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Back to Back, One Month MD Podcast
Back to Back, One Month MD Podcast
Hosted by Dr. Mark Moran, this podcast dives into the fast-paced world of medicine, education, and personal growth. Each episode features insightful conversations with expert guests, sharing knowledge, experiences, and the mindset needed to excel in healthcare and beyond. Whether you're a medical professional, student, or lifelong learner, tune in for inspiring discussions that keep you moving forward—back to back.
Back to Back, One Month MD Podcast
Injury Prevention: Stories and Tips
Unlock the secrets to cutting-edge pain management with Dr. Kevin Barton from the Texas Spine Clinic. Discover how groundbreaking interventional radiology procedures are addressing knee arthritis and plantar fasciitis, and explore the fascinating world of scrambler therapy for peripheral neuropathy. We'll guide you through the innovative treatments that are transforming lives, including spinal cord stimulators and the potential of angiogenesis in healing. This episode promises a treasure trove of insights into modern medical advancements and highlights the often-overlooked importance of proper body mechanics to prevent everyday injuries.
Our conversation takes a deep dive into the common causes of back and neck pain, offering practical advice on avoiding injuries from lifting luggage to navigating the perils of holiday travel. We emphasize the differences in treatment approaches between chiropractors and physical therapists, advocating for conservative methods as the first line of defense against pain. For those with more life experience, the gradual reintroduction to physical activity is key, and we share humorous anecdotes and personal stories to make these valuable lessons resonate with our listeners.
Dr. Barton and I also tackle the challenges posed by insurance companies and their impact on patient care. Despite these hurdles, we remain committed to innovation and patient education, advocating for better options beyond surgery. From angiogenic embolization to exciting developments at the Texas Spine Clinic, we offer a glimpse into the future of medical treatments. With a mix of humor and heartfelt stories, this episode invites you into a world where collaborative spirit and shared knowledge strive for the best possible patient outcomes. Join us as we explore these transformative topics and more.
Thank you very much for joining us. This is Dr Mark Moran. We are here to help you understand what's going on in your life, with your pain with your back and anything else we can help you with as far as community involvement. This is my good friend. What's your name?
Dr. Kevin Barton:You know, I'm actually really bad about that. Somebody I've known for 15 or 20 years and I'm like I stumble with their name when I get put on the spot. So yeah, Kevin Barton, I'm a chiropractor. I've known, uh, Dr Moran. For how long we've been with each other like 10 more than 10 years.
Dr. Mark Moran:Yeah, it's a long time.
Dr. Kevin Barton:Yeah, a long time but we both still look young. Well, I hope so that's good.
Dr. Mark Moran:It's been a long time it has been, it's been very good friend helped me out a lot, yes, so I appreciate that. Oh, anytime so anyone that has problems that needs a chiropractor go see Dr Barton. He's a good guy. He'll take good care of you.
Dr. Kevin Barton:Absolutely.
Dr. Mark Moran:Okay, next, we've got to give a shout out to the wonderful people that are letting us use this room. If your needs, go to Hapathy and they will take good care of you. And the other shout out I want to do is for Toolbox Studios. They helped me with my website and all my marketing. Both of them are very good marketers. Please use them.
Dr. Kevin Barton:Sounds good.
Dr. Mark Moran:There you go, so what have you been up to?
Dr. Kevin Barton:Man a lot. We have been through some serious transformations. You have 15 seconds. Yes, that's pretty fast. I might be able to do it all in about 15 months.
Dr. Mark Moran:Do we have that much time? Can you maybe give me just high level summary?
Dr. Kevin Barton:High level summary yes, so we did a little transition with our main practice and brought in an interventional radiology group to start doing interventional radiology procedures.
Dr. Kevin Barton:So we are doing anything from knee arthritis treatments through a vascular approach to frozen shoulder syndrome, plantar fasciitis, so we're doing a number of musculoskeletal type vascular procedures, which is cutting edge. Super brand new came out of Japan. A guy in Japan started it about 15 years ago and it's just kind of made its way to the States in the last seven, eight years. Awesome stuff. We'll talk more about that some other time, but uh, so that. And then we started a brand new therapy with our chiropractic office called scrambler therapy.
Dr. Mark Moran:Scrambler, scrambler. What a name Like a breakfast taco at Benny's or something.
Dr. Kevin Barton:Yeah, More maybe like scrambling the brain. No, in a good way I like it. Yeah, we'll talk more about that. We have to talk about that tonight okay, super exciting.
Dr. Mark Moran:I will definitely talk about scrambling.
Dr. Kevin Barton:I just like the name yeah, it's super cool, it's catchy. Okay, you'll remember it. You'll be like do I have? Peripheral neuropathy.
Dr. Mark Moran:Oh, I heard something about scrambler therapy yeah, so I will not ever forget that yeah, okay well, last time we saw each other, I remember you were expanding to other cities and about to take over the country well, that was the intent, and then, apparently, the insurance companies had other ideas.
Dr. Kevin Barton:Oh, and so they went through this in 2022, a 60 cut in those gel injections that we do for the knee, and they literally just squashed our reimbursement. So bad that we were like, but on the brakes.
Dr. Mark Moran:And then that's when we brought in the intervention let me get this straight you have problems with insurances well, every day, all day long, because that's the life I live I understand, I feel your pain and I'm a pain doctor it's a oh man, that's like a double.
Dr. Kevin Barton:I know I understand what you're. You should have no pain, since you're a pain doctor.
Dr. Mark Moran:I personally don't have pain, but dealing with the insurance company is frequently painful because they limit things we can do for our patients.
Dr. Kevin Barton:Well, you know, I say I never really understand how insurance companies get away with practicing medicine without a license, right, I mean, that's the truth. Oh yeah, because they're dictating the care 100%. Yeah, and then we'll see crazy things like a pediatrician giving recommendations for a pain procedure or an interventional radiology procedure. I'm like what in the world that's?
