excited to be here. I like that they all wore blue today. I know. I feel like we’re vibing.

Yeah. Yeah. I was planning to wear a red shirt, but it was a lot. So, I’m glad I kind of toned it down a little bit. I I love all your little accents there. Yeah. You got You’re ready for the holiday? I I I really am. Yeah. It’s fun that these are kind of evergreen shows, but people can suspect must be around Christmas time. Sure. Sure. In fact, I have one post that I talk about getting along with your family during Christmas

with Carve your own Path the therapy group I love and probably three times a year we put it out there it’s like oh it’s almost Memorial Day got that barbecue coming up you better learn about

Yeah absolutely get mentally prepared

absolutely so I met you probably about 5 years ago I feel now and you’ve transformed your chiropractic practice into almost like a life it’s lifestyle collective yes so what all do you do there and I know you know we have a long show so we’ll probably not get into every single thing that you do there. But what’s sort of the main uh drive that led you to kind of transform your practice into this?

Yeah, Nick, thanks. I I remember meeting you. We were in like a little networking group and you came in town and you just were interested in getting getting connected with people, but Zel Lifestyle Collective was born with the intention of really attacking the the big guns in the healthcare industry that we have right now. And we have been working on this for about 10 years. Mhm. My wife and I have had this dream of having everything under one roof that is integrated with physicians that are like-minded, that are more proactive than reactive. So, at Zel Lifestyle Collective, we have brought on nurse practitioner, nurses, medical doctors, we have an acupuncturist, we have a massage therapist, we have a functional medicine doctor um that cohesively work together to provide the best care for individuals. Now, we’re called an integrative medical clinic because we have everyone there as a chiropractor, muscularkeeletal specialist. We can pretty much tackle anything and everything. So, usually we won’t turn down anyone. Mhm. So, if you’re looking for something that standard medical model didn’t address, we are the place to come. Awesome.

So, and there’s an entire show that is a disclaimer. I think I called it something like “don’t turn your toaster on in the bathtub.” It’s completely unprofessional, which the only reason I do these shows here in the studio is because it’s so difficult for me to be professional for any amount of time. But again, this isn’t medical advice. Um, I actually like it now when patients use AI to say, “Oh, here’s what might be wrong with me.” So, this is sort of like that. You might get some tidbits to take back to your doctor or maybe you’d be interested in, you know, visiting Ascend or visiting Zel with whatever you’ve got going on, but it’s not personalized quite yet, but it can be if you visit some of our clinics. Yeah. Yeah. So I I do like that approach for sure. And I think it’s also important to note that uh on occasion the standard medical system does work where you we’ve seen this a lot of us send where someone will come in and they’ll get an anti-depressant from our psychiatrist and it works and so they keep taking it and that’s kind of the end of the story which is great. It’s fabulous if that happens and if that is one of our viewers, yeah, keep doing that. It’s working. Uh be grateful about it and keep taking your medicine. But of course, the reason the places like yours exist is because a lot of times I think you called it a the medicine 2.0, a pill for every ill. Do you want to explain that a little bit?

Yeah. Well, that’s the model that um it’s interesting knowing the curriculum of a of a medical curriculum to get your MD behind your name. Nutrition, they get four hours of nutrition, total nutrition. I mean, that’s the basis of healthcare. Whatever you put in your mouth is this the energy that all your cells need. So it’s interesting if you look right before you put something in your mouth and you’re like, “Huh, I wonder if this is going to fuel my cells in a good way.” Medicine 2.0 never addressed that. And there is a pill for every ill. Medicine 3.0 is actually finding root cause of medicine of of disease. And first of all, why do you have heartburn? you’ve been taking a medication for your heartburn every time you have heartburn. Well, if you’ve been taking it for 40 years, your heartburn has never been fixed. And one day, that heartburn could be very likely a heart attack and you take your little heartburn medication and you never wake up. So, that’s that’s old school medicine 2.0. It’s 50 years old. Now, if new 3.0 medicine is the regenerative medicine, it’s proactive medicine. Let’s figure out how do you stay healthy because health is all you got. It’s your biggest wealth. And I think too when we talk about root cause, it does really help to go to a place that’s uh trying to think of the right word there that tells you the truth. So there’s a lot of gimmicks out there too where cuz I’ve preached about root cause for I don’t know how many years 10 20 something to that effect. Uh, and now it’s almost seems to be a gimmick a lot of times where root cause is a euphemism for come here every week for the rest of your life. We’ll find something to work on. Just give us your money. Sure. So, I think that’s a challenge too cuz once in a while we will have patients at Ascend where we’ll say, “Okay, here’s what’s going on. Here’s what we can help you with. You might get 20% better if we do these more treatments. You know, in this particular case, it might not be worth it.” For example, this