WEBVTT 1 00:00:00.000 --> 00:00:22.000 Welcome to the Biohacking Superhuman Performance Podcast. My name is Natalie Nettom. I'm a nutritionist, a human potential in epigenetic coach, and I created this podcast to bring you the latest ways to take control of your health and longevity. 2 00:00:22.000 --> 00:00:32.000 We cover it all from new technology to ancestral health practices, personalized interventions, and a very special interest of mine, peptides. Enjoy the show. 3 00:00:32.000 --> 00:00:44.000 Riffural neuropathy is a condition that affects far too many people in the U.S. and Canada worldwide. 4 00:00:44.000 --> 00:01:00.000 The fine guest today is a leading researcher, physician, and teacher of other physicians, both in the world of peripheral neuropathy and also how diabetes impacts neuropathy or vice versa. 5 00:01:00.000 --> 00:01:16.000 My guest today is Dr. Stephen Barrett. This interview was, honestly, it was a gift to me, and I think it's going to be a gift to a lot of you guys as well. Dr. Barrett is a board-certified physician by the American board of foot and ankle surgery, as well as the American board of pediatric medicine. 6 00:01:16.000 --> 00:01:26.000 He formerly served as the president of the Association of Extremity, nerve surgeons. I mean, his bio is huge. I'm not going to read it to you here because I'll just bore you tears. 7 00:01:26.000 --> 00:01:36.000 And really what you need to do is get to the meat of this episode and hear this man speak. Check out his TEDx presentation, which is named some nerve for saving diabetic lives. 8 00:01:36.000 --> 00:01:48.000 So suffice to say that Dr. Stephen Barrett is an incredible resource and I think has so much to share both in his attitude, his professionalism, and his approach to complex problems. 9 00:01:48.000 --> 00:02:06.000 So to learn more from Dr. Barrett or about Dr. Barrett, you will want to go to nervetx.com. I think he may even give his email at the end of the podcast, but if he does, you're lucky. If not, go to nervetx.com and you will be able to find him there or check out his TED talk. 10 00:02:06.000 --> 00:02:14.000 As always, if you get value from this episode, please make sure that you share it with your friends, your family, and anybody else who you know who will get value from it as well. 11 00:02:14.000 --> 00:02:26.000 Leave us a five star review if you're feeling the love. If not, by all means, move on. And I'm so excited about this episode. I'm just going to stop talking right now and let you dig into it right after we hear from our sponsor. 12 00:02:26.000 --> 00:02:34.000 So thank you so much for being here. Totally appreciate you guys as always. And I look forward to hearing your comments on this interview. Enjoy. 13 00:02:34.000 --> 00:02:50.000 Hey folks, just a quick reminder that all of the information presented in this podcast is for information purposes only no medical advice, no diagnosing, no treatments suggested here before you try anything that you hear about or learn about here. 14 00:02:50.000 --> 00:02:58.000 Make sure that you check with your medical provider. Dr. Stephen Barrett, such a pleasure to have you here. I'm so excited for this conversation. 15 00:02:58.000 --> 00:03:02.000 Well, likewise, I appreciate the time to spend with you today as well. 16 00:03:02.000 --> 00:03:06.000 Oh, I think this is going to be so good and you guys are in for such a treat. 17 00:03:06.000 --> 00:03:17.000 We are going to start this episode as we do most episodes because I think that you just have a great story. Everybody has a great story, but your story is exceptionally great as we were talking about before. 18 00:03:17.000 --> 00:03:37.000 And so if you could tell share with the audience a little bit about your background and how you got to this place where not only are you you're kind of to me, you're bridging the world between conventional medicine and what we would call functional medicine in an area that's in high need of this stuff. 19 00:03:37.000 --> 00:03:40.000 Tell us about yourself, Dr. Barrett. 20 00:03:40.000 --> 00:03:53.000 Well, let me preface everything that I think you really have to be open minded and you have to integrate everything available that's out there, whether it's considered functional or integrative medicine or traditional medicine. 21 00:03:53.000 --> 00:04:04.000 And when you treat difficult things like peripheral neuropathy, it humbles you very quickly because there's many things that don't work. 22 00:04:04.000 --> 00:04:11.000 And most of the time you have to have some type of an amalgamation and bring everything you possibly can for that patient. 23 00:04:11.000 --> 00:04:24.000 And clearly when you get to that realization, then you start adopting these other things that weren't taught in the traditional medical school pathways. 24 00:04:24.000 --> 00:04:35.000 So my story is kind of interesting because in the early 90s, I didn't really like the way one of the common foot conditions was being treated called Morton's neuroma. 25 00:04:35.000 --> 00:04:45.000 And it's not a neuroma at all. In fact, it should be called Morton's entrapment, but we developed a way to decompress it rather than cut the nerve out. 26 00:04:45.000 --> 00:04:58.000 And that led me to crossing paths with my mentor who was a professor at Johns Hopkins and in plastic and neurosurgery. 27 00:04:58.000 --> 00:05:06.000 And he took me under his wing in the late 1990s, early 2000s, his name's Lee Dellen. 28 00:05:06.000 --> 00:05:20.000 He just retired last month, I believe. And anyhow, Dellen had made this incredible observation that people would diabetic peripheral neuropathy. 29 00:05:20.000 --> 00:05:38.000 Most of the time, or in a large majority of cases, let's say, their nerve symptoms are due to the fact that because of their metabolic condition, the nerve swells and where it goes through a tight tunnel, like the carpal tunnel in the hand, it causes a focal nerve entrapment. 30 00:05:38.000 --> 00:05:52.000 So if you relieve that focal nerve entrapment, then all of a sudden, many of the symptoms of diabetic peripheral neuropathy can go away completely or to a significant level where a patient now has a protective sensation. 31 00:05:52.000 --> 00:06:03.000 So when a diabetic patient loses protective sensation, that increases the risk of ulceration, a subset of them will go on, unfortunately, to have an amputation. 32 00:06:03.000 --> 00:06:08.000 And once you have an amputation, then your life expectancy is less than about five years from that time. 33 00:06:08.000 --> 00:06:20.000 So it's a pretty significant and very serious disease, not only from the mortality standpoint, but also the amount that some of these patients suffer. 34 00:06:20.000 --> 00:06:28.000 I have a question for you just to clarify. So when you say loss of protective sensation, you're talking about basically going numb, like the nerve stops. 35 00:06:28.000 --> 00:06:34.000 Is it that the nerve stops sending the pain signal? Cause I'm if you could clarify that, I'm just not clear on it. 36 00:06:34.000 --> 00:06:45.000 I'd love to clarify that, but there are some folks that have incredible amounts of numbness, but yet can feel everything very well, which is very, oh yeah. 37 00:06:45.000 --> 00:06:58.000 So no, it is very odd. It is very odd. But basically protective sensation is provided by the a beta fiber, which is one of the three main fibers in the peripheral nerve. 38 00:06:58.000 --> 00:07:11.000 There are more fibers, of course, but for our discussion, let's talk about the three that are really, you know, the most concerning or at the top of the list, the first would be the motor fiber. 39 00:07:11.000 --> 00:07:24.000 That's what makes the muscles contract and work. The second is the a beta fiber, which is the sensory nerve fiber. And that tells your brain that your skin is being touched or pressed by something. 40 00:07:24.000 --> 00:07:37.000 And then you have the C fiber, which is a pain fiber and then you have Delta fibers, D fibers as well. But the a beta fiber is the first fiber to be affected by a focal nerve compression. 41 00:07:37.000 --> 00:07:49.000 So when that fiber loses its ability to function, then it, then you become in sense. So your level of sensation. 42 00:07:49.000 --> 00:07:59.000 And it's such an insidious process in many people. They don't even know that they don't have sensation. And you can, you can test them and they'll say, no, I can't feel that. 43 00:07:59.000 --> 00:08:05.000 So they may not have the feeling of numbness at all, but yet they, but they can't feel so for that. 44 00:08:05.000 --> 00:08:07.000 They can feel pain. 45 00:08:07.000 --> 00:08:11.000 They can feel pain and for sure they don't know they can't feel. 46 00:08:11.000 --> 00:08:12.000 Right. 47 00:08:12.000 --> 00:08:27.000 So, so nerves are really fickle. They're very individual and the more you study and and spend time with patients who suffer from neuropathy, the more humble you get because something's just don't make sense. 