Dr. Mark Moran:because you're thinking logically Exactly.
Dr. Kevin Barton:You can't do that, throw that out the window.
Dr. Mark Moran:Throw it out the window.
Dr. Kevin Barton:Because any time you're dealing with an insurance company, not much is logical.
Dr. Mark Moran:Clearly, I agree, yeah, I agree, okay, so, anyway, so good to have you on.
Dr. Kevin Barton:Yeah, thanks for coming on Well. Thank you, I feel honored to be here.
Dr. Mark Moran:Well, I'm honored that you're here. Well, good, it's good, it's good, so I'm going to put you on the spot.
Dr. Kevin Barton:Yes, so everyone to know you a little bit. Sure, teach me the most exciting thing that you ever did in your life, the most exciting thing I've ever done in my life.
Dr. Mark Moran:I mean because you've got a lot of exciting things.
Dr. Kevin Barton:I do a lot of exciting stuff. I am a bit of an adrenaline junkie to some degree. I I fly a lot of airplanes. I've been flying airplanes for 25 years. Um, probably the most exciting thing was learning how to fly helicopters during okay, covid.
Dr. Mark Moran:Okay, so I remember you're doing that. Yeah, I had a lot of time on my hands.
Dr. Kevin Barton:I had always wanted to do it and I was like I'm gonna get my helicopter license. And I, I did that, bought a few helicopters and I mean there's enough.
Dr. Mark Moran:In my opinion, nothing more fun than flying helicopters almost nothing okay, so you fly multiple helicopters, but you're still late to get here.
Dr. Kevin Barton:Well, I mean, unfortunately they don't really let us land these things anywhere.
Dr. Mark Moran:Oh, you can't land on top of the building.
Dr. Kevin Barton:No, they tend to frown on that.
Dr. Mark Moran:That would be great if you could do that.
Dr. Kevin Barton:Without permission, at least.
Dr. Mark Moran:I'm giving you a hard time. That's awesome. I thought it would certainly be like swimming with the sharks.
Dr. Kevin Barton:I do like swimming with sharks. That's pretty fun too.
Dr. Mark Moran:Oh, I'll tell you, I did have an amazing experience.
Dr. Kevin Barton:recently, I spent a month in Southeast Asia by myself. Wow, and it was a phenomenal trip. Started in Singapore, went to Bali, but I spent two weeks on a liveaboard dive boat and dove four times a day Tons of sharksons, of manta rays. If you've never seen a manta ray in real life, let me tell you. It's unbelievable. The span was like 15 feet On one dive. We saw over 30 manta rays on one dive. It was insane. Okay, so that was really cool.
Dr. Mark Moran:Well, I went to Chick-fil-A last night, does that count? For anything that's not super exciting, is it though? I think it is.
Dr. Kevin Barton:Yeah, certainly probably not as exciting as you, I mean.
Dr. Mark Moran:Merrill diving Asia.
Dr. Kevin Barton:Chick-fil-A. It's all relative. It's all relative yeah.
Dr. Mark Moran:I knew you'd have a more exciting story than I would have.
Dr. Kevin Barton:Sure, okay, well, thanks for sharing that.
Dr. Mark Moran:I appreciate that. So what we're doing here is we want. We want to try and help people out, educate them, because knowledge is power.
Dr. Kevin Barton:Yes.
Dr. Mark Moran:Okay, we want them to be active participants, not passive recipients, in their health, absolutely. So we want to empower them with knowledge so they won't hurt themselves, and then they don't come see us.
Dr. Kevin Barton:No kidding, we're trying to prevent them from coming see us Absolutely.
Dr. Mark Moran:Right. So can you tell me and our viewers appreciate that some examples of common things you see during the wintertime, the holidays coming, and what people can do to help prevent those injuries? Teach me something and then I'll teach you something Absolutely.
Dr. Kevin Barton:I think of two things when I think of Christmas. I think of unnecessary falls off ladders from putting up Christmas lights.
Dr. Mark Moran:That's what I was going to say. Seriously, yeah, yeah, people reaching to the side.
Dr. Kevin Barton:Oh man, I can't tell you how many people had a, really bad injury like obviously a femur fracture or something worse, hip fracture, and then, of course, they tend to injure their spine simultaneously, and so they're coming to us for their spine problem, but the injury was really much worse in terms of fractures and things like that. So that's top of mind. Number two would probably just be lifting, lifting heavy boxes for this or that. My big thing as far as teaching patients and education is don't lift and twist at the same time.
Dr. Kevin Barton:Lift and then turn your hips and turn your legs and turn your body, but don't lift and twist at the waist, because that's how we shear. That shearing motion on the disc is what hurts the disc under compression. So a compressive load with the shear is how a lot of people rupture the disc.
Dr. Mark Moran:Right, and the example I see of that is when older people, or I'll say people with more life experience, go to see their families and they bend down to pick up a grandkid and then they lift and twist the kid up like that, absolutely. You see, that all the time? Yes, the other thing I see is luggage. When you're on a flight, what do you do? You lift your luggage up and try to put up a thing and you get herniated disc or you can tear your shoulder.
Dr. Mark Moran:Yeah, exactly, literally. Yeah. I have one patient who bent over to get some casserole or something out of the fridge and he sneezed at the exact same time. So he was bent over and then increased his pressure in his abdomen and just came up with a horrible bulging disc.
Dr. Kevin Barton:Terrible, horrible, terrible, horrible.
Dr. Mark Moran:Terrible. So certainly the ladder thing where you go off to the side is very, very concerning. Don't get on ladders, they're very dangerous.
Dr. Kevin Barton:They are very dangerous.
Dr. Mark Moran:They lose balance. You'll fall. It'll fall on you. You'll hurt yourself.
