Aspirin, Ninety Nine Percent, Fifty Percent discussed on The Stock Podcast | CEO and CFO Interviews

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Aspirin which is technically a surgical procedure where you don't have the licensing fuel to do that 'cause you talk about that just a little bit more so doing a multiplied or liquefied fat injections not doing a fat stem cell injection fatter trapped unless you add that that regulates that then as a drug in you have to go through years and years of of research in the approved safety and all that stuff that's expensive that's time consuming and so aggress on fat from an episode so if I come in of I decided and I may decide to do this is just for me it's an issue of money in ah kind of bugs me a little bit but because we're all physicians and we all trained and we'RE ALL SUB specialty train we're all interventional pain or sports train right and so at the end of the day you were physicians and we want to be responsible right the first step in anything is to just you know for for patients as we want you to come in and we do a physical exam right can't get to know you if we don't do a physical exam we need to look at imaging you look at your x rays or MRI is and see what's going on and see if it correspond wants to your symptoms right I think you and I talked a little bit about how not oh meniscus tears are created equal right if we managed you know if we imagine uh-huh bunch of people over forty a substantial portion of those people are going to have meniscus tears with no symptoms at all just random people with no knee pain on the reid did MRI's of everybody around fifty percent of those people are going to have some municipal tearing so imagine how many niece copes that is right if you just so happen to tweet your knee and you go into the surgery and say a tweet my knee and then look what happens again marine you find a meniscus tear and sometimes that's the only abnormality and so oh you pin it on that right funny enough there was a study that just came out that showed that expert orthopedic surgeons there is a fifty fifty chance of them addicting who would benefit from a partial Minnesota me Ernie scope in other words like it was a coin flip the they evaluated the they looked at the imaging but it was a coin flip for them to predict who would respond well to getting some of their meniscus taken out in other words like I don't think anybody actually quite knows yet which meniscus tears they should be respecting which ones are going to cause problems down the road it's kind of just a coin flip dance that hey yeah this I think we should cut this meniscus so it's it's a little bit of a wild card now I will say there's there's people with meniscus tears have what's called obstructing symptoms like I can't straighten my neon all the way or I get such bad locking that causes my need to to lock up or or snap or something like that and caused a lot of pain that's a different story but that's probably about like five percent of meniscus tears don't quote me on that it's a small minority of meniscus tears the vast majority are tears that again sort of wear and tear of time it's frayed meniscus tissue but realize that even if it's frayed meniscus tissue it's still serve a purpose and it's still sitting in the joint still protecting your joint he but when you when you chisel some of that out of there you're putting a lot more force through the joint after that meniscus tissues gone yeah and so oftentimes what we see is on that on that side of the neither the meniscus was taken out people get arthritis outside high rate of arthritis ten years out from Minnesota me so again you know there's a big push to you know save the meniscus right house like that was a big thing save the meniscus but but going back for for you you know you come in we do an exam we figure out what's important SUV meniscus tear is it an important meniscus tear we need to fix it you know and then we talk about sort of the role of stem cells in in you know knee pain and rightous and meniscus issues maybe it is a symptomatic meniscus maybe it's one of those bad ones there's some pretty early evidence that you know when you poke a bunch of holes also into the meniscus at the root truth nation and then you augment I think the studies with PRP but it showed that increase miniscule healing rates that there's some early events that says that hey we know that biologics like Pierre P. or stem cells we know that there's a function of those things to help heal tissues I is there a big randomized controlled trial with five thousand people know but there's really evidence and and your other option is sort of again meniscus surgery which we know is not that great yeah so we have that conversation we say hey here's the evidence that's out there in fall transparency and this is the procedure that we typically do on and we see if it's good fit for you if that makes sense to you yeah but a lot of people have improved pain and function after after a stem cell injection after bone marrow stem cell injection in it's debatable what where that benefit comes from yeah because we track all of our outcomes in a registry at our clients so if you have a procedure done otherwise prp or bone marrow stem cells we track your industry in we wanna see how are you doing at six weeks how're you doing three months year two years three years and that way we can sort of come up with some sort of predictive models and that we can give people a little bit of a expectation okay if I'm in this position what was the