time of year, it’s almost like a reunion that ascend. I see patients I haven’t seen for 6 months, 9 months, 3 years because with especially this year for whatever reason with the weather changes all they take a dip in their depression or their pain or whatever and I think that’s the ideal way to have a collective or a clinic is where you can help people and then they can go off take what you learned what you said about nutrition for example change their lifestyle and then they know they can come back whenever they need to. Yeah. Although you also have a subscription model too though right? Yeah. Before we get into that like medicine 2.0 going, “Oh, still works. There is a need.” Like, you break your arm, Nick. Don’t come to us. You’re not going to put an herb on it. Yeah. You’re going to go to the ER room. Or, god forbid, you do have a heart attack that you never prevented, right? You’re in the best place in the world to treat those kind of issues where you can go to the ER room, but don’t treat the ER room as your primary care physicians and how to to take care of you because it’s one and done, that kind of thing. I don’t know if you have any insight on that. I mean, I have just been I’ve been in medicine for 20 some odd years, so like I’ve seen how it has evolved, how it’s changed, where we’re kind of lacking, and I think that um we just don’t have somewhere to go where we’re like really heard and we get to spend time with a provider. So that’s what’s nice about like our model, like we’re able to kind of really bond, create like a family with our patients, kind of like a little community so that they can come in and out, right? like if you are sick and need standard pharmaceuticals like that’s what I’m going to do. I come from that 2.0 there’s a pill for everything kind of a thinking but you know um so we can do that right but there’s a lot of other things that we can do and get to the root cause and then when you need us you can just circle in and out as as you need us. Well, similar to your advanced practice training, uh, as a nurse practitioner, I think as a nurse and neesthetist, it’s probably even farther than that where there is an IV drug for every literally everybody, right? Yeah. So, it’s like you come in with a symptom, we’re going to get you over here with a medication, a synthetic version of a medication, and we’re going to treat that symptom, and you may have another symptom that we’re going to have to add another pill on for, but we that’s what we kind of do. Which is also very important because most people that need us are in pain. Nobody’s really going to come. Yeah. Now that the atmosphere and the dynamic is changing, let me be more optimized. But those that are really hurting and in pain, they might be in pain for a long long time and never really somebody fix the pain. So when we do need something like that where we need to intervene, make them feel better so they’re they can kind of think straight and not because pain will drive you absolutely nuts. It will disturb every part of your life, right? And without some intervention to get you out of pain so that way you can focus on right like what not to do anymore to to get this pain anymore. So yeah, it’s it’s it’s it’s amazing model. We love it. We’re just so passionate. It doesn’t feel like work to me anymore. It never did. I think us in medical field, we’re we’re all in it for one reason, to help somebody. And sometimes some individuals in our field have we’re never given the opportunity to get the right tools, right, to give to our patients. And that’s okay because that’s all they knew and maybe they didn’t have any continuing education to provide more tools. True. And a lot of times that’s where the burnout happens when you feel that you’re you can’t actually help someone. You’re just watching them suffer and you don’t have the tools or the time or the ability or or whatnot. So and with what you’re saying with pain too, a lot of times pain masks so many other symptoms. We used to have an issue at Ascend where we would do ketamine infusions for pain and the patients can tolerate it because it’s a strange experience. It’s almost like you step out of time and talk to a therapist about your deepest problems for eight hours all in like a 45 minute time period. Yeah. So it can be very stressful. So, I mean, we found ways to fix it. We do now smaller injections to kind of dip the patient’s toe in the water. But because these patients thought pain was their only issue, ketamine, which is a drug that really affects your mental state, it sort of shines a mirror on like what you’ve been doing your entire life. It strips away all the subconscious uh mechanisms that you might have had to defend yourself. Patients could not tolerate it and they realized, oh no, I have more problems than pain. I actually do have depression or anxiety or these other issues, but the pain just overwhelmed everything. So, it became like, no, this is my sole issue. So, which which makes sense like you don’t want to talk about someone’s heartburn if they’re writhing in pain. So, that is a little bit of the root cause that let’s get to the bottom of it, but we also can’t even start until we deal with the most pressing issue that brought you here. Right. So do you see with a lot of patients when you do ketamine do you see a lot of things because we focus on a lot of the things if they arise up like as feelings arise that’s part of healing. So, do you see that a lot with patients? They just kind of bring up a bunch of feelings that maybe they’ve been struggling with. In some ways, even though like you all do some functional medicine, I have a background in it. But the way we practice at a center, it’s almost the