Dr. Kevin Barton:I tell people that all the time Stay away from ladders.
Dr. Mark Moran:I know I often think I should advertise on ladders.
Dr. Kevin Barton:Well, that might be helpful. We might drum up some business that I put a stamp above the third step and say above this level, get ready to call Dr Moran. Literally.
Dr. Mark Moran:There you go. So I get that one, I get the lifting thing.
Dr. Kevin Barton:I get the the castrol thing.
Dr. Mark Moran:The other one I get a lot is people that travel. They stay in hotels or foreign beds and they get cervical neck pain, absolutely. The beds aren't very comfortable or it's just sitting down a long time. They get a lot of SI joint pain.
Dr. Kevin Barton:No kidding, a lot of back pain like that. Do you see that? A lot too I do, thinking of just changing beds and changing pillows. I know me personally, you know I mean it's. Everybody thinks it's really funny when a chiropractor has their own back and neck pain. But I suffer from it too, just like everybody else. You know it's like your neck, your body gets used to a certain thing and then when you? Switch it up. It's like, oh, why is my head elevated so much?
Dr. Kevin Barton:and then you know you wake up with a crick in your neck, or your neck super tight, stiff, all you know it's very common?
Dr. Mark Moran:yep, I get that too. I get that too. See my other list um doing new things. Your body is not used to.
Dr. Kevin Barton:I mean, you know what comes to mind there is. Everybody's getting close to the new year, so everybody is sort of thinking about okay, what's my new year's resolution? I'm going to start getting back into the gym or I'm going to start doing more activity or more walking, and they just bite off more than they should too fast, so I think they overdo it.
Dr. Mark Moran:Absolutely. I totally agree with that and my perspective is people that go skiing once a year snow skiing or snowboarding for the first time, or they get with their family and friends. They're like oh, I can do that, and they don't realize that they have more life experience this year than last year and they just do things that their muscles and tendons and ligaments aren't used to or adapted to.
Dr. Kevin Barton:And by more life experience you mean a little more time has passed, that's what I mean. They're not as young as they were.
Dr. Mark Moran:That's what I mean. They have more life experience. That's just the way I say it.
Dr. Kevin Barton:Absolutely, it is true. Everyone has more life experience every day, every day.
Dr. Mark Moran:Good, so we see the same problems.
Dr. Kevin Barton:We do, we do see that.
Dr. Mark Moran:And you have helped me out a lot with my patients, so thank you very much for all your help, yeah, and you've done the same for us. I appreciate that. But what I want to talk about now is because I have lots of patients that come in and they say what do you want to do with me? And I say, well, here's your options. Obviously, one of my first options is conservative things like physical therapy or chiropractor.
Dr. Kevin Barton:Yes.
Dr. Mark Moran:And a lot of patients.
Dr. Kevin Barton:And that makes a ton of sense, by the way. Oh, thank you. Start conservatively and work our way up. It seems pretty simple.
Dr. Mark Moran:It seems pretty simple. I'm not a rocket scientist. I don't see that every day. I'm not a rocket scientist.
Dr. Kevin Barton:Yeah, it seems pretty simple. Try conservatively, it sounds like very good medicine. Oh, thank you.
Dr. Mark Moran:I appreciate that. So the question they have is what do chiropractors do that physical therapists can't do? And they just crack my back right. So give me a quick summary of what a chiropractor can offer you and how they differ from physical therapists, and some of the advantages, or anything is sure, yeah that's a super good question.
Dr. Kevin Barton:You know, probably when I started out in chiropractic and I've been practicing for 21 years now it was probably a little different than that it is now.
Dr. Kevin Barton:Most physical therapists do not manipulate the way chiropractors do. Some do, and some have been trained in it, but they don't train every single day of their sort of chiropractic education like we do, and so in my experience they tend to not be as proficient. It is a skill, it's a very technical skill and you have to have a feeling for it, and we just have a lot more background in that. One major thing which is again very technical.
Dr. Mark Moran:So let me interrupt. When you say manipulate, you're saying that as a movement or joint type thing. Yeah, so like the situation.
Dr. Kevin Barton:Yeah, yeah, exactly. So we're saying like mobilizing the joint. So if we're mobilizing the spine because it's tight or restricted or it's stiff or it's tight, probably I mean I'm just I'm throwing a number out there, but I would say probably less than 10 percent of physical therapists adjust like a chiropractor would adjust.
Dr. Mark Moran:Some do, but not many.
Dr. Kevin Barton:So that's probably the main difference. Number two I would say in terms of what I like to do is I think every physician and every practitioner has what they really enjoy doing and seeing. I'd like to see the spine patients. I don't really want to see a shoulder patient. I don't want to deal with an ankle problem. I just have my preferences. So I want to see a herniated disc patient or this kind of patient or that kind of patient and I'm very good at the spine. I let all the physical therapists like, if I have a what I would consider a PT issue, like probably rehabbing a shoulder or certainly a post-surgical problem, I'm going to refer that to a physical therapist. I'm going to let them do what they do well, and then hopefully you know we don't get a lot of referrals from PT, but we send out a lot of referrals to PT.
Dr. Mark Moran:But what you said I think is very important is you know what you can do. Well, you know what your boundaries are and then, when you start operating outside those boundaries, you say you know what, I need some help, so let me send you to someone who's better A hundred percent. That's better for the patient. You know what that makes sense.
Dr. Kevin Barton:Well, that's good. That's good. That seems like it makes sense.
Dr. Mark Moran:I always like to go back to.
Dr. Kevin Barton:Let's do what's right for the patient. It's pretty simple. Yes.
