Healing Over Hype: The Truth About Stem Cells with Dr. Vincent Depasquale

Are stem cells legit or just hype? In this powerful conversation, Daniel Walton sits down with Dr. Vincent Depasquale of Orthobiologics Associates to separate the facts from fiction around regenerative medicine.

Dr. D shares his journey from chiropractic care to becoming a leader in stem cell therapy, what most doctors still get wrong, and how inflammation, diet, and mindset can either sabotage or supercharge your healing. You’ll learn the difference between treating symptoms and actually healing the body—and why surgery should be the last resort.

From rebuilding joints without going under the knife to exposing the biggest lies in traditional healthcare, this episode is a must-listen for anyone chasing long-term vitality.

Topics include:

• Why most joint pain isn’t about injury—it’s about inflammation
• What makes someone really a good stem cell candidate
• The Meta-3 Method: a 360° approach to chronic pain
• How big pharma and mainstream media control the health narrative
• What to ask your doctor before getting surgery

If you're ready to challenge what you've been told and take control of your healing, it's time to Go Higher.

🔗 Connect with Dr. D / Orthobiologics Associates here

Presented by Daniel Walton (@yourpropagandist)

Transcript

0:00: Yo, what's cracking. 
 0:01: This is Daniel Walton, and this is the show for those who don't believe in limitations. 
 0:04: So if you're ready to be better than you were yesterday and hit new levels mentally, physically, financially, or spiritually, it's time to go higher. 
 0:11: I like to really just start these off kind of getting a, a good understanding of your story, where you're at. 
 0:18: And, you know, what made you choose your particular field of medicine? 
 0:23: I mean, there's so many different options that you can choose. 
 0:26: What was it that ran through your head to, to choose specifically what you guys are doing now in the, the regen and chiropractic space? 
 0:33: Yeah, so I mean that's, that's a little bit of a long story. 
 0:37: you know, to some degree, I always knew that I wanted to impact people's lives in a unique way. 
 0:43: wanted to impact them a little bit better than I could in the chiropractic space, but really, The reason that I went into chiropractic is primarily so that I can learn a more holistic approach to wellness and lifestyle science, you know, I watched my grandparents die of end stage diabetes, watched, you know, the slow decay of their health over time. 
 1:00: They didn't forget to go to their doctor, they never forgot to take their medication and for 20 years, their health declined, you know, rapidly. 
 1:08: , as a result of seeing that, you know, I had an interaction with the chiro who really just helped me achieve a certain level of health that no other doctor could, and I knew that that's what I wanted to learn. 
 1:20: I wanted to learn mostly the wellness and lifestyle science from a holistic perspective. 
 1:24: So I went to chiropractic college and soon, you know, I realized that, you know, chiropractic wasn't for me. 
 1:30: I came out of, you know, school, opened to practice. 
 1:33: I did predominantly conservative therapeutic, traditional chiropractic work, and I just wasn't finding the results to be satisfactory. 
 1:41: I wasn't getting the results that I really wanted in terms of changing lives, so I got more into functional medicine, got a certification, you know, did a whole bunch of study on. 
 1:50: You know, really wellness and lifestyle science. 
 1:52: I don't really like to call it functional medicine per se, but essentially, you know, helping people achieve health through, you know, nutrition and lifestyle type medicine protocols. 
 2:03: I focused predominantly on diabetes for obvious reasons and, you know, I was seeing amazing results. 
 2:09: the way that I found regenerative medicine was. 
 2:12: Sort of by luck, you know, I went to a, seminar and I would, you know, listen to a stem cell scientist talk about how they were helping diabetics with using stem cells. 
 2:21: This was probably 16 years ago and I was really intrigued, so I just kind of dove in and learned as much as I could. 
 2:28: when I came back from that particular seminar, I literally closed. 
 2:31: I had two practices at the time. 
 2:34: Closed the doors, integrated medically, and we started doing regenerative medicine from that day forward. 
 2:39: That was about 14.5, almost 15 years ago, and since then I've been doing it ever since. 
 2:45: So was that was the moment that the aha moment in your career that made you choose stem cells. 
 2:51: You know, look, when you boil down what the chiropractic principle is, it's really, using the body to heal itself, right? 
 2:58: Or, or putting the body in a position so that it can heal itself by eliminating impediments, whatever those may be, from a physical perspective. 
 3:05: And what I learned a bit about what adult stem cells or regenerative medicine can do, I mean, it really was in line with You know, everything that I wanted to accomplish, and obviously just with my knowledge of, you know, orthopedics from the perspective of improving function and biomechanics and everything that, you know, chiropractic allows me to understand, regenerative medicine just made a lot of sense, you know what I mean? 
 3:31: So was there like one particular patient who made you realize chiropractic like wasn't quite enough for you? 
 3:40: Yeah, you know, the thing about traditional chiropractic, like the adjustment, I'm a, you know, a firm believer in chiropractic care and I think from a conservative perspective, especially in orthopedics, we should always start in the conservative model, but what happens is many patients don't do, you know, well in the conservative model and they typically progress into like an interventional pain model which is driven predominantly by symptom reduction or drugs, right? 
 4:07: and for me, you know. 
 4:10: Employing the resources and tools that can get people back to doing what they love and getting them back to fully functional pain-free is really the most important goal that we have as practitioners and doing it in a conservative environment, you know, that's the key, without any downside in terms of side effects or risks in terms of, you know, surgeries or procedures like that. 
 4:32: Yeah, I've only ever been to I mean, I, I love going to the chiropractor. 
 4:37: I think there's, you know, it's so valuable, to have a good chiropractor, but I've only ever been to a chiropractor for, for pain. 
 4:45: Is there any other reason that people go to chiropractors than just pain? 
 4:50: You know, there are a wide variety of conditions that respond really well to chiropractic, but predominantly, most people go for pain, right? 
 4:59: you know, patients with headaches respond really well, but really, the chiropractic adjustment is, is designed specifically around restoring function, to reduce pain, right? 
 5:10: And that's, and that's, I think, an important tool. 
 5:12: the problem that I saw in chiropractic is many people come. 
 5:16: , with, you know, with the idea that they're gonna get out of pain and they're completely metabolically unhealthy, you know, their, their daily habits and their activities and their personal life are not consistent with the long-term outcome that they're looking for, right? 
 5:30: So, you know, when we talk about wellness and lifestyle science and functional medicine and back to the idea that I really want to impact lives long term. 
 5:38: If we're not teaching those individuals how to eat and do nutritional protocols to, you know, improve their health, then you're very limited in a chiropractic environment with the, with the tools that you have at your disposal. 
 5:51: What are the biggest like health issues or bottlenecks that most people are doing wrong when it comes to like what they're eating? 
 6:00: I mean, you know, look, that's for me, metabolic health is an important piece of the puzzle, even, even in the regenerative space, you know, I talk about this quite a bit, you know, there are, there are primary drivers to chronic joint pain, right? 
 6:15: And typically chronic joint pain is characterized by damaged tissue that creates symptoms. 
 6:19: Those symptoms are typically inflammation and pain and joint dysfunction, meaning that the joint doesn't work as well as it should. 
 6:27: And those primary drivers are, you know, excessive wear and tear. 
 6:30: They can be, they can be traumatic in origin, but one of the real, you know, underlying issues that a lot of people miss is the overall relative inflammation in the in the patient's body as a result of metabolic dysfunction or the foods that they're eating. 
 6:45: And that inflammation, wreaks havoc on your entire body, not just on your joints, but it really accelerates the degenerative process over time. 
 6:54: So if we're not addressing metabolic health in any environment, I don't care what, you know, type of health practitioner you are, then you're missing a really large piece of the puzzle and you're missing out on opportunities to help people long term. 
 7:06: Yeah, it's, it's I I've noticed that with a lot of health it's more they're putting band-aids on, on things instead of figuring out well why, where did this wound come from in the first place? 
 7:15: Like why are we having to put a band-aid on something when there's something much deeper so. 
 7:21: When somebody is experiencing joint pain, what are the leading foods or, or diets that generally are are most correlated to that, that joint pain? 
 7:31: Well, it's, it's all the things that you would expect, right? 
 7:34: So we talk about the standard American diet, and it's obviously atrocious, but it's anything that promotes inflammation in the body, right? 
 7:41: So it's, this isn't about, you know, weight per se. 
 7:44: , or weight loss per se, it's really just about the relative inflammatory load associated with specific foods, right? 
 7:52: So we know that sugar is highly inflammatory. 
 7:54: We know that, you know, simple carbohydrates are highly inflammatory. 
 7:58: We know that processed food is highly inflammatory because it contains mostly sugar and seed oils as preservatives, so. 
 8:06: You know, those are typically the things that, you know, we want to address initially. 
 8:11: you know, we want to teach them that look, you know, the things that you're putting in your body, the things that you're exposing your body are causing your body to adapt to those things, and you're creating an inflammatory and metabolic environment that isn't conducive to healing, whether I'm adjusting you or giving you stem cells. 
 8:27: Yeah, yeah. 
 8:28: Yeah, it's crazy how impactful the, the diet is. 
 8:31: I got really lucky. 
 8:32: Like my family was poor, so we always had to have home cooked meals. 
 8:37: And I hated it growing up. 
 8:38: I'm like, well, we can't ever eat out. 
 8:39: All my friends get McDonald's, all these processed frozen foods. 
 8:43: And now as an adult that I've learned, you know, what real health is and how, how much of it is metabolic like you said, you know, I, I feel super blessed that I learned what, you know, what foods to put in your body. 
 8:57: So,, the standard American diet, high sugar, high processed foods, those are the leading causes in, in most joint pain that you're experiencing aside from like high, you know, high impact, high use cases like athletes and traumatizing situations. 
 9:13: Yeah, I mean, I think we have to make the distinction, you know, when we say joint pain, there's, there's a lot of different circumstances, right? 
 9:20: We can have injuries, we can have somebody who's, you know, competitive athlete that develops repetitive stress problems and, you know, that's not necessarily just driven by diet. 
 9:30: So, you know, in the chronic and degenerative conditions, the ones where we talk about like arthritic conditions like in knees. 
 9:37: I use knees as an example, very commonly. 
 9:40: , there's a reason why some people develop significant amounts of arthritis in their mid-40s, and some people don't develop it until they hit their 60s or 70s, and success leaves clues, you know, usually the individuals that that develop it very early, sure there's some genetic predisposition, but it's mostly driven. 
 9:58: By the fact that, you know, their internal environment is conducive to tissue degeneration or tissue breakdown. 
 10:05: And you couple that with wear and tear, you couple that with, you know, the fact that maybe they're overweight and they're sedentary and all of those things combined to form this condition. 
 10:14: Right, so you know, because of my background in wellness and lifestyle science and because I understand a holistic approach, you have to take a holistic approach to chronic joint pain, otherwise you're missing a big piece of the puzzle and more importantly, you're not getting the outcomes that you really want, right? 
 10:29: How does, weight gain affect joint pain? 
 10:33: So it's really interesting. 
 10:34: So, you know, the, the most common thing that people think of is you carry excess weight, so it causes more wear and tear on the joints. 
 10:41: And yes, that's true. 
 10:41: There's some, there's more mechanical force than if you weren't carrying that weight, but what's really interesting also is that adiposity or excess fat promotes inflammation in the body. 
 10:52: It's highly inflammatory tissue, and that inflammation again is a primary driver of degenerative change, but more importantly, it's also a primary driver of hypersensitivity. 
 11:03: So we know that they experience pain at a higher degree than somebody who doesn't have a lot of adiposity and what would be considered like excess fat? 
 11:10: What, what's like 10%, 15% body fat? 
 11:14: No, I mean 10% body fat is, is not bad, right? 
 11:18: you know, I think, you know, if we use BMI as a general measure, you know, the general rule is like 25 and up. 
 11:25: , you know, we're kind of entering a stage where we're getting overweight and, you know, once we hit 30 to 35, now we're starting to get to the clinically obese stages. 