opposite of functional medicine where functional medicine you test, you don’t guess. So, you do all the lab work, you really drill down to the into the cause. in our case because usually people are in an emergency when they finally come to us because we do treat treatment resistant depression and anxiety and pain. Uh it’s usually where we start treating and as they start improving we kind of it’s almost like stirring the pot. We see what’s really going on and then we know which direction and sometimes it is uh a simple case of okay we’ll still help you but for this particular problem let’s send you over here. So, I mean that’s honestly one of the big reasons I have this show is just so I can pick people’s brains so we better which is nice because right like we have patients that can benefit from what you guys are doing. So, it is it’s nice to have that big network and all work together. Yeah. Well, one of the biggest things that we pride ourselves on is making sure you find somebody if you’re watching this and if if your doctor is not progressive about around what is happening in medicine right now, it’s one of those things are you it are they doing you a service because so many things change with AI and all this now diagnosing diagnosing somebody is like almost we rely more on the AI but we kind of filter everything through making sure that the data we provide side is accurate of what the feedback is back. So finding a practitioner that is proactive and continuing learning because we’re all doctors in in capacity of we need to continue learning to provide the best care for our patients because they rely on us. They trust us. So, it’s I think it’s very important to to find somebody that’s very proactive about their learning because we’re all in it because most of us we all want to learn more because we’re just that’s the way we give back to our patients and yeah um with our relationship building because well yeah like I think we don’t know everything right like you need to have time and energy to like put into researching the new things that are out there like whether I know we’re going to talk about some peptide therapy like there are things that are out there now that are evolving like that we never knew before and we’re seeing good results. So, you know, there’s ways to integrate it in, but you have to find somebody like that is a medical provider obviously and can monitor, you know, your labs and your symptoms and treat you as a whole. But it does require a lot from us because it’s all new stuff, you know, like finding the research and, you know, kind of doing our own research really, you know. So, um I think it’s great. You know, my dad had cancer and was sick and dying and there was just like no options for him. You know, it was like, okay, we’ll just watch him deteriorate. But there were things that like we have out now, right, with some of these peptides and natural things that we could have integrated in, you know, 10 years ago when he was going through that, but you didn’t do that then. So, I don’t know. I just feel like we need to bring everything that is out here for our patients so we don’t have to like watch people suffer. Especially in cases like that. Uh I had Casey the death doula on the show before and we talked about how a lot of times it’s okay they can be your loved one can be clear-headed and in pain and you can have some time together or they can not be with it and be comfortable and you want time together. So it’s like it is through things like ketamine and really a lot of it isn’t pills like you were saying. It’s these different interventions that can allow you to have quality time with your loved one at the time. Absolutely. Right. And that’s good for us too in our mental health, but I feel like, you know, you’re watching that happen and you have literally no option. So, it’s sad, you know. So, I think that’s kind of the reason I found this space is I wanted to be able to offer everything to everybody. So, yes, conventional medicine’s great sometimes, but like there’s other things. So, you you you’re making a good point because collaboration is key. Yeah. when it comes to talking with a patient’s health, like I can reach out to you. I can reach out to colleagues that you know and you trust. Hey, I’m just asking for a patient because they’re probably going to turn to the the Instagram doctor or the influencer said take this because you might have this symptom. Well, here’s the issue, too, because so we’re just starting about how there’s research and it used to, especially in anesthesia, it would take years and years for things to go from research, here’s the academic paper to here’s how we practice. Now, it’s quicker. But what the problem is that there’s a lot of private equity money that goes into the feds, whether it’s ketamine, marijuana, peptides. So before I’d have a lot more patience with patients of like okay let’s slowly you know we don’t want to get ahead of the research but now if we don’t act then they’ll go online and end up with some sort of uh crazy online version of whatever we’re telling that isn’t safe that isn’t appropriate that isn’t personalized and that’s where you hear all the horror stories right it’s like people getting this stuff online from China like whatever we have no idea the dosing they’re trying to manage the dosing on their own or mixing the meds on their phone. Um because yeah, they’re desperate for options obviously, so they’re willing to try things. So, we do have to be kind of up and coming because our patients are going to go out there and use them anyways, right? Yeah. There was a case recently of a person who died uh using at home ketamine. Oh, I can imagine. Yeah. It was only a matter