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
Spinal Cord Stimulation and Intracept
Dr. Mark Moran explores spinal cord stimulation therapy with Boston Scientific Neuromodulation representatives Mark Waters and Reed Clark, uncovering how this technology intercepts pain signals before they reach the brain. The discussion reveals why this unique treatment allows patients to "test drive" pain relief before committing to an implant—a rare opportunity in medical interventions.
• Spinal cord stimulation works by interrupting electrical pain signals traveling through nerves
• The technology has evolved significantly since the 1960s, with major advances in the last 15-20 years
• Approximately 15 million Americans could potentially benefit from spinal cord stimulation
• Patients undergo a 7-day trial period before deciding on permanent implantation
• Success rates range from 75-85% with significant pain reduction for most patients
• Treatment can be customized with different stimulation patterns for individual needs
• Recently approved for diabetic peripheral neuropathy in addition to back pain
• New "Intercept" technology targets pain by treating nerves inside vertebral bones
• Knowledge empowers patients to make informed decisions about pain management options
Contact us to learn if spinal cord stimulation might be right for your chronic pain condition, and visit markmoranmd.com or onemonthmd.com for more information.
Welcome to our next episode of Back to Back. I am Dr Mark Moran. We are here to help you understand as much as you can about low back pain and health and wellness. Our two guests today are from Boston Scientific, which is a medical device company that does many different things, and one of the things they do for us specifically is something called spinal cord stimulation. So which one of you guys is cooler?
Speaker 2:Definitely Mark. Okay, so Mark.
Speaker 1:Waters is here, and then Reed Clark is also here. They take very well care of my patients and we're going to learn a lot from them about spinal cord stimulation and maybe a little bit about intercept. Okay, what is intercept, you might might say, and we will get back to you about that. So, first things first, which one of you guys can bench more?
Speaker 2:oh, definitely read, that's yeah that's read all day how much is that?
Speaker 1:five pounds 10 I do kilograms.
Speaker 2:I figure nobody can convert it, so so I can make up numbers. Okay, so 45. That's Mark 45. Mark yeah.
Speaker 3:I got some weight, some weight. I'll put some weight.
Speaker 1:If I said, drop and give me push-ups until you're fatigued, how many push-ups?
Speaker 3:would you be able to give me? I can, if you want me to be honest and I'm not bragging. There is room. I can probably do more than 100.
Speaker 1:More than 100 push-ups. Yes, reed 30, 40.
Speaker 2:Hey, I appreciate the honesty. Yeah, that's good, I got no pride left, okay.
Speaker 1:Do you have a?
Speaker 3:max a PB. So I'm gauging it off of our previous PT test, right, Because I'm still in the military. We have a two minute drill part of the PT test where you do pushups for two minutes. In two minutes I can accomplish 85 pushups.
Speaker 1:Okay, in two minutes that's pretty good. So like one and a half a second.
Speaker 3:About that's pretty good.
Speaker 1:Yeah, it is, and thank you very much for your service.
Speaker 3:Thank you. Thank you for your support and all those who support.
Speaker 1:And are you? You're a major.
Speaker 3:Major, yes, promotable major.
Speaker 1:Do I need to call you major?
Speaker 3:You just call me Mark.
Speaker 1:Can I say hey, bro.
Speaker 3:You can do that too.
Speaker 1:Do I have to salute?
Speaker 3:you, you do not, you do not.
Speaker 1:Okay, that's only for other officers, right.
Speaker 3:Actually, it's not even for the officers. It's for officers that are um subordinate to me, and the enlisted, all enlisted, okay, and that's out of respect, not a something that I earned I grew up on uh wilford hall and lackland, lackland. Yeah, it's good that's.
Speaker 1:That was a air force.
Speaker 3:Uh, major there oh for like 25 years so I grew up in in Fort Bliss, el Paso, texas. That's a birthplace and that's kind of I guess that's motivation of the Army. I always grew up around that, surrounded by it. Surrounded by it, inevitably joined it, even though I didn't think I was going to, did it anyways, did it anyways, and now you're on part-time.
Speaker 3:Part-time, that's right. I serve primarily the state, so my direct boss, if you will, is the governor. Governor Abbott, we respond to local well, we respond nationally too, but mostly statewide interventions border, which is probably going to be very big within this next couple of years.
