Measuring Brain Blood Flow and CO2 in Real Time—Why This Changes Concussion Recovery with Dr. Nate Keiser (Part 2) | E58

Your autonomic nervous system isn’t “just stressed,” and dysautonomia isn’t a single, one-size-fits-all box. We zoom out from symptom labels and zoom in on mechanisms: how the brain senses the body, builds an internal map, and then uses that map to regulate heart rate, blood flow, digestion, sweating, temperature, and even hormone feedback loops.

We talk neurocardiology in plain language, including why the brain controls the heart beat by beat, how the cerebellum helps automate autonomic function, and why a disconnect can show up as tachycardia or rhythm issues. We also dig into the insular cortex and interoception, including why some people feel a pounding heartbeat even when their heart rate is normal and what that can reveal about nervous system signaling.

From there, we connect functional neurology with acupuncture and Chinese medicine concepts, focusing on objective feedback like pulse shifts, sensory tingling, motor twitches, and vasomotor changes. We also get real about treatment: why “try this medication” is common, how paradoxical responses can happen (even when blood pressure looks better), and why measuring outcomes like cerebral blood flow can change the entire plan. If you’re dealing with POTS, post-concussion syndrome, or chronic autonomic symptoms, you’ll leave with a clearer way to organize your timeline, ask sharper questions, and pursue strategies that match your physiology.

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Transcript

Dr. Nate Keiser 0:38

The autoimmunity levels are going to go up. The amount of difficulty with digestion is going to tend to go up. The things you are sensitive in your life are going to go up. Your ability to control your hormone regulation is going to be impaired because all of these feedback loops require a brain that can feel what's going on in here and what's going on out there accurately and generate a motor response. And I think we s we skip that a lot in terms of trying to understand the way that those systems work.

Welcome And Recovery Focus

Dysautonomia Has A Long Backstory

Dr. Ayla Wolf 1:11

Welcome to Life After Impact, the Concussion Recovery Podcast. I'm Dr. Ayla Wolf, and I will be hosting today's episode where we help you navigate the often confusing, frustrating, and overwhelming journey of concussion and brain injury recovery. This podcast is your go-to resource for actionable information, whether you're dealing with a recent concussion, struggling with post-concussion syndrome, or just feeling stuck in your healing process. In each episode, we dive deep into the symptoms, testing, treatments, and neurological insights that can help you move forward with clarity and confidence. We bring you leading experts in the world of brain health, functional neurology, and rehabilitation to share their wisdom and strategies. So if you're feeling lost, hopeless, or like no one understands what you're going through, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact. I came across an interesting, I will say it was maybe, I'll call it a statistic. It was, it was in a research paper, but it was this was an online survey of people that had already been diagnosed with a form of dysautonomia. And 63% of them reported that they had had essentially certain signs and symptoms for most of their life that something was maybe amiss. Now there's just so much information on the internet, lots of people kind of trying to figure things out, but maybe having certain misconceptions. How often do you pay attention to kind of the timeline of does this this person maybe currently now has dysautonomia? But how much do you dive into their past in terms of, you know, did you faint when you were a kid or a teenager, or did you have a lot of dizziness? Or like I'm just always curious on how long has this kind of these little maybe errors in the system, how long have they actually been there? Do you pay much attention to that?

