Barbell Shrugged - The Science Behind Stem Cells, Sports Medicine, and What You Should do Before Going Under the Knife w/ Dr. Guarav Goswami  — Barbell Shrugged #362

Episode Date: December 8, 2018

Dr. Guarav Goswami, MD  specializes in regenerative and restorative sports medicine, providing advanced minimally invasive (non-surgical) treatments to athletes of all levels and ages. Tissue preservation, quick recovery, and little to no downtime are the cornerstones of his philosophy.   As a member of the American College of Sports Medicine, Dr. Goswami is focused on utilizing his years of experience to help his patients and athletes reach their maximum potential. He is also the founder of PreciseCare.   In this episode, we talk dive into understanding stem cells, the future of sports medicine, how can you harvest the most effective stem cells, are stem cell operations the nest way to avoid surgery? and more.   Enjoy! - Doug and Anders ----------------------------------------------------------------------- Show notes at: http://www.shruggedcollective.com/bbs_goswami ----------------------------------------------------------------------- Please support our partners! @bioptimizers: www.BiOptimizers.com/shrugged  “shrugged” to save 37%   ► Subscribe to Barbell Shrugged's Channel Here ► Subscribe to Shrugged Collective's Channel Here http://bit.ly/BarbellShruggedSubscribe 📲 🎧 Listen to the audio version on the Apple Podcast App or Stitcher for Android Here- http://bit.ly/BarbellShruggedApple http://bit.ly/BarbellShruggedStitcher Shrugged Collective is a network of fitness, health and performance shows that help people achieve their physical and mental health goals.  Usually in the gym, but outside as well. In 2012 they posted their first Barbell Shrugged podcast and have been putting out weekly free videos and podcasts ever since. Along the way we've created successful online coaching programs including The Shrugged Strength Challenge, The Muscle Gain Challenge, FLIGHT, Barbell Shredded, and Barbell Bikini. We're also dedicated to helping affiliate gym owners grow their businesses and better serve their members by providing owners tools and resources like the Barbell Business Podcast. Find Shrugged Collective and their flagship show Barbell Shrugged here: SUBSCRIBE ON ITUNES ► http://bit.ly/ShruggedCollectiveiTunes WEBSITE ► https://www.ShruggedCollective.com INSTAGRAM ► https://instagram.com/shruggedcollective FACEBOOK ► https://facebook.com/barbellshruggedpodcast TWITTER ► http://twitter.com/barbellshrugged

Shrugged family, we're back. Another Saturday edition of Shrugged. Hanging out with Dr. Goswami, Andy Galpin. Pretty awesome conversation on stem cells we did a couple months back. But man, we've been putting so many good shows out, it's hard to get all of them out and just do two a week. So we're a little backlogged, and this one's really killer. Other cool thing, Andy Galpin actually went and got the

stem cell surgery done after talking to Dr. Goswami. And I had lunch with him two weeks ago and his knee has never felt better. He had to go back in and do a couple surgeries and get the dosing dialed in. And I wish I knew all of the exact details, but he said his knee has never felt better. And Dr. Goswami was the guy that did it. So if you're ever checking out stem cells, I highly recommend going to see Dr. Goswami out here in Orange County,

if you can get to Southern California. But find a really good qualified doctor in your area, get some stem cells and enjoy your life. No one wants pain. No one wants bad knees. No one wants a bad back. And science, research, and the medical world is starting to come around with some really cool ways to do it.

And I think stem cells is going to be at the front of that conversation for a very long time to come. I want to thank our friends over at Viore. I'm wearing the clothes right now. I've got a sweet talk to give down at the Naval Hospital. In about 45 minutes, I got my fresh joggers on because they accentuate the quads. They show a little bit of ankle at the bottom,

which means I'm a professional fitness trainer. And then I got this sweet jacket on because it's very form-fitting. It makes me look yoked, and it's comfortable as hell. So get over to VioriClothing.com. V-U-O-R-I clothing dash. It's not dash. VioriClothing.com.