Speaker 1:So yeah, things like that. Well, thank you for your service.
Speaker 3:Appreciate it.
Speaker 1:And you are a UTSA graduate.
Speaker 3:I am. I am UTSA alumni go runners. You know part of the inaugural football team, so still always go runners, that's right Forever.
Speaker 1:That's right. What was your degree in Kinesiology, kinesiology, and what position did you play? Center?
Speaker 3:Safety Center, safety Number 25.
Speaker 1:Yeah, google it it shrunk a little bit Now. I thought safeties were fast and athletic.
Speaker 3:How did?
Speaker 1:you get that place.
Speaker 3:See, time passes, oh, and that goes away. Oh, okay, right, some of it stays, but most of it goes away, okay, I understand Very good and, reed, you are an A&M graduate.
Speaker 2:I'm an Aggie yep Gig'em. Gig'em.
Speaker 1:Did you guys notice what I did for your school alma maters?
Speaker 3:Which one, I don't know. I'm representing both you do have. There's no orange, but that doesn't count, but there's blue.
Speaker 1:Orange. I don't have orange scrubs. Orange is just so repulsive.
Speaker 2:I thought I did pretty good. I'm going to find a compromise.
Speaker 1:I thought I did pretty good just matching this with Giggum maroon and blue.
Speaker 2:That was good.
Speaker 1:Come on, I'm not really good at matching colors, that's pretty good, so A&M now.
Speaker 2:I know, are they doing biomedical? No, no, they're smart.
Speaker 3:They are finding their own way, so that's good.
Speaker 1:We're really proud of them. That's good, okay. And two young kids.
Speaker 2:Two older kids, two older kids. I have a daughter who's about to start driving this coming summer, and my son is 12.
Speaker 1:Okay, so that's good.
Speaker 2:You have younger kids.
Speaker 3:I have three younger kids. Oh my gosh, I got a whole posse here.
Speaker 1:Okay.
Speaker 3:Ten seven six, so prayers are always welcome.
Speaker 1:So you don't really want to go home that fast, you want to drag this out.
Speaker 3:You know what I do? Because I still get that daddy's home. I still get that they come and I have to throw them up in there, regardless of how tired I am. They run and I've got to throw them up in there.
Speaker 2:Did they? Did you tell them you were doing a podcast? Did they just start up and tell them you were doing?
Speaker 3:this today? Absolutely not.
Speaker 1:They're going to think you're a star.
Speaker 3:I'm the GOAT Dad. I'm the GOAT dad. My kids are too old to think I'm a star.
Speaker 1:They know this, they still want to know They'll think you're a star. Say yeah, I did a podcast today, Just another day Going to get tons of followers.
Speaker 3:I told them I'm going to talk to Dr Moran and we're going to talk on a video. They watch. Youtube. I told them you're going to see that on YouTube too, there you go Well.
Speaker 1:Thank you guys very much for being here. I appreciate that, and Boston Scientific is a great company. There's lots of great companies, but specifically Boston Scientific. You guys are vital to the care of our patients and I'm honored to have you guys helping me out with that. Thank you, let's talk a little bit about Boston Scientific spinal cord stimulation. Okay, I don't know anything about that.
Speaker 2:So what is spinal cord stimulation? The idea there is your nerves, you have motor nerves and you have sensory nerves.
Speaker 2:And the sensory nerves take all the sensations to the brain and if you've got chronic pain, those nerves are taking a pain signal to the brain for no good reason typically, and they do that via electrical impulse. So they communicate via electrical impulse and they do that via electrical impulse. So they communicate via electrical impulse and this is just a way that some really smart doctor back in the day figured out to basically kind of interrupt or intercept that signal and either deliver a little like a light, soothing, like tingling sensation, or, as research has gone on, we found that we don't even have to deliver any sensation to the patient for them to get really, really significant pain relief.
Speaker 1:Okay, let me clarify. So you're saying we can put electricity or use electricity into the spinal area and stimulate nerves like an on-off switch to make the pain not be felt?
Speaker 2:Basically, is that a good summary. Yes, a great summary.
Speaker 1:Very good. And how long has this technology been around? A long time.