likelihood that I get this result yes so those are some of the things that we consider when you come in you know when we when we talk to you about themselves so like a good doctor you you went to the diagnosis process which I would hope you know any good doctor would do I thinking about how well you know what's the issue and what are the different alternatives in just trying to figure out what exactly is wrong and thinking about the different alternative treatment it's for that issue but I still go back to the question of so what is the process of drilling into the bone pull out the bone marrow like how does that work and yeah and on a pain level I'm just curious yet for on a personal level rate I'm still considering to do this and I should also note for listeners that Dr Lucas here Matt did not say you know you need stem cells he actually said that you're not suffering any pain from this municipal it's actually what was the Patella formula and you had you had suggested that maybe the PRP might help and PRP is less expensive and anyway I just want to note that you know I'm not here pushing stem cells because you told me I should get them I think it's maybe a right of passage maybe for podcasters to talk about themselves but find it fascinating but but yeah the process of extracting and in growing stem cells would be really interesting to yeah so you know for every every stem cell procedure we do we you come in you know realize we do this on the same day so outside of that same day going to the government no it's it's more than minimally manipulated so in other words you can't we can't grow our culture stem cells here so everything is in the same day same procedure aspirated so you're on a receiver table we prep the back like a surgery and it's kind of like if you if you put your hand around your hip it's that that we call the Elliott crest and that's kind of on your on your backside near your sacred in there's a lot of bone marrow stem cells in there you know people I've heard of people taking bone marrow from a from your heel bone from your steamer from your you know your lower leg bone the Elliott has has the most stem cells per unit volume in the body the end actually ironically enough the sternum has a lot of stem cells and that's how they do it on horses actually we obviously don't do that for burr clear reasons right your heart's behind there so we don't do turn them but so we do the Elliott crass so you're scaling faced down we numb the area of and then we pushed kind of a a larger needle into the bone marrow space and then we'd take small volume polls from that area and we do a couple of spots on each side you know that's been shown by a French surgeon to routinely get higher stem cell counts if you do couple sites you cannot do small volume draws of bone marrow you get higher stem cell counts that's what we do we've tested that in our lab to so a lot of people you know regardless of our clinic allows people go elsewhere to get bone marrow stem cell procedures done a lot of the orthopedic surgeons are starting to do it to the community what most of them are doing as a high volume draw from one site but what happens is when you do that you start getting regular blood and there's not a lot of stem cells in it in so so google us this this technique that was made popular by a French surname hearn ago and he does a small volume multisided raw and so so you get a couple of poke holes into the bone in your in your backside most you know start pain goes I had two people yesterday fall asleep during it you know it more so feels like a little bit of an aching in your pelvis but it's not what you think of it's not like you know granny's bone marrow aspiration that she had an hospital to test you know test for some leukemia or something you know this is you know we have a procedure suite your made comfortable heck you can like your music you know and and we hang out and we prep it like a surgery and people were talking were having conversation we can give you a little something if a valium or muscle relaxer to kind of make you feel better about it if you're hesitant but ninety nine percent of people do incredibly well and we have several biochemistry background or micro biology background employees are lab staff they're great and their job is to process cells process blood products so we bring the blood to them under sterile hoods what they'll do is they'll they'll take that they'll separate it out into a bunch of vials and then we spin it down in a centrifuge the and you can spin it down and then you separate out cell layer that has a different density than the rest of your blood cellars off from all the different vials and then they combine that into like a cell pellet and that's what's called bone marrow concentrate so when you ask great it from your pelvis it's bone marrow aspirant is this whole whole bone marrow then when you centrifuge it out and you combine the cell layers it's concentrate so it's now concentrate there's more stem cells in concentrate obviously than an aspirin because you just separated out all the cell layers and you put them together and so that's that's what we use curry sites in it that has you know your your classic Ms's it has a lot of these small molecules one of which has gotten a lot of attention recently called a two M R a two macro globulin and that's been shown to be cartilage protective so so bone marrow search and a lot of things some of which we don't even know about yet so there's a lot of.

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