48 00:08:28.000 --> 00:08:50.000 But to go back to the insensitivity. So if you're unable to really feel something because of this compression, then you could, a pebble could be in your shoe and you could walk around all day and you take your shoe off and it's filled with blood and you've never felt anything painful at all. 49 00:08:50.000 --> 00:08:55.000 And then, you know, if an infection sets in, then you have prop. 50 00:08:55.000 --> 00:09:05.000 So in diabetic peripheral neuropathy, you have really two components that you have to worry about it. One is a sensation, the neuropathic component. 51 00:09:05.000 --> 00:09:24.000 And the other is what's the vascularity and there's almost always some component of micro angiopathy with the peripheral neuropathy. But what's interesting is many times when we decompress these entrapped nerves, the circulation will improve. 52 00:09:24.000 --> 00:09:43.000 And the question is why? Well, there could be a couple of reasons. One is because the nerve now can function and that provides some homeostatic benefit to the extremity. The second is that the nerve many times will run through a tight tunnel where also the artery runs through. 53 00:09:43.000 --> 00:09:50.000 So if you open that up, you know, you've released or relate to a mechanical component of compression. 54 00:09:50.000 --> 00:10:12.000 So that's a long story before telling my story. But basically, I was just lucky enough to cross paths with Dr. Dell and back in the late 90s, early 2000, I ended up helping him train surgeons, we trained about 300 surgeons and nerve decompression and and Lord strumming nerve surgery, other techniques and 55 00:10:13.000 --> 00:10:33.000 I think one of my emotions when I first met him and went up and started spending time in his office was that I was kind of unhappy because this I'd seen all these patients for such a long period of time that we were told, sorry, there's nothing you can do. 56 00:10:33.000 --> 00:10:48.000 You just have to live with your condition. That's it, you know, go home, take some take some lyrica, take some nironton, and that's that's the best we can do. That's it. And so that didn't 57 00:10:48.000 --> 00:11:08.000 sit real well with me because here I had all these patients flickering in the back of my mind that I said, you know, there's nothing that we can really do except give you a drug to maybe mask some of the symptoms, but certainly didn't provide them with any benefit for improved sensation and protective sensations. 58 00:11:08.000 --> 00:11:37.000 So, so then, you know, we started into, you know, this rabbit hole so to speak and now 20 years later, all I do is peripheral nerve and the more we did, the more we realized that there's still a lot of things we need to do to optimize the human because although we all want that one magic hammer or one magic bullet, there is no such thing. 59 00:11:37.000 --> 00:11:52.000 And so that's what led me into the things that we'll talk about with peptides and some of the other, you know, things that we do to try to make these patients better that have peripheral neuropathy. 60 00:11:52.000 --> 00:12:07.000 It's so interesting because again, peripheral neuropathy I'm going to say is in my Facebook community, it's one of those issues like people are just at their wit's end, they don't know where to go anymore and it's clearly not just a question of taking some anti inflammatory. 61 00:12:07.000 --> 00:12:35.000 They do sometimes experience some and I guess we'll talk about this, they and maybe if they're not too far gone, I mean, I don't know under what conditions, this is even possible, but occasionally you'll come across someone who might get some benefit from a BPC 157, I haven't seen much great results with ARA 290, which is another peptide that's hadn't done, people have done some research around it and nerves and mostly it's the chronic fatigue, I think. 62 00:12:35.000 --> 00:12:51.000 But occasionally they'll get that benefit from the BPC 157 and I wonder if maybe that's someone who just they haven't gone so far down that path yet that just even that little bit of anti inflammatory benefit. 63 00:12:51.000 --> 00:13:04.000 And the BPC 157 has some benefit for nerves, so I'm just wondering if it's possible that when it's to not too far gone that BPC 157 might be enough just to help a little bit, I mean, not that it resolves the issue obviously. 64 00:13:04.000 --> 00:13:27.000 So I think the thing is is that, you know, when you talk about peripheral neuropathy, well, what, what does that mean? Because it's a very nebulous broad term peripheral just means outside the central nervous system outside the brain and the spine, of course, but neuropathy, if you break it down, it's Greek, it's neuro and opathy just means something's wrong with the nerve. 65 00:13:27.000 --> 00:13:55.000 So it's not a very broad, yeah, it's so broad that it's really not even helpful to tell you the truth because I mean, you can have a neuropathy from a contusion, you can have a neuropathy from metabolic disease like we've been alluding to and you can have neuropathy's from toxic mold increased heavy metal exposure, there's mirrored neuropathy's out there. 66 00:13:55.000 --> 00:14:14.000 And so to categorize them all as peripheral neuropathy is really it's kind of a yeah, it's a disservice because it doesn't help us figure it out. And I think that's one of the things that, you know, we look at neuropathy totally different than most practitioners. 67 00:14:14.000 --> 00:14:29.000 And that is we want to get to the cause of it. So you'll see the term idiopathic neuropathy and idiopathic means we're just idiots and can't figure it out or we don't have enough energy and emotional interest to to figure out what's really causing it. 68 00:14:29.000 --> 00:14:41.000 But most of the time, if let's say that 50% of the time it's idiopathic neuropathy, probably a good 80% of those 50% we can figure it out. 69 00:14:41.000 --> 00:14:53.000 It's not easy many times because we'll do mold testing on them, we'll look at heavy metals. I mean, we do complete metabolic assessments on these folks. 70 00:14:53.000 --> 00:15:03.000 And most of the time we're able to identify something. So I think the first thing is to really dial in and say, well, we need a good accurate diagnosis. 71 00:15:03.000 --> 00:15:13.000 And the sad thing is just that patients can have more than one thing at one time. So they may have a reactivated Epstein bar. 72 00:15:13.000 --> 00:15:26.000 They may have a high level of mold or less than ideal metals, these types of things. And so you have to really kind of treat the whole scenario. 73 00:15:26.000 --> 00:15:38.000 That's why these cases are not easy to treat. And in truth, there's a lot of people. And most neurologists really don't like to treat peripheral neuropathy because that's weird. 74 00:15:38.000 --> 00:15:54.000 Well, it, you know, I have a lot of neurologist friends. It's like, well, we don't really like to treat that so much because, you know, all we can do is diagnose it and, you know, give them, you know, gabapentin or Lyrica and, you know, that's it. 75 00:15:54.000 --> 00:16:12.000 And so we've taken a different approach. We have to look at, well, why is this person having some problem with their nerve? And then so it's a circle back to your question about BPC 157. I love BPC 157. I've seen unbelievable benefits from it from a musculoskeletal standpoint. 76 00:16:12.000 --> 00:16:27.000 I have not had much experience at all with it from a neurological standpoint, but this is one of the things that we are talking about earlier with the bioregulatory peptides because I think that if you just make the person more healthy. 77 00:16:27.000 --> 00:16:42.000 And you improve their circulation. You're going to decrease their symptoms of neuropathy, even if it's an idiopathic case where you can't figure it out. 78 00:16:42.000 --> 00:16:53.000 So I don't know if that answered your question or not, but I think, but I think there's certainly no harm giving somebody BPC 157. 79 00:16:53.000 --> 00:17:04.000 And it's one of the few that you can take orally and it can get past the get well, because it came from the gastric juices. But, you know, so it seems to make, you know, a big difference. 80 00:17:04.000 --> 00:17:14.000 Now, one of the places we do use peptides almost routinely now is on some of our nerve decompressions, especially if we're having to do revision surgery. 81 00:17:14.000 --> 00:17:26.000 So I use thymus and beta four on every one of those patients to decrease the scar tissue formation after surgery. And if they've already had surgery, they're a mess from a scar tissue standpoint. 82 00:17:26.000 --> 00:17:38.000 And you know, they're going to scar more. So, you know, we try to, you know, do everything we can to mitigate that postoperative scar tissue formation. And that has made dramatic, dramatic benefits. 83 00:17:38.000 --> 00:17:45.000 Interesting. So, okay, so before we get it, jump into the peptides, I wanted to talk a little bit about what you used to your progression, right? 