of time until this happened. This is why we do everything in our clinic, right? These aren’t if you can’t have both something that’s powerful and effective and completely safe without supervision. Absolutely not. either getting an ineffective dose or a dangerous dose. A lot of times there isn’t this happy medium. Sure. So despite all the marketing that you might see about many of these products. So Oh yeah, that’s exactly to the point. We we do a lot of GLP1 weight loss and we’ve not had we’ve been doing this for almost two years. We don’t have our patients lose muscle mass on like what you see on the Zmpic face and right because they might have gotten this and just have no clue what to do and they’re dosing themselves. They’re increasing the dose by themselves because they’re like, “Oh, I lost 10 pounds this month. Maybe if I double down, I will lose 30 pounds next month.” Well, if you don’t have the proper guidance, you are going to get yourself in some trouble and a mess. And sometimes, you know, like patients are upset with us because we do go a little bit slower on things in our monitoring, especially with the GLP1s because we’re seeing awesome things that are happening with these patients, right? So, they’re feeling better, less inflammation, and of course, right, they want to lose more weight, but we do go slow and if they start losing too much muscle mass, we have to re-evaluate our plan, you know? So, we’re trying to h add longevity, you know. Well, how do you negotiate? So, we mentioned if you uh go to the hospital cuz you have a heart attack. Me as an anesthetist, you know, a lot of times I would do epidurals and the mother would have a birth plan and sometimes be like, “Nope, absolutely not. Scrap this whole thing. You’re in danger. Let’s go do the C-section.” End of story. No negotiation. Uh but with our types of practices, especially in mental health, where this is something where how the patient feels is the reality, right? So, it’s it’s a little bit different than like, well, I feel that my cholesterol is fine in my areas. Yeah. So, because it’s based on filling, there is a lot of negotiation. I mean, sometimes we say, “Nope, this is the option. I’m sorry.” But how do how do you all deal with that in your type of practice where there’s so many different options? There is. Right. We’re seeing them and having like an established patient visit. They’re coming to see me. I’m getting their history, their physical, doing like basic medicine stuff. Um but they all get like comprehensive pretty I feel like those labs that we do we kind of cover every aspect of every part of their function with our comprehensive labs so that we have something to compare to. Now yes we are treating symptoms too like if I’m doing hormone replacement therapy a lot of that is like you’re treating symptoms and basing your dosing on symptoms. Um and the GLP1s it’s kind of the same thing like you know what are your symptoms? Is there food noise? are you losing muscle mass? And we because we don’t deal with insurance have freedom, you know, so we can kind of play around and do dosing that may not be the standard everywhere else, but we don’t have to fall under that umbrella either. And it’s really focusing and Nick, on the partnership between the doctor and the patient and then the staff and and the team. It’s it’s a partnership. It’s not you’re not going to be on your own. So, it’s it’s give or take. you know, if the patient’s not willing to do something, well, let’s, you know, let’s talk about this a little bit because the results are going to be skewed if we monitor you and this is what we’re going to see at the end of 3 months. This is what we’re having a prognosis on your condition and therefore it’s it’s a two-way streak when it comes to patient really really focusing on their health and improving their life just because we’re not here to just keep you on something forever, right? We are truly here to be a resource for your lifestyle because there there’s basis for that. If if you’re building a house in a swamp, would you would you say that you want to build a really really good foundation or just leave it up to the swamp, right? Because you’re never going to be able to build your house on that swamp on any foundation. So really focusing on we may not see the results right away because in our society now everyone wants that instant gratification. I want to feel good, right? Well, you’ve been neglecting your body for 20 years. What do you expect? You can’t feel good right away. Uh so it is I think it’s important to really find provide that environment and we pride ourselves. Yeah. We provide an environment for safety first and connection, right? Because that’s where true because people will connect with those individuals that are on social media. Maybe they have a story that’s compelling or that’s relatable. Those influencers, they tell their story. This is what I’ve been through and this is what I’ve done. So on the other end, people are actually connecting with that individual and they’re trusting without even interacting once oneonone. So that’s what we want to do is we want to build that safe environment first for anyone just come in talk to us. So the takeaway for the patients is as they’re watching this make sure that your provider is honest so that if you have an idea cuz sometimes we say no that won’t work we won’t do it and other times say it’s not the ideal way but this might work. We’re willing to give a try. So, I think it’s important for patients if they do want to negotiate some sort of treatment to at least have that baseline where they know that their provider would tell them if it’s a bad idea that’s not going to work cuz it’s I’ve cuz I’ve