 11:36: Yeah, entering a stage, that's one way to frame what's going on in in America. 
 11:41: what I think 75% of the population in America is overweight, over 50% is, is obese. 
 11:48: , we have our health expectancy rate has dropped significantly. 
 11:52: I looked it up the other day. 
 11:54: I think we're at number 55 in the world for life expectancy. 
 11:59: Costa Rica, which is a third world country, is higher on the life expectancy list than America. 
 12:04: And I believe our diet and weight problem is, is one of the leading causes, if not the biggest impact to our, our decline in health. 
 12:17: what other impacts aside from weight are you seeing that can really affect people's joint pain and just overall. 
 12:22: , you know, vitality and health. 
 12:25: Wow, that's a really long, right? 
 12:28: so, you know, I think when we, when we talk about health, and you know, like biohacking and longevity and all of these things that are really popular are wonderful and health optimization in the form of hormones and peptides and other things, they're all wonderful, but what we need to do is we need to boil it down to really specifically. 
 12:48: The simple things that we get to control, which is diet, exercise, and the right mindset, right? 
 12:55: And those three things we get to control and really that should be the core of any health journey. 
 13:01: what I see predominantly and like you just hit the nail on the head in terms of the overall health of our country. 
 13:08: I think our food system is one of the worst in the world. 
 13:11: I think it's highly toxic. 
 13:12: I think what most people have access to, unfortunately is, you know, just, just not doing their body a service, you know, so if we, you know, if, if we eat clean, if we move often, if we have the right mindset, your body will start adapt adapting towards health, because that's really what what health is or what sickness is, is an adaptation to either a chronically stressful environment. 
 13:38: Or an environment that's conducive to producing normal health and physiology, right? 
 13:44: So if we look at it from that perspective and we look at it, you know, in that way, which is really powerful, then we're not a victim, we can control the environment that we live in, and then we can achieve the result that would be normal for human beings. 
 13:58: We're designed to be healthy, we're not designed to be sick. 
 14:02: Yeah. 
 14:03: And, and that's something that I think a lot of people, yeah, the, the mindset is so, is so important. 
 14:10: I see it in the, the medical community, they have a lot of fear-based mindsets and, you know, just as someone who's been navigating the whole health. 
 14:19: Care industry in the last 8 months dealing with monody twins which are considered high risk. 
 14:23: I could see it from like literally every day we, you know, the last 2 weeks we've dealt with no less than 5, sometimes upwards of 15 to 20 different providers, all different types of interactions talking with us, and so much of it is just really like fear-based, thinking and fear-based narratives on these large data sets that don't even. 
 14:46: Look at what particular like outcomes were most aligned with, right, which in our case we were both healthy, yeah, she was young and you, you look at a lot of the data they were unfolding and so much of the data that they were making these, these fear-based decisions on was around obese people or women over the age of 40. 
 15:05: So I saw firsthand, how, how impactful that, that can be on the outcome and. 
 15:10: , it's really important to reframe people with the right mindset. 
 15:16: From your experience with these, you know, mindset being one of the biggest impacts to health, what, what's a reframe that somebody can, can immediately do that's going to impact their life, you know, to, to, to allow them to be more healthy and feel less pain. 
 15:33: In terms of reframing belief systems, this is a really big deal. 
 15:37: yes, you know, we've been led to believe that, you know, everything's genetic or, I mean, and not so much like nowadays, which is wonderful. 
 15:46: There's been a big shift, right? 
 15:48: You know, since everybody started learning about epigenetics and and the the influence of the environment on the human body. 
 15:54: , I think now it's changing a little bit, but really the belief system that they're genetically determined to be sick and they're a victim. 
 16:01: And I think, you know, traditional medicine, as wonderful as they are with the tools that they have, you know, they've, they've propagated that central dogma for a very long time. 
 16:12: You know, it's DNA to RNA to protein and you don't have a choice and your body's gonna develop this sickness as a result. 
 16:18: Of just being you and I, I, I talked to thousands, I've talked to thousands of patients over the years and you know I, I'm still floored at how many patients come in and say, you know, I have arthritis, my dad had arthritis, my mom had arthritis, or my aunts and uncles all had arthritis, and they don't realize it's a wear and tear disease. 
 16:36: Yeah, there's some genetic predispositions, some people, you know, develop it at an earlier stage, but you know what, diabetes has some genetic predisposition too. 
 16:45: But if your environment is clean, you never develop it, you know, based on, you know, kind of what you expose your body to. 
 16:50: So I think that's really the biggest reframe is that, no, we're not genetically determined to be sick, we're genetically determined to be healthy. 
 16:57: We're genetically determined to function at a very high level and the reason that we, move away from that is simply because of what we're doing on a regular basis and what our habits dictate our body needs to respond to. 
 17:18: You know, in that direction of pain-free, longer living, vitality. 
 17:22: Yeah, I mean, you know, look, it's, it's variable. 
 17:24: So, you know, if somebody just initially starts to develop chronic pain in the joint that isn't traumatic in origin, they're in a really good stage of the game, right? 
 17:32: They can, they can make changes in order to offset the end stage of the disease. 
 17:37: and, you know, it's a really important. 
 17:39: , time because they really have two choices. 
 17:44: managing pain with drugs leads them down a road that ultimately ends up at the end stage of the disease. 
 17:50: So in the beginning stages of things, then, you know, making changes that include, you know, daily activity, right? 
 17:57: So making sure that you're moving, joints, the way in which joints. 
 18:02: Acquire nutrients, specifically the connective tissues and joints is through inhibition, and you have to actually pass fluid over the joint through movement on a regular basis. 
 18:12: You wanna make sure that the joints are stable, so you know, physical therapy and doing the things that are necessary to promote mobility and and stability in the joints. 
 18:21: But then look, just, just eating a healthy diet like eliminating toxic foods. 
 18:26: That's, that's key. 
 18:27: I mean, I can't stress that enough. 
 18:29: You know, you know, possibly taking, you know, specific types of supplements. 
 18:35: You know, I'm not a proponent for throwing a million supplements at patients, but there are things that move the needle like collagen peptides, specifically for joints, but also for gut health. 
 18:45: you know, these are things that you can implement very easily, in an effort to offset, you know, the condition from developing over time or getting worse, you know. 
 18:55: Understood. 
 18:55: So then. 
 18:56: With the, the, the people that are actively healthy, they are moving, they are doing all the things, but they still have pain. 
 19:08: They might be an ex-athlete or somebody that's just had, you know, heavy use case of certain, certain, you know, certain movements from their work or whatever it was that they did. 
 19:20: How, how do you help people like that? 
 19:23: Yeah, it's an awesome question. 
 19:25: So, you know, we're talking about two different populations, right? 
 19:28: So the one that we just talked about are, you know, the sedentary patients who are typically metabolically unhealthy that are developing joint pain over time. 
 19:38: You know, when it comes to repetitive stress, and that's, that's like a different population, we have trauma. 
 19:44: And it comes in two forms you can get hit by a bus where there's injury to tissue all at once or you can do things like regularly on a daily basis that creates small amounts of damage over time and that's what we call repetitive stress. 
 19:57: So for like athletes, that do, you know, whether they train or do a specific sport and they develop conditions that really just represents damage to specific tissue. 
 20:08: You know, in, in general terms, when we talk about chronic joint pain, that's really it, it's damage to tissue, either all at once or over time. 
 20:16: in a regenerative model, the difference is we don't just manage the symptom associated with that, we direct our care at the damage itself. 
 20:24: And that can come in a wide variety of, you know, unique presentations. 
 20:30: It can be soft tissue, it can be cartilage in origin, it can be many different things. 
 20:34: So once we understand what the target tissue is, then you can develop a plan that's consistent for healing that. 
 20:40: , and with the understanding that we want to take into account, you know, their metabolic health because we don't care about joints, we care about long term health, right? 
 20:49: And, and you said you, you don't just treat the symptom of it, which the symptom, that's the pain that they're feeling, of course, yeah, you know, pain and inflammation and joint dysfunction, those are just symptoms. 
 21:00: So, you've been, you know, you, you started off in the traditional chiropractic, and it wasn't enough, a lot of the treatments, it wasn't just doing what you wanted, you wanted to really transition. 
 21:13: I guess like how have you saw the transition early on 1516 years ago now with stem cells. 
 21:21: How have other doctors changed their minds when it comes to these stem cell therapies? 
 21:26: You know, it's really interesting. 
 21:27: In the early days, nobody knew really what it was or anything about it, even though there was a significant amount of literature to support it. 
 21:35: Over the years now, it has, it has become widely accepted. 
 21:40: you know, 66% of interventional pain or practices, use at least one form of biologic granted, they typically just use PRP, which is kind of a basic tool. 
 21:52: but outside of that, now we've been able to implement it in personal injury settings where we've had to develop medical efficacy and we've gone in front of, you know, judges in order to get what's called a Dauber challenge accepted because the literature now supports the efficacy of what we do on a grand scale using all the tools we have at our disposal. 
 22:11: So over time, and that's just happened. 
 22:13: Literally in the last 3 or 4 years, but now it's widely accepted. 
 22:19: I mean, you know, regenerative medicine, stem cell therapy, you know, these types of approaches because there's an abundance of literature and abundance of, you know, information coming from clinical practices, it's just hard to argue with and it provides a ton of benefit to patients and now it's entering sort of the zeitgeist with patients because of. 
 22:40: You know, social media and podcasts and other things, and patients have the ability to educate themselves, where people are actively pursuing it because they see, you know, what they see is they see professional athletes choosing to do this type of therapy. 
 22:54: You know, so, and then, and they say to themselves, well, if, if it's good for them, it's probably good for me, right? 
 23:01: Yeah. 
 23:01: What's the biggest wrong idea that doctors have about stem cells and regenerative medicine? 
 23:07: Man, there's a couple, right? 
 23:08: So first and foremost, when we say the word stem cell that may bring up, you know, some negative connotations. 
 23:13: We have to be clear in the distinction. 
 23:16: There are different types of stem cells, right? 
 23:18: Embryonic stem cells are not legal in the United States, nor should they, should they be because they're dangerous. 
 23:25: these are adult stem cells, so these are taken from tissue. 
 23:28: Now, with that, there was a period of time when, you know, there was a, a large push using what are called allogeneic products. 
 23:38: These are stem cells that come off the shelf, usually from umbilical cord blood or Wharton's jelly. 
 23:44: And while those, those types of products are really useful these days, back in the back maybe 8 years ago, biotech companies were putting out a lot of those products and there was no standardization. 
 23:58: So what happened is, many of those products just weren't able to achieve the goals that the doctor was promising the patient, and it wasn't the doctor's fault, by the way. 
 24:07: , you know, they, they actually believed in that and as a result, you know, a lot of medical professionals, especially GPs and even orthos, you know, after they saw the patient fail in that environment, they just, you know, had the belief that stem cell therapy doesn't work, but we have to understand and compare apples to apples, and realize that what are the best tools and resources for the specific condition. 
 24:31: what I do in terms of, well, not just what I do, but. 
 24:35: You know, taking stem cells from the patient in various forms, we have what's called FDA draft guidance. 
 24:42: So we've always been able to do that since 2006, and many of those products that come off the shelf do not have FDA approval, although that is changing here, more recently in terms of the new law, but I think there's a negative connotation based on some of that, but I also think it's lack of education. 
 25:01: You know, I don't think or like orthos don't learn this. 
 25:03: The only orthos and neuros that understand regenerative medicine are surgeons. 
 25:09: That are not recently trained, but are, are, are up on most recent protocol because they use regenerative medicine along with surgery to improve the likelihood of recovery and outcome. 
 25:21: Right? 
 25:22: And that's that's standard care for those, those two you said Earth and what was the other one? 
 25:28: And like neurosurgeons. 
 25:29: So like if they're doing like a two fusion on a lumbar spine, most surgeons who are worth their weight, and this should be the gold standard, it's, it's not, you know, they'll use like some bone marrow aspirate or some PRP in conjunction with that because they want, they want to improve the likelihood of recovery and outcome. 