84 00:17:45.000 --> 00:17:53.000 You said that you used to use PRP, then you moved to stem cells or I think it was stem cells, not at all. 85 00:17:53.000 --> 00:18:07.000 Oh, like, yeah, like, and then you found the peptide. So let's start with the PRP, because again, like I hear this a lot in the group, people are, to your point, they're scrambling, they're looking for answers. 86 00:18:07.000 --> 00:18:22.000 And oh, I heard PRP, I heard this, I heard that. And I, you know, one of the things that you said that I think is so important and so, you know, it'll bring tears to some of these listeners eyes is that you mentioned the terms EBV or viral load. 87 00:18:22.000 --> 00:18:32.000 Or heavy metals. And, and of course, as soon as you have one of these imbalance, you become much more susceptible to the rest of them, right? So, right? 88 00:18:32.000 --> 00:18:50.000 So I think that even acknowledging that these issues are a part of this, of the, of the catchment of what you're looking at is so incredible. But, but let's start with them, what you used to, like, I mean, you, you came to a place where PRP was what you were treating. 89 00:18:50.000 --> 00:19:05.000 Right. So until about the late 90s, when I was fortunate enough to cross paths with Dr. Dell and I, I was, I pretty much was a reconstructive foot and ankle surgeon. That was what I specialized in. 90 00:19:05.000 --> 00:19:30.000 And then, you know, evolved into nerve from then. So I, I saw a lot of heel pain developed a procedure called endoscopic plantar fasciotomy back in the early 90s and that technique, we trained about 6000 surgeons. So we saw incredible amount of heel pain that unfortunately, there's a lot of heel pain out there that has a neurogenic component to it. 91 00:19:30.000 --> 00:19:53.000 But it's in the literature about 93% of the time it's a, it's, there's at least part of it's due to a disorder of the plantar fascia. And so, I came across an article in the Journal of Hand Surveyor, one of the hand journals, probably early 2000s by, I remember the authors there, Calendrushia Edwards, I don't know why I remember that. 92 00:19:53.000 --> 00:20:22.000 They just, they just took blood from one arm and injected it into the tendon outside the elbow and the other arm and the people got better. I thought, wow, this is really kind of interesting. So I started looking into it, thought, well, you know, there's, there's got to be something to, you know, to that. And the traditional treatment at that time for plantar fasciopathy was you just inject them with a steroid until that doesn't work. And then you, you know, you know, you know, you just inject them with a steroid until that doesn't work. 93 00:20:22.000 --> 00:20:37.000 And then you'd do some type of surgery. Nobody took the time to really even look at it with ultrasound and know whether it was an elephant or it was a mouse from a, you know, severity standpoint. But having, having been the plantar fasciitis route myself. 94 00:20:37.000 --> 00:20:51.000 Anyway, long ago when I used to teach high impact, they were called aerobic classes at the time on a concrete floor. I have a lot of sympathy for people with plantar fasciitis. It was a journey. 95 00:20:51.000 --> 00:21:19.000 I did, I did too. I suffered it myself a couple of times. And I, you know, wouldn't wish it upon anyone. But back to your question about PRP. So after I saw that article, we did some investigation. And there were a couple of companies that were already making platelet rich plasma. And we integrated that into our practice. And it was really fantastic as far as how it regenerated it. 96 00:21:19.000 --> 00:21:29.000 So I hate the use of the term plantar fasciitis because in 2003, an article got published that one of the authors was Harvey Lamont. 97 00:21:29.000 --> 00:21:41.000 Really brilliant guy. And they took specimens from 50 surgeries and put them under the microscope. And there weren't any histological markers of inflammation in any of them. 98 00:21:41.000 --> 00:22:07.000 So you had, yeah, so you had 50 specimens. And you had 50 people that didn't have inflammation. And so that blew the whole paradigm right there that this isn't an inflammatory condition. And what did we do for it? We gave people and sets and we gave, and we injected most steroids, which if you look at the, the steroid injections were really no better than just a regular lidocaine injection at one year. 99 00:22:07.000 --> 00:22:21.000 And the steroids caused a lot of problems because they caused fat pad atrophy. So they were not very good thing. But empirically, if we could inject a patient with their own autologous platelets, right? Yeah. 100 00:22:21.000 --> 00:22:43.000 And then, you know, it's going to end do some growth factors. And so we saw really within six to eight weeks with ultrasound, not only did we have patients telling us, yes, they were better from a pain standpoint. But we saw changes in their plantar fascia that indicated that it was regenerator. 101 00:22:43.000 --> 00:23:00.000 Well, if you go back to the degenerative finding in 2003, that makes a lot of sense, right? And I think it's great because it tells about how much the body can repair itself if you give it the opportunity. 102 00:23:00.000 --> 00:23:20.000 So then we did that for six, seven years and then amniotic quote stem cell injections came and we use that. And then that was much better from the standpoint that people had less pain after the injection because it wasn't quite as inflammatory. 103 00:23:20.000 --> 00:23:39.000 And we just saw really better and faster results with that. And then about two years ago, I started using BPC 157 and that I mean, we would see changes that sometimes four or five weeks post injection with the amniotic cells. 104 00:23:39.000 --> 00:23:59.000 But with the BPC 157 at three weeks, we would see huge amounts of regeneration. So you can just see the tissue, how it repaired itself. So BPC 157 for muscular skeletal stuff is extremely good. It works really well in Achilles tendon opathy as well. 105 00:23:59.000 --> 00:24:09.000 So that was kind of where we got into it from really more of a muscular skeletal standpoint, rather than a peripheral nerve situation. 106 00:24:09.000 --> 00:24:26.000 And then, you know, we talked earlier this morning about hydrodisection and then the use of something like thymus in beta four after that in order to prevent the scar tissue from reforming. And so basically what you're trying to do there is, you know, you're putting a large bowl as a fluid. 107 00:24:26.000 --> 00:24:37.000 We use D5W. And that is does a couple of things. One, it kind of separates the tissue away from the nerve. So you get a little bit of a mechanical decompression. 108 00:24:37.000 --> 00:24:46.000 Some reason dextrose and 5% solution shuts down one of the voltage gated high on channels that conducts pain. 109 00:24:46.000 --> 00:24:56.000 Yeah, it's interesting because if you use dextrose and like 30% it causes scar tissue formation. And that's used in prolotherapy. 110 00:24:57.000 --> 00:25:02.000 Yeah, higher concentrations. So I guess everything all drugs come down to dosage, right? 111 00:25:02.000 --> 00:25:06.000 At the end of the day. Yeah, yeah, even exercise, right? 112 00:25:06.000 --> 00:25:09.000 Yeah, that's my favorite drug exercise. 113 00:25:09.000 --> 00:25:11.000 Yeah, I love that. 114 00:25:11.000 --> 00:25:22.000 But so anyhow, I think there's a lot of future for some of these peripheral neuropathy cases, particularly in cases where somebody's had an injury. 115 00:25:23.000 --> 00:25:28.000 And something is entrapped or scarred now. There, it makes a lot of sense. 116 00:25:28.000 --> 00:25:43.000 I don't see much applicability to like PRP. If somebody just has some type of a systemic metabolic axonopathy where there's a disease process inside the nerve. 117 00:25:43.000 --> 00:26:01.000 So with peripheral neuropathy, you have to kind of separate out some of these things because well, you know, if a nerve swollen and it's pinched in a tight tunnel, like the carpal tunnel in the hand, well, we can decompress that and the nerve will regenerate even in patients with diabetes, which is fantastic. 118 00:26:02.000 --> 00:26:14.000 There, I would not see much application for PRP. I would see application for thymus and beta four to minimize scar tissue formation. 119 00:26:14.000 --> 00:26:28.000 But in a patient that has had, you know, a bad contusion or burn or something like that, you know, that might be a really great application for, you know, the peptides after a hydrodisexion. 120 00:26:28.000 --> 00:26:40.000 Yeah. And so when you're talking about using peptides, like a BPC157, whether it's for the fat, I don't want to say fasciitis anymore, the fasciosis. 121 00:26:40.000 --> 00:27:00.000 For planter fascia repair, or whatever else, you have a great story, actually, when I was first introduced to you, it was through, through a fellow physician, and you helped his daughter by using BPC157 in a very specific way. So are you doing site injections. 122 00:27:00.000 --> 00:27:15.000 Like under imaging, like the whole like I just kind of want to help the audience to understand, like we're not just talking about a systemic into the into the belly injection here, like we're talking about conditions that are, you know, they're, they're very acute. 