Speaker 2:So I tell patients, if I can go a little beyond that the first stimulator was put in a patient like in the 60s and people are always like that's crazy, but I think it wasn't commercially available to like the 80s and then even then I bet most doctors didn't even know what it was until like the early 2000s. That's when it really really took off. The technology kind of took some like leaps and bounds. The technology became much better, it started gaining more acceptance and I the best analogy I have is like it's like cell phones. So there were probably cell phones in the 60s. I know there were in the 80s.
Speaker 2:My dad had one and it was a brick, you know, like car one, two yeah, and so it wasn't until like the early 2000s, cell phones kind of became small and useful and everybody had one affordable, and I think stimulators have really kind of almost paralleled that, like around 2010, 2015,. You see these big like leaps in the technology and now, like, what we have compared to just 15 years ago is pretty crazy. So from a hardware perspective to a software perspective, so yeah, it's been around a while but it hadn't really been popular and common until maybe the last 20 years.
Speaker 1:Perfect, I agree with that. It's been around since I ever started practicing. And how many patients around the country?
Speaker 2:Is that in the 60s? Is it in the 60s? 67, 68-ish I started practicing 40-ish.
Speaker 1:How many people in the country would qualify for something like spinal cord stimulation for low back pain? Just roughly Within two?
Speaker 3:Within two.
Speaker 1:Yeah, plus or minus two, I'm not sure I have.
Speaker 2:Bad odds. Tens of thousands, oh yeah.
Speaker 3:Tens of thousands, easily Hundreds of thousands.
Speaker 2:I would say so yeah.
Speaker 3:I'd be confident, as you know you talk about it in your video series.
Speaker 2:The most common reason people go to the doctor as an adult anyways is back pain, specifically back pain. There's a lot of reasons why people have that pain. Some of them are not appropriate for spinal cord stimulation, but a lot of them are, or a lot of those diagnoses are. So I don't. I never thought about what the number is, but it's huge.
Speaker 1:do you know a percentage of people that have back pain that could be treated Just rough Back? Pain that could be treated With spinal cord stimulators. Is it 5% of the population? Is it 10% of the population? What do you think? I would guess it's somewhere in there. 5% to 10%. Let's be conservative and say 5%, and there's about 330 million people in America right now. So let's make it easy and say 300 million people. 5% of that is I need a calculator Well, 10% is going to be 30 million, so it's going to be 15 million.
Speaker 1:So 15 million people roughly just guessing off the top of my head that might or could be a good candidate for spinal cord stimulation. The point is there's plenty of patients out there that could be candidates to benefit from spinal cord stimulation out there that could be candidates to benefit from spinal cord stimulation, and the reason I like spinal cord stimulation is because it's exactly like a car test drive. Do you know the analogy I'm talking about? I do. Do you want to explain it to our follower.
Speaker 2:Yeah, so what Dr Moran is saying, I think I agree, is one of the coolest things about what we do with spinal cord stimulators. They're very effective. Dr Moran has a very high success rate. He created identifying patients but for some reason, some unknown reason, they don't work for everybody. Even patients that kind of fit the profile. But they work for the vast majority.
Speaker 2:So before we go and put an actual implant into a patient, just assuming hey, you fit all the criteria, before we just stick an implant in them, each patient gets to do their own little seven-day test drive. We call it a trial, but it's typically seven days. Some doctors do shorter. Very rarely do they do longer than that. But like Dr Moran does those in his office, it's a very safe procedure. It's kind of like getting an epidural steroid injection. A lot of patients have had that.
Speaker 2:Basically it's kind of a way for the patient to have the actual stimulator in and the actual effect. But some of the components are external and they get to go home with it for a week and they take the week-long test drive if you will. And what's important about that is we don't just want to, we could test it right there in the office and say, hey, does this feel good? Does it help your pain? But a patient really needs, they need to go home and live with it. They need to see if it improves their functionality. That's how does it affect your life. And so it's more than just going to the auto dealership and saying, hey, I like the car, it looks great, it's going home and kind of live with it for a few days.
Speaker 3:And if I could chime in, I like to tell most of my patients it's one of the very few things in medicine that you get to try before you actually proceed with the. We call it a permanent implant, but the actual implant right an implant, but the actual implant right when you go into surgery. The intent for surgery is for you to get better when you walk out of there, assuming that you have some time to heal. Well, there are some cases, as we all know in medicine, that you may go into a surgery and may not come out as great as you want it to. Our stimulator, the device itself, gives you an opportunity to try and determine whether or not you want to proceed. I tell my patients all the time very few things that you get to try before you say I like it, I want it, I want to move forward. And so that's very important for patients to really understand is we aren't the ones who determine whether or not you move forward. It is you. It is always a patient.