 25:47: Wow, yeah. 
 25:49: Yeah, that's, that's crazy. 
 25:51: A lot of the doctors just looking at some of the wrong, wrong data or old data, obviously, I mean, if we, if we let that, that's a very narrow, way of looking at things one sided, per se. 
 26:03: That's like saying, well, because healthcare had previous protocols and they changed their stance on that we can't trust healthcare at all for anything. 
 26:11: , is pretty much what, you know, what that's saying. 
 26:14: Now, with the mainstream success, like you said, it's been on podcasts, stem cells, all this health craze is just blowing up. 
 26:24: What's the, the worst thing that you've heard somebody say that could possibly cause damage or that's contradicting to the, to the truth of, of stem cell therapy? 
 26:33: You know, I I think the biggest misconception is that the type of regenerative medicine that we utilize, that we utilize grows things, right? 
 26:42: So when we're talking about embryonic stem cells, the reason they're dangerous is because they are proliferative. 
 26:47: They can, they can differentiate into every cell type and they don't have growth inhibition. 
 26:52: They're designed to grow things, right? 
 26:53: And that's why they can be dangerous. 
 26:55: So, You know, in this environment, the biggest risks that we have are failure to improve, because again, you know, and, and it depends on what you use, right? 
 27:07: So there's a small, risk using off the shelf products, you know, there could be possible immune reactions or graft versus host disease, that, that, risk is extremely small, but when we're working with like bone marrow or adipose or PRP or PRG. 
 27:23: any of the blood components, there is no risk for cross reaction or rejection, right? 
 27:27: The biggest issue that we see is failure to improve. 
 27:30: however, as long as we're dealing or or addressing all the variables within that patient and selecting patients appropriately, we can keep that number relatively low.stood. 
 27:41: Have you lost like any friends from college or or friends from deciding to pursue this type of, of medicine? 
 27:50: You know, no, not, not so much. 
 27:51: I, I mean, I think I gained a lot of really great contacts, over the years. 
 27:56: For me, actually, you know, there's one individual that sticks out quite a bit, that was a really good friend, back in the Cairo days and he was a physiatrist, pain management doc. 
 28:08: And, you know, I think it's mostly just his ego. 
 28:11: I think he just doesn't like me to be successful in a way. 
 28:16: A lot of people he doesn't believe in what we do, right? 
 28:19: so, and I, I don't think he ever will. 
 28:21: I mean, he's an old school allopathic practitioner trained in an environment that won't allow him to see past. 
 28:28: You know, new and unique tools or modern medicine, you know what I mean? 
 28:31: but that's the only one that I can think of. 
 28:33: Everybody else is really supportive, loves what we do, and, you know, as a result, you know, we've, we've developed really great relationships. 
 28:39: It's awesome. 
 28:40: Yeah, that's amazing. 
 28:41: So, started in Cairo, transitioned to more functional health, and now you're full-time regenerative med? 
 28:50: Yeah, I mean, you know, for me, I am like the owner CEO of the clinic, right? 
 28:54: We have to be a multi, we're a multi-specialty medical practice. 
 28:58: So, you know, for me, I'm, you know, as a chiro or a classically trained chiro, I don't necessarily treat patients in the regenerative space. 
 29:06: however, I'm, I'm intimately rela involved in protocol, right, in terms of our actual protocols, they're really complex and comprehensive because of my understanding of biomechanics and some other things. 
 29:17: , but everything is delivered by medical personnel, so we have everything from orthopedic surgeons to, you know, great nurse practitioners, anesthesiologists, and, you know, all the associate, like all the ancillary staff that would go along with that. 
 29:32: OK. 
 29:33: And how, like, how are all of those, those intertwined for somebody who's just looking to get healthier or reduce their pain, you know, chiro functional health and regenerative medicine. 
 29:44: You know, the beauty of what, of who we are actually is that we're multi-specialty, right? 
 29:49: So I have the opportunity to take a look at it from my perspective on the front end. 
 29:54: And then also, you know, interact with other docs who are maybe in the interventional space and say, you know, what do you think of this? 
 30:00: Is this something that we can solve, you know, if it's something that's that's really pretty significant, you know, we can run it by, you know, the ortho and determine, look, is this patient a surgical candidate? 
 30:12: Is this something that we can help with? 
 30:13: And then, you know, obviously, you know, from my perspective too, understanding. 
 30:19: Just, their overall health and what we can accomplish on the functional side and the integrative side, just again allows us to bring a holistic approach to solving chronic joint problems and that includes not just knees and shoulders and hips, but we do a lot of really complex spine work as well. 
 30:35: Wow. 
 30:36: Yeah. 
 30:37: What's the craziest like turnaround or or recovery story that you have? 
 30:43: Man, there's a bunch, so I'll tell you the craziest one. 
 30:47: we had a guy come in. 
 30:48: , 58 years old. 
 30:52: He had 4 lumbar fusions, so 4 segments were fused that he had had the surgeries after the first one, he ended up developing a hematoma, so he was hospitalized for 9 months. 
 31:05: They had to do a revision, clean out, all that stuff. 
 31:08: He did OK with the second surgery, the clean out, then had to have another surgery about 6 or 8 months post because the one above became destabilized, so. 
 31:19: This was probably I would say 5 or 6 years prior to coming to see us. 
 31:23: He was never really out of pain, you know, he had a 10 out of 10 consistent pain for a really long time, half a decade. 
 31:32: He came to us, he was on opiates, he was taking morphine, his health declined pretty significantly. 
 31:39: And he was like, look, I just need some help, whatever you can do, you know, and I said, look, I don't, I don't know, right? 
 31:45: We treat a lot of post-surgical spines. 
 31:46: This was probably the most complex one that we treated. 
 31:49: So what I did is I, I started him on like a, like a wellness protocol first. 
 31:56: I said if we're gonna get ahead of it, let's just make your environment as healthy as possible because we need your body to heal. 
 32:02: we decided to harvest cells cells from that patient. 
 32:06: Because he's young enough, and after doing like wellness protocols, I felt comfortable that, you know, we would get enough cells and they would be viable. 
 32:14: And then essentially, you know, the doc went to work injecting you know in a way that took about 1.5 to 2 hours in terms of, you know, getting the cells to, to where where they were needed, and within about 6 months, he was probably a 2 out of 10 instead of a 10 out of 10, and he's been that way for about 6 years now. 
 32:37: Yeah. 
 32:38: So, you changed the environment first, got him into a, a healthier environment, and then started, you said extracting cells from his own body. 
 32:49: Yeah, so a typical, regenerative procedure would be like a one day procedure, right? 
 32:55: well, most of the work will be done on one day, so we, we would harvest cells from, let's say bone marrow, especially for orthopedics. 
 33:03: You know, for me, we're evident, you know, we have to follow the evidence and what we have a tremendous amount of evidence for is bone marrow aspirate, or cells taken from the patient's bone marrow in combination with PRP, and then delivered to the area of injury and there is a ton of evidence for that for, for all different types, all different parts of the body. 
 33:25: And you know, we can see what the outcome would be based on the literature and then obviously address the patient's individual needs to improve that outcome. 
 33:35: However, there are a wide variety of tools in regenerative medicine, right? 
 33:39: We don't have to just harvest from the patient we have really great products that come off the shelf in the form of Wharton's jelly, umbilical cord blood, exosomes. 
 33:47: I mean, there's lots of things that you can bring into the fold, and for us, it's really just about having as many tools as we possibly can. 
 33:55: Because everybody presents a little bit different, there are variable, there are, there are different variable issues that may prevent, you know, one person from improving with a specific product as opposed to another, right? 
 34:09: So we have to take all of those things into account in order to help as many people as possible. 
 34:14: So most people think you stem cell doctors like yourself are just harvesting aborted babies and using stem cells that way, but you're saying you're getting all of these stem cells from the patient's body, the individual body. 
 34:29: In many cases, absolutely. 
 34:31: So, you know, again, this goes back to the embryonic versus adult discussion. 
 34:35: And there has to be a clear distinction. 
 34:38: embryonic stem cells come from aborted babies, right? 
 34:42: However, we can get adult stem cells from donated placentas, right? 
 34:47: But it's really the difference between embryonic and adult stem cells. 
 34:51: Adult stem cells live in our tissues. 
 34:53: They're designed to repair and maintain our tissues throughout the course of our life. 
 34:58: The problem is when we develop injuries or we develop problems that our body can't overcome on its own. 
 35:04: And what we can do is we can use your body's natural ability to heal, to heal another part of your body, I see. 
 35:12: And the the bone marrow is is generally the best stem cells for that? 
 35:18: Well, I think it depends, right? 
 35:19: So it depends on the target tissue. 
 35:21: If we're talking about orthopedics, in my opinion, bone marrow produces far greater results than anything else that we've used, and, and we have to make a distinction so. 
 35:32: What I consider to be a good result would be a great long term outcome, right? 
 35:36: I'm talking 5678, as as long as we possibly can to return that patient in years, right? 
 35:43: Return that patient to pain-free, fully functional and in order to do that, in many cases you have to heal dense connective tissue, and what I find is that bone marrow does that, at a higher degree. 
 35:56: Than some of the other things like adipose or even some of the off the shelf products. 
 36:00: Now when I say off the shelf products, those are really powerful resources, right? 
 36:05: There are many applications for soft tissue, lateral epicondylitis, different types of soft tissue issues where those can solve problems really well. 
 36:14: , they, they produce, a really great anti-inflammatory effect and it's, it's just really powerful and essentially can, can provide a great resource for specific patient populations. 
 36:28: However, if there's a lot of damage to cartilage, let's say, as a, as an example, like a big labral tear or meniscus, or disc injury or, you know, degenerative change. 
 36:39: Then in my opinion, bone marrow just produces the best long term outcome. 
 36:42: So really it's, it's an art and a science. 
 36:44: It's determining, you know, what target tissue needs to be addressed, what we want to accomplish, whether that's short or long term, and then determining what are the variables that are gonna prevent us from getting there and trying to control them the best we can. 
 36:57: Wow, and then with these patients. 
 37:04: You said they're in and I believe with the specific guy who had or the patient that had the, the four back surgeries and was in a 10 out of 10 pain wise. 
 37:15: With that patient, you said they were within age of using their own cells. 
 37:21: What is that age range generally that you're seeing for somebody to be able to tap into their own stem cells. 
 37:27: You know, and again, there is no specific delineation, right? 
 37:34: our first choice for orthopedics would be to harvest bone marrow. 
 37:38: However, if the patient is above 75 and metabolically unhealthy. 
 37:44: And metabolic health really plays a role. 
 37:46: So really the primary issue is as we age, and one of the hallmarks of aging is what we call stem cell fatigue but also cellular senescence. 
 37:55: That's where cells in our body are living but they're not functional, and these are hallmarks of aging along with like mitochondrial dysfunction, glucose dysregulation, all of the things that create the aging, situation in our body. 
 38:08: So what we have to understand is it's not always a number because like for example we treated an 85 year old woman who was extremely healthy for her age and we chose to harvest bone marrow in that patient. 
 38:21: She had a really great response, you know, the other side of that or the flip side of that would be a 50 year old who's type 2 diabetic, insulin dependent, and has severe arthritis, but we're not gonna use their cells. 
 38:34: Their cells are going to be relatively incompetent and the number of actual cells that we'll be able to achieve, which is a really big piece of the puzzle, the amount of cells, the total nucleated cell count is really important. 
 38:47: You know, the literature tells us that, but we know from the science is total nucleated cell count makes a difference. 
 38:53: And when we're harvesting from the patient, we may not be able to achieve the numbers that we need. 
 38:59: Understood. 
 38:59: So to answer your question, there isn't a specific number, but the range I would say is right around 70 to 75-ish, but also in younger populations, it just depends on how they present. 
 39:10: Wow, that's much older than I expected. 
 39:13: I've heard rumors. 
 39:14: That like 40 or older, you're pretty much past the, the limit. 