123 00:27:15.000 --> 00:27:17.000 Yes, yes. 124 00:27:17.000 --> 00:27:27.000 And there's a story from BPC for sure, systemically in many instances, but in terms of what you're talking about here, this is all very targeted and specific. 125 00:27:27.000 --> 00:27:40.000 Right. And one of the important things is that, you know, with the use of high, you know, resolution ultrasound, we're able to see the disease or the degenerative areas of the tendon. 126 00:27:40.000 --> 00:27:59.000 And so what we like to do is we locally anesthetize the area. So it's like, it's really a virtually painless procedure for the patient, but then under real time, a sonography, we're able to put the BPC157 or whatever we're putting in into that degenerative area. 127 00:27:59.000 --> 00:28:13.000 And one of the things that we do do in addition to just infiltrating the BPC157 is we needle that tissue a little bit. And so that's kind of like if you think about it, it's like a debris, so to speak. 128 00:28:13.000 --> 00:28:31.000 You're taking this tissue that is diseased and you're kind of disrupting it a little bit by, you know, multiple little fenestrations of it with the needle. And then when you put the peptide in or the PRP or the amniotic, it just fills that whole area. 129 00:28:31.000 --> 00:28:44.000 You can see it on the ultrasound, it just fills it. So you're getting a really high concentration of that that peptide in that area of where that tendon is damaged. 130 00:28:44.000 --> 00:28:55.000 And that's I think, you know, I think it makes sense to stack, you know, oral or systemic peptides on, but you're not going to get that that effect of the debris, 131 00:28:55.000 --> 00:29:03.000 and that as well as the effect that man, you're delivering a load that's really, really much higher than a systemic administration would allow. 132 00:29:03.000 --> 00:29:08.000 Yeah, well, it's kind of like sending a piece of wood before you apply stain. 133 00:29:08.000 --> 00:29:10.000 You disrupt the surface area, right? Right. 134 00:29:10.000 --> 00:29:18.000 And you'll give, you give the ability for the tissue to absorb so that it doesn't, it's almost like it doesn't bounce off. I don't know. 135 00:29:18.000 --> 00:29:24.000 No, that's a great, that's it. No, that's a great analogy because that's what we do with diabetic wounds. 136 00:29:24.000 --> 00:29:39.000 So if we have a diabetic wound that's not healing, we can't put a biological dressing on it until we degrade it, clean all of the dead tissue away so that there's new viable bleeding tissue below that will allow for integration of that biological dressing. 137 00:29:39.000 --> 00:29:46.000 So that's exactly what we're doing when we, we fenestrate and needle, um, attendant or ligament. 138 00:29:46.000 --> 00:29:50.000 Yeah, nice. Yeah, well, there's me just bringing it down to basics. 139 00:29:50.000 --> 00:29:55.000 Yeah, I like that. I'm going to use that in my practice. We got to sand the wood before we see. 140 00:29:55.000 --> 00:29:57.000 I love that. 141 00:29:57.000 --> 00:30:01.000 It helps patients a lot. It helps patients a lot when you can explain things like that. 142 00:30:01.000 --> 00:30:07.000 Yeah, well, because they can kind of get their heads around it, right? It's almost like, oh, okay. Yeah, no, I get that. 143 00:30:07.000 --> 00:30:08.000 Yeah, that makes sense. 144 00:30:08.000 --> 00:30:17.000 I can, I can get my heads around that. So if so far, so BPC 157 is your star peptide for the time being, I suspect knowing you. 145 00:30:17.000 --> 00:30:32.000 And I think what's what, well, and I don't know you that well, but from what little bit I do know of you is that quality that we often lament that sometimes maybe gets sucked out of doctors as they go through the process of becoming a doctor is this whole issue of curiosity, right? 146 00:30:32.000 --> 00:30:44.000 And openness to something new. And have you looked at GHK CU yet as an as an agent, because again, it's another one that seems to be very helpful with scarring the TV 4. 147 00:30:44.000 --> 00:30:49.000 It's the anti-fibrotic effects. I think that seeing the benefits from. 148 00:30:49.000 --> 00:30:54.000 I've looked at that a little bit. And I've come across really more with the hair follicle on that. 149 00:30:54.000 --> 00:31:06.000 And for Stanley, right? Yeah, yeah, yeah, they're using an alopecia and and that, but to answer your question, no, but that's one that we should definitely look at. 150 00:31:06.000 --> 00:31:14.000 Yeah, well, Dr. Lauren Picart, who's the doctor, he's still alive. He's in his 80s now and he's hard at work on a book on GHK CU. 151 00:31:14.000 --> 00:31:21.000 So he's the one who discovered it back in the 70s. I think of him as a grumpy guy, because I've reached out to him a couple of times to do a podcast. 152 00:31:21.000 --> 00:31:29.000 And he just, you know, he just kind of grumps at me. I'm too busy. I don't have time for podcasts. I'm writing a book and I'm like, yeah, but it's only an hour. 153 00:31:29.000 --> 00:31:32.000 Right. And it'll get people to read your book. 154 00:31:32.000 --> 00:31:42.000 Exactly, right? And no, his mind is like, no, books got to be done first before I do anything else. But anyway, he's done a ton of research on it. 155 00:31:42.000 --> 00:31:46.000 So he might talk to you because you're, you know, you're a doc. 156 00:31:46.000 --> 00:31:50.000 No, I don't, I don't know, but I'd like to talk to him. 157 00:31:50.000 --> 00:32:02.000 I think that's the whole thing. Like you talk about, you know, first of all, I love what I do. And one of the reasons I love what I do is because I learned that I really don't know that much. 158 00:32:02.000 --> 00:32:11.000 And I got to go try to learn some more. And then I realized there's more unknowns out there than I knew there were before I, you know, became a little bit more educated. 159 00:32:11.000 --> 00:32:37.000 And so, you know, you know, you know, I mean, I think about 10% of our practice is suicidal. 160 00:32:37.000 --> 00:32:43.000 Because there's no escaping the pain, right? You know, because I think painkillers don't even really touch it when it's really. 161 00:32:43.000 --> 00:32:52.000 Yeah, you know, opioids don't seem to do that much. There's been a huge pushback on opioids. Of course. 162 00:32:52.000 --> 00:33:11.000 And in all fairness, it's a pain that's 24 seven for people. And they just get to a point where, you know, if you have peripheral pain, then very quickly you have an alteration in your central nervous system neurotransmitters and your ability to fight pain is greatly decreased. 163 00:33:12.000 --> 00:33:23.000 You rarely find a patient a chronic peripheral nerve injury patient that does not have some component of anxiety or depression. I mean, it's almost impossible. 164 00:33:23.000 --> 00:33:31.000 And now people manage that, you know, in different ways, but it's a devastating condition to have. 165 00:33:32.000 --> 00:33:46.000 Yeah. And do you find that because I, there was a book that I read many years ago now by by gentleman by the name of Norman Deutsch and he was called the brains way of healing, I think, I think that's the name of the book. 166 00:33:46.000 --> 00:34:00.000 And it was a series of short stories about different brain different people who'd had different issues and how they dealt with it. And there was one guy who dealt with severe chronic pain. 167 00:34:00.000 --> 00:34:04.000 And he talked about addressing it actually from here. 168 00:34:05.000 --> 00:34:25.000 Because what he was explaining is once you've had this pain long enough, it becomes like you can almost, it's almost he was talking about almost you can resolve the source and still experience the pain neurologically because it was almost like a vicious circle in the brain that you had to somehow break. 169 00:34:26.000 --> 00:34:29.000 We call that central sensitization. 170 00:34:29.000 --> 00:34:43.000 And so you can have a peripheral sensitization where you have a peripheral nerve that's damaged to a point that it then starts to actually change epigenetically and develops receptors that it's not supposed to have it develops. 171 00:34:44.000 --> 00:35:03.000 The fibers that are not supposed to conduct pain conduct pain. And so that's called central sensitization, but then in the brain, if you have a bad stimulus for a long enough period of time, you can get negative plastic changes in the in the brain itself, not only the cortex, but other parts of the brain. 172 00:35:03.000 --> 00:35:17.000 And so that would be called all the central sensitization. Now, good example of this is like the wounded warriors, if they've lost a leg, they have, you know, phantom pains and they can feel their toes hurt, but they don't have any toes. 173 00:35:17.000 --> 00:35:22.000 And that's clearly imprinted on the cortex of that individual's brain. 174 00:35:22.000 --> 00:35:35.000 And that's what makes peripheral neuropathy so difficult because many times it's not just peripheral. It's actually centralized as well. And so that's why you have to treat the whole patient. 