Dr. Mark Moran:I agree with that Absolutely. Work inside your wheel well, know what you do, do it well. Take care of the patients first. If you can't do it, there's nothing wrong, say you know what? Let me send you someone who's going to do a better job. Absolutely. I do that all the time. 100% Appreciate that, okay. So I cannot wait to hear about scrambled eggs.
Dr. Kevin Barton:I'm pretty good, cook gets come, oh really.
Dr. Mark Moran:Yeah, it's something like that.
Dr. Kevin Barton:I can't remember what it was, but I know something scrambler therapy, scrambler therapy, yeah. So what I in in my career, I think we've always tried to find, like our organization, we've always tried to find the really neat treatments that, or really, yeah, really neat treatments that, um, we don't feel like are well treated in the medical profession in general, and one of those things is like peripheral neuropathy. I mean how hard like how hard is it to treat peripheral neuropathy?
Dr. Mark Moran:It's very hard.
Dr. Kevin Barton:It's very hard.
Dr. Mark Moran:It's very hard, it's a very common problem. Especially in San Antonio.
Dr. Kevin Barton:Especially in San Antonio, because one of the biggest causes for peripheral neuropathy is diabetic neuropathy. Uncontrolled diabetes leads to nerve damage.
Dr. Mark Moran:And there's a couple of people with diabetes in San Antonio, one or two I think, maybe, maybe.
Dr. Kevin Barton:And so you know, traditionally speaking, we have some medications that Usually it's medicines can work pretty well. But when they don't, what are our options? So, from your perspective, how do you treat?
Dr. Mark Moran:peripheral neuropathy. Usually it's medicines. Because, it's peripheral problem, it's vascular. There's not a the blood vessels so usually it's medicines for peripheral neuropathy.
Dr. Kevin Barton:Yeah, and so people will try things, some physical therapy type approaches. They'll try some home remedies. There can be some nutritional aspects, you know. So obviously we want to treat the underlying problem that's causing the neuropathy. But once those things have been treated, you know, unfortunately once the damage has been done, you're not typically going to reverse those changes, and so what scrambler therapy does is it's actually treating the neural pathway to the brain. So we are literally retraining the brain to understand that this machine generates this signal. It's, it's quite complex. There is there's 16 algorithms that runs through this code. That so it's basically. This is an electro analgesic device.
Dr. Kevin Barton:So think about this like a.
Dr. Mark Moran:TENS unit.
Dr. Kevin Barton:So the analogy that our trainer, the guy that came in and trained us on this thing, he said you know, it's kind of the difference between a Volkswagen bug and a Tesla. Okay, yeah. So you know, Teslas have an amazing ability to drive themselves and they do all this advanced stuff. Are they the same thing? I mean sort of, but I mean obviously one's way more advanced than the other. So this machine generates a synthetic signal to replace the existing painful signal. So it's replacing the previous painful signal with a no pain signal.
Dr. Mark Moran:It's scrambling the pain signal.
Dr. Kevin Barton:Literally scrambling the pain signal with a no pain signal. It's sending this new message to the brain and how the brain works over time it retrains the pathways to the brain and the neuroplasticity improves with time. So this is sort of like. The analogy we give is how do you learn a foreign language? So it starts out with a few words, which turns into a few sentences, which turns into some phrases, and the more you do it, the more you learn and the faster your brain learns it and figures it out.
Dr. Kevin Barton:So same principle with neuroplasticity of learning a new pathway, and so eventually we want the brain to recognize this no pain signal as the normal signal. And so where, with a TENS unit, you're always placing the pads on the painful part of the body where the scrambler therapy, we're actually placing this on good neurons. We're actually placing this typically proximal or in front of where all the damage to the nerves are so like on the thighs?
Dr. Kevin Barton:yeah, so if had. Usually it's about two finger widths from the problem area. So if they had peripheral neuropathy in their feet, we'd actually place the pads about two finger widths away from the problem.
Dr. Mark Moran:So like ankle, yeah, really close to the problem.
Dr. Kevin Barton:But where the problem? Where the neurons are still good, where the nerves are still sending a proper, good signal. So then we start overriding that signal to the brain. And this is how we treat peripheral neuropathy. So over time. So this was invented in Rome by a guy named Giuseppe Marineo.
Dr. Kevin Barton:And he invented the scrambler therapy like 20 years ago, but it was FDA approved in 2009 in the States. So he sent some machines to the States to so they could study it. So, uh, most of the studies have come out of Johns Hopkins university. It got him Dr Smith there. He's in the pain department. He's a anesthesia pain guy just like you, so they use this extensively to treat all kinds of neuropathic pain. So we are just sort of getting out the peripheral neuropathy word but to CRPS, phantom limb pain.
Dr. Mark Moran:Yeah, crps, any neuropathic pain, any neuropathic pain literally any neuropathic pain.
Dr. Kevin Barton:So we saw some amazing results on some patients just this week. So this is our first week of the machine, so we're just kind of getting started with it. But so one of the very first patient peripheral neuropathy patient, diabetic neuropathy feels like he has sponges on the bottom of his feet the typical yeah, numbness, right, His burning pain's about an eight at night, and so when he came into the office he complained of a pain score of about a six. Well, obviously, with the numbness and the spongy it never changes. He has very difficult time with balance due to proprioceptive loss, so he has a hard time just walking. So we watch with the cane.
Dr. Mark Moran:So he has a sensation in his feet like proprioception. I'm just saying yes, exactly. So he doesn't feel where his feet are, so he gets a lot of goosebumps, exactly.
Dr. Kevin Barton:So we hook him up to the scrambler therapy, we start treating them and the amazing thing about this treatment is patients see immediate results. So patients that have been in pain, so this guy's been in pain since 2015. And for the first time in nine years, this guy is pain free.
Dr. Mark Moran:After one treatment, during the treatment and after, but I'll explain how that works.
Dr. Kevin Barton:So the whole goal with each treatment is to zero the patient's pain.