 39:19: Is that just for PRP? 
 39:21: No, so PRP is useful for long, for, forever in my opinion. 
 39:26: you know, I just don't know, like at the end of the day, you know, I hear all those numbers get thrown around quite a bit. 
 39:31: , I don't know that it's based in science specifically. 
 39:37: I I'll be honest, I don't think there's a study that suggests that somebody at that age just doesn't have competent cells in, in, in the abundance that we need to, to solve problems. 
 39:47: I think that's just the general theory based on. 
 39:50: You know, like, like practical purposes, like, like what I was describing in terms of age is true that, yeah, your stem cells are not as active and viable and in the numbers that you would normally have when you're younger, but I don't know that those studies exist and I don't know that there's hard evidence to suggest that's true. 
 40:09: With that being said, I've been doing this for a really long time and treating an aging population. 
 40:14: And our outcomes are consistent with what the literature tells us they should be in, you know, long in big, in case studies that are published as well as in, clinical trials. 
 40:25: Yeah, because a lot of med spots, that's what they say is, oh well, you're over the age of 40 PRP is like pretty much not effective, so we're not gonna use it. 
 40:33: So what it, what does the literature say then? 
 40:35: , you know, as it relates to age, there is no study that that shows like in, like they don't study like 40 year olds compared to 60 year olds pull their pull their cells and determine, you know, what the cell viability is and the cell count is and what the, the demographics of those cells look like, right? 
 40:53: Like what kind of cells are we getting? 
 40:54: Are we getting MSCs, hematopoietic, are we getting? 
 40:56: , accessory cells, you know, are they CD 34? 
 40:59: What are they? 
 41:01: those studies don't really exist unless I haven't seen them, and I'm, I may just not have had the chance to see them. 
 41:08: I think a lot of practitioners, especially in the aesthetics environment. 
 41:12: , they want ease of use, right? 
 41:15: It's easier to pull something off the shelf and inject it into a patient than it is to understand how to draw and spin down PRP in office because you need a lab. 
 41:25: And also the same with bone marrow. 
 41:26: I mean, these are procedures, right? 
 41:28: , aspiration that has to go into the iliac crest right in their pelvis, and then that has to be prepared in office, has to be prepared properly, has to be done properly. 
 41:39: So I think a lot of that has to do with ease of use, to be perfectly honest, understood. 
 41:44: So PRP is pretty simple, just a blood draw, and then they can possibly run that in in an in-house lab. 
 41:50: But bone marrow, how, how do you even get bone marrow stem cells? 
 41:55: You know, a lot of people get nervous when we say bone marrow, right? 
 41:58: So here's the thing, it is what's called the needle aspiration we put a needle we go just below the buttock, right? 
 42:05: So we have these big broad bones in the pelvis they're the largest flattest bones in the body, maybe not the largest, but the flattest obviously, and there was really no sensitive tissue between the skin and that particular bone, so it's an easy target. 
 42:19: We numb the area, we use a needle to get to the bone, but then we do have to enter the bone. 
 42:24: It is not a biopsy, so it's a little bit different, a needle aspiration, mild discomfort that's over in relative seconds, so 3 to 5 minute procedure it feels like a little bit of a deep charley horse, but it's over pretty quick, and it's pretty tolerable. 
 42:40: OK. 
 42:42: And that's enough one-time procedure for them to experience a full recovery. 
 42:49: So, it really depends, right? 
 42:51: Again, there's lots of variables. 
 42:53: most of our patients, we can achieve the results they want with one treatment. 
 43:00: again, when we go into the, the bone marrow's volumetric, we'll get enough fluid. 
 43:04: So that we can acquire enough cells and then the way that it works is once we inject them into the site, those cells are gonna live there for an extended period of time actively healing the tissue and also controlling the environment so what we, what we see is incremental improvement over time in terms of reducing symptoms which is related to the repair of tissue. 
 43:25: OK, understood. 
 43:27: So walk me through like the step by step process. 
 43:30: Somebody comes in, they've got a, a, a knee that's just in chronic pain. 
 43:36: What is the step by step process when they come to see somebody like yourself or come into your guys' clinic? 
 43:42: Well, I mean, obviously we're gonna have to learn a little bit about their medical history. 
 43:46: We want to understand how the condition developed. 
 43:49: we wanna understand the severity of the condition, so diagnostics are really important. 
 43:53: And once we have a clear picture of the environment, which is the patient, right, and what they're dealing with metabolically like just we need to have a whole health history, and we understand the joint itself, the target tissue that needs to be addressed, then essentially what we'll do is we'll recommend a treatment plan that fits their goals, right? 
 44:12: and that's part of it, you know, when we, when I consult with patients, I really just ask them what is it that you'd like to accomplish? 
 44:19: I mean. 
 44:19: , and once we kind of outline what it is that they'd like to accomplish and if we can possibly achieve that. 
 44:26: Then we'll lay out a treatment plan that's necessary to get them there. 
 44:31: yeah, the regenerative component of what we do is typically a one day procedure, but it is common that we, that we may need to do some booster injections. 
 44:41: It really just depends again on, on how they present and booster injections are typically blood-based, so we don't usually have to pull bone marrow more than once. 
 44:49: OK. 
 44:50: And then if. 
 44:52: You know, they decide stem cells is right for me. 
 44:54: I've had, had knee pain. 
 44:56: They've done the analysis. 
 44:57: What's the step by step process for somebody to get stem cells with you and put, put that into like a, you know, a knee that's experiencing pain consistently? 
 45:06: Yeah, I mean, so basically we send them out for labs. 
 45:08: We, we pick up a procedure date, send them out for labs on the day of the procedure. 
 45:13: It's about like for a knee, it's about a 40 minute it's a 40 minute office visit. 
 45:19: You know, they come in, we numb the area, we go in and do the bone marrow aspirate, we pull some blood so that we can prepare the PRP and the bone marrow, and then essentially once we have those products, ultrasound guided into whichever joint is affected, you know, but if it's a knee, really very straightforward, shoulder obviously also straightforward if it's a spine, it's a little bit different. 
 45:41: we use video fluoroscopy and those procedures can take a little bit longer, 1.5 to possibly 2 hours depending on how much work we have to do. 
 45:48: , but then they go home and resume normal activities immediately following, so there really is no downtime. 
 45:55: We're not cutting things out. 
 45:56: We're doing it, we're doing basically a transplant, right? 
 45:59: It's really that, that's the most important thing that, you know, I try to instill in patients is, all we're really doing is there are tissues in your body that don't have the capacity to heal because they lack blood supply and they lack the basic components that are necessary to heal it. 
 46:14: Which are the cells. 
 46:16: What we're doing is we're going and getting blood components and cells and we're placing them in direct contact with that damaged tissue and letting them do the work for us. 
 46:25: Wow. 
 46:25: So what, like for, for a knee, what is the normal ticket on, on stem cells for, for a knee? 
 46:31: , so again, it'll, it'll depend on what we have to use. 
 46:35: if it's off the shelf, it's right around 6. 
 46:37: 000. 
 46:38: if, if it's a bone marrow procedure, it's 6900. 
 46:43: OK, so let's just say like 6 to $700 roughly for a knee or is that for both knees for a knee, but again, like if we're doing two knees or two joints at the same time, we only charge 1000 bucks. 
 46:56: OK, so roughly like 6 to 80, somebody can come in and see some pretty significant. 
 47:03: , improvements, possibly even like full recovery from what they're experiencing, and they would have virtually zero downtime. 
 47:13: How much downtime would they have if they did like a knee surgery and and something like that? 
 47:26: You know, it varies based on the patient, but it's. 
 47:26: There's even more recovery. 
 47:27: That's not the issue. 
 47:28: The issue isn't the recovery time, right? 
 47:30: The issue is the relative risk if it doesn't work and the relative risk with an invasive procedure. 
 47:36: There's a hierarchy, right? 
 47:37: So. 
 47:38: Certain replacement surgeries are really great, so hips do really well, right? 
 47:44: Hip replacements when patients come to me with severely degenerated hips and they're like, look, I just don't want a hip replacement. 
 47:51: I don't care how much it costs. 
 47:52: I tell them no, go get a hip replacement because the relative risk for that procedure is really low and the recovery time is really short and they're back up and moving pretty quickly and they go really well. 
 48:03: But past that when we're talking about knees, you know, the, the basic literature, I mean, the number varies, but 33% of them fail, meaning that patients still have pain post-surgical. 
 48:14: 10% of patients who go through that procedure have serious complications. 
 48:18: You know, when we're looking at a shoulder, it gets even worse because the recovery time is really significant, and the relative risk is slightly higher, right? 
 48:27: So. 
 48:27: You know, we just have to weigh what our options are, what tools and resources are available to us and what we want to accomplish. 
 48:33: Yeah, yeah, that's crazy. 
 48:35: So what other surgeries would you disco discourage somebody from, from doing, you know, you said hip replacements, you encourage people to do that. 
 48:45: What are the ones that you would say, hey, I, I recommend you doing a more, I guess, is this considered holistic? 
 48:53: Well, this would be considered a minimally invasive approach, right? 
 48:57: it's conservative in the sense, that it, we're not cutting things out, right? 
 49:03: So what surgeries do you see the, the, the, that have like the most, I guess what's the, the language, what surgeries have the most error or, or pain, I, I don't know if there's a terminology for that where they, they have pain after the surgery or it doesn't do the job. 
 49:23: I think I know what you're saying. 
 49:24: So, you know, what I teach is really simple. 
 49:27: there's a time and a place for surgery, right? 
 49:29: If something is completely broken, it can't help you. 
 49:32: They have to be surgically repaired. 
 49:34: So, you know, in those cases, surgery is not a choice. 
 49:38: Those patients are gonna get surgery because it's really the only option and they have a certain level of dysfunction that won't allow them to, you know, use their body. 
 49:47: In those cases, surgery is always the option. 
 49:50: Right, regardless of what the outcome is in that situation, but when things are sub threshold like partial thickness rotator cuff tears, I mean, historically, yeah, I mean they can provide some relief, but at the end of the day, it's a really invasive procedure and a lot of them tend to recur, meaning they retear. 
 50:08: , impingement syndrome in the shoulder, if there's any sign of osteoarthritis, the literature says don't do it, depending on how old you are. 
 50:15: For meniscus repair, depending on the severity, for arthroscopic meniscus repair in in a middle aged individual with any sign of arthritis, even on the mild stage, the New England Journal of Medicine says you'll have a knee replacement 1/3 sooner if you do that, right? 
 50:31: The British Medical Journal says the small and consequential benefits don't outweigh the risks. 
 50:35: There's no reason to do it. 
 50:37: Now, from that perspective, what I want to instill in, in people is really very simple. 
 50:43: If things are partially broken, it makes more sense to repair it because the long-term outcome is better. 
 50:49: If things are totally broken, then you have to surgically repair it because it's the only tool available. 
 50:54: Now, one last thing, never do surgery on the spine unless it's tumor infection or instability, and tumor infection instability, those are reasons to do surgery on the spine, severe neurological deficit, weakness in an extremity, cord impingement, those are surgical, everything else, it doesn't make sense because the long term outcome is really poor. 
 51:15: Understood. 
 51:16: Wow. 
 51:17: So you guys have you throw around some, some big terms like orthobiologics. 
 51:22: What exactly does that mean? 
 51:26: Believe it or not, You know, I, my previous company was called NSI Stem Cell, right? 
 51:34: And back when, when I was talking a little bit about the off the shelf products, the FDA got really clear about regenerative medicine, and they're like, we don't like the term stem cell therapy. 
 51:45: they de-platformed us on Google, you know, back in those days, and you just couldn't use those terms. 
 51:51: So when I rebranded my company like 5 years ago,, I used a very traditional term, so the practice of what I do is called orthobiologics, yeah, and basically what it pertains to is ortho obviously orthopedics, and biologics are living tissue, right? 
 52:11: So, and biologics can mean a lot of things. 