Speaker 1:The patient's always in control, regardless of what a doctor says or a rep says or anything else, the patient's always in control. I agree with you guys. You guys are right. The reason I like these stimulators is because you get to test drive it before you have anything implanted in you. It's like the car. You go to the car dealership, you say I want to try this one.
Speaker 3:You test drive it if you don't like it, you turn it back in and nothing has changed.
Speaker 1:It's the same thing with the stim trials you come in, we put the wires in.
Speaker 1:It takes 20 or 30 minutes, and then you go home and live with it for a week because we don't want to just see how much it benefits you that day. We want to see how much it benefits you not just with pain, but with activity and energy and sleeping and smiling and everything with your overall quality of life. And we that only comes if you wear it for five to seven days. Correct? You'll come back after five to seven days. We pull it out. It's very easy. You just take the tape off and pull it out and then we ask you these questions and then the patient will give us this overall quality of life improvement. The insurance requires you to have at least 50 improvement to to qualify for the implant. But if you do qualify, it's still 100% up to the patient if they want to have it implanted or not.
Speaker 3:So it's a test drive If you like it.
Speaker 1:You decide if you want it implanted. If you don't like it, we move on to other options. So I like that technology. We've done dozens of patients with them over the years. Are we in the hundreds?
Speaker 2:yet oh, we're in the hundreds. I must be busier than I think. I am. There you go.
Speaker 1:And we have very good success rate. I usually tell my patients roughly 75 to 85% of them will get roughly 75 to 85% of benefit. Some of them it doesn't work, it's not meant for everyone, but the vast majority of people will get some benefit. And this is only for back pain, or can you use it for other types of pain too?
Speaker 2:It does have a few indications. Back pain is the most common. The most common is a patient who's had a back surgery and they're still in pain. But it can be used for patients that haven't had back surgery. It can also be but have cracked back pain. Also things like radicular leg pain. That's usually pain that's coming from the back. But also some of the newer indications are complex regional pain syndrome, which is you've had several patients that have done really well with that.
Speaker 1:Usually they respond very well to stimulation.
Speaker 2:Yeah, they do, they do well. I won't get into the nature of that condition because I don't really fully understand it, but it's usually of the extremities, sometimes it's of the arms or the foot, so you can use stimulation for arm pain too. Yes.
Speaker 1:Okay, so you can do it in the low back and or the neck.
Speaker 2:Correct. Well, it's not on label for the neck, but it is on label for the CRPS.
Speaker 1:I understand you have to be careful because the lawyers, we love lawyers. We're not doing anything illegal, but we are trying to help the patients as much as we can and in the end it's up to the insurance company. Absolutely If the insurance company is going to approve it, then we're going to go ahead and do what the insurance will approve, and certainly it's very common for doctors to do spinal cord stimulator trials for neck and arm pain.
Speaker 3:Correct. Yes, In addition to that, I've got to add DPN diabetic peripheral neuropathy right, and that mostly stems from patients who have diabetes a lot of pain in their feet. We have acquired that indication for spinal cord stimulation too, so that's very important.
Speaker 2:Yeah, that's the newest indication.
Speaker 1:It's very exciting and that was just acquired a couple months ago.
Speaker 2:Six months ago.
Speaker 3:About a year ago. About a year ago, yeah, okay.
Speaker 1:Which is great, because diabetic patients with peripheral neuropathy usually it's just medicines that they can take to treat their pain. Now, this is a very powerful, effective way to treat their diabetic pain, because this type of pain really helps a lot with nerve pain, and dpn, or diabetic peripheral neuropathy, is nerve pain that can be treated with these stimulators I agree with that. Uh, lots of benefits for dpn patients or diabetic peripheral nerve patients. Good, all right, um which one you guys is funnier?
Speaker 2:oh, it's definitely that's free he keeps yeah, it's free
Speaker 3:it's free I think, I have, uh, I have humor in my mind.
Speaker 1:That only works in my mind, but you know he has more experience as a dad, so he has more dad jokes.