Dr. Mark Moran:Okay.
Dr. Kevin Barton:Like you, literally zero it out. So you scramble the bad signals, scramble the bad signals, override the synthetic new signal, send that to the brain, brain starts picking up the new signal as the normal signal and the patient's pain literally melts away in just minutes.
Dr. Kevin Barton:So then they're zero pain and he's like you know what? I can feel my feet, I can literally feel. So the first time in nine years I literally feel like I have normal feet, like I can feel the ground. So he has his shoes off and his socks off, so he can literally feel the floor. So after the treatment we take everything off, he stands up and he starts walking without his cane. And I had to, I had to, like, hold him as he stood up. I'm sure he was nervous, yeah, and so during the treatment, before it's it really started helping him. He was his, his balance was terrible. As soon as the treatment was over, he stood up, he started walking and wasn't even using his cane, that's right, it was unbelievable.
Dr. Mark Moran:I've never seen anything like it.
Dr. Kevin Barton:And then we saw another lady that was an amputee that had phantom limb pain and just terrible pain. Again, zero pain.
Dr. Mark Moran:And how long is it on?
Dr. Kevin Barton:Yeah, so the first guy got relief for four hours, zero pain for four hours, and when his pain did come back, it was less, it was about 20 to 30% less than it was.
Dr. Mark Moran:So he came in and he was better today, trending in the right direction.
Dr. Kevin Barton:Same with the other girl, but she had a little less timeframe that it felt better. So maybe, um, I think it was maybe 45 minutes to an hour, okay. And then she comes back in today and she was. I mean you, you know, you see people in pain every day. You know it's like you could tell she was hurting. I mean she rated her pain scale a 9 out of 10, and it was visible in her face Like you could tell it wasn't a good day.
Dr. Mark Moran:I'm sure it was worse than normal because she had this relief, yeah, and she forgot how bad it hurt. Yeah, exactly so then when that rebound pain comes back, it's much worse. It can be worse, totally get that.
Dr. Kevin Barton:Yes, so she sits down and within three minutes of her being on the machine, we zero her back out and then she feels amazing and she leaves smiling and happy.
Dr. Mark Moran:So what the?
Dr. Kevin Barton:expectation is is that each time we do the therapy, we get a little longer pain relief and eventually we're going to break through to where we get more than 24 hours of relief, and then days of relief, and then months, years or longer, and so some patients will go through maybe three to five sessions and that's it and that's all they need. Or some patients might go through 10. Most patients are going to go through 10 or less treatments. It's incredible. I've never seen anything like it.
Dr. Mark Moran:I mean it?
Dr. Kevin Barton:was literally almost miraculous.
Dr. Mark Moran:You're scrambling my mind just thinking about it. I don't even know how to describe it.
Dr. Kevin Barton:I mean, I think it's a pretty fitting name. So I'm getting to go to, uh, rome, at the university of rome, oh, in january I'm sorry it's terrible. I mean I look for any excuse to like travel and do fun stuff, but uh get to go meet giuseppe marineo the inventor and train with him in the hospital, uh, and literally like treat patients with him yeah so it's going to be a fantastic week so then we'll have to have you back on. Yes.
Dr. Mark Moran:And all of our viewers can see how the training goes.
Dr. Kevin Barton:Yes, the training's progressing. That's great.
Dr. Mark Moran:I had a similar patient with CRPS, which is a bad nerve problem. People know it's a horrible nerve problem in her arms and we did a spinal cord stimulator. And the point is when she came back and she had the trial she literally ran and jumped in my arms and almost knocked me over because she said I have my life back.
Dr. Kevin Barton:Yes.
Dr. Mark Moran:It seems like very similar to what you're telling me Exactly yeah, incredible, and what else could you want as a doctor?
Dr. Kevin Barton:I mean, that's why we're here, to help people. Yeah, it's the most Absolutely.
Dr. Mark Moran:Especially to that significance of nine years of having spongy feet and pain and everything. It's all the things they don't tell you. But you know, comes with it, the sleeping there their energy goes down. They're feeling bad because they're not doing things with their family or friends.
Dr. Kevin Barton:I mean, this was the second girl I was mentioning that had the amputation. It was a crazy story. So she was 30 years old. Um, get first day on the job as a police officer, get shot with an ak-47 oh really and it blew out so she had partial cauda coena syndrome thanks to all the policemen out there and firemen yes, first responders.
Dr. Mark Moran:Thank you so much this told me story no one would ever know. Does he literally yeah?
Dr. Kevin Barton:just terrible, terrible situation. And, uh, she's lived with pain ever since 16 years.
Dr. Mark Moran:She's been been miserable.
Dr. Kevin Barton:How old is she? Yeah, oh, young, she's like 46. Yeah, yeah, you know, younger than us.
Dr. Mark Moran:Can we delete that part out? So thank you for doing that. That's great that she can. She can have that back and these guys with their peripheral neuropathy are feeling better. That's awesome.
Dr. Kevin Barton:It's fun. That's very good. I love doing stuff that is just life-changing for patients.
Dr. Mark Moran:Yeah, absolutely, and it's good that you're on the breaking edge and trending up and trying to learn new stuff.
Dr. Kevin Barton:I think that's great, very good.
Dr. Mark Moran:I should have known you were going to tell me something crazy like that Always building, pushing boundaries.
Dr. Kevin Barton:Always.
Dr. Mark Moran:That's good. Yeah, that's why you're so successful. Maybe I should take lessons from you. Cool, what else? Do you have any other stories to tell me?
Dr. Kevin Barton:Well shoot. What do you want to learn about? Well, first we have to have a word from our sponsors.
Dr. Mark Moran:Okay, let's do it and we're back. Okay, go ahead and tell us this other story.
Dr. Kevin Barton:You want to talk about something medical, something interesting.