 52:13: There are drugs that are considered to be biologics, but biologics in this sense are things like PRP, bone marrow aspirate, SPF or stem cells taken from adipose. 
 52:24: Those are biologics. 
 52:25: Those are traditional biologics. 
 52:28: Understood. 
 52:30: how is what you guys do different than some of these other stem cell clinics that make these big promises and wild miracle claims? 
 52:41: Well, you know what, that's a really sensitive subject. 
 52:45: The FDA is very clear about making outrageous claims. 
 52:50: we stick to what we have evidence for, right? 
 52:52: And what we have, clinical experience and, and that's predominantly orthopedics. 
 52:58: you know, we know there's standardization, relative standardization in orthopedics, so we don't make outrageous claims. 
 53:05: Because we have clinical experience and we've dealt with so many patients, we know when patients are gonna improve or are highly likely to improve, right? 
 53:13: And we can have those discussions with them. 
 53:15: You can't make outrageous claims in in any healthcare practice because it's not a good practice builder and what I usually tell patients is look, this is not magic, right? 
 53:26: A stem cell isn't gonna cure your Alzheimer's disease, you know, we don't that that we don't have evidence for that. 
 53:31: It's not gonna cure your autoimmune disease. 
 53:34: It's not gonna do X, Y, and Z because they aren't magic. 
 53:38: They are simple biological tools that have the ability to do specific things and the most powerful thing that they do is heal and regenerate tissue. 
 53:46: I mean they do some other things, they can regulate immune function, they can regulate the inflammatory process, and there are useful cases for using some of these products in those circumstances. 
 53:56: But at the end of the day, from an orthopedics perspective, you know, we, we kinda know what we can and can't accomplish, right? 
 54:04: Yeah, you guys have developed your own proprietary system, the, the meta 3 method. 
 54:09: What exactly is that? 
 54:10: So meta is metabolic. 
 54:13: there are 3 things that we have to address. 
 54:16: we have to address the metabolic health of the patient. 
 54:19: We have to address the functional deficit that kind of led to the issue, the biomechanical problems, and we have to address the damaged tissue, and we do that with various tools. 
 54:29: If we do all three of those things, we can just improve the outcome long term. 
 54:33: So, you know, one of the things in terms of protocol and the delivery of regenerative medicine, let's say to to a spine, for example, you know, there isn't one pain sensitive tissue in the spine, you know, most orthos, traditional orthos, God bless them, they're wonderful people, they have a myopic view of things, right? 
 54:52: They see a disc herniation and they focus on the disc herniation, when in fact there are many pain sensitive tissues in the spine that can be creating the symptomatic presentation for that patient. 
 55:03: You know, maybe they have really severe low back pain with the disc herniation, but they don't have leg pain. 
 55:08: You know, we can't cut that disc out and expect the patient to do better, so what we have to do is address it from a more global approach or comprehensive approach where we're healing as much tissue as we possibly can. 
 55:20: Mhm, mhm, yeah. 
 55:21: So our protocols for spine are really complex. 
 55:24: The same is true for like shoulders, for example. 
 55:26: Shoulder is the most muscular joint in the body. 
 55:28: You have two joints. 
 55:29: , one is the primary mover, the glinohumeral joint. 
 55:32: You got all kinds of structures, you got cartilage surfaces, you got labrum, you got 5 rotator cuff muscles, you got big primary movers. 
 55:40: All of them have to be addressed because the pain isn't just coming from the one small tear that they have in the rotator cuff. 
 55:46: It's coming from many things. 
 55:48: Right, so when we have a deep understanding of form and function, this is, this is as a chiro, I mean, obviously this is my wheelhouse, then we can then again take a holistic or global approach to the joint itself, but then also to the patients so that we get the best outcome. 
 56:06: What are the, the main reasons people are coming to you? 
 56:10: The main reasons currently are orthopedic, right? 
 56:15: So chronic joint pain predominantly. 
 56:17: What are the main joints that they come to you for? 
 56:19: Do you have a special specialty in in joints that you treat? 
 56:23: We do, shoulders, I mean, well, I would say knees are probably, well, I would say it's a toss up between knees and spines, and then shoulders. 
 56:35: Those are the three most common. 
 56:36: And you know, we've, we have a doc who's certified in a procedure called disk seal, which is really amazing, in line with everything that we're describing, it's a little bit different in, in the sense that we're using a, a, a different biologic, it's called fibrin. 
 56:51: And we're able to actually seal disc herniations with a needle as opposed to going in and cutting the disc herniation out. 
 56:59: it's outpatient, we're not removing tissue, we're repairing tissue, and the clinical outcomes so far have been really good. 
 57:06: We had a, we had a competitive triathlete, start competing 3 weeks post procedure. 
 57:12: She had like multiple disc herniations, she did really well. 
 57:16: Yeah. 
 57:17: Everyone's heard the saying, you are what you eat. 
 57:19: How does diet affect some of these, these outcomes that your patients are seeing? 
 57:26: Really simple. 
 57:26: We want to control inflammation. 
 57:28: That's the key. 
 57:29: So imagine that our primary objective, like you have a broken down house, right? 
 57:34: And our objective is to gather construction workers and raw materials, and then we have to bring them to the house so that they can repair it. 
 57:41: What if the house is on fire? 
 57:44: They're not gonna be able to do the job they need to do, right? 
 57:47: So, so dealing with the inflammatory or the systemic and chronic inflammatory process is a really big piece of the puzzle. 
 57:53: So every patient that we that we see gets an anti-inflammatory diet. 
 57:58: Some have to be completely perfect because they have other issues. 
 58:03: Some, you know, their general recommendations, you know, what I would tell anybody who's listening to this. 
 58:10: Is we get one opportunity to heal your body, right? 
 58:14: You don't have to be perfect for the rest of your life. 
 58:16: You don't have to be a monk, you don't have to be a vegan. 
 58:19: I mean, if you wanna be a vegan, you can choose to do that, of course, but what we need to do is control the environment so that we get the maximum amount of healing within the time frame that would be necessary to promote the outcome that you want, right? 
 58:32: And what what diet is if you had to pick like one diet that's trending right now or that you know, people would at least be aware of, what are you seeing as the diet that's most aligned with reduced inflammation? 
 58:47: Well, I think, you know, anything that's trending, they're all good at doing one thing, eliminating toxic foods, right? 
 58:55: , there are, there are some issues associated with some, not everybody responds to all of them, but if we look at like the paleo diet, if we look at the carnivore diet, you know, you name it, keto, all of those diets, what they really do is they eliminate the things that are highly inflammatory. 
 59:12: , you know, a vegetarian diet or a vegan diet. 
 59:15: The one thing about vegan diets that I don't agree with is there, you know, the animal products that we eat are really important, especially for, the health of our joints, in my opinion, so I don't, I'm not a proponent for strict veganism. 
 59:31: With that being said, you know, it's, it's very common, that, you know, I, I recommend certain types of diets for specific patient populations. 
 59:41: So carnivore diet as a therapeutic tool for autoimmune disease has been shown to do really well in those individuals, because it is the least toxic, it's predominantly animal-based, right? 
 59:51: , but you know, plants can be toxic to autoimmune patients. 
 59:55: You can have a predisposition that causes them to be hypersensitive to some of the compounds in plants, even though those plants are healthy for other individuals. 
 1:00:03: So it really just depends on, on the patient, but it's really just removing the toxicity. 
 1:00:08: It's sugar, it's alcohol, it's simple carbohydrates, breads, pastas, right? 
 1:00:12: , at least breads and pastas in the United States and then processed food. 
 1:00:17: Anything in a jar or a box, it's just gonna have all kinds of crap in it that's gonna create inflammation in the body. 
 1:00:23: Yeah. 
 1:00:24: Yeah, I think so many people look at all different things like what do I need to add to their my plate, and I see this in business, you know, as somebody who consults on businesses, they're like, what do I need to do? 
 1:00:35: It's like, well, what do you need to stop doing? 
 1:00:36: let's start there. 
 1:00:38: Like those are gonna be the powerful things that aren't like helping you because you, you know, most people do have a lot of successful actions in life and their health and business. 
 1:00:46: Now it's like, what are the unsuccessful things? 
 1:00:48: What are the things that are hurting all the progress that you're making. 
 1:00:52: And the path of removal is, is always easiest. 
 1:00:55: That's how I think how I've stayed healthy so long and, you know, fit relatively. 
 1:01:00: I think right now I'm probably around like 11% body fat, but relatively lean, like always under like 10% body fat. 
 1:01:06: And it's just like, I don't eat processed sugars. 
 1:01:09: I don't drink any soda. 
 1:01:10: I don't drink anything. 
 1:01:11: I don't consume anything with added sugar unless it's like a dessert, which is, you know, rare rare instances. 
 1:01:18: But aside from that, it's like I don't ever buy any processed foods. 
 1:01:21: I don't have any food that junk food in the house. 
 1:01:23: And just by eliminating the things that are going to hurt my progress and my goals, I've been able to maintain like, you know, pretty good health, and so that's, that's interesting that that's what you're seeing is like the most common. 
 1:01:36: I never actually thought about it like that, which is so true. 
 1:01:39: It's like, what aren't they doing? 
 1:01:40: Like those are the things that you wanna focus on and eliminate those things. 
 1:01:43: , Are there any like special nutrients that might help in this healing process? 
 1:01:53: Yeah, I mean basic compounds like, you know, we make nutritional recommendations as part of the process, but you know the thing that I that I try to help people understand is like, there isn't a supplement that's gonna solve a problem, right? 
 1:02:07: I mean, if you're eating a healthy balanced diet, you're getting most of the nutrients that you need. 
 1:02:11: , yes, we should probably be taking like some methylated B vitamins or B complex, you know, yeah, I think that's important, vitamin D, there are certain nutrients that are absolutely essential in terms of supplement form that we don't typically get, but you know, for me there isn't, there isn't a magic supplement that's gonna ultimately help. 
 1:02:31: The key is getting them to eat whole foods, right? 
 1:02:35: that's, that's the key for me and yes, we make recommendation like I love collagen peptides. 
 1:02:39: , I love it for a couple of reasons. 
 1:02:43: it's great for joints, but more importantly, it's really good for gut health and reducing systemic inflammation is obviously our goal. 
 1:02:50: a large majority of that comes from our gut, right? 
 1:02:54: So if we can calm the gut down then. 
 1:02:56: We'll we'll tend to see a, you know, leveling off of that inflammatory response, but we also employ like fasting mimicking diets and other things and even peptides, right? 
 1:03:07: you know, I, I love peptides. 
 1:03:08: They're a wonderful tool to help move the needle pretty quick. 
 1:03:11: I find them to be very synergistic. 
 1:03:13: Yeah, yeah, peptides are blowing up, especially ones like BPC 157. 
 1:03:18: What are some of the peptides you guys are are helping in or seeing have the greatest impact for recovery or pain management. 
 1:03:26: So typically, those are the, those are the ones, right? 
 1:03:29: So BPC 157, thymusin beta 4, if they have some autoimmune predisposition, maybe thymusin alpha 1, it really, you know, there's, there's a wide variety of peptides that you can utilize and you can go down a lot of rabbit holes in terms of health optimization. 
 1:03:44: But BPC 157 and TB 500 are the ones that really aid in the healing process, so those are probably the most common that we use because they're synergistic. 
 1:03:56: now, you know, with that we also look to possibly balance hormones with patients. 
 1:04:01: Men are relatively straightforward women a little bit less so, but again these are synergistic tools that allow us to. 
 1:04:09: You know, achieve our goals, which is to repair, to possibly regenerate tissue and promote stability in joints, and those peptides have been shown to do that pretty well. 
 1:04:18: It's pretty cool. 
 1:04:19: Yeah. 
 1:04:20: Oh, it's, it's crazy, what peptides can do and and are doing and just this whole, this whole market. 
 1:04:28: I love, I really love being in this space. 
 1:04:30: So with Regen you got peptides, you got stem cells. 
 1:04:34: I guess like if these work so well, why aren't other doctors? 