V-U-O-R-I clothing.com. Use the coupon code SHRUGGED 25 to save 25% on your order. Vioreclothing.com. Use the coupon code shrugged 25 to save 25% on your order. It's the coolest clothes in the game. I promise you. You're going to love them. Everyone that wears them loves them. Vioreclothing.com forward slash or use coupon code shrug 25 to save 25 let's get into the show Yeah.

Brett Contreras has been on that mic. Famous lips. So has John Cena. So has The Rock, Arnold, Tyson, all of them. Tyson. That's a weird one. You don't want to share a mic with him. That's a lie. Ready to rock? Welcome to Bar a mic with him. All right, that's all right.

You ready to rock? Welcome to Barbell Shrugged. I'm Anders Varner. We're here with Doug Larson, Dr. Andy Galpin. We are at Precise Care Regenerative Sports Medicine in Newport Beach with Dr. Gaurav Goswami. I think I nailed that. That's huge.

What a huge day. That's the best I've been called in years. So you are like the leading doctor in stem cell research, fixing people, all the things. I'm so stoked to learn about this. I feel like this is like the piece of

where medicine is going that I know very little about. And we're going to rap about this today from how are we harvesting cells, how are we making people healthy, and just the general progression to how you got to leading the charge in stem cell research. Absolutely. The older I get, the more I'm worried about my joints and keeping them healthy

so I can still be active all the way into my 40s, 50s, 60s, 70s. I can keep going for runs outside and keep lifting weights and keep playing with my kids, et cetera, et cetera. And if I have something wrong with a shoulder or a knee, I don't want to get cut on. That's like a last resort. And this seems like something that's a good in-between where I can still be super active and have some way to regenerate my joints potentially. But I don't know anything about it i want to know the basics you know how you know who's it for what does it work on what does it not work on how much does it cost how long does it take what's the recovery like just all all the

basics that like that if i had those answers i could go get treatment right away or just or just recognize that this is not for me and i gotta go find something else and this could not be more timely because you know the word is gaining more and more buzz in mainstream media now. But we're also at a crossroads, you know, with anything new. It reminds me of electric cars a few years back, you know, when Tesla first came out. You know, there was so much skepticism and, you know, nobody really wanted to even cover the car for insurance and stuff. So in a lot of ways, you know, we're moving towards alternative fuel and alternative medicine. And I think this is a huge step, but still needs a lot of refinement, a lot of discussion.

So hopefully, you know, looking for a fun session where we can educate as we talk. Well, we're going to do a lot of that. We've got like a thousand credentials and degrees hanging on the wall over here behind us. How did you get into stem cells? Where did your medical practice start, and how did you find stem cells? So pretty much I did my medical schooling in Bombay, India. He totally skipped you. He totally skipped you.

It's like I'm not even here. No, you're here. It's fine. It doesn't matter. We're bringing in the firepower later. Right. That's fine. Let's keep the simple questions to the simple people.

Doc, just go on. Don't worry about Anders forgetting about me. It's fine. There's only three people here. It's actually very boring. I talk too much in this show anyways. It's fine. Yeah, it's too boring anyway to hear about a doctor's background.

No, you go ahead. Tell them. For years, we are institutionalized. Long training, 15 years of training. I'm usually the only doctor on the show, but I'm not a real doctor. Not like this kind of doctor. So if people understand,

oh, we're talking to a real doctor this time, that's probably good. Well, you know, the real doctor in LA was Dr. Bus. I saved that to people. You can make millions. So basically, I did my medical schooling in Bombay, India. And after that I did a surgical residency and got a research scholarship to come to the United States in the early 90s. And the way it works for a lot of us when we come to this country is obviously we have to retrain and do some, you know,