Speaker 3:That's right, that's right. Right, I'm gonna catch up. Maybe use that one maybe that's what's going on here I don't know if they'll get it, and a couple more things with stimulation westerns.
Speaker 1:Is this something that you'd go to right away when you have back pain, or do you usually want to try other things first?
Speaker 2:I mean I'm up for it. Yeah, let's do it, but but no, truthfully, no, we it's. This is kind of at the end of, uh, at the end of the algorithm. It might be moving up. I think it is moving up. Um, some of that is dictated, a lot of that is dictated by insurance. But obviously you want to start as a doctor, right?
Speaker 2:you want to start with what's one most easy obtainable, you know, like the insides over the counter stuff. So you're gonna start with what's easiest, and of course safety is considered there. But patients are pretty much going to have to go through a series of other treatments that you would try, and you know a lot of those can be very effective for a long time and then maybe over time they don't get the same effect, and so as that efficacy wears off, they might become a candidate. As that, as efficacy wears off, they might become a candidate. Um, but also, you know, I do think it is moving up in the algorithm. Oh, you're that we're seeing that?
Speaker 1:yeah, I see that. Yeah, so reed is correct. Uh, usually most doctors are going to try conservative things first, because we know the vast majority of patients are going to get benefit from conservative options like chiropractor, physical therapy, acupuncture, these type of stretches. The next option would be medicines, whether non-narcotic or over-the-counter medicines, and then prescription medicines. Then after that, you start to consider interventions like injections. Then after that you start to consider spinal cord stimulator and or surgical options for treating pain correct.
Speaker 3:So that's sort of a rough algae analogy or algorithm.
Speaker 1:patients need to go through, so you're right, it's not initially. But I have had patients that have come to me and they've tried those other things, and then we do go initially to right spinal cord stimulation.
Speaker 3:And we always tell patients right is when you've come to us, there have been procedures and interventions done, like you already stated right, and they have this success and they're like why didn't it start here? It is a procedure, right. Once you proceed to the actual implant, there's surgery involved, and so the doctor does their due diligence to make sure that they can try to treat as with little intervention as possible, or it's not the word that I'm waiting for Minimally invasive.
Speaker 2:Minimally invasive.
Speaker 3:Thank you, reed. Thank you. So they get to us kind of at the middle or the end of the road of pain and hopefully we can help that. But the doctor is doing their due diligence, like Dr Moran does, to see if other things work before we have to move to that route.
Speaker 1:Okay, Okay, so we have tens of people listening. Okay, who knows how viral this is going to go. What is like the top three best pieces of advice you guys can give to people considering spinal cord stimulation?
Speaker 2:As a patient.
Speaker 1:As anyone, as a rep or a patient or a friend.
Speaker 3:Very first one I'd say is don't be afraid of it. I think that we come across more fear than anything and I think that comes from lack of education, where we try to intervene in that part and make sure patients understand what to expect, and that's why I'm very careful. I said earlier, we have an implant. We typically refer to it as a permanent implant and most patients kind of are weary of that and it's not permanent whatsoever. It can always come out if medically necessity. But I think the number one, biggest advice is don't be scared of this.
Speaker 1:I agree with that. I think a lot of times people get caught up by the name spinal cord stimulation and they're like I don't want to mess with my spinal cord. So technically it's not going into the spinal cord, it's resting on top of the spinal cord Correct.
Speaker 1:So that's why it's a stimulating thing. I agree with that. Also, and I tell patients frequently don't confuse possibility with probability. Certainly, possibility with probability. Certainly. It's possible right now that we get hit by a meteor, but that's not going to happen. None of us are worried about that because the probability is so low we don't worry about that. It's the same thing with any medical procedure. Don't confuse possibility with probability. Certainly it's possible. There's complications, but the probability of it, especially with this technology, is very low, correct.
Speaker 2:Correct, so that's a good one. Do you have anything? Well, I have a couple of things, but I also kind of want to add on to that. Like we were lucky enough in your office to get to educate some patients, sometimes early on. You know, maybe they're they're just they're asking about, they see stuff in your office and they want to know, like, what is this all about? Maybe they're not even close to being ready for it, but educating those patients early on I think goes a long way, because I always encourage them like hey, go do your homework.