Dr. Mark Moran:Whatever, something we can teach the viewers, okay, the viewer.
Dr. Kevin Barton:So another really fascinating thing we're doing, and I don't think a lot of people I mean. How much interaction did you get with interventional radiology when you were in medical school?
Dr. Mark Moran:No none.
Dr. Kevin Barton:Or in residency. Very little, very little, probably any. So when we talk about these interventional radiology procedures, most doctors even you know high level physicians like I would consider. Obviously you're a specialist, so you typically know more than you know, some doctors for sure and um, they just it's like you're looking through somebody and they just don't even understand and don't even get it. So there are some new musculoskeletal, vascular procedures to treat. We're going to talk about a big fancy word here called angiogenesis.
Dr. Mark Moran:So, angiogenesis.
Dr. Kevin Barton:So for those of you who don't know and I've never heard this, probably not many, I didn't even really understand this until I really started studying it. But basically what happens when someone is injured, our body grows vessels, new blood vessels to compensate for the injury, to basically send in oxygen, to send in blood, to get things to start healing properly.
Dr. Mark Moran:You need oxygen and blood to heal.
Dr. Kevin Barton:Yes, I learned that in medical school.
Dr. Mark Moran:Oh, thank God, you do need oxygen and blood to heal. Yes, and if you?
Dr. Kevin Barton:don't have that. Obviously things heal a lot slower. So it's our body's natural defense mechanism.
Dr. Mark Moran:So it's like sending out an SOS. It's why discs have a hard time healing.
Dr. Kevin Barton:Yeah, no blood supply.
Dr. Mark Moran:There's not a lot of blood supply, yeah.
Dr. Kevin Barton:So spinal discs are avascular Right and then when they get hurt it just tends to get worse from there.
Dr. Mark Moran:There's not.
Dr. Kevin Barton:Exactly so. The same, the same goes with arthritis. So cartilage has very poor, if any, blood supply, so it's almost an avascular structure like the disc. And so when we injure the cartilage, especially at a young age, like maybe an ACL tear or a meniscus injury, it's sort of downhill from there. But patients may not experience symptoms for a long time.
Dr. Kevin Barton:But these angiogenic blood vessels are developing, the new blood vessels, yeah, and so they're new and they're somewhat abnormal to a degree because little tiny nerve endings get in there as well. So this is called neovascularization. So there's a nerve ending with all these new blood vessels and the problem is a lot of these blood vessels are new, they're immature blood vessels and they leak fluid into the joint. So it causes an inflammatory response and then it triggers cytokines and this starts a vicious cycle of inflammation and pain and inflammation. So when we start out early in the disease process, when we have mild arthritis, things tend to work okay, like ibuprofen, motrin, aleve, but it's able to overpower the effects of the angiogenesis because the inflammation is sort of mild. Sure, then we progress to okay, that doesn't work anymore.
Dr. Kevin Barton:So the next thing would be maybe steroid injection. Steroid injection is a little stronger than the previous stuff. So that tends to work okay for a while. But then what do you do after? You have knee injections for arthritis and then nothing else works. There's always been this gap in the paradigm between what do you do after knee injections. You typically have knee surgery, and it's a big step for a patient, especially if they're younger, like maybe 50 or maybe 60. And they're like I'm just not quite ready for a knee replacement. So there's never been a stopgap in between until now. And so now what we do is we attack that source of inflammation by going in and treating those angiogenic blood vessels. And it's really simple we just go in through a femoral approach, go in through the blood vessel track a little tiny micro catheter under x-ray guidance. We have a vascular package on our C-arm.
Dr. Kevin Barton:And so we see all this under x-ray guidance. Inject a little contrast. There's eight blood vessels that supply the knee joint. They're called the genicular arteries, so the procedure is called a genicular artery embolization. So what we're doing is we're blocking the blood flow just to the angiogenic blood vessels, not to the main arteries.
Dr. Mark Moran:So we want to leave the main arteries to the people, so to the new blood vessels that are there from the injury, that's right.
Dr. Kevin Barton:So the ones that are responsible for the inflammation and pain. So we take care of those. We knock those out by injecting these little tiny. We call them like particles of sand. They're actually made of like gelatin, the little flexible, tiny balls.
Dr. Mark Moran:They're not.
Dr. Kevin Barton:They're not microscopic, but it basically clots off the artery. So as we stop blood flow to that, all those vessels and those nerve endings that are causing a hypersensitivity of pain and causing your pain threshold to go down, making things that wouldn't normally be painful painful, we knock all that out and patients get better fast. So they'll get better in usually about three to five days and start seeing big signs of improvement, and they may get years of relief.
Dr. Mark Moran:Yeah, that's great.
Dr. Kevin Barton:Years plural. I mean it's unbelievable from a 30,. It takes us anywhere from 30 minutes to an hour to perform the procedure. It's unbelievable, I mean it's almost as cool as the scrambler therapy.
Dr. Mark Moran:I like the scrambler therapy.
Dr. Kevin Barton:I like the scrambler therapy, yeah, and is that covered by insurance? So the vascular procedure, yes, covered by most insurances, the scrambler therapy, unfortunately not governor insurance cash procedures, but still amazing.
Dr. Mark Moran:Yeah, still new, yeah, still new. Okay, well, you're definitely cooler than me.
Dr. Kevin Barton:I mean yeah.
Dr. Mark Moran:I noticed you didn't say no, always have been, haven't I? No, no, I'm not. That's what I'm expecting. You didn't say anything. That's okay, very good. Anything else you want to tell us or teach us our viewers?
Dr. Kevin Barton:You know, I mean I love what you're doing. I think it's amazing that you're spending time to educate patients. I think one of the hardest things in medicine today is, you know, back to those insurance folks. You know a lot of people think doctors make a ton of money and I mean there probably are some physicians out there who do well, but reimbursements are actually quite low for what we do. I think and the risk that you take.