repeat at least our residency training here to get certified or be on par with the U.S. doctors. So I was a fully trained surgeon, so I was kind of looking for something new to learn, you know, because the drive behind coming to the United States was not so much financial or the glamour of it, but was really to excel in the field. And I got introduced to a field called, the title is interventional radiology, which generally the radiology is the only word that makes sense. But what it does is, it's not a radiologist like sitting and reading phones, but it's using imaging equipment to do procedures less and less invasively. That means, you know, whatever required open surgery, if that can be approached by using ultrasound or CAT scan, even MRI in some

cases, or x-rays, without cutting open the body to treat conditions. So it was quite a natural fit for me, having been a surgeon, having done tons of surgeries, and now figuring out ways how some of those conditions can be treated without having to cut open the body. Sounds like terrible job security. Cut yourself out of your own job. I know. To some degree, it is. And this is why you're personal training now.

I suppose it's better that he did it before somebody else did it. No kidding, right? Get ahead of the curve. So I did a residency and fellowship training on the East Coast in New York, and then my fellowship was at George Washington Alexandria Program in Virginia. Pretty strong programs in this field. At that time, it was even more new than it is today. And then that took me to University of Washington. I was faculty there

in Seattle and had a great time teaching and learning. But the quest was always to find better ways of treating. And I think medicine tends to become very stagnant because it takes a long time to master a certain set of skills. And then a lot of physicians just want to practice those skills. So it's, but, you know, knowledge is exploding, just like in any field. It's newer things are coming up all the time. So I stepped out of the university just to form my own clinic here in Southern California. Part of it was getting a little bit tired of the rain. What? We're both from Washington, so we feel you.

And also I missed riding motorcycles, you know, which used to be my passion through medical school. So I just thought this would be a great place to come down. And right around that time, I started hearing about a lot of the athletes traveling to Europe. And so I was kind of curious as to what is drawing people, you know, away. I mean, we obviously are supposed to be the best in the world in what we do, or at least supposed to be. I don't know. We certainly are not. And so I got curious, and that took me on a journey of really finding out what was going on. And then a lot of what we'll talk about came from there. These aren't regular athletes. This is like Kobe Bryant athletes. Yeah, I mean, he's kind of used as the poster boy for this.

They're not like normal people just going to Europe to find this. This is like the people chasing millions of millions of dollars looking for the right answer. There's something there when you're looking for like, why is that athlete going over there? Yeah, and you know, the competitive, I mean, at the heart of it is we all want to stay active, you know, and performance is important. You know, at whatever level you are, you don't have to be necessarily a pro athlete. Even if you're a recreational athlete or a weekend warrior, you still want to be able to do the things that, you know, you're either used to doing and would love to continue to do as As we age, obviously, you do modify a few things,

but you shouldn't be asked to shut down. You shouldn't be asked to. And especially for these guys, when it's their livelihood on the line, they're going to go and find what's the best out there for them. So what kind of things do you do these days as far as repairs? Is it mostly joints related? Like someone tears their ACL and you're able to go fix it without doing surgery? Or someone like tears their labrum and their shoulder and you're able to do injections

rather than, you know, some type of arthroscopic surgery? So, you know, some of the treatments have always been there, you know. I mean, we used to joke in medical school that, you know, if your ortho boards were just about treatment, everybody would pass because there are only five sets of treatments out there, right? Painkillers, and we know how those work. And then you get to cortisone injection, you know, you'll throw in some physical therapy in there, but you know, if something's really damaged, physical therapy can only make it worse. It's not going to heal it. Then arthroscopic surgery, which is their version of minimally invasive surgery, and then open surgery and either a replacement or a complete, you know, change of the structure. So, but what we've also learned

is that a lot of these treatments have not necessarily delivered the results and they might be very good at getting rid of some of the symptoms, primarily pain, but they come with a lot of scar tissue formation. They come with a lot of prolonged healing and rehab and are counterproductive in terms of return to performance. You know, there's two things in sports medicine we always talk about. One is return to play and one is return to performance, right? So return to play, yes. The majority are after these surgeries because a lot of data is available in professional athletes who supposedly have the best of everything in terms of their diet, nutrition, taking care, and they're used to, you know, the whole rehab and taking care of their bodies. And even in those group of patients,