Speaker 2:Obviously you always want to be careful when you're looking at reviews and stuff online. You're going to get some extremes on both ends, but I think every patient should do their homework. But, like Mark said, you know it's natural to be kind of a little apprehensive, like, oh man, you're going to do what. But you know, do your homework. And also reach out to the office and ask if there's.
Speaker 2:I know we've got a lot of patients that you've treated that are have told me expressed they're willing to talk to other patients. In other words, patients that have gone through the trial, they've gone through the implant. They're so happy with what they did that they want to talk to other patients and because they know that they had those same fears. So you know, ask if you're. If you're, don't just dismiss it If those same fears. So you know, ask if you're. If you're, don't just dismiss it. If you're nervous about it, don't dismiss it. Talk to the office. If you've already been in contact with a rep, you know, let them know. Beyond that, I would say part of it is setting expectations.
Speaker 2:So you know, have good expectations. Ask the reps, ask the doctor, like you know what. What does successful look like? You know you mentioned at least 50% improvement. It's all subjective, it's up to you, the patient. Was this successful for you, um, but I always do preface with patients. I'm not looking for a hundred percent success. It's just not realistic. Um one, you've probably got other little ailments that this isn't going to help. It's not going to help with your arthritic knee, it's not going to help with your stuff like that. But in my opinion it should be very significant improvement that you've experienced with the trial before you move on. But you have that expectation. It's not going to help with the aches and pains that we all deal with, but it should really knock out most of that neuropathic pain, that's, that's the, the big source of pain. And then I have something else neuropathic pain, meaning nerve pain and I agree that knowledge is power.
Speaker 1:I advocate that to my patients all the time. Knowledge is power, and be an active participant, not a passive recipient, in your health. If you are considering this, then do your research. There's lots of information out there and you can go to my website it's markmoranemdcom to learn all kinds of things about options for back pain, including spinal cord stimulator. Another thing is you can always go to onemonthmdcom, which is my website, to help people educate them about all types of treatments and options and causes for low back pain, and one of the options I give is spinal cord stimulation because of the success we've had with you guys. So I agree with that Knowledge is power. Encourage the patients to become active participants, not passive recipients, in their health. They come to me and say what are you going to do for me? I say nope, we're a team. You're going to be participating with this treatment problem. So go learn as much as you can and always bring us questions.
Speaker 1:Right, correct, good, did you guys have like one thing that patients that have stimulators do that you wish? You could just say all tens of people that are watching what would be one piece of recommendation.
Speaker 3:My very first one that I go to is as far as Boston Scientific is concerned. Our ability to navigate and create customized therapy is again. This is a bias, but it's beyond everybody else. So what I tell patients is that as you start to utilize the spinal cord stimulation therapy, be willing to change right, just like you would when you come into this office, if something is not working or you want to make adjustments. We purposefully, intentionally place different modes of therapy so you don't just get one type of therapy. So try the different therapies that we initiate for the patients. Don't just stick to one. Don't be afraid of the remote right, it looks a little wonky. Change the channel. That's what I tell the patients.
Speaker 1:And you mean you give patients different options with their stimulator during the trial? So they can see which one works best and they like better or not as much. Absolutely so they have options during the trial to see which one works.
Speaker 3:They have options during the trial that have even more options when they actually have the device right. We have a limited timeframe. Our intent during the trial is just to see if that actually works right. We want to see if spinal cord stimulation works for your patients. The limited amount of time is where we try to make sure that we have the right parameters set and that's kind of the entirety of the trial. Once we find out what the right parameter is, then we know where to gauge and where to aim when you have the actual implant. And so when you have the actual implant, just like everything else, you kind of habituate to the type that you like or a level and we tell patients change it, change the channel a little while, like change the channel every now and then, change up your routine every now and then. Uh, that's the very first thing that I typically tell my patients.
Speaker 1:Good, so good, very good. Do you guys have anything else?
Speaker 2:yeah, I was gonna say, uh, kind of along those lines. Like some people also get intimidated by they're just from the off, the right off the bat. They're like they don't want to touch the remote. They're like I don't do technology and we can with boston scientific. We can make it as simple and set it as and forget it as, as you like, um, or we can, like mark said, we can create crazy customizations for you that you can. If you're somebody that you like to mess with stuff and you want to change things all the time, we can do it however you want. So, um, and if, if you are a little intimidated and you think you might want to try those things, we can teach you and get you there. But we can set it however you like. We have automated um. We have an automated version of our fast, that's the fast acting sub perception Therapy.