heard not in our practice thankfully but cases where it’s like well I didn’t really want to do this but the patient really wanted it. So there is a line there where it’s like nope this will waste your time and ours let’s not do it. And then in other cases like well this isn’t the most ideal situation but it could work so let’s you know take it for two visits or try this for a month and then we’ll revisit this. I agree with that completely cuz you know I’m doing a lot of hormone replacement therapy and people are scared at first you know like one of one of the big things we offer is pellet therapy. Well, people were a little bit anxious about having pellets implanted, you know, underneath your skin, regardless of how easy it is and how great it is and all of these things. They were still a little apprehensive. So, we started offering like creams and injectables, but to your point, it’s like, okay, well, we can do this, but you’re not going to have the benefits. we’re not going to be able to get your numbers up where they could potentially be and you could be optimized, but if this is where you want to start, let’s start it. Great thing is is we do some follow-up labs 5 weeks after they’ve started like a topical version of testosterone. Well, then you can see on paper, right? Like you were here, we’ve done this, we’ve tried it, we only could get you to here because it’s not absorbed the same. Like maybe there’s a better way. But sometimes people need to like be able to work through that and go at their own pace. Yeah. No, that makes sense. Yeah. Sometimes we tell patients like, “Okay, you’ll see us a lot more if we do it this way.” And that’s fine, but just letting you know. Just so you know, it’s going to take a longer time, but we can get you there. But it also has to be personalized. You know, it has to be personalized. So, it’s kind of like going to your Chipotle. You’ve been to Chipotle before. You go in and you say, “I want this, this, and this, and that that.” And it’s going to compile a Chipotle burrito, right? and it’s going to be tasty Chipotle burrito. Well, that that can work sometimes. Our patient says, “I’m I’ve done research. I want this, this, and this.” And you’re just kind of like, “Okay, advising them that actually might work. We might be a good Chipotle burrito.” We’re not that, but we’ll accept it. We’ll invite you for for discussion on that. So, it’s like going to So, you’re going into the doctor without knowing exactly what all these ingredients are clearly, but you’re putting it together. allow us like allow our training to kind of like flourish and your training nurse practitioner training like give us a chance to cook you up a burrito in a treatment plan. And that’s why I think like peptides are a big thing right now in our world in like in medicine. Um short amino acid chains that are like signaling molecules what is what peptides really are. And because we get to know our patients and know what they’re taking and what their lifestyle is and if they’re ready to make lifestyle and diet changes and focus on sleep and you know the things that we all should be doing, but um we can add and like sprinkle some peptides in for regenerative medicine, dealing with pain or helping um with hair, skin, and nails. I mean there’s like everything right that you can and it still takes that cuz I remember going to restaurant like are you sure these chicken livers are good? Don’t lie to me. And like I said, they’re great. They were not great. I sure could be on with that. So, uh, before I get off onto another tangent because it’s my favorite thing to do on this show. So, you’re in Talmage. You’re opening up in Fairlon. Uh, early January 2026, you’re opening up in Hudson. So, those are all the areas uh where we’re covering. Okay. And that and most of the therapies are available at any of those. Yeah. Okay. Great. It’s exciting news. I mean, we’ve kind of went from one clinic to three in a very short amount of time. The vitality uh zeal vitality in fereralon has been a work in progress since last year of November. This is going to be fabulous cuz you’re about 2 minutes away from our it makes it a lot easier to cuz that’s how again this is how the show works. I even brought compet direct competitors here saying okay what do you do? What do we do that’s slightly different just so we can all work together. Yeah. Absolutely. So super exciting for that office and and the Hudson office was more of a a calling for me personally. When I feel right something, I I go with that direction. If my heart, my soul is aligned, I’m going to just absorb that energy and I’m just going to go with it. So a colleague of ours had some health issues that couldn’t continue practicing. Mhm. So, we just sat and talked and came up with an option that I was able to reach out to to him and just kind of come up to not have him just close down the clinic, right? And just take over in Hudson. And it’s just been great opportunity for us to expand into the Hudson market, especially with the regen medicine that we’re doing and preventative medicine. So, we’re kind of everywhere. So, you can always find us and come and see me. have some direct primary care. We’ve got all of the things. So, and that’s always the appropriate way to grow. Like a lot of times patients say, “Why’d you do 64 shows in Wadsworth? We can just do some marketing and more people know about you.” It’s like, “No, this has to be an organic process, not some sort of huge business plan led by an MBA instead of clinicians.” So, I think it makes a difference. So, thanks for having us. Yeah, absolutely. Thanks for being on the show. Yeah. Oh, wow. That was 27 minutes.

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