 1:04:38: Jumping on board with these these treatments. 
 1:04:42: Yeah, I mean, that's a really good question. 
 1:04:45: So, you know, a lot of, it's, it's starting to get to the point where people are really paying attention. 
 1:04:53: I think, you know, I think it really just depends on training and kind of, you know, what, what doctors are, are. 
 1:05:00: You know what they've interacted with over the course of their career, right? 
 1:05:03: Like the majority of orthos don't have time, you know, they, they learn drugs in surgery, they have a specific pattern, you know, that when they identify patients, they identify it in a unique way that only allows them to think in terms of symptoms and surgical intervention, right? 
 1:05:18: And that's normal. 
 1:05:19: That's the nature of that type of practice. 
 1:05:21: , so to do what we do in the environment that we work, it is, it is really complex, right? 
 1:05:28: So we're harvesting tissue, we're doing a lot of advanced injections, you know, it's not that easy to implement that type of approach. 
 1:05:37: I think what we're seeing more and more coming down the pipe is those off the shelf products because they're a lot easier to administer. 
 1:05:45: but the problem is, is that a lot of docs aren't taking the time to learn. 
 1:05:49: Like ultrasound guided techniques, and obviously many of them are unqualified to do to do spine work, but you know, I don't know what the answer to that is, I think. 
 1:06:00: I think we're making an impact. 
 1:06:02: I think things are changing. 
 1:06:04: I think you can't argue with the outcomes, and as a result, like more and more clinics are offering these types of solutions, but to be honest, I kinda, I kinda keep my head down and and do as much as I possibly can to help as many people as I can. 
 1:06:18: I don't really care about anybody else, to be honest. 
 1:06:20: Yeah, yeah, yeah, results focus. 
 1:06:23: I get that same way. 
 1:06:25: I don't focus too much about what others are doing. 
 1:06:27: , and, and I know you mentioned that some of your best patients are generally like 50 to 65 in age. 
 1:06:37: tell me, like specifically what does your ideal patient look like? 
 1:06:41: Yeah, I mean, we, we don't wanna like Narrow it to a specific age range, but what I would say is that's probably most of the patients I see and the reason that I see patients in that age range is because these are typically active individuals, that wanna enjoy their life. 
 1:06:56: They play sports, maybe it's pickleball and golf, maybe it's. 
 1:07:00: You know, competitive sports. 
 1:07:01: I have one guy that's playing senior ice hockey, but my point is, these are individuals that want to continue to function at a high level. 
 1:07:09: They want to enjoy themselves, you know, maybe they want to enjoy their, their early stages of retirement. 
 1:07:14: They want to play with their grandkids, they want to keep up with their grandkids. 
 1:07:17: , these are people that wanna get better with age, not worse with age, so they're looking for solutions that are consistent with achieving that. 
 1:07:25: Now that doesn't downplay the, the, you know, the patients we see a large amount of patients who are well educated who when they develop a condition recognize that. 
 1:07:35: They should solve that problem, right? 
 1:07:38: And they come to see us, but I think that's a smaller percentage of the population. 
 1:07:42: It shouldn't be it should be the other way around, but our ideal, you know, patient is one that cares about their health and cares about their ability to function and is willing to invest in it. 
 1:07:53: Yeah, so what makes somebody like perfect for stem cell therapy versus somebody that's not. 
 1:07:57: , again, there is no perfect model from a clinical perspective we really just have to do an evaluation. 
 1:08:04: , you know, I would not want to preclude anyone from coming in, but what I would tell them is, look, if you're, if you're an insulin dependent diabetic, and you are 50, 60 pounds overweight and you're expecting us to solve your problem, it's probably not likely, you know, if. 
 1:08:24: You know, in those circumstances, and those are difficult, you know, we don't, we don't ever want to turn people away, but we have to call it the way we see it. 
 1:08:30: I'm not taking anybody's money unless I know that I have a really high likelihood to achieve their goals. 
 1:08:37: outside of that, anyone with active cancer, right? 
 1:08:40: So that's a clear contraindication pregnant women, we can't treat those, but anyone with an active cancer, isn't somebody that we would generally treat. 
 1:08:49: Not because there's any risk to developing cancer with your own cells and the literature is pretty clear on that. 
 1:08:55: there's just liability and risks associated having that kind of condition, right? 
 1:09:00: Sure, sure. 
 1:09:02: I mean, how do you guys help somebody who comes in saying nothing works on me? 
 1:09:08: Well, usually what I try to explain to that patient is when, you know, when people have that mindset. 
 1:09:15: What I find most common is that they just feel like nothing works on them because they're working in the same environment over and over and over and over they're working with short term tools and those short term tools wear off and the condition typically worsens over time so what happens is they'll go in for, well they'll get some physical therapy that doesn't solve the problem they'll get a cortisone injection that doesn't solve the problem maybe they get a gel injection. 
 1:09:40: That only solves the problem for a short period of time, but then it wears off over time and then they enter the end stage of the condition and now they have pain all day every day and they can't function and when they come in they're like, look, nothing works on me and I tell them, you know, it's because you're working in the same model you're looking for long term solutions with a short term tool, right? 
 1:09:59: And those tools aren't designed for that. 
 1:10:00: They've done their job up until this point, but you're in the position that you're in because you're continuing to work in that model. 
 1:10:06: So if we don't look at something different, then we're never gonna get a different result. 
 1:10:10: Right, right, yeah. 
 1:10:13: Yeah, I see that. 
 1:10:16: you said the the biggest problem isn't, isn't so, you know, the money, it's the belief. 
 1:10:22: Can you explain that more? 
 1:10:24: Yeah, I think, you know, look, if everyone believed 100% that they're gonna get a positive outcome, would it matter how much it cost? 
 1:10:32: If the problem's big enough, right, so if there's a big enough, it's if it's affecting your life, if it's keeping you from doing the things that you love and enjoy, right? 
 1:10:41: Pain is a really big motivator. 
 1:10:44: if you're tired of being in pain, then you knew that there was a resource that 100% of the time would work no matter what, you would just figure it out, right? 
 1:10:52: You would figure out, I mean because there's lots of there's lots of options for financing, we can make it really affordable. 
 1:10:58: , it's not completely out of range for the majority of the people that come to see us. 
 1:11:04: We have in-house financing. 
 1:11:05: We do everything we possibly can, hardships, we can do all kinds of stuff if the patient is motivated, so it really is just a belief that, OK, well, I don't want to invest in this if I don't think it's gonna work, and I think that goes back to that previous situation where they failed so many times where people give them promise. 
 1:11:24: And unfortunately, they're not getting the outcome they want, so they don't believe in the next therapy, let's say, you know, yeah. 
 1:11:33: I mean, how do you help somebody or convince somebody who's been let down by traditional doctors for so long? 
 1:11:40: Well, you know, it starts with education. 
 1:11:42: I, I help them understand the the nature of the condition. 
 1:11:46: I do the best that I that I can to make that distinction between models, and this is what the, you know, this is what the traditional model has to offer, and this is the expected outcome, and here's what we can do and then really it's just a matter of, you know, trying to show them testimonials, case studies, literature, everything we possibly can. 
 1:12:07: To help them make a better, a better decision, you know, sometimes that doesn't work. 
 1:12:13: It's hard to get past certain belief systems, but that's OK because eventually if they're motivated and they're and they're, they're, they're still looking for a solution down the road, maybe they come back at a, at a later date, you know. 
 1:12:26: Yeah, yeah, and you said numbers generally $6000 to $8000 is a typical treatment. 
 1:12:34: Insurance doesn't cost these, so these aren't exactly like super affordable. 
 1:12:39: How, how can somebody even justify that? 
 1:12:42: Well, I mean, I think it's really about the value that we can bring. 
 1:12:45: I mean, think about, you know, the majority of your pain, fully functional as a result of intervention. 
 1:12:54: You know what? 
 1:12:54: you know, for the individual who has chronic knee pain, osteoarthritis, the cost for managing that. 
 1:13:01: Condition over time is well into the 125,000 range and this is documented right in terms of co-pays for physical therapy, co-pays for doctor, loss production because you're not as functional as you need to be. 
 1:13:14: I mean, the cost for having a chronic and degenerative condition is extremely high, so it's relative. 
 1:13:20: You know what I mean now in terms of like a price point, you know, we can make that affordable in terms of payments and most patients choose to do that. 
 1:13:28: So it's not, you know, it's not that they have to write a check day one, we can offer them financing to make it a little bit easier. 
 1:13:36: So it sounds more like it's, it's not like what's the cost. 
 1:13:39: It's more of what's the cost of not solving this problem, you know, when you factor in all the copays, all the visits, all the pain, all the lack of sleep, the lack of life that you don't get to experience. 
 1:13:53: Maybe it's traveling, doing certain things that you used to love to do, sports, being active, you have to really get clear on, on what that cost is and be real, because this seems like it's, it's buying back so much more than it's really costing them. 
 1:14:11: Well, imagine if you worked your whole life, you know, and you were able to retire at a reasonable age, let's say 60 years old, you're in relative good health. 
 1:14:20: But you have really bad knees, right? 
 1:14:22: You know, you're looking forward to living 1015, maybe 20 years of on the back end of your life enjoying yourself. 
 1:14:30: You know, a lot of people tell me they can't get on cruises because of the walk. 
 1:14:33: They can't go walk the mall with their daughter or granddaughter. 
 1:14:37: And these are, these are real, these are real issues, you know, it's not, look, it's not everyone that's that that debilitated, you know, I speak to, so many patients, some just wanna be able to play a pain-free round of golf, right? 
 1:14:51: or sleep through the night. 
 1:14:52: I mean there's varying degrees of what is meaningful for each individual patient. 
 1:14:58: we're not promising that we can solve everybody's problems, but at the end of the day, if they're, you know, if we qualify them. 
 1:15:06: Appropriately, and we manage variables. 
 1:15:09: There's a really high likelihood that they're gonna do really well. 
 1:15:12: Yeah, yeah, and you said that a lot of patients back in the early days did get get lied to. 
 1:15:19: Is that still going on today? 
 1:15:21: Yeah, so you know what's interesting is there is a lot of clinics that make claims about treating conditions. 
 1:15:31: they talk about stem cells as a magic cure and they're not. 
 1:15:33: I mean, look, they can do some wonderful things in the body. 
 1:15:36: , but at the end of the day, there's still a lot of that going on, even with clinics outside the country, there's some really great ones. 
 1:15:46: I, I, I send patients to them often when it's necessary, but a lot of that still exists. 
 1:15:52: So one of the things, there was a recent. 
 1:15:55: , issue in Georgia where there was a regenerative medicine clinic that was sued and had to give back like 5 million bucks just recently it was, it was posted for making outrageous claims and promising cures for advanced conditions again like Alzheimer's, Parkinson's, things like that, ALS, You know, and think about that, like, you know, telling a patient that you can cure their ALS with this magic solution, and getting them to pay you 100, right? 
 1:16:23: That's, that's criminal and that's a problem. 
 1:16:25: Yeah, yeah, major. 
 1:16:27: Wow, that's great. 
 1:16:28: That's crazy. 
 1:16:29: I, I've known personally some people that have gone through, and will not, I, I didn't know the people that were experiencing in ALS personally, but I was close with their very close friends and family, and man, that's like, yeah, that's, that's insane that people do that. 
 1:16:44: How can someone trust you versus those fake stem cell clinics? 
 1:16:50: I think, you know what you really have to do is, is just. 
 1:16:55: I guess do your research, you know, like what environment do they work in, you know, what is the nature of the medical providers that they have, how long have they been in business? 
 1:17:03: Is their longevity in their practice, do they have a lot of good clinical outcomes? 
 1:17:09: do they take and, you know, first and foremost in orthobiologics, they, we have, you have to do image guidance, right? 
 1:17:18: So there's a lot of clinics that I'll just inject and. 
 1:17:21: Without having ultrasound guidance because precise placement is really key to getting the cells exactly where you need so like looking into those things and understanding that you know are they standard practices in the orthobiologic space right? 