Speaker 2:So you're not feeling this therapy, but it's unique in that it works quick and you don't feel it. A lot of the old programs that patients wouldn't feel it would take a couple of days for the therapy to wash in. So with this we can turn it on and you'll get almost instant relief.
Speaker 1:So this is like young Mark's safety as compared to current Mark's safety, correct?
Speaker 2:It's much faster, very fast.
Speaker 3:Very fast.
Speaker 1:Very fast back then. Very fast Did you beat me in a race?
Speaker 3:Absolutely 100%.
Speaker 1:Sound a little confident there.
Speaker 3:There are very few people that can beat me.
Speaker 1:I don't know, is there a Chick-fil-A at the end line? I might be pushing your limits, right there, those Chipotle guys.
Speaker 3:No, no, very good. What's your 40 speed? Like my top 40 speed. No, your lowest Top top. I ran officially in a combine 440. So that's my fastest time, that's my official time. I ran faster than that, but that's.
Speaker 1:I got 4.5 on one leg hopping. I'm just saying.
Speaker 3:With a Boston Scientific Stimulator.
Speaker 1:4.4 ever okay, remember, we are trying to teach people some stuff here. I agree with that. Spinal cord stimulator very good technology. What you're saying is you can personalize individual options for each patient when they come in with stimulation.
Speaker 1:Absolutely, it's not a cut block, cookie cutter type thing. Everyone gets the same. Every patient gets individualized treatment. Absolutely Got it. Good, it should be that way. Next thing we want to talk about a little bit because we're starting to run out of time. I know our watchers and listeners really want us to keep going, but I do want to quickly mention do you?
Speaker 1:want to say hi to your mom, hey mom, okay, reed, yeah, hey, mark's mom, we want to talk a little bit about something that's relatively new for Boston Scientific called Intercept, and you're kind of in charge of this for the VA, right.
Speaker 3:No. So I'd say that I wouldn't be comfortable talking about Intercept as much as I'd like. Okay, we manage the flow, but we do have a rep, beth Irwin, who is completely in charge of educating. Beyond that, then I wouldn't feel as comfortable. I wouldn't feel as comfortable. Well, do you mind if I take a shot? No, please.
Speaker 1:I thought we should teach them about stimulators and Intercept yeah.
Speaker 1:So Intercept is a procedure for people with back pain where a lot of people try something called radiofrequency ablation, where you put a needle in and you burn a nerve that's on the outside of the vertebral body. This is a procedure where the needles go inside the vertebral body. Now, as we find more results from research and medicine, where we used to think that the discs, the cushions between the bones, were causes for a lot of pain, now we realize that it's not the discs, it's the bones that are the cause for a bunch of back pain. So instead of treating disc problems for back pain, we now know that there's a lot of research that shows getting a needle into the actual bone and burning the nerves inside the bone can have significant benefit for back pain absolutely right, that's what the intercept procedure is correct rf or radio frequency is burning on the nerves that are outside the bone.
Speaker 1:Intercept is inside the vertebral body and putting a probe in there and heating it up and burning the nerves that go to the vertebral body inside the body.
Speaker 3:Correct, correct.
Speaker 1:That's just a guess. Is that a good?
Speaker 3:guess? No, that's. I mean, we've got to take you to Vegas. Totally guessed Going to Vegas tomorrow.
Speaker 1:And this is an up-and-coming technology.
Speaker 2:How long has?
Speaker 3:that been around.
Speaker 1:Boston.
Speaker 2:Scientific acquired it probably about a year ago, but I think it was out maybe two years before that. Don't quote me on that, but it's been out a few years.
Speaker 1:I know that the five-year data is just now recently coming out to substantiate it, and I know that the results are really good. That's why I'm going to start doing it. Yeah, we're excited to start doing it. Yes, yeah, so another bullet in my holster to try and help the patients out with their back pain. On top of that, another thing we can do is knowledge is power, so learning about the causes and treatments and options for back pain before they even get started is very valuable, which is why you guys should remember to check out One Month MD to see if you can learn anything that way as well, because we want patients to be active participants, not passive recipients, and a lot of times you can prevent pain just by doing yoga.