some of these surgeries haven't really been able to deliver in terms of performance, you know. So you're always asked to then slow down. You're always ask to cut down, which can be very frustrating for a lot of people. So I think that's where we kind of, and stem cell itself is such a big, huge word with so much thrown in it right now that it's still finding its place, let's say that. So what types of injuries typically respond well to stem cell and which ones don't? Right. So even before we get into the discussion,

I think it will be worthwhile to really talk about what a stem cell is and what it does. Your show, man. You run it. No, I mean, I didn't mean to. You're right. You're right. Because there's so much out there. A real doctor.

There is. Even as we talk and meet today, there's a meeting going on in the Orthopedic Society down somewhere in Texas, I believe, where there's a lot of negative press about these treatments. And part of that is right because what's happened is like anything when it comes new, there's lots of people who get on board just as a fad or not really, you know, they're not into the science of it. And they try to make claims or start offering treatments that are not exactly what the treatment is supposed to be. And so the outcomes are not there. And these patients go back, you know, to their doctors or the orthopedic surgeons and they say, well, see, I told you stem cell doesn't work. So when I see a failed stem cell treatment patient, you know, I have lots of patients reach

out to me, you know, obviously trusted the science and had the procedure done elsewhere. I mean, and they didn't see any results. My first question to them is, it's not the word I had stem cell therapy. It's what was done. You know, the devil is in the details, as they say. So that is very, very important to understand. You know, obviously, people are going to call it stem cell treatment because the fundamental science is what are stem cells? So we all grew from one cell cell and that cell is capable of multiplying itself and specializing into different organs. For us, the most important thing is how are we

able to live our daily life? And a lot of that comes from the constant process of regeneration that's taking place. That means we are carrying the seeds of our stem cells in all of our organ systems. You know, our cells are turning over every single day, every single moment. Some part of, you know, in some organs, some cells are dying and new cells are being formed. In fact, I tell people that the reason we have cancer is because of the process of regeneration. Because cancer, by definition, is when the process of regeneration goes out of control. So suppose you form 100 cells today in an organ, say liver, and 100,000 are formed because of some stimulus that becomes a tumor.

And a lot of pathologists will tell you that cancer cells look like just regular cells. It's just they're too many in number. So we've known this fundamental concept of regeneration that takes place in our body. And what happens when we are deceased or when we are injured, what happens is that at that site, because of either the repetitive nature of trauma or just the chronicity, the cells stop functioning because there is a state of inflammation that sets in. So that inflammation puts the cells in a state of shock, so to call, and the process of regeneration and healing doesn't take place.

When the injury is minor, we heal and recover. We give our ankle a rest for a couple of days, and then we're fine. We have minor cuts, we heal. We don't require stitches or go to the doctor for that. How is that happening? Because cellular regeneration takes care of when it's small. When it gets a bigger injury or it's chronic, then that inflammation sets in. So is this mostly for damaged ligaments, tendons, joint capsules, cartilage, things

like that? Yes, absolutely. So there is a possibility of if enough regenerative cells are delivered into the area which is damaged, there is a possibility of removing that inflammation and having those local cells start functioning again. Because one thing we know about these cells is that they are very strong anti-inflammatory in nature. So that is at the root of it.

Now, what conditions can we treat? Obviously, the commonest conditions we see is knee joint issues, you know, could be a ligament injury, could be meniscal tears, you know, could be cartilage damage, and shoulders, hip joints, ankle joints, and slowly the application spine also, because the discs in the spine are just like the meniscus. It's just like the cushion between the vertebral bodies, and they tend to suffer wear and tear with time and activity. In a lot of ways, we have to think of these like the tires on our cars.