 1:17:34: First and foremost because that's really gonna dictate the outcome and then you know what are the credentials of the doctors that work in the clinic? 
 1:17:41: Are they multi-specialty? 
 1:17:42: What can they offer? 
 1:17:44: and do they have experience, right? 
 1:17:47: Yeah. 
 1:17:48: So, aside from those things, like what other factors should people look into before getting stem cells so that they know that they're not going to get ripped off. 
 1:18:02: I think you know a center that has the ability to access multiple tools and a deep understanding of when to use each tool to produce the best outcome possible, is key because many clinics are relatively dogmatic in what they provide. 
 1:18:21: They'll have like, you know, one resource as a primary solution and say this is the best one in the business and this is the only one that we use. 
 1:18:27: , and I think that when you do that, you just, you, you, you, you limit your ability to affect large populations, right? 
 1:18:36: So if I was a consumer, I would just, you know, I, I would want to go to a, to a doctor who first and foremost is, is honest and is gonna tell me with certainty, look, you're not a candidate, or I can't help you. 
 1:18:47: , but then on the flip side is tell me with certainty that yes, I can help based on these factors, based on this experience and based on the tools that we have at our disposal, you know, because then you know they're taking a comprehensive approach and the art and science of regenerative medicine exists within that practice. 
 1:19:04: Yeah. 
 1:19:07: So what are those? 
 1:19:08: So I mean there's a wide variety so from a from a cellular perspective again we have bone marrow, we have adipose, right? 
 1:19:16: we also have Morton's shelling and umbilical cord blood which we can pull from from a blood-based component, we have PRGF, we have PRP, and then we have also what's called fibrin, specifically for discial procedures, in very specific cases we can also utilize exosomes, If you're not familiar with exosomes, I think a lot of people understand them. 
 1:19:41: The exosome is basically the packet of growth factors that the stem cell produces or secretes. 
 1:19:47: That's how stem cells heal tissue. 
 1:19:49: That's how they control the environment is they secrete messages in the form of growth factors and they're and they're contained within exosomes. 
 1:19:57: So there are products that you can utilize that have isolated exosomes in abundance, and those can be utilized for, you know, inflammatory reduction, for many different purposes. 
 1:20:09: they're useful in certain situations, but, as an adjunct, and then, you know, also we employ like. 
 1:20:15: , peptides predominantly hormone optimization and obviously dietary intervention understood. 
 1:20:23: So there's a lot of, of different tools and resources you guys can use to help people feel better, live pain free, and Florida actually just passed some new laws allowing or laws that that made stem cells legal. 
 1:20:40: , what I mean, what's different now versus what you've been doing for the last 15 years? 
 1:20:47: Yeah, so the law that they passed is essentially what they allow for now is the clinically unapproved or non FDA approved products. 
 1:20:58: So those are the allogeneic products, the things that come from the outside. 
 1:21:02: So exosomes. 
 1:21:04: You know, umbilical cord blood and Wharton's jelly, right? 
 1:21:08: So those products previously the FDA was very clear. 
 1:21:12: These are unapproved, products approved by the FDA meaning, and they're considered experimental and in the United States experimental procedures, you know, are, are, first of all, they're not legal, but with umbilical cord blood and allogeneic products previously, you know, you have patients sign waivers and. 
 1:21:31: Many clinics can fly under the radar. 
 1:21:34: I never really used a whole lot of that during those times, but now that the law has passed, they are useful tools in my opinion, you still have to use them for specific purposes, so for orthopedics and for wound care predominantly, you know, they can't be used for intravenous application for things like diabetes or autoimmune disease. 
 1:21:55: , or they don't want you to use it for that. 
 1:21:58: You can use it for that. 
 1:22:00: Obviously not in the United States, but there's some benefit, with that. 
 1:22:04: , and now they just allow for, which is pretty amazing. 
 1:22:08: I mean, I think it's a testament to the, the changing tide in the regenerative space, you know, I think a lot of consumers, resonate with regenerative medicine and as a result we're starting to see, you know, legislation change as a result, but now with, with bone marrow and things that are taken from the patient. 
 1:22:28: , we've always had FDA draft guidance since I've been doing this, so FDA draft guidance, all that really means is that we don't require FDA approval because these are things that are taken from your body. 
 1:22:40: So you know, the cells in your body are not a drug or a device and therefore are not inherently dangerous and they, they do not fall within the confines of what the FDA can approve or deny. 
 1:22:50: So we don't require FDA approval. 
 1:22:52: The only thing we have to follow is what's called FDA draft guidance. 
 1:22:56: And what that means is that there are specific parameters that we have to follow while we're delivering those biologics. 
 1:23:02: Yeah, some say Wharton's jelly is the secret stem cell that could possibly even replace bone marrow. 
 1:23:11: What are your thoughts on that? 
 1:23:15: Yeah, I mean, look, these are very early, really powerful cells, right, I've And again I go back and forth because I, I have, I'd like to follow evidence in the literature and what we don't have a ton of evidence for is long term regeneration of cartilage using those cells and, and the theory behind it is the way in which stem cells actually heal tissue is not a growth process, it's not a one time event. 
 1:23:43: We don't put stem cells in place and they replicate to rebuild tissue. 
 1:23:47: , what they do is they live in space. 
 1:23:50: I mean there'll be some differentiation, don't get me wrong, but they live in space and they secrete growth factors. 
 1:23:55: It's called the paracrine effect and those growth factors influence the tissue to change and to heal over time. 
 1:24:02: So what that requires is that the cell can live in space for extended periods of time and unfortunately when we're taking things from the outside, they have foreign genetic material. 
 1:24:13: So what tends to happen, or at least from a theoretical perspective is that the immune system clears them before they have the ability to heal tissue to completion. 
 1:24:22: Now they're also extremely powerful anti-inflammatory. 
 1:24:26: It it provides an anti-inflammatory mechanism and it does promote some healing and really beneficial effects, but I just don't, there's not enough evidence for me because I don't care about knees, let's say care about long term health. 
 1:24:40: I need people to exercise and to be fully functional so that they can achieve and maintain health throughout the course of their life. 
 1:24:46: And if we're not getting that long-term outcome, I'm not achieving my goals. 
 1:24:51: So for now, because we have evidence to suggest that bone marrow does repair cartilage, not even suggest we know it, that's really the primary tool if it's available. 
 1:25:02: Understood. 
 1:25:05: so then, are stem cells actually coming from abortion clinics? 
 1:25:12: No, so the way that it works is these are donated and screened placentas. 
 1:25:17: So these, these are biotech companies and laboratories. 
 1:25:22: That what they do is women donate the placenta after they give birth, right? 
 1:25:27: so it doesn't harm babies. 
 1:25:28: There are no abortions involved, yeah, the baby's taken to term and in the hospital you can donate the placenta. 
 1:25:35: And then what they do is they take that and they screen them rigorously, right? 
 1:25:38: They screen them for all kinds of things all the really good labs screen for, you know, all contractable illnesses, but also like Epstein-Barr and cytomegalovirus and Lyme's disease, all the chronic ones that can wreak havoc in the body, but also, in many cases, even like COVID vaccine stuff, believe it or not, you know, those are, those, they're screened for spike protein and other things, so. 
 1:26:03: , we know that they're clean and then what they do is they extract the cells from that tissue. 
 1:26:09: So, yeah, that I actually that was something I saw, I was like paying attention for, in the, you know, in the operating room yesterday. 
 1:26:17: I was watching them. 
 1:26:18: They, they got, I think that and then maybe a piece of the umbilical cord. 
 1:26:23: Is that what they do too? 
 1:26:26: Yeah, so you, you reserve the right, as a new parent to take a portion of that umbilical cord and save it for future use. 
 1:26:35: Now, the thing about that is, the reason that that makes sense is because like if the, if God forbid your child. 
 1:26:43: , develops a really serious like, let's say like a cancer or something, and they need to do a bone marrow transplant, then they have the donor, right? 
 1:26:54: but it's not typically used down the road for regenerative purposes. 
 1:26:58: Yeah, it's not it's not to do that. 
 1:27:01: OK, OK. 
 1:27:02: So then how can somebody know that they're they're not getting stem cells from an abortion clinic? 
 1:27:08: Well, that's completely illegal in the United States. 
 1:27:12: Right, so there's high regulation on allogeneic or off the shelf products. 
 1:27:17: However, there's not a whole lot of standardization, you know, so early on when those products came into the market, they came in with a vengeance. 
 1:27:25: I mean, everybody in, in every clinic, that had the ability to offer them and put up Facebook ads, right, was doing umbilical cord blood products. 
 1:27:36: So, you know, we weren't in that market initially. 
 1:27:39: So we were obviously need to take a look at those things so we had a flow cytometry lab over at USF and we bought all of the major ones and we brought them over to the flow lab and we're like, OK, look, just tell us what this is tell us what the cell counts look like tell us what the relative distribution between cell types, give us an idea of viability like we just wanna understand, you know, whether this is a superior product to what we're currently doing and believe it or not, There was 10 samples, only 1 had living cells. 
 1:28:09: Now that was back then, right? 
 1:28:10: Nowadays, it's very different nowadays there are really amazing products, that come from reputable places, but again, you know, it's just, it's, it's just a different resource and we have to understand that it's one tool. 
 1:28:25: It's not the most ideal tool for every individual, right right OK. 
 1:28:30: Yeah, I mean, some people, they say stem cell treatment is just fake medicine. 
 1:28:36: What do you say to that? 
 1:28:38: Yeah, you know, it's funny as a chiropractor, we hear that quite often, don't we? 
 1:28:43: I think, I think just, you know, they, they're uneducated, they don't understand, you know, what it is that we're actually doing. 
 1:28:51: and, and where that comes from, you never really could tell, but at the end of the day, You know, we wouldn't be able to do what we're doing for as long as we are. 
 1:29:03: One, we weren't getting patients better and two, we were practicing something that was experimental or fake. 
 1:29:09: Yeah, exactly. 
 1:29:09: Your patients, they're happy, they like the results they've got from you, so that definitely speaks for it. 
 1:29:16: Now, what about to the people that just say, you know, stem cells is just essentially delaying surgery. 
 1:29:22: What would you say to that? 
 1:29:24: Well, you know, I think again that goes back to the conversation as to whether or not we can actually change tissue, right? 
 1:29:30: So if we're, if let's use well. 
 1:29:34: If we're not able to affect tissue long term and actually heal it, then yes, we're prolonging the inevitable in a natural way we're managing symptoms so this is what I tell patients who typically take part like who have a lot of arthritis in a knee, let's say we know that the end stage of that condition is gonna be a knee replacement if we just manage symptoms and even though they're using PRP as a primary tool, it's a, it's a natural anti-inflammatory. 
 1:29:59: But it's not gonna regenerate the cartilage to the degree that it's gonna prevent the need or possibly prevent the need for a knee replacement and yeah that's true again if we're if we're symptomatically if we're affecting the patient in a symptomatic way without making structural change that is true, but we can make structural change just depends on what tools you have at your disposal and this is also back to because I hear that a lot from even general practitioners. 
 1:30:27: You know, with a lot of the umbilical cord blood products, they're really powerful anti-inflammatories, patients get 6 to 8 months' worth of relief like in a chronic joint, and there are, there are circumstances where it provides long term relief for other issues, so we have to be clear, but in a chronic like degenerated knee, you know, maybe they get 6 to 8 months' worth of relief, but then they're back in pain because the damage is still there, right? 
 1:30:51: And yes, that means they have to go in the direction of possible surgery in that case. 
 1:30:56: I see. 
 1:30:56: , so if somebody is listening and they've been told they have to get surgery, what questions should they be asking their doctor before they, they do that? 
 1:31:08: You know, I think what I would ask very simply is, what's the likelihood for success for me specifically, right? 
 1:31:16: If we take into account, you know, all of the circumstances that exist with me and metabolic health is a big one, comorbidities, all of those issues secondary to that, what are the risks? 