Speaker 1:I've had several people tell me recently, when I finally bugged them enough, they started trying to yoga. They said I did it for the first week and my pain in my hips and knees and shoulders is gone.
Speaker 3:I believe it Absolutely.
Speaker 1:I'm telling you, I know a couple things about pain. Absolutely, if you're over 40, yoga is very good for your back pain. Yeah, I'll have to figure that out when I get there.
Speaker 3:No back pain for Dr Moran.
Speaker 1:When I turn 40.
Speaker 3:Oh that's right. 21 tomorrow.
Speaker 1:Really Happy birthday.
Speaker 3:Thank you.
Speaker 1:You going out for a drink?
Speaker 3:Two, just two.
Speaker 1:Okay, very good, alright, did you guys have anything else you want to share or tell or any questions you want for me? What else can we do to help empower the patients with knowledge?
Speaker 3:No, I think you covered it very well. I think for your audience it's very important to know that spinal cord stimulation is not for everybody, right? We try to do our due diligence to make sure that Dr Moran is in front of the appropriate patients for the appropriate time, but at the same time, do your due diligence in learning about spinal cord stimulation. It may not be now, it may be down. The road. Time is against us all as we start to deteriorate in age and time.
Speaker 1:I like to say, as people get more life experience.
Speaker 3:Yeah, I like that one.
Speaker 1:No one gets older, they get more life experience. Yeah, I like that one.
Speaker 3:No one gets older. They get more life experience. They get more wise as we wisen. If that's a word, it's a new word. Just prepare yourself for the opportunity or the possibility that spinal cord stimulation may be down the road for you Maybe not now, but later on down the line. So educate yourself a little early on. Reach out to myself or read. We're always in Dr Moran's office willing on down the line. So educate yourself a little early on. Reach out to myself or Reed. We're always in Dr Moran's office willing to share the information, even if it's not for you now. Maybe you need the information for one of your parents or friends or anything.
Speaker 1:I agree, reed gig him, yeah, gig him.
Speaker 2:I think you know what Mark said is kind of summarizes everything. But, you know, ask questions, find out what other options are there. Um, I think the earlier you get educated and start looking into options, I think the better off you'll be in the long run. Um, maybe, maybe it's intercept, maybe it's spinal cord stimulation, maybe it's something else radiofrequency ablation, stuff like that that Dr Moran offers, or your pain doctor. If you start asking about those things and learning about them, when it does come up and it is something that the doctor thinks you're ready to try, I think it'll be you set yourself up for more success because you'll have kind of prepared yourself, you'll done your research. You're not like surprised to hear about it.
Speaker 2:So, yeah, knowledge is power. I think that's a great way to put it. And definitely you know, once you, if you do get to a point where you have you're doing a trial, you've done a, you've had an implant rely heavily on your reps. You know where that's. Our job is to make sure you're comfortable with the device, make sure the device is working optimally for you and so be, like Dr Moran said, be an active participant. You know you've got to take part in your care and you know, we'll get you there.
Speaker 3:Big shout-out to Dr Moran. No, no, I think it's important for patients to also understand. You know there are multiple pain doctors locally here in San Antonio, but not all of them are so interventional, and what I mean by that is that you may run into a doctor that has a very stringent one way for everybody. When patients go into your office, they should be very confident in knowing that you'll be able to approach them in different manners. And we said this earlier. Spinal cord stimulation may not be for everybody, but Dr Moran will have an option for you. That's appropriate and I think it's important for patients to understand that you want to be in an office where a doctor is willing to go left and right and down the middle and maybe a little off the path a little bit if necessary. But uh, not everybody's like that.
Speaker 1:Not everybody has the sound hands minds to be an interventionist well, I appreciate that, and I guess you just want me to buy you a drink for your 21st birthday too. Okay too, but you're right. I tell my patients the patients are the boss like I work for them. I'm just giving them advice and answering their questions. But the patients decide what they want to do, and if they don't want to do something, then we find another option. So you're absolutely right. Very well, I encourage everyone to continue to become an active participant in their health and not a passive recipient. If you have anyone that you would like to be on the show or know that would want to be on the show, we're happy to have anyone, because we're always here trying to educate the community about options, about health and wellness and taking care of themselves.
Speaker 1:Thank you guys very much, I appreciate your time and dedication taking good care of our patients. We appreciate that and we'll see you guys next time. On back to back.