175 00:35:35.000 --> 00:35:48.000 And, you know, we send people routinely for psychiatric consultations because there's nothing that I can do peripherally if the brain isn't ready for it. 176 00:35:48.000 --> 00:36:01.000 So they have to be dialed in by somebody who's really into that from a psychiatric standpoint, and they, they can get them, you know, maximally better individually. 177 00:36:01.000 --> 00:36:13.000 A surgical procedure may be then very effective and the outcome would be much better, but if you just ignore that central component, you're doomed for failure. 178 00:36:13.000 --> 00:36:24.000 And so that's why you have to spend a lot of time with these patients, because the more they are able to tell their story, the more you're able to pick it up. 179 00:36:24.000 --> 00:36:34.000 But I mean, we pick up a lot of PTSD and there's incredible level of PTSD and patients with chronic nerve pain. 180 00:36:34.000 --> 00:36:35.000 It makes sense. 181 00:36:35.000 --> 00:36:36.000 Yeah. 182 00:36:36.000 --> 00:36:47.000 Right. Like you're traumatized just from, and you know, anybody who's like anybody who's had a surgical procedure, let's say, or had a severe injury, it's the you get exhausted from pain. 183 00:36:47.000 --> 00:36:57.000 Like constant pain is it's just draining in a very unique way to the human system, like it's because there's no getting away from it. You can't sleep it off. You can't. 184 00:36:57.000 --> 00:37:04.000 Right. Well, and then the other thing is is that your your life as you know it is like taking away from you. 185 00:37:04.000 --> 00:37:12.000 So you can't you're not you're not able to go to the gym. You're not able to, you know, walk at the mall or do the things that, you know, pick up your grandkids. 186 00:37:12.000 --> 00:37:25.000 It's here, you know, it's almost like someone has stolen your life. And you know, that's very hard to deal with without developing some psychiatric overlay for sure. 187 00:37:25.000 --> 00:37:36.000 So you were talking about heavy metals and mold and EBV. And you were saying that sometimes people have multiples of these, but do you find like with the heavy metal. 188 00:37:36.000 --> 00:37:50.000 Is that do you find a particular profile of patient that that develops that is that the metals getting into the nerve somehow or do you have any sense of what how that contributes to the neuropathy. 189 00:37:50.000 --> 00:38:09.000 So the actual physiological mechanism is pretty complex. But one patient that comes to mind is a lady that had a very unsuccessful hip replacement. 190 00:38:09.000 --> 00:38:23.000 And they used an implant with cobalt and this for some reason just ground away and her cobalt level was astronomical. 191 00:38:23.000 --> 00:38:36.000 And she came to us with her with her labs already and said, you know, I have a high cobalt level. Nobody nobody knows what to do to get this cobalt down. 192 00:38:36.000 --> 00:38:51.000 So I actually sent her to one of our nature path colleagues who did chelation on her. And after about six to eight weeks broader cobalt level down from like 33,000 to 3000. 193 00:38:51.000 --> 00:39:04.000 And magically guess what happened her neuropathy went away. So, you know, I mean, just having that excess load of heavy metals is is going to play a role. 194 00:39:04.000 --> 00:39:17.000 And he is just keep reaching they took it out. Oh, they did. Oh, yeah, they took it out. And then they replaced it with a non cobalt implant, but they couldn't get the cobalt levels down. 195 00:39:17.000 --> 00:39:38.000 So that's sent her over to the nature path and they were able to key late her very successful in and get this cobalt out. So, you know, so you have to look at it. And I think what you, you know, as you do with all patients, you, you kind of go through a systematic approach. 196 00:39:38.000 --> 00:39:53.000 You don't look for the rarest thing. You look for the more most common thing. And we know that diabetic peripheral neuropathy is the most common. And so a lot of people don't realize that they are prediabetic or diabetic. 197 00:39:53.000 --> 00:40:06.000 I guess with the standard American diet or standard North American diet that, you know, it's pretty hard. You're either prediabetic or diabetic. I mean, there's not unfortunately, you know. 198 00:40:06.000 --> 00:40:19.000 And so, you know, that they'll be incredibly surprised when you, you look at their serum fasting insulin levels and, you know, they have an insulin of 35 or 40. 199 00:40:19.000 --> 00:40:29.000 And you do a home IR calculation on them. And it's 9.8 or, you know, something, you know, really high. 200 00:40:29.000 --> 00:40:44.000 And then that causes the high brincyluminemia in and of itself causes the, the neurop, the nerves to swell. So, we're able to take care of, you know, a nervous entrap because it has become a damaged or swollen. 201 00:40:44.000 --> 00:40:54.000 But we also want to take care of the person so that they don't continue to have these metabolic things. So, you have to treat the whole human. 202 00:40:54.000 --> 00:41:02.000 That's what's, and that's what's missing in medicine so much right now is people don't, and it takes time. It's a totally different type of practice. 203 00:41:02.000 --> 00:41:19.000 And if I see 16 patients in a day, that's like, I'm exhausted because they're complex and you have to really look at them. And, and it's not like a 70 patient a day internal medicine practice where everybody's like in and out in two minutes or something, you know, it's crazy. 204 00:41:19.000 --> 00:41:21.000 Yeah, it's, it's, it's a real difficult. 205 00:41:21.000 --> 00:41:27.000 Yeah, no, it's, it's really challenging and it's interesting to me, right, because what you're really doing is you're going upstream. 206 00:41:27.000 --> 00:41:30.000 You're going, this is this whole root cause. 207 00:41:30.000 --> 00:41:37.000 Right. Some people love some people hate, but at the end of the day, it's like, yeah, I can treat your nerve pain. But if I don't know why it's coming, it's just coming back. 208 00:41:37.000 --> 00:41:38.000 Right. 209 00:41:38.000 --> 00:41:50.000 And, and you were talking earlier, I think it was before the podcast about heel pain and how you will often diagnose person as being prediabetic or diabetic before they even know it. 210 00:41:50.000 --> 00:42:01.000 Just because they have this heel pain that they've come to you because, you know, they have intractable knee heel pain, like pain in their heel because of the a nerve that's going. 211 00:42:01.000 --> 00:42:03.000 Something about the calcaneus. 212 00:42:03.000 --> 00:42:11.000 Right. So, no, yeah, you're right. So, so they'll come in and their chief complaint will be heel pain. 213 00:42:11.000 --> 00:42:16.000 And so again, you're going to think about the planar fascia is the number one thing. 214 00:42:16.000 --> 00:42:27.000 And within three minutes after you've done a diagnostic ultrasound on them, you can tell they either have had some component of planar fasciopathy or they have a perfect planar fascia. 215 00:42:27.000 --> 00:42:38.000 If they have a perfect planar fascia, then obviously something else is going on. And there's a small nerve. There's actually several of these nerves on the inside of the heel called the medial calcaneal nerves. 216 00:42:38.000 --> 00:42:46.000 But they go through very tight little tunnels and there's not much tissue and there's an incredible amount of weight that goes through that part of the foot. 217 00:42:46.000 --> 00:43:03.000 And so if you have nerves that are swelling, they're going to show up symptomatically earlier in tunnels that have less, you know, forgiveness, less ability for that nerve to expand and one of those nerves happens to be the medial calcaneal. 218 00:43:03.000 --> 00:43:18.000 So then you have to think, well, if they have this nerve entrapped, then we usually run another neurosensory test with a device that's called a PSSD stands for pressure specified sensory device. 219 00:43:18.000 --> 00:43:31.000 It was actually invented by my mentor, Lee Dalin, up at Hopkins. And it picks up very early sensory abnormalities before these patients even know that they're manifesting sensory impairment. 220 00:43:31.000 --> 00:43:44.000 And then you look at all four nerves and both legs are affected. Well, now we know that it's not just heel pain on their right side. It is a metabolic condition that led to that. 221 00:43:44.000 --> 00:43:55.000 So now we're obliged to, well, what is it metabolically? We're going to get the blood test. So you see how it just takes you right down to like what you said, let's get to the core of the problem. 222 00:43:55.000 --> 00:43:58.000 And we're trained as symptom treaters. 223 00:43:58.000 --> 00:44:09.000 In, right? I mean, one disease, one pill, one deformity, maybe 10 different surgeries, but we're not treating the human. 224 00:44:09.000 --> 00:44:26.000 And when you treat, and when you're able to find the cause, now a lot, unfortunately, a lot of times once the nerve is entrapped, even if we get the most compliant patient in the world, and they do everything, and they get all of their metabolic turned back into, you know, pretty good shape. 