 1:31:26: Right, and then more importantly, can you suggest any other options at this stage in the development of my condition because a lot of times what happens with knee replacement specifically or replacement in general is that they just, they're just failing to improve with all of the tools that we have at the all the tools they have at their disposal and the only other tool they have left is surgery. 
 1:31:50: So in many cases if those patients are still struggling with pain. 
 1:31:54: Maybe they're not an ideal candidate for surgery just yet because it's not the end stage, but they're running out of tools so it makes sense in that environment. 
 1:32:02: Yeah, their system might not have the tools that that. 
 1:32:08: That can help. 
 1:32:09: So they're using the tools that they do have. 
 1:32:12: what about like some of these, these bigger places, you know, for, for example, I, I, I was at Kaiser growing up and I remember they actually said I needed knee replacement surgery, and I don't even know if that was true. 
 1:32:27: you know, I'm an ex-wrestler, wrestled in college, was just very active, had very like damaging knee, and they're like, if you ever wanna run, like you're gonna need knee replacement surgery. 
 1:32:37: And I just went to, you know, physical therapist, did rehab, and I was able to strengthen my knee. 
 1:32:45: I actually ran a marathon since then and never had surgery. 
 1:32:49: But I think there's a lot of places, that might just, you know, throw surgery because they can. 
 1:32:56: Have you ever seen instances like that? 
 1:32:58: I run into really interesting things all the time. 
 1:33:01: I'd like to believe that every doctor, every doctor cares has integrity, and doesn't make mistakes, right? 
 1:33:10: It's perfect at all times, but that's not always the case because we're dealing with human beings. 
 1:33:15: you never really know what the intention is, and I'd like to believe that it's not nefarious in any way, but if we're making perfect recommendations. 
 1:33:25: Like in somebody at your age, I can't think of a situation outside of like a a vascular necrosis, or some type of bone disease. 
 1:33:35: I mean that would require a knee replacement in a young individual, right? 
 1:33:39: That doesn't make sense to serious traumatic event, who knows, you know that really doesn't make sense, but I've run into a lot of patients who have gotten recommendations from doctors. 
 1:33:49: , that weren't exactly the right recommendation and chose not to move forward because in their gut they felt like it wasn't the best for them, right? 
 1:33:58: So you really never know. 
 1:34:01: And those recommendations, so there, there are times where you've seen patients recommended surgery. 
 1:34:07: That didn't necessarily need the surgery and we're able to recover other ways oh all the time, right? 
 1:34:15: And what, what I would tell patients is when you're doing something that's permanent, that's invasive, always get a second opinion, right? 
 1:34:24: Never just go with the first opinion, maybe get multiple opinions because again we're, we're doing something that is relatively invasive and can be life changing if it doesn't go the right way. 
 1:34:35: Yeah, I, that was, yeah, I, I, I've always been against surgery unless absolutely needed. 
 1:34:41: I think Western medicine is, has done some amazing things, I mean, just yesterday. 
 1:34:47: The amount of blood that was coming out of my partner after, you know, delivering twins was crazy and they intervened possibly saved her life. 
 1:34:56: I, I have no idea like what would have happened if that continued going on and we weren't in the hands of the amazing doctors at home, but, aside from instances like that where it's not life threatening, I think there's a lot of other alternative medicine, or alternative routes that could be very. 
 1:35:14: , very helpful and very impactful and just, you know, the overall outcomes. 
 1:35:21: What would you say is the biggest lie that the medical system tells people about joint pain? 
 1:35:28: The biggest lie, I don't know that. 
 1:35:31: I, I don't know that it's they lie specifically to individuals. 
 1:35:35: I think, I think the biggest problem is that we've, we've kind of instilled in most people that there's only access to one style of health care. 
 1:35:46: I think that's the biggest lie, you know, and it's back to what you just said so one of my mentors when I was going through a wellness certification. 
 1:35:54: Has an analogy and it's wonderful it's it's fantastic. 
 1:35:56: I talk about it all the time traditional medicine is the fire department. 
 1:36:00: They have axes and fire hoses and they're amazing at what they do. 
 1:36:04: They can put out fires, right? 
 1:36:07: Axes and fire hoses are analogous to drugs and surgery, and those tools are absolutely appropriate if your house is on fire. 
 1:36:13: The problem is you can't call them back the next day to rebuild the house because they only have axes and fire hoses, but somehow we've led people to believe. 
 1:36:22: That the only type of health care that we have access to is axes and fire hoses. 
 1:36:28: It doesn't make any sense, and there are many paradigms in health care, lots of paradigms in health care, and there are many modern tools that are designed as repair and maintenance tools so that we can achieve health and recover from injuries. 
 1:36:41: So really like the biggest lie that I think is is propagated. 
 1:36:45: Is that first and foremost, because my insurance covers this style of health care, that's the only one that I have access to, that's a big one. 
 1:36:54: Yeah, yeah. 
 1:36:54: , so why do hospitals want you to have surgery instead of trying to heal a more natural route? 
 1:37:04: Because I think that system is, is well ingrained in multiple respects, right? 
 1:37:09: So we have the insurance system, we have the AMA, we have, you know, we have medical practitioners that are trained in that environment, we have Pharma, we have a lot of different moving parts that are that are solidified in one specific paradigm. 
 1:37:25: And I don't think that you know there's one doctor who really cares that wouldn't say yes we should do this first prior to doing surgery but they're not looking for that or and they don't really have a deep understanding of it you know what I usually well what I like to to say is regenerative medicine is, is really gaining a lot of popularity because it fills the gap in orthopedic injury care. 
 1:37:49: Orthopedic injury care because we only have drugs in surgery. 
 1:37:52: We can manage symptoms until it gets bad enough that ultimately we can do a radically invasive surgery with poor quality of life through that process, so there's this really big gap if we, if we use the analogy of like cardiology, we used to do a lot of triple bypass surgeries, triple and quadruple bypass surgeries, right? 
 1:38:11: and primarily because we really didn't have any interventions to prevent the need for a triple bypass surgery. 
 1:38:17: Now we have cardiothoracic catheterization. 
 1:38:20: So we can get in there and we can clean things out and we've done significantly less triple bypass surgeries and that's a good thing because those are inherently dangerous and they represent the end stage of the disease. 
 1:38:32: Well, that's what we have in orthopedics now where we can manage symptoms to make people comfortable but then solve problems so that they don't have to have a radically invasive replacement surgery down there. 
 1:38:44: Yeah. 
 1:38:45: How many people are currently living in pain right now because they're possibly following their doctor's advice. 
 1:38:55: I mean, the numbers are pretty straightforward. 
 1:38:57: 80% of individuals are gonna have low back pain at some point in their life. 
 1:39:00: 55%, 54 to 55% of the population has chronic degenerative knee pain or arthritis. 
 1:39:08: the numbers are huge. 
 1:39:08: I mean, in terms of chronic illness, you know, obviously we have the big ones in terms of cardiovascular disease, diabetes, and obesity, but osteoarthritis and chronic joint pain is pretty close to those. 
 1:39:21: Wow. 
 1:39:22: And then what are the numbers? 
 1:39:23: Like, how much does the average person spend on physical therapy, pills,, any other treatments before they finally get surgery? 
 1:39:35: So you know I have it in in one of the talks I do and I can't think of the publication, but it's. 
 1:39:40: It is a government organization that did the that that did the analysis and it's something like 125 to 150,000 over the course of their lifetime, wow, including the copay for the replacement surgery at the end stage and for a fraction of that they could see you and develop a comprehensive plan that would have significant impacts with you said virtually no downtime. 
 1:40:04: Well, forget about dollars to dollars think about the 20 years of pain and dysfunction, right? 
 1:40:10: Yeah. 
 1:40:11: Oh yeah, I, I just see it too. 
 1:40:12: Like I've been dealing with an injury, for, for some time, and I mean, it's, I'm, I'm, I'm a hyper-aware person. 
 1:40:21: I, maybe some people just aren't that aware. 
 1:40:23: I see just the, the impact it has on little things, my focus, all these little things and as a business owner, a high achiever, like my time, my focus, my ability to execute at a high level, whatever it is I'm doing. 
 1:40:38: is very, very important. 
 1:40:41: and if something is stealing seconds, minutes, hours of the days because of pain or whatever it is, like it's not worth it for me. 
 1:40:49: So I have to really be clear on, on these impacts and, and I think a lot of people aren't aware of that, but when you look at the, the bigger picture of how much people are spending on all these things, it's crazy that, you know, they're not a little bit more receptive or open minded to, some of these treatments. 
 1:41:08: Any, I know, we're running on a time crunch here, Any closing thoughts for you that we might have missed? 
 1:41:15: I, I mean, there's just so much information we, we went through. 
 1:41:18: I, I would love to, possibly have you on the podcast again where we can dive into a little bit more in depth, but I know, you know, we, we are on a timeline. 
 1:41:28: Any, any closing thoughts that you have for the listeners. 
 1:41:31: You know, I think just what I, I, I want to express is that you don't have to live in pain, you don't have to jump from one drug to the next. 
 1:41:40: You don't have to have short periods of comfort followed by worsening of a condition. 
 1:41:45: , and if that's the case, then you should consider a different environments. 
 1:42:01: You deserve, right, right. 
 1:42:01: Now, if people have questions about stem cells, regenerative medicine, and any of the topics that we've discussed, what's the best way to get a hold of you? 
 1:42:08: So I mean, most patients come to our website and then contact us, you know, via the website. 
 1:42:15: The best thing to do because again we don't know that we can help everyone is really to set up a consult a consult would be at the very beginning stages with me and then obviously as it progresses with the medical team, but really that's the easiest way. 
 1:42:28: OK and are you on social media? 
 1:42:31: Are you active on social media? 
 1:42:32: Can I give you a follow to stay engaged? 
 1:42:35: Yeah, so it's DR. 
 1:42:37: De Pasquale is my is my personal and then orthobiologics Associates. 
 1:42:43: OK, that's the, the business handle. 
 1:42:46: Well, Doctor De Pasquale, I appreciate your time. 
 1:42:50: again, I'd love to, really dive into some of this stuff. 
 1:42:53: It's so new and emerging. 
 1:42:55: I, I love where things are going. 
 1:42:57: I think social media has had such a massive impact. 
 1:43:01: Of sharing information, you know, people aren't aware. 
 1:43:04: I, I forget what interview it was. 
 1:43:05: I was watching an interview with one of the top pharma ex pharmaceutical. 
 1:43:11: , like board members, and they were asking her like, why, why do you, you know, how many people actually come in for these, these, these pharmaceutical drugs after seeing an ad on the news? 
 1:43:24: And what she said was, oh, like almost none like what we don't run ads on the news to get people to come in. 
 1:43:30: We run ads on the news to control narratives so that nobody can talk bad about us because when you're we're spending billions of dollars in advertising. 
 1:43:38: , you're not allowed to speak bad against us or you're gonna lose that paycheck, which is huge, right? 
 1:43:44: I, like if my client said that I was spending all this money with me, was like, hey, I don't want you to talk about these things. 
 1:43:50: Now, obviously if they're like directly causing harm, I wouldn't do that because of moral and ethics, but if they're like, hey, like, I'd prefer you not talk about a certain subject, like I would probably consider that and really understand like is this negatively impacting people? 
 1:44:02: And if it's not, then I would honor them because they're paying me money. 
 1:44:07: And once I realized that it, it was, it all made sense as to why for so long, so much of this information has been suppressed because the news, which is controlled by these pharmaceutical companies spending billions, has been able to control the narrative. 
 1:44:23: Now social media is just really exploding so much information, people like yourself. 
 1:44:28: For, you know, coming on podcast and just speaking the truth and really setting, you know, the record straight on this. 
 1:44:35: So we appreciate you coming on. 
 1:44:38: It was great, diving in, learning a little bit more about your business, just the whole landscape of this. 
 1:44:43: And, yeah, I look forward to to working with you and, and helping you guys heal more people. 
 1:44:48: Yeah, I appreciate it very much.