Dr. Kevin Barton:I mean you're putting a needle into someone's spine, I mean a millimeter sometimes from somebody's spinal cord. That could be very precarious if you didn't know what you're doing, obviously. And you do this for, like on a medicare patient, like less than 200, and it takes like 15 minutes to do it, which doesn't sound like that takes long, but it takes like time to turn the room over and get another patient. So I mean it's a lot less than what people think, a lot less, a lot less. So, unfortunately, what I'm getting at and the point is is that insurances don't pay us well enough to spend time educating patients. I mean, I think you, I think our office does a fantastic job educating patients.
Dr. Kevin Barton:We'll spend the time with patients, but I just don't hear it from our patients when they see other doctors. Sometimes it's like oh, he just told me I needed this surgery or that surgery and didn't explain anything and walked out of the room and said Mary, you'll schedule the other run.
Dr. Kevin Barton:And it's like it leaves patients not understanding what their condition is. I mean, I can't tell you how many patients I've seen for knee arthritis that didn't understand that knee arthritis was just simply you were losing some cartilage in the joint. They, it does no comprehension, but they nobody had ever taken the time to explain it or what all the options were, how important weight loss is for the spine or for the knee joint. You know they say for every 10 pounds you're overweight is 40 extra pounds on the knee, so it's a huge deal to just lose some weight.
Dr. Kevin Barton:So if you're 100 pounds overweight, you have 400 extra pounds on your knee. I'm sure there's a similar statistic for the spine, for the lower back. So if you're, overweight and you're putting all that additional pressure on your disc. I promise the discs are wearing out faster than they should, absolutely without a doubt, and they're well. I guess there is such a thing as a disc replacement sort of in the low back I think it works better in the neck, but less weight.
Dr. Mark Moran:Yeah, yeah, so yeah, but you're right that the problem is that medicine is becoming much more of a business than it is the art to helping people. Because of the nature of the business, you have have to generate money, because expenses are going up and people want to be seen. Did you get a?
Dr. Kevin Barton:raise when inflation went up.
Dr. Mark Moran:Did.
Dr. Kevin Barton:Medicare call you and say Dr Moran, we feel so sorry for you, we should give you a raise, because I think everybody got a raise but physicians. And it goes down and down and down. I've never seen an increase in reimbursement in 21 years.
Dr. Mark Moran:I've never. Seen it, never. And the problem is we don't get paid to educate patients.
Dr. Kevin Barton:We don't. There's not a code for that, which is probably one of the most important things.
Dr. Mark Moran:It is the most important thing.
Dr. Kevin Barton:I mean one of the guidelines in the American Academy of Orthopedic Surgery recently talked about how important educating a patient on arthritis was, and it was literally one of the key components and one of the most effective things you can do for arthritis. But I guarantee you that's not being done very well.
Dr. Mark Moran:Which brings me to my point of my online course. So I have an online course. I don't know if you know about that.
Dr. Kevin Barton:No, I did see the text where you sent out a huge text thread to a lot of people.
Dr. Mark Moran:And you were announcing. You're the only person I sent it to.
Dr. Kevin Barton:I was the lone one. No, I did see that you were making a push to do something really cool and innovative, and I've never seen a doctor do this, so congratulations.
Dr. Mark Moran:That's amazing. That's part of the problem. So did you know? I got my MBA. What, what.
Dr. Kevin Barton:What I can't say. I'm surprised.
Dr. Mark Moran:I got my MBA last year and my graduating project was come up with a business.
Dr. Kevin Barton:Nice so.
Dr. Mark Moran:I decided to come up with an online course, because right now I see patients one at a time, but on an online course I can see patients multiple at a time 24-7.
Dr. Kevin Barton:Yes.
Dr. Mark Moran:So I came up with the world's biggest cause of disability, which is low back pain.
Dr. Kevin Barton:Low back pain Shocker.
Dr. Mark Moran:So I went after that and I came up with this video course. It's called One Month MD. I can teach you everything you need to know about treating and causes and prevention of low back pain in one month.
Dr. Kevin Barton:Nice, so it's One.
Dr. Mark Moran:Month MD and we're doing low back pain causes. So it's 10 minutes a day for about four weeks and I give you Fridays off.
Dr. Kevin Barton:Well, that's awfully nice.
Dr. Mark Moran:And what I'm trying to do is I'm trying to build a habit for patients to take 10 minutes. While you're having coffee, you're relaxing, watch the videos and you can learn about the causes and treatments of low back pain, so you can be an active participant in your health instead of a passive recipient. And then you're halfway to developing a habit to using that 10 minutes instead of watching videos. It's a genius, go do yoga, I love it. Try to do some exercises.
Dr. Kevin Barton:You know, I will tell. Speaking of yoga, I will tell you. I tell patients all the time, if people would just do yoga, I mean it would put chiropractors out of business. I swear to you Like I'm a huge proponent of yoga. So if you've never tried yoga, go try it. It's amazing. You know what? If you really get into the habit of it, it's awesome.
Dr. Mark Moran:How many doctors in a small room doing a podcast will agree yoga is important?
Dr. Kevin Barton:Well, two, two out of two.
Dr. Mark Moran:Because I love yoga. I do yoga all the time. It's incredible.
Dr. Mark Moran:I did one this morning. It was actually really hard this morning and I totally agree with you. I think that after 40. I think I did yoga with your brother one time. Do you remember that? I do remember that. Yeah, that's another story for another time, but I do think it's very important. I think anyone over 40, just to mobilize the joints and get stretching and range of motion yoga is one of the easiest and best things you can do yoga is one of the easiest and best things you can do.