So how long a tire will last depends upon how much you drive, how you drive, what surface you drive on, and whether your tire gets damaged somewhere. So think of the joints just as, you know, people are active and they're using it. And obviously if you use them more, you're likely to wear them off sooner. And that's what really happens. This whole process logically makes so much sense, but why hasn't this been accepted as the go-to source for healing and tissue repair? So two things. First of all, coming back to the earlier point of the devil is in the details, there is such a lack of standardization. So you could supposedly go to three stem cell clinics and walk away with three different kinds of information

and treatment plans. So there is no standardization. And part of that is going to come down to documentation of results and publications and more elaborate studies to really prove it to the scientific community. So the standardization would be the first step. And then next would be, you know, then comparing results. I mean, I've told insurance companies that, why don't you send 10 of your meniscus or cartilage loss patients to arthroscopic

surgery and send 10 for the treatment that we offer and let's see the results you know because no matter what doctors feel about it or what the general public feels about it this is going to be the path of the future you know it. It's just that we are right at the beginning of it, so there's lots of confusion, and unfortunately some bad players who may not practice the way it needs to be practiced. So it'll take some time for it to find its role. What are those practices?

I don't know. I mean, I'm not trying to knock anybody down but i'm just saying that well there's probably a right way to do things and yeah not so right here's what fundamental is that as i was talking we have regenerative cells you know so majority of my work has been based on refining techniques to take the athletes or the patients' own regenerative cells and try to use them as anti-inflammatory agents. So they can come from a variety of sources. There's obviously foreign sources of cells, some of which, like an embryonic stem cell is banned in the United

States. And even in countries where they have experimented with it, the results are very unpredictable because now you're dealing with somebody else's, you know, foreign DNA. But there are other sources of, you know, foreign cells too. The problem is those cells have to be manipulated in a laboratory and processed. And we don't, again, have enough data or information as to how safe they are and how effective they will be in your body. So that, I think using some of those products and calling it stem cell treatment is where the problem is because those patients are less likely to see positive results. And that can only give a bad name to the whole, you know.

From the patient's perspective, is that something that they are more comfortable with? You're like, okay, don't worry about it. We've got the stem cells already come in. We'll inject them or what have you. And now we don't have to, like, you know, take out your own bone marrow as an example, which sounds like it's more uncomfortable than just having them, you know, ready to go. So the selling point is right there. You know, I mean, yes, you're going to have these foreign cells or baby cells or somebody else's real strong and potent cells because you're already beat up

and your cells are not going to be. But I don't think, again, we have any evidence to suggest that's true. You know, I've treated a patient, I mean, my youngest patient is a 12-year-old competitive swimmer. My oldest patient is an 86-year-old woman who just wanted to travel the world, didn't want to use a wheelchair at the airport. And so I think that that argument is not very valid. But again, I said, I mean, we don't have any scientific evidence one way or the other to say that. The concern also is that when you manufacture something or process something, you're likely to introduce variables into the cells or what is being delivered.

And we don't know what the long term. I mean, we're just finding out about ibuprofen, so many bad things every day. For years, we all have popped Motrin and ibuprofen and Advil. Tylenol. I mean, right. Tylenol too. Tylenol has got some. Tylenol is still, I I mean but Ibuprofen really

interferes with cell multiplication in fact when we have to wean people off of that even before we do the

procedure because that has to be out of your system because now it's been proven to

interfere with cell multiplication that's why I got a black box warning a few years back in heart failure

patients because patients really you know, I mean, they're literally clinging to the few cells they have. And just a couple of weeks ago, there was an article about ibuprofen and, you know, low sperm count. So it's, and why is that happening? You know, it's not like ibuprofen specifically works on these organs. I think it goes to the heart of that it does interfere with cell multiplication.