Breadcrumbs Before The Breaking Point

Dr. Nate Keiser 3:30

I think that's a really good insight. I think because we talk about things so much in terms of symptoms, and so dysautonomia kind of represents symptoms to a lot of people, that it becomes a monolith. Right? Like everybody like di dysautonomia is just kind of like the same. Like your disautonomia and mine are the same. We're buds. Um so this the as I would say the first part of that is is to just recognize that it's it's not. It's just a way that we use as a shorthand to describe what you're feeling. But as soon as you even start to use words, you're not really accurately rendering what you're feeling. You're using a word to describe something that you heard somebody else say or you saw on the internet. And it's really like language is a hard way to describe what you're what's going on inside you. So that's number one. And so my encouragement for a lot of people is to not get stuck there and is to consider more what's happening. What is the mechanism, like what is physically happening in your body that is causing this error to occur. And like that's a way better language to start from, right? So if you do it that way and you realize for most people, there is a catalyst. There was a moment when I could no longer ductate this thing together anymore and it breaks, so to speak. But a lot of people have all these breadcrumbs through their life of other things that happen. Like um, I have not talked about it publicly other than I just we just published a video for the first time a week or two ago about my experience with that. So I had you know, different things happen where where I ended up having to get heart surgery because I had a problem in this in this realm. And there was a catalyst for me, but if you go back in time, like I had an episode after, you know, a thing wrestling, we went on uh, you know, I had a wrestling practice, had a thing happen, and then went on vacation with my family, was laying on the floor, stood up, tipped over backwards and fell through a glass table. My mom yelled at me. I could hear her, I couldn't see anything. Um, she's like, stop screwing around, you're gonna break your grandmother's table. And um, so I like passed out, but then like it was fine. Went to Disneyland, did the whole thing, or Disney World and did the whole thing. And then later on, you know, had another fracture in my neck that we didn't find until later, and then had you know problems that ended up causing arrhythmia in my heart and blood flow problems in my brain. So like I've I've lived a lot of this life that in a way that I haven't talked about. Um, but in my life, you know, there's looking back and seeing like, oh man, that stuff was happening kind of all the way along through there, and then it finally got to this point where it was like I couldn't do it anymore. But then in the solution phase, like so I ended up with a problem with the rhythm in my heart. I had an AFib, and it was drastically impacting the blood flow to my own brain, ironically, before I had any Doppler testing. And uh that was really that was a big deal for me. And but I ended up getting a heart surgery, and so for most AFib at that age, young AFib, lone AFib, the heart, you get a heart surgery and you're like generally fine. You're pretty good. But I wasn't, my my heart went back into rhythm, but I had a long process of getting strong again. Like it took me a year to get back to like any like semblance of strength. I had to go back through, you know, working, seeing one patient at a time and taking naps in between cases. And wow on my way home, stopping at Costco, laying back in my in the car to like get enough energy, and I would go take one lap around Costco and then back in the car and have to rest and then drive home, and I would just expose myself to that, trying to get stronger. So I've done all of these things. And um, but the the portion of that that matters, like when you think about history, is it's really easy to think about the catalyst, the thing that like was the most recent problem. But as you mentioned, for so many people, it's a culmination of a life well lived. All the adventures and all the mistakes and all of the interesting things that happen, they come with just these little augmentations to you that make you who you are, but then they also can can have an effect on that physiology. But if we don't understand them, it's really hard to solve it. So, like in my scenario, if we would have just said like aphib surgery, there you go, good to go. Why why are you still having these problems afterwards? Your heart looks great. Well, it's it's because of all the other stuff that happened before that, that when the heart part went bad, all that stuff starts to show up now. Um and so I get to I I feel in a very visceral way, and so it's very easy for me. But for um, like if you've not experienced that before, then it's it's kind of hard to pin down where it is. But if you can organize it and say like a lifetime of things, write the whole thing down. When you go to the doctor, bring everything. You had your tooth pulled out, let's check that sucker out, let's see what's going on. Um, but I think that that part, if you're willing to spend the time on it, can can unlock a lot of mystery in people that you don't you don't think about.

Dr. Ayla Wolf 8:55

Yeah. And I think the other thing that doesn't get talked about enough is the brain's role in controlling heart rhythm and heart rate. And I think what what was so uh visceral for me to watch was when Dr. Carrick was doing a clinic theater and he had someone's heart rate, uh, their heartbeat was hooked up to a speaker so you could hear it. And he was doing a specific right cerebellar activation technique, and you could hear the change in the heartbeat. And it was just one of those moments of such a beautiful way of explaining the heart, it doesn't have its own brain. It's actually getting its feedback from our brain. And now, you know, originally we thought the cerebellum just controlled our limbs, and now we realize there's all these really important parts in the middle of the cerebellum that dump into the brain stem and control our heart rate and our rhythm, and it's all connected. And I think that it's just it's still something that we don't talk enough about the role of brain function on heart function.