Dr. Kevin Barton:It will melt spinal pain away. I mean, there may still be some underlying issues there sometimes that still need to be treated, but I'll tell you, for the most part it would greatly improve well, function, flexibility, I mean a lot of things, and then the things that you do, and potentially the things that I do, would work better and last longer and they would need us less so we need to have a yoga, a yogi.
Dr. Mark Moran:We need to have a yogi on the podcast. Attention, all you yogis out there. If you want to come on, let me know, or maybe I can invite some of my friends that do yoga.
Dr. Kevin Barton:Yeah, absolutely, that's a great idea.
Dr. Mark Moran:I'm actually having a personal trainer on that does yoga, so maybe he can teach me some new stuff.
Dr. Kevin Barton:There you go, but, yes, totally agree, yoga is the key. So tell me, tell me about the course. Is this something you're going?
Dr. Mark Moran:to test people on Well a lot of times. I just encourage patients to go do it or see what they do so they can get the benefits Now do you know how much they participate in it? Yeah, we can track them, oh, we can track them, and at the end they get a little certificate and we're going after everyone. It's not just patients, it's employers, because patients with back pains.
Dr. Mark Moran:Healthcare expenses are 60% higher with back pain than without. Any employer in the country will have 15% of their workforce. Lose 10 work days a year from low back pain. Oh, I believe it so think about the revenues on that. I just did a talk for a big school district. They have 20,000 employees. So every year they have 3,000 employees that lose 10 days a year from low back pain. So that's 30,000 work days a year.
Dr. Kevin Barton:Holy smokes, that is unbelievable, and that's, I mean, the burden that is on the system is tremendous.
Dr. Mark Moran:And talk about that is. You know we do all these things. I'm kind of getting off on this Lost productivity For taking care of the students.
Dr. Mark Moran:But fundamentally, to take care of the students, you have to take care of the teachers. So they say why would you focus on investing in all the students' well-being and health, and education and strategies to train them to be a better teacher? You have to take care of yourself, right? And the example I give is when you get on an airplane. What does the stewardess say? First, put the oxygen on yourself, yes, so you can help others.
Dr. Kevin Barton:Isn't that the truth?
Dr. Mark Moran:You're taking care of yourself so you can help others. I'm taking care of myself so I can help others. Teachers need to take care of themselves so they can help others.
Dr. Kevin Barton:Well, and you've seen what fantastic guy's in you know, so it it means a lot when you go to a physician who does take care of themselves I try, I like to practice what I preach.
Dr. Mark Moran:That's right. Yeah, that's awesome, you do too, yes, very good 100 very good. So is there anything else we need to share publicly or we can share publicly? Or do you have a funny story you want to tell me? Are we just going to say enough is enough I know you have a funny story.
Dr. Kevin Barton:Funny story. Funny story Nothing's coming to mind. Well, it's almost the holidays, yeah, Leaving tomorrow. Family trip Nice, Portugal and Morocco Nice, so super fun. So my son mentioned flying earlier. My 17-year-old is applying to the Air Force Academy Awesome. So on December 1st he applies for summer camp and if he gets into summer camp it's really good. But I mean he's doing amazing Super cool, super fun.
Dr. Mark Moran:That'd be awesome. That's a great school. Yes, I've been there. Have you been there?
Dr. Kevin Barton:Yes, it's incredible.
Dr. Mark Moran:We went in March for a tour, very good. So, kevin, thank you so much for coming on. I appreciate it you taught me a lot of good stuff, so teach me good stuff. I'm always interested in learning new stuff, so you taught me lots of good stuff and I appreciate that. I'm sure our viewer really appreciated it Our one viewer. Hopefully it's more than one.
Dr. Kevin Barton:We're trying to help out, that's right. We're trying to do our job.
Dr. Mark Moran:Tell your friends to do our job. So tell your friends. Tell your friends, right, yes, go see Dr Kevin Barton and Texas spine clinic. Is that your name? Oh, yes, that's right. Yep, yes, that's right, that is my name.
Dr. Kevin Barton:Yes, texas spine clinic, and then we have our sister business, all in the same building as arthritis relief and vascular centers. So with that business we focus mostly on knee arthritis and then joint pain in general we don't do a lot of spinal stuff over there. And then, uh, the new vascular stuff that we talked about. We do uterine fibroids as well, and we do men with large prostates. Know anybody with a large prostate? I'm sure I do. Statistically they say anyone. So men over the age of 50 50%. So not me, no, no.
Dr. Kevin Barton:Next year, next year so men over the age of 50, between 50 and 60, 50% will have an enlarged prostate, and then so we'll talk about this on another podcast.
Dr. Mark Moran:But it's just really cool stuff. So you're going to come back.
Dr. Kevin Barton:Well, maybe, if you invite me back, yeah.
Dr. Mark Moran:You're always you know what I'm going to give you a lifetime membership to the podcast. All right, bring some tools, bring some games, we'll have some fun hey whenever you're ready to have me back.
Dr. Kevin Barton:I have a lot of other really cool stuff to talk about, so our whole mantra is is we're trying to prevent trying to give people better options than surgery with less recovery time less risk and get them back to feeling good and back to work in very short amount of time.
Dr. Mark Moran:That's great, yeah, weak or less. Surgery is great when you need surgery, when you need it, when you need it, surgery is great.
Dr. Kevin Barton:But it goes back to that conservative approach and starting out with the things that make sense first and then leaving surgery as a last resort.
Dr. Mark Moran:I think that's very logical.
Dr. Kevin Barton:Unless it's an emergency.
Dr. Mark Moran:Unless it's an emergency, there's reasons to do anything. There is yeah, very good. So thank you so much, Thanks for having me.
Dr. Kevin Barton:Thanks for having me, Dr.
Dr. Mark Moran:Moran. Thank you guys, and if any of you guys have suggestions or want to come on and teach me about something or talk to your community, please let me know we.