225 00:44:26.000 --> 00:44:53.000 They may still have that nerve entrapment. But they're better, you know, we have patients come in all the time saying, you know, I mean, my vision seems sharper, right? I can think better. I can do all these, you know, we're not treating cognition. We're just treating them, you know, stop eating all the sugar, super neuroinflammatory, start exercising, try to get you sleep, you know, the pillars of good health. 226 00:44:53.000 --> 00:44:57.000 And it's amazing. It's amazing how the body will heal itself if you give it a chance. 227 00:44:57.000 --> 00:45:12.000 For sure. But yeah, but as you're saying, I mean, I guess if the, if the, if the nerve entrapment's gone on long enough, there's a certain amount of damage and then that you need the mechanical treatment that you would bring to bear through the surgery, that would actually believe that. 228 00:45:12.000 --> 00:45:32.000 And I guess that, that nerve entrapment in the heel is probably descriptive of other stuff that's going on in the rest of the body, but it's because the heel, like you can't not walk, you cannot exercise, you cannot do all these. So they would know that they might have the same thing going on in their shoulders, for example, because they're not lifting weights. 229 00:45:32.000 --> 00:45:49.000 Right. Yeah. And so, you know, I mean, diabetes, for example, you know, as you know, affects all of the musculoskeletal tissues. I mean, it affects the, the nephron and the kidney. It affects the, you know, the, the retina. 230 00:45:49.000 --> 00:46:05.000 Yeah, yeah, you know, cognition. I mean, if you look at all of the, you know, the stats with folks with type 2 diabetes, high levels of cardiovascular disease, dementia, cognitive disorders, or, you know, off the chart cancer. 231 00:46:05.000 --> 00:46:25.000 So it's a disease that really affects every cell on the body. And what happens is that certain areas might be, you know, the things that show up first, but you, I can guarantee you, if you have diabetic peripheral neuropathy, you have some impairment of your kidneys, you have some impairment of your vasculature. 232 00:46:25.000 --> 00:46:36.000 I mean, it just, there's no way to just say, okay, it's only going to affect this part of the body or this cell type, you know, almost like it's the canary and the cool mine, you know, it is. 233 00:46:36.000 --> 00:46:43.000 It's the loudest or the reddest biggest flag kind of thing, but there's all kinds of stuff going on in the rest of the body at the same time. 234 00:46:43.000 --> 00:46:59.000 Yeah. And it's, it's really, it's really shocking for a patient to come in sometimes and they're, they're complaining, he'll find and then they leave, you know, two or three visits later. And it's like, what you need to go to your internist, your family practice, docking, get managed because you're diabetic. 235 00:46:59.000 --> 00:47:01.000 And they didn't know. 236 00:47:01.000 --> 00:47:02.000 They had no idea. 237 00:47:02.000 --> 00:47:12.000 They had no idea, no kidding. Well, and you know, and as you just said earlier, I mean, it's both sad and inspiring that by going back to the basics, you can improve so much. 238 00:47:12.000 --> 00:47:25.000 You may not, you know, you may not solve something that's been progressing for a period of time, completely, but that you can get that kind of improvement from something that's a cheap, be, you know, pretty foundational. 239 00:47:25.000 --> 00:47:44.000 Right. I think that's, that's really amazing. So, so one of the things, you know, I find a lot of things really inspiring about you, but one of the many things that I find very inspiring about you is that you're actually training med students in this school of thought, which is, I just think it's so amazing. 240 00:47:44.000 --> 00:47:49.000 Like I remember when you told me that I was like, there's hope. 241 00:47:49.000 --> 00:47:52.000 Like there's hope in the world. 242 00:47:52.000 --> 00:48:06.000 Yeah. So we, I've been involved with residency programs for, gosh, for 30 years and about six years ago, developed a nerve fellowship programs, two year fellowship. 243 00:48:06.000 --> 00:48:16.000 So they'll spend two years just studying peripheral nerve and, and then they're pretty far down the rabbit hole. They can't come out. 244 00:48:16.000 --> 00:48:19.000 And yeah, there's no way out except for. 245 00:48:19.000 --> 00:48:37.000 Yeah, it's, it's just like, all right, you're in there. You're, you're not coming out. But, but yeah, no, that's what we need to do. And then, you know, the nerve fellows train more nerve fellows. And then we also have a very important organization called the association for extremity nerve surgeons, which 246 00:48:38.000 --> 00:48:49.000 we train, I don't know how many we train, but probably 30 surgeons a year in advanced and introductory fundamental peripheral nerve courses. 247 00:48:49.000 --> 00:48:57.000 We're starting to train more residency directors now so that they're, you know, getting this into the residency curricula. 248 00:48:58.000 --> 00:49:08.000 We are making some inroads with the curricula at some of the schools where they're, they're actually teaching it. But yeah, you know, there's, there's the old dogs like me. 249 00:49:08.000 --> 00:49:15.000 We're not going to be around for a long, long time. So we've got to get the new blood to start carrying the baton. And that's what we're trying to do. 250 00:49:15.000 --> 00:49:17.000 Yeah, that's awesome. I love it. 251 00:49:18.000 --> 00:49:27.000 So looking ahead, so you've now, you know, you've discovered BPC 157 TV4 and you're exploiting them to their backs and continue to explore that. 252 00:49:27.000 --> 00:49:37.000 What are you most excited about looking ahead? I mean, you know, it's, you know, I think everybody who's been listening to this podcast knows it ain't going to stop there. 253 00:49:37.000 --> 00:49:46.000 No, no, it's, it's not, no. Well, I think, you know, the bioregulatory peptides, I think that's the next event horizon for me to go. 254 00:49:47.000 --> 00:49:59.000 And to that next black hole or rabbit hole, whatever you want to call it, thanks to my colleague and personal physician who's absolutely brilliant. You had him on Dr. Gus Vickery. 255 00:49:59.000 --> 00:50:00.000 Yeah, he's awesome. 256 00:50:00.000 --> 00:50:09.000 No, he, I think maybe the only place I would question his intelligence is why he became a friend of mine. Other than that, he has pretty good judgment. 257 00:50:10.000 --> 00:50:24.000 Anyhow, I think that, you know, this goes back to the core human. And he and I have had a lot of discussions about, you know, treating the person rather than just the symptom. 258 00:50:24.000 --> 00:50:34.000 And I think that is the case with a lot of the peripheral neuropathies. And, you know, that's why I look forward to seeing what we can do. 259 00:50:34.000 --> 00:50:38.000 And if you look at Caffeine's research, it's pretty incredible. 260 00:50:38.000 --> 00:50:47.000 When you see what he's done with the retinal scans and that type of thing. And those are very objective. It's not just somebody saying, you know, yeah, my pain was a 10 out of 10. 261 00:50:47.000 --> 00:50:57.000 And now it's a four out of 10. I mean, it's like these scans are the scans. It's like the tendon on the ultrasound. It's either improved or not. It's a very objective finding. 262 00:50:57.000 --> 00:51:08.000 So I think there's a lot of, you know, and it's not like these things haven't been around for a long, long period of time. It's just they've been undiscovered for a long, long period of time. 263 00:51:08.000 --> 00:51:22.000 And, you know, I think your podcasts with Bill Lawrence were great to explain that history and everything. But anyhow, I think that's the next horizon for us to be running toward. 264 00:51:22.000 --> 00:51:40.000 Because I think we can, I think we can make the person healthier, even though there's really not much written on peripheral nerve. But you would think that if you see some of the things from a central nervous standpoint, you would think, well, if it acts on the neuron inside the brain or the spine. 265 00:51:40.000 --> 00:51:53.000 And why shouldn't there be a peripheral applicability as well? And I think that's our next thing. And I like, you know, you always have to look at what's, you know, the risk versus the reward. 266 00:51:53.000 --> 00:52:11.000 How, you know, how dangerous is something for that patient, you know, and in surgery, we're always balancing out is, is the benefit outweigh the risk. And sometimes it doesn't. Sometimes we'll say, you know, we'd be better off not operating on it. 267 00:52:11.000 --> 00:52:34.000 We've got to figure out some other way to go because your chances of getting an outcome that we would want for you, let alone what you would want for you are, you know, not, not ideal. So I think that's where this will come into play. So I'm very anxious to do this. And because we work with students and pre-med students and have interns and fellows and whatnot. 