Dr. Nate Keiser 10:02

Yeah. It's uh can I tell you a quick story about Dr. Kerrick? So I know that exact video that you're talking about. When I first started to teach for Dr. Kerrick, I was reasonably young and so very nervous. And he they would give us this list of like what do you think your strengths are and what do you think your weaknesses are, and what courses do you think you'd be the best at, and what courses do you think you'd be the worst at? And so I the one I didn't I never really said like I'm really the best at this, and that's not really how my mind works, but I knew which one I was the worst at, and it was neurocardiology. And so you can guess what the first class I ever taught was neurocardiology. Yeah, and so I taught that one terrified, and I worked I worked harder on that class than any other one that I taught in that in that kind of section of the of the curriculum. And um but what it taught me, I think is what I'm still talking about now. It's still from that course of understanding like that dynamic, the same way like everything is constantly being troll controlled all the time. And like beat by beat, your brain is controlling the whole show. And if it doesn't, just like a little, like you have a baby, the baby's heartbeat is about 100 to 120 beats per minute. And an adult, we look at that and go, that's not oh, that's not good. If we decouple, if we cut all the wires from the brain to the heart, and your heart just is gonna do its thing, it's gonna beat around there. And so what you're literally looking at with a lot of people with tachycardia is that disconnection of the brain's influence over the heart. And the primary places that exists are not so much in the things we think about, but they're in all the stuff that we count on. And as you mentioned, that cerebellum is like the main feature of automating thing. It's it's almost like our own internal AI where it's like everything that you want to automate in your life, that's the cerebellum's job. You like you give the cerebellum an idea and it's like, I will automate that baseball swing, I will automate gate, I will automate the way you drive to work. It's like it will, I will take over everything that you don't want to think about. I got you. But um, it's also the thing that is uh is control, like perfectly controlling the entire autonomic system, which is beautiful.

Insular Cortex And Heartbeat Awareness

Dr. Ayla Wolf 12:29

Yeah. You know, when when we again going back to like learning neurology and we learn about the different lobes of the brain and how can you kind of functionally assess these different lobes of the brain. So we have all these different ways of assessing different parts of the frontal lobe and the parietal lobe and the temporal lobe. And uh, and and then we have this thing called the insular cortex, right? And I was like, gosh, this is such an important part of the brain. Again, something that I don't think we talk about enough, something that I think acupuncture really modulates in a way that's unique. And I finally came across um because I have patients who have increased heartbeat awareness, right? So I'll have people come in and they'll say, I think I'm having tachycardia. And when I pop my heart rate monitor on them, it's like, well, no, your heartbeat is 60 beats a minute, but you you have increased heartbeat awareness and your heart is like pounding, but it's not pounding fast. And so uh, and obviously there's a lot of things involved with that. Um, but one of the ways to functionally assess your insular cortex is can you sit there and close your eyes and count how many beats per minute you can feel your heart? And uh I was like, okay, finally I I found my functional test for this particular part of the brain. I love it.

Dr. Nate Keiser 13:51

Yeah, I remember that test. Yep. Yeah, the insular cortex is amazing. And and as a note for you, so the first the first paper that I read that coupled um kind of the the posterior insular cortex with what we were looking at with vasoreactivity in the body in a way that was regional was an acupuncture study. It was the first one that I could ever grab onto that that like showed because no amazingly, I mean this is probably 15 years ago, but amazingly, no one had ever shown you can you can cause different blood flow in the body by changing activity in the brain, right? So like it's not all one, it's not like all one blood flow. It shifts based on what's happening. And I think people understand that better now. But that first that was the first paper where they looked at it's it's segmental, it's regional, it's it's distributed version of being able to control this. But you can only do that if you have an accurate rendering of what that body looks like.

unknown 14:59

Right.

Dr. Nate Keiser 14:59

Which has to put together in an internal representation, right?

Dr. Ayla Wolf 15:03

Yeah, and acupuncture is incredible for remapping the body in the brain, but not just remapping muscles and limbs, actually remapping blood flow.

unknown 15:14

Yeah.

Mapping Sensation To Blood Flow

Dr. Nate Keiser 15:15

Well, it's the same map. So that's what that's what that paper showed was the same map for how people will experience, you know, all the way down. So if we take a biopsy and go skin to muscle or skin to bone all the way through, and we've got that little sample. All of those things are integrated in your brain in terms of what they are experiencing. So if I have um like a peripheral neuropathy, I don't feel my feet. If I can't feel the skin on my feet, there's a high probability that I'm also not gonna be able to control the blood that flows to them either. Same way I'm not gonna be able to control the strength of them. The same way I'm not gonna have, I'm not gonna be able to maintain like the hair that covers that area or the sweat that should be on that area. And that paper, I wish I could think of the author right now, but was the first one that was like, yes, there it is. And um and so tying it back there and and moving from that insular cortex out is actually a really useful tool when people are trying to understand how like what we just talked about, especially with neuropathy, being able to figure out like how is this thing that is happening peripherally, right? So undeniably it's a peripheral nerve problem, but what is that doing in the brain? And so often if you have someone that's got a neuropathy or has a problem in the periphery, we all we almost don't even consider what that's doing in the brain. Does that do you find that too?

Dr. Ayla Wolf 17:38

Um I I I think I am looking at it from a similar perspective. And what's really cool with acupuncture is that your needling technique can change whether or not you're stimulating so if we obviously with our nerve fibers, we've got our our sensory motor and autonomic fibers uh in the nerve, but your needling technique can actually change which of those fibers you're stimulating, whether you're stimulating a sensory, a motor, or an autonomic. And so that's where I think that again, from a high-level acupuncture perspective, needling technique is very important and can actually change how the body's gonna respond from autonomic, motor, and sensory perspectives.

Acupuncture Technique And Objective Feedback

Dr. Nate Keiser 18:25

And what's cool is so maybe I'm gonna interview you for a second for the audience. So when you're looking at that and when you're trying to explain that to other people that are doing whether it's because I know you teach, so whether that's in other people that are wanting to do acupuncture or whatever, whatever their choice of tool is, how do you relate to them, how to think about that technique versus how do they know what they're hitting? So are you giving that uh do they have a way to be able to kind of like capture an objective on the other side of that to keep them moving forward?

Dr. Ayla Wolf 18:58

Yeah. So there's a difference in needling where you would feel a sensory kind of like tingling versus a motor twitch, for example. Um, and so I can needle the same point and I can get a sensory sensation of tingling, or I can get a motor sensation of um an actual twitch and maybe a movement, or I can be simultaneously feeling their pulse and feel a change in their pulse when I needle. And so when I'm doing, for example, like stroke uh rehab, if I have somebody with paralysis of their arm, I will be feeling their pulse on one part while I'm needling another part, and I'm waiting until I feel changes in their pulse to know, okay, I'm having kind of this change in autonomics here based on my needling technique. So I would say that's kind of how I teach it is that you you can distinguish these things by actual physical reactions.

Dr. Nate Keiser 19:59

Right. I'm glad you described it that way because I don't think it I don't think it's tool, it's kind of like tool agnostic. So the same way you can do that with acupuncture, people can be thinking about that if you're a PT and you're applying it, you know, you're doing a stretch or you're you know doing a movement of the limb. You can see if if the motor response is changing, like you talked about a twitch, but like tremulousness is the same idea. Or you might see like an abnormal flushing in that area, which is kind of like a skin vasomotor response versus a pulsatility one. And and so I guess yeah, I guess to I bring that up to kind of point out, um, you know, I may talk about it through my language and you talk about it through yours, but we're all really kind of speaking the same language, and if we can just extrapolate that out, you can you can think about autonomic systems in the application of almost any kind of a treatment strategy. Um I think it's useful that way because it it points back to dosage and it points back to getting that traction.