268 00:52:34.000 --> 00:52:54.000 We'll be able to track this data and hopefully get some things published. But I expect, and I think one of the things to, you know, if we if we do a study, one of the selection criteria would be, we have to have a patient who's willing to invest in it themselves. 269 00:52:54.000 --> 00:53:11.000 Because a lot of patients will come to us and they don't want to do the work. But they just want, they just want you to write a prescription. Here's the pill. And then they're not happy a month later or six months later because they're no better. And the answer is, well, they've not invested in their own health care. 270 00:53:12.000 --> 00:53:25.000 Yeah. Yeah. So, you know, I think that's the big thing. It's like there is no magic pill. It's a lot of hard work. And I wish there was. I mean, make my life a lot easier and make a lot of other people's lives a lot easier. 271 00:53:25.000 --> 00:53:42.000 But when you have a condition like this, you have to be invested in it and you have to say, OK, I'm willing to do the work. If somebody shows me how to do the work and augment that with what we're doing with the peptides and all of the other things that we do. 272 00:53:42.000 --> 00:53:52.000 But those patients will often say it didn't work. And they're in there and lies the nut. Right. It work. Actually, the work comes from you. 273 00:53:52.000 --> 00:54:04.000 Right. And or if anything, it's a collaboration. Right. You have to it's working with it with working within. And I will often talk to people about finding a physician who will walk with them. 274 00:54:04.000 --> 00:54:22.000 Because at your point, you know, for someone of your statute to say we don't have all the answers and it doesn't always work. It means that you're on a discovery process with everyone of these patients as you move through your continuum of what you're going to look at and what you're going to consider and they're contributing to that. 275 00:54:22.000 --> 00:54:44.000 Well, and so I think there's a huge mind body connection as well. And I think that unfortunately with peripheral neuropathy, people have lost hope. And when you when you have lost hope, it's hard to press on and to buy into. 276 00:54:44.000 --> 00:54:50.000 All right. I'm going to I'm going to, you know, chop the wood, tote the water type of thing. Right. Yeah. 277 00:54:50.000 --> 00:55:01.000 Yeah. And so there's no way I wish I could figure this out. But there's no way to ultimately motivate somebody to do something. 278 00:55:01.000 --> 00:55:11.000 I mean, education comes close. We can give them all of the reasons of why it's good and what it could do for for them. 279 00:55:11.000 --> 00:55:23.000 But until they're willing to buy in and say, all right, I'm going to go through the pain of what I need to do. I'm going to give up that bag of potato chips. I'm going to give up these sugary things. Yeah. 280 00:55:23.000 --> 00:55:39.000 Until they're willing to do that, it's really more kind of handcuffed, you know, and and there's nothing I like more than the motivated patient, you know, I end up spending. Yeah. I mean, you spend more time with the motivated patient because they want more. They want more. 281 00:55:39.000 --> 00:55:52.000 What, you know, I'm doing all this and what more can I do, you know, that that really because if you think about it, we do what we do because we want the patient to get better. 282 00:55:52.000 --> 00:56:03.000 That's that's it, you know, and there's nothing worse than, you know, going home at the end of the day going, oh, man, I just can't get these, you know, three or five people that I saw today. 283 00:56:03.000 --> 00:56:16.000 I can't move them. I can't, you know, and part of it is the condition part of it is, you know, are they willing how motivated they are and then, you know, we still need to discover some more things. 284 00:56:16.000 --> 00:56:31.000 But I think if you come to the table with a condition like that and you have a physician that kind of looks at all of the different things and you're willing to invest and buy in and do the work, I think there's great hope for many, many people. 285 00:56:31.000 --> 00:56:46.000 And it's a much more positive than I am, you know, I really don't have a lot of pessimism other than I just wish I could get the motivation pill and it's like give everybody, okay, here's your motivation pill, you take it. 286 00:56:46.000 --> 00:56:49.000 Yeah, that's get it done, you know. 287 00:56:49.000 --> 00:57:01.000 A lot of people will say, and maybe you found this as well, that there's something about the BPC 157 is that sometimes even before someone has fully bought in and invested. 288 00:57:01.000 --> 00:57:10.000 It gives them a glimmer of hope like it gives them a sign that things can get a little bit better and just that, even though it can't do all the work. 289 00:57:10.000 --> 00:57:19.000 Just that little bit of improvement that they see kind of fuels this fire of, wait a minute, if I can get this far, well, what else can I do? 290 00:57:19.000 --> 00:57:27.000 Yeah, I kind of, it can sometimes reignite that belief that things can change. 291 00:57:27.000 --> 00:57:44.000 Yes, and I think I think that can happen with a lot of disease processes. If you just give the person some more energy, right, and if they have more energy throughout the day, then they can go to bed and sleep better at night. 292 00:57:44.000 --> 00:57:56.000 Well, now all of a sudden they have, they have an improvement that it's an integral, but at least they have enough energy to say, okay, I see a little difference. 293 00:57:56.000 --> 00:58:01.000 And I think the BPC 157 is great for that. 294 00:58:01.000 --> 00:58:14.000 One of the things I discovered a while back is, like you said before, I'm a hybrid, so I'm going to take whatever functional medicine and whatever, and I'm not a big pharma fan at all. 295 00:58:14.000 --> 00:58:18.000 But big pharma has done some great things for us. 296 00:58:18.000 --> 00:58:22.000 If you look at some of the infections, people would die if we didn't have these antibiotics and everything. 297 00:58:22.000 --> 00:58:28.000 But at the same time, you can't just write prescriptions to cover up all of these problems. 298 00:58:28.000 --> 00:58:36.000 But if you ask the nerve patient, how do you sleep? I guarantee you 99 out of 100 will say very well. 299 00:58:36.000 --> 00:58:40.000 And then follow up that question, well, do you fall asleep throughout the day? 300 00:58:40.000 --> 00:58:43.000 Oh, yeah, I have to take naps because I don't have any energy. 301 00:58:44.000 --> 00:58:56.000 So if they're taking naps and they're falling asleep at their desk, they're in this quagmire of they can't, they can't really get sleep. 302 00:58:56.000 --> 00:58:58.000 And they have, and sleep is so important. 303 00:58:58.000 --> 00:59:02.000 Without it, you know, you die, really. 304 00:59:02.000 --> 00:59:07.000 And I think Matthew Walker's book, why we sleep is a fantastic book. 305 00:59:07.000 --> 00:59:11.000 Every, every person should be required to read that because it's so important. 306 00:59:11.000 --> 00:59:22.000 But, but anyhow, one of the things that we, we discovered is that if we would give a patient that was in that type of a situation, some, 307 00:59:22.000 --> 00:59:28.000 or a pedophile, then they would be able to stay awake throughout the day. 308 00:59:28.000 --> 00:59:31.000 And they did not off all the time. And then guess what happened? 309 00:59:31.000 --> 00:59:36.000 We didn't have to really give them anything for sleep because they were able to go to sleep. 310 00:59:36.000 --> 00:59:45.000 Right. And they, exactly. And then, you know, the, the dopaminergic effect of that drug, I think, gives people a little bit of hope. 311 00:59:45.000 --> 00:59:51.000 And so it's, of course, it's kind of an off label usage, but, you know, we're still allowed. 312 00:59:51.000 --> 00:59:55.000 I'll be it with everything that has been said to use drugs off label. 313 00:59:55.000 --> 01:00:02.000 But that's an interesting way to, to look at it and it goes back to what you're saying is that if you give them a little bit more energy. 314 01:00:02.000 --> 01:00:12.000 And that's why I think the bioregulatory peptides may really do that because you're not asking a big buy-in from the patient. 315 01:00:12.000 --> 01:00:17.000 Like, I got to have you down to the gym and doing all of this and doing all of that. 316 01:00:17.000 --> 01:00:21.000 All we got to do is you just got to swallow these pills every day. 317 01:00:21.000 --> 01:00:27.000 And then we measure them. And the other thing is patients love metrics, right? 318 01:00:27.000 --> 01:00:38.000 So if we can show a patient that their blood pressure has gone down, or their hemoglobin A1C has gone down, 319 01:00:38.000 --> 01:00:41.000 their lipid panel has gotten better. 320 01:00:41.000 --> 01:00:45.000 All of these things, they, most people are able to see numbers. 