Mechanisms Behind POTS And Treatment Choice

Dr. Ayla Wolf 21:02

Yeah. And one of the cool things, because uh as I, with my Chinese medicine uh perspective study dysautonomia, and we look at the Compass 31 questionnaire, and it's broken down into kind of six basic domains of autonomic function, you can trace those six domains of autonomic function back to what we call the five functions of qi. And so we have these different kinds of functions of containment and regulation and fluid dynamics. And so it's it's one of those things where I can have a patient fill out the compass 31 and I can look at it from a neuroscience perspective, and then I can look at it from a traditional Chinese medicine theory perspective and say, okay, here are the different aspects or the different functions that aren't working in the body. And then what's cool about that is that then you start to look at, for example, somebody that has POTS. Well, we know that there's different mechanisms that cause that. And if somebody's having excessive surges of noreprinephrine, that would be a very different treatment strategy than somebody that has a hypovolemic cause for the tachycardia. And so you can start to look at the mechanisms kind of driving a POTS presentation and realize that the actual TCM approach would be completely different once you understand those different mechanisms. So the like your experience of the more you learn neurology and neuroscience, the more you see, oh my gosh, if I start to change the kinematics, if I start to work with people's like actual physical structure, it changes their brain. And same thing with me, it's like I went through this journey of learning functional neurology and then wanting to use all of these other tools, like the eye and the head eye vestibular rehab and you know, peripheral nerve stimulation. And then after learning all of that and playing with all of that, I come back to the power of, oh, well, what happens if I just stick an acupuncture needle right here? Oh, look, look at look at what changes. And so it's like I had to almost like set aside what I had known and go learn all this other stuff in order to come back to what I had learned in originally and then integrate it all together.

Dr. Nate Keiser 23:20

Yeah. I think that's a really good, I think that's a good message for a lot of people learning just in general. Um and I think that's that's wonderful. It's it's interesting to me. Um so Chinese medicines are actually a really Really interesting thing in in terms of its relationship to Western medicine. But more importantly, it's like maybe not Western medicine as much as like just neuroscience, I think you put it that way. Um is that a lot of what the language that Chinese medicine uses is very accurate in terms of how to actually think about autonomic systems because they got it's almost too generalized when you think about, well, you have a parasympathetic and a sympathetic system, and they are they're opposite to each other, they're antagonistic to each other, and you know, one is up and one is down. And it's actually a really poor way to think about it because they're really just too we name them because somebody cut someone open and said, like, hey, these these nine these nerves are all structured the same. And like, hey, these nerves are all structured the same with no relevance to the function. And actually, the people that were early on, when you look at like Canon, um, said like these are physically similar because of where the ganglion is and the type of neurotransmitters they use, but they're actually like they're they're all distributed, they're all functionally different. So the ones that are going to control blood vessels are not, they don't have the same, they're not necessarily tied to the ones that are gonna control sweating and not necessarily controlled heart rate. And so they're all have these distinct functions. And I think Chinese medicine does a really nice job of kind of explaining that that ability to be specific by using terms, you know, language, I'm gonna get the language wrong, but using the language around like congestion and things is a way to say, like, we're having two systems that should act independently that are acting together. And they shouldn't be, they should be, they should be separated. Um, and I think that I think that people have known about this for a very long time, and it's exciting to kind of talk about it in those terms, but but in in Western medicine, we've made it really gross in that like we only think about we think about them as the antagonistic. So if I want, you know, you mentioned narpinephrine, if I want my my heart rate to come down, I need to do something that's parasympathetic. Those two things don't even don't even matter. They're not even correlated in that way. If I want to change my blood vessels, your blood vessels have in your body have like zero parasympathetic innervation at all. Um, so they're not related. But unfortunately, because of the way people think about it as one versus the other, a lot of the at least the conversation around how to solve them is in that language, which is which really prevents people from being able to do a lot. Um but I think the language that pre-existed was was probably more useful.

Dr. Ayla Wolf 26:13

Yeah, and I think it allows me to pick up on some things that uh again, knowing both, knowing the information on both sides has helped me to understand why would a patient say that they feel really, really hot, but their skin feels cold. And in Chinese medicine, you know, we talk about all these concepts of like either buried heat or what we call like a yin deficient heat versus an excess heat. And again, it's like you use different treatment strategies based on whether someone's got just an excessive amount of heat or if they have more of a deficient heat and maybe that's trapped somewhere and it's and it and it gets gets back to this idea of the patient can't regulate the open and closing of their pores. And so they might have different sweating irregularities, but it's like once you understand the underneath that, what's causing it, then you can have the right treatment strategy. And so we talk a lot, like Chinese medicine focuses so much on temperature and on the difference between phasomotor versus secretory secretomotor functions and being able to differentiate between flushing and redness versus sweating or not sweating and there's different herbal combinations that kind of address all those subtleties. And all of that gets completely missed when you just kind of pharmaceutically try to come in with a physiological hammer and just shove the system one direction.

Dr. Nate Keiser 27:36

Yeah, and that's been a big, it's been unfortunately a big barrier as we try to understand, not understand, but try to help people because the physiology that's wild. So we we have we've been really lucky to test multiple people looking at they'll come in with either meds on or off, and we'll we'll run through our battery. And then sometimes we'll see that and be like, for example, somebody comes in with meds off and they're and they're like, ah, I could like to see what they look like on. And the things they that you would expect based on, you know, kind of the the label on the box, it is amazing how often that's not what's actually happening in the physiology. So I'll give you an example.

Dr. Ayla Wolf 28:19

Interesting.

Dr. Nate Keiser 28:20

Like I we had one person that was on she was on midadrin. Midadrine. I don't know how to say it, everybody says it differently. But it's basically a medication that should just rather than you controlling beat by beat what the vessel tone is, it just makes it more constricted. Just hold. And when it does that, it's supposed to increase your blood pressure. And if your blood pressure is increased, then it should translate into more blood flow in your brain and you should feel a little better. And so we did that with her, and we looked at the blood flow, the amount of blood flow that she had in the brain off the midadrine. And then we looked at it with it on, and amazingly, on the midadrine, the cerebral blood flow was worse. So it was like you mentioned paradoxical reactions. If anything, that her blood pressure is going up, but the actual response that's happening in the brain was fully decoupled from that, right? And so if you don't measure it, you have no way to know. And so she's taking this medication thinking like it should be helping my brain get more blood. She's looking at her blood pressure, and her blood pressure is higher, but the amount of that that's actually transferring to her brain is less. So the overall volume is less. So yeah, things like that are amazing. But it is the it is the lowest friction solution for a lot of people, both in terms of like it's easy because you just pop it in your mouth, but also because it's what available, it's what third-party payers will pay for. Um, and so that is like overwhelmingly what people are being exposed to. And unfortunately, I think in a lot of cases, um, we're just it's like a swing and a miss altogether.

Dr. Ayla Wolf 30:05

Yeah. And it seems to me like more and more when people come into my office, the the they're parroting their doctor saying is, well, my doctor said I should just try this. They're not really sure if it's going to work or not. But they said, here you can try it, you know. And it just comes back down to like there is no protocol.