321 01:00:45.000 --> 01:00:52.000 And like intraoperatively, when we do a nerve repair, many times we'll do intraoperative EMG. 322 01:00:52.000 --> 01:00:57.000 So we have a number of how much that nerve is conducting before it's decompressed. 323 01:00:57.000 --> 01:01:05.000 And then a number that, you know, so it may go from 600 to 6000 after the decompression. 324 01:01:05.000 --> 01:01:11.000 And the patients will look at that and they'll say, wow, okay, now I know that, you know, 325 01:01:11.000 --> 01:01:15.000 and I take a lot of intraoperative photos and I give them the full. 326 01:01:15.000 --> 01:01:20.000 Yeah, no, because, because a lot of times they internalize, I must just be crazy. 327 01:01:20.000 --> 01:01:25.000 It's in my head. But when they see that picture of where the nerve is pinched and it looks like an hourglass, 328 01:01:25.000 --> 01:01:28.000 it's very easy for them to understand, yes, I did have an urban trap. 329 01:01:28.000 --> 01:01:35.000 So now that gives a huge psychological benefit to them because they know it wasn't just in their head. 330 01:01:35.000 --> 01:01:39.000 They weren't just making it up. They had a real condition and just you validated it. 331 01:01:39.000 --> 01:01:40.000 Yeah. 332 01:01:40.000 --> 01:01:41.000 Okay. 333 01:01:41.000 --> 01:01:42.000 And they've won. 334 01:01:42.000 --> 01:01:43.000 They won. 335 01:01:43.000 --> 01:01:44.000 Exactly. 336 01:01:44.000 --> 01:01:45.000 Right. 337 01:01:45.000 --> 01:01:46.000 Exactly. 338 01:01:46.000 --> 01:01:47.000 Yeah. 339 01:01:47.000 --> 01:01:51.000 And it's one of those things where you build success upon success. 340 01:01:51.000 --> 01:01:59.000 But the average patient that comes in to see us, they're with us for, you know, 18 months, 24 months, 341 01:01:59.000 --> 01:02:04.000 because it takes, it's a process. It's not like, okay, yeah, we'll see you next week and you're good. 342 01:02:04.000 --> 01:02:05.000 Yeah. 343 01:02:05.000 --> 01:02:06.000 Yeah. 344 01:02:06.000 --> 01:02:08.000 It's a totally different animal. 345 01:02:08.000 --> 01:02:09.000 Yeah. 346 01:02:09.000 --> 01:02:10.000 Okay. 347 01:02:10.000 --> 01:02:17.000 But it's exciting because I think, you know, I think the peptide thing is just, it's the next, 348 01:02:17.000 --> 01:02:20.000 it's the next frontier that we really need to get to. 349 01:02:20.000 --> 01:02:21.000 Yeah. 350 01:02:21.000 --> 01:02:22.000 No, I agree. 351 01:02:22.000 --> 01:02:30.000 And I think it's really exciting when people like you and Gus kind of get enthralled by them and start digging in and leaning in and, 352 01:02:30.000 --> 01:02:34.000 and playing with them, you know, and, and exploring what you can accomplish. 353 01:02:34.000 --> 01:02:37.000 And I'm really excited to see what happens. 354 01:02:37.000 --> 01:02:42.000 And, you know, I'm hoping that in, I don't know whether it's six months or 12 months time, 355 01:02:42.000 --> 01:02:47.000 we can hop on another podcast and talk about what you found. 356 01:02:47.000 --> 01:02:48.000 Well, I'd love to do that. 357 01:02:48.000 --> 01:02:50.000 I'm starting with my end of one today. 358 01:02:50.000 --> 01:02:51.000 Amazing. 359 01:02:51.000 --> 01:02:52.000 Amazing. 360 01:02:52.000 --> 01:02:53.000 Yeah. 361 01:02:53.000 --> 01:03:04.000 What, you know, like back in the old days, the Chinese medicine, the Chinese doctor couldn't do anything that he hadn't done to himself. 362 01:03:04.000 --> 01:03:05.000 To himself? 363 01:03:05.000 --> 01:03:06.000 Yeah. 364 01:03:06.000 --> 01:03:07.000 Yeah. 365 01:03:07.000 --> 01:03:10.000 So it's like here, take this herb, you know, but yeah, I love the end of one. 366 01:03:10.000 --> 01:03:17.000 But to go back, one other thing is that like Dr. Vicar and I, we really get excited about this stuff. 367 01:03:17.000 --> 01:03:20.000 First, it's an academic excitement. 368 01:03:20.000 --> 01:03:26.000 You're reading this stuff in journals and you're looking at people who are lecturing about it and that type of thing. 369 01:03:26.000 --> 01:03:35.000 But then once you cross the abyss from clinical or from intellectual understanding into clinical implementation, 370 01:03:35.000 --> 01:03:40.000 and you actually see it work on a patient, that's like reading a thousand journal articles. 371 01:03:40.000 --> 01:03:48.000 It's like, even though you knew it was going to do it, when that person comes in and says, wow, I can't tell you how that, you know, 372 01:03:48.000 --> 01:03:52.000 it's like there, that then pushes you that much farther down that rabbit hole. 373 01:03:52.000 --> 01:03:54.000 And I think that's what we're going to see. 374 01:03:54.000 --> 01:03:56.000 And I'm really excited to try that. 375 01:03:56.000 --> 01:03:57.000 Nice. 376 01:03:57.000 --> 01:03:58.000 Nice. 377 01:03:58.000 --> 01:04:01.000 Well, it's going to be a fun ride for sure. 378 01:04:01.000 --> 01:04:05.000 So Steven, I think we could keep talking for a really long time. 379 01:04:05.000 --> 01:04:12.000 But maybe what we'll do is we'll leave it at this and with a promise of a continuation down the road. 380 01:04:12.000 --> 01:04:18.000 But before we say goodbye, maybe you can tell people how they can reach you or your clinic. 381 01:04:18.000 --> 01:04:24.000 If what's something they've heard here has inspired them to think, hey, maybe I could be the next one. 382 01:04:24.000 --> 01:04:31.000 Yeah, so probably the best way to get a hold of this is at nerve any RV ETX dot com. 383 01:04:31.000 --> 01:04:36.000 And you can email through that, read about a lot of the things that we've talked about. 384 01:04:36.000 --> 01:04:43.000 We're trying to get a kind of an exciting little tool on our website where if a patient does have heel pain, 385 01:04:43.000 --> 01:04:49.000 they can answer some certain things and the algorithm then tells them how likely they are to have a nerve entrapment, 386 01:04:49.000 --> 01:04:51.000 or versus just playing plan or fashion. 387 01:04:51.000 --> 01:04:53.000 So that could be a useful tool for people. 388 01:04:53.000 --> 01:04:54.000 Yeah. 389 01:04:54.000 --> 01:04:59.000 But that's really the best way to get a hold of us or us in a wrap at these centers dot com. 390 01:04:59.000 --> 01:05:02.000 But it's easier to say in nerve TX dot com. 391 01:05:02.000 --> 01:05:04.000 So so TX, you're in Texas. 392 01:05:04.000 --> 01:05:07.000 No, TX just for treatment treatment. 393 01:05:07.000 --> 01:05:08.000 Oh, treatment. 394 01:05:08.000 --> 01:05:11.000 Yeah, like R X TX, you know, yes. 395 01:05:11.000 --> 01:05:13.000 Yeah, so that's why we did that. 396 01:05:13.000 --> 01:05:14.000 Okay. 397 01:05:14.000 --> 01:05:18.000 And where are you located just so people know because this is not this is not telemedicine medicine here. 398 01:05:18.000 --> 01:05:20.000 We're talking hands on stuff. 399 01:05:20.000 --> 01:05:21.000 I mean, you know, right. 400 01:05:21.000 --> 01:05:25.000 Well, we do actually a lot of telemedicine with initial patients because about. 401 01:05:25.000 --> 01:05:30.000 Yeah, about 30% of our patients are from out of state, but we're in Marietta, Georgia. 402 01:05:30.000 --> 01:05:31.000 Okay. 403 01:05:31.000 --> 01:05:33.000 And just which is just outside of Atlanta. 404 01:05:33.000 --> 01:05:34.000 Okay. 405 01:05:34.000 --> 01:05:35.000 Great. 406 01:05:35.000 --> 01:05:36.000 Amazing. 407 01:05:36.000 --> 01:05:40.000 Well, Dr. Baron, it's been such a pleasure today talking with you again. 408 01:05:40.000 --> 01:05:43.000 And I'm really looking forward to talking with you again. 409 01:05:44.000 --> 01:05:46.000 I am too, Natalie, and I appreciate your time. 410 01:05:46.000 --> 01:05:48.000 And I really love your podcast. 411 01:05:48.000 --> 01:05:52.000 So I just have to figure out how I can get more time in the week working. 412 01:05:52.000 --> 01:05:56.000 Listen to everybody's great podcast because it's very good. 413 01:05:56.000 --> 01:05:57.000 But thank you. 414 01:05:57.000 --> 01:05:58.000 Thank you. 415 01:05:58.000 --> 01:06:03.000 Thanks so much for joining me on this episode of the biohacking superhuman performance podcast. 416 01:06:03.000 --> 01:06:08.000 If you enjoyed the show, please remember to leave us a five star review on iTunes 417 01:06:08.000 --> 01:06:12.000 because that's what helps us to be heard and to be seen. 418 01:06:12.000 --> 01:06:16.000 If you'd like to connect with me directly, or if you'd like to leave any comment, or if 419 01:06:16.000 --> 01:06:22.000 you have any questions about this episode, please reach out to me directly through my website, 420 01:06:22.000 --> 01:06:23.000 natmidum.com. 421 01:06:23.000 --> 01:06:29.000 And of course, if you're not already a member of the biohacking superhuman performance community 422 01:06:29.000 --> 01:06:32.000 on Facebook, that's where you'll find me every day. 423 01:06:32.000 --> 01:06:34.000 It's a short application. 424 01:06:34.000 --> 01:06:40.000 Just answer a couple of questions and you're in and interfacing with other amazing biohackers. 425 01:06:40.000 --> 01:06:44.000 Thanks again, and we'll look forward to seeing you on the next episode.