The POTS Roadmap And Next Steps

Dr. Nate Keiser 30:23

Yeah, let's try stuff, unfortunately. But I think if if we can, if we can the wonderful thing about the exposure to information right now is people can get a much broader swath of information. That's why we get to do this. And I think if we can shift people toward thinking about like what is the underlying mechanism as a like a core driver of what I'm gonna do, then I think um I think people will start to trend toward things that are like that are more helpful, that are, that have more of a positive outcome over their lifespan rather than just in those little epochs of time where we can kind of manipulate chemistry. So I'm really hopeful for that. And that's obviously why we we spend a lot of time talking about it. We built um, we call it, it's a pot's roadmap where it just kind of gives people like all the steps of like where, if you were starting from the beginning, what things would be useful to check, which things would be useful to talk to your doctors about, how do you move through that in a in an organized way rather than having to feel really chaotic and like I'm pulled in all these different ways, so that people can kind of like structurally start to look at what's going on here. And that's been something that seems like people are really responding to as a way to just like figure out how to nab it. Where do you start from is a big question for a lot of people.

Dr. Ayla Wolf 31:41

Yeah, and I really do see a growing number of comorbidities between autoimmune disorders and dysautonomia, and I feel like those numbers are just skyrocketing.

Dr. Nate Keiser 31:54

Yeah. Well, they have to, because they're both governed by the same system. So um the same way the auto immunity levels are gonna go up, the amount of difficulty with digestion is gonna tend to go up, the things you are sensitive in your life are gonna go up, your ability to control your hormone regulation is going to be impaired because all of these feedback loops require a brain that can feel what's going on in here and what's going on out there accurately and generate a motor response. And and I think we s we skip that a lot in terms of trying to understand the way that those systems work.

Dr. Ayla Wolf 32:35

Yeah. So anything that we haven't talked about that you wanted to touch on today.

Dr. Nate Keiser 32:44

Maybe for another time. No, I really appreciate you, Sharon. And it's always I always enjoy hearing about the acupuncture side of the world because I think it converges more than it diverges, so it's really helpful.

Dr. Ayla Wolf 32:56

Mm-hmm. Yeah. Well, it's been interesting and fun to just really mill merge what I've learned through the Carrick Institute and Dr. Carrick and and this functional neurology approach. So it's a it's a whole kind of new frontier of neuroscience meets uh Chinese medicine.

Dr. Nate Keiser 33:15

It's great. Keep going. Let's keep doing it.

Dr. Ayla Wolf 33:18

Yeah. Well, uh, yeah, I think uh we'll we'll have to do uh a round two here at some point in the future.

Dr. Nate Keiser 33:24

I'd be thrilled. That sounds great.

Dr. Ayla Wolf 33:26

Awesome. Well, where can people find you?

Dr. Nate Keiser 33:29

Um if you search my name, it's pretty easy to find. The last name is spelled K-E-I-S-E-R, and that can be tricky. But Doc Kaiser on most things like D O C K-E-I-S-E-R. And we put a lot of stuff out on YouTube and just try to help people and give you some things to think about, research that comes out, and just keep people posted on opportunities to to know more, learn more, be able to help themselves out of out of a bad spot.

Dr. Ayla Wolf 33:54

So yeah, excellent. Well, and your clinic is in an adorable little town in Chelsea, Michigan. So you got a great space there.

Dr. Nate Keiser 34:04

Thanks. Yeah. It's it's wonderful. We've got a great team. We are are super blessed, and we're always trying to pull more people into that team. So just be aware of that world. And um, yeah, we'll keep we'll keep going.

Dr. Ayla Wolf 34:18

Awesome. Well, thanks so much. I'll put all that in the show notes so people can find you.

Dr. Nate Keiser 34:22

Well, thanks. I appreciate that. It's great to talk to you again.

Medical Disclaimer

Dr. Ayla Wolf 34:25

You too. Medical disclaimer. This video or podcast is for general informational purposes only and does not constitute the practice of medicine or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and materials included is at the user's own risk. The content of this video or podcast is not intended to be a substitute for medical advice, diagnosis, or treatment, and consumers of this information should seek the advice of a medical professional for any and all health related issues. A link to our full medical disclaimer is available in the notes.