So we're just going to keep finding more and more problems that it can cause. So that's where manufactured cells right now really make, I mean, we don't know enough about their safety. Now, the flip side to that is also some of the physicians. I mean, it's very easy for physicians to pull something out of a vial and inject. It's very difficult when you have to learn the techniques. I mean, we train other doctors, and I can tell you in about the first two hours, I get to know who's going to be able to go back and do this whole process and who's not going to be. Because it does require a certain level of skills.

You were talking about bone marrow. Anytime I talk about bone marrow, the first thing patients say is, oh, my God, that's bound to hurt. But, you know, I've been doing bone marrow. Yeah, that's actually painful. The bone. But, you know, it's again comes down to the skill set of the person doing it. And, you know, so there's lots of ways. I mean, we do bone marrows and we always ask people for how it was.

And, you know, we'll just stay the casual day for them. What is the process for the harvesting of the cells for you? So basically, you know, usually blood has platelets. So I'm sure people have heard about PRP or platelet-rich plasma, and it's been around for a long time. And platelets are, I mean, our blood has red blood cells that work with the oxygenation and all of that, and then white cells that fight infection. And then platelets are really these tiny cells that carry these anti-inflammatory factors. So platelet-rich plasma basically is where you remove the red and the white

cells, and then you're left with platelets, and plasma is the suspension of the blood. So that's a great source. And for a lot of patients, sometimes that's all that's needed, you know, to heal the, because like I mentioned, at the heart of it is inflammation. And if we can suppress that local inflammation without having to use foreign chemicals, natural healing will take place. Our body is equipped to heal itself. We just need very little help. And so far that help has come in the form of pills and cortisone injections and hyaluronic and synviscs and other things, which are chemicals. So yes, they might do, they might suppress the inflammation, but they also leave their footprint by damaging cells.

And that's how anybody who's had cortisone injection knows that, forget about the side effects on the rest of your body. But even at the local site, it doesn't keep working. After a while, it's ineffective. And why is that happening? Because the local cells itself are getting damaged that they're not going to respond to that chemical anymore. I'm going to take a left turn here. At what point are we going to be able to just, you know, mainline right into your bloodstream stem cells and they'll just kind of travel to wherever they are needed does that make sense like a full

body stem cell treatment is that something that you think is in the realm of possibility well again i mean you know as a physician it's important for me to you know treat a specific condition and i think we're learning more and more about the power of these cells and what their applications would be and what their delivery method would be. You know, I mean, obviously a targeted delivery, I mean, you know, knee joint injection with the platelets is just like having any other knee joint injection. But for certain autoimmune or systemic conditions, you know, where people have rheumatoid or people have some of the other disorder like lupus, and we don't know what would be the right way and how many cells and what dose it would be.

So how would you know if you needed PRP versus stem cells? And then there's other options that are kind of in between those two, if I'm not mistaken. So going to the sources, I mean, there is bone marrow is an excellent source because bone marrow is sort of a 24-7 factory that produces cells. You know, in fact, a lot of the blood cells come from there. So bone marrow has the stem cells. So harvesting the bone marrow, collecting the bone marrow, and then just putting it through a process of filtration, and you kind of collect. The important thing really to understand is, and then there's fat also, a lot of people.

Our whole body is full of stem cells. Every organ system has stem cells because that's how that organ replicates and renews itself. So I think a lot of the confusion out there amongst even the FDA right now is fat or bone marrow does not belong in a knee joint, right? Actually, fat and bone marrow are just being used as a source of collecting your stem cells, right? But they are also right because there are people who have seen inject fat into the knee joint and call it stem cell treatment. Oh, geez. So I tell my patients, you know, I can get your stem cells from any organ, right?

I mean, I can cut a piece of your liver or I can collect some fat. What would you like? And obviously the answer is clear there, right? So I think, yes, fat, bone marrow, a lot of these do not belong into the joints because they are different tissues. But what we are really using them is because, you know, if I remove your bone marrow, it's going to take you less than a week,

even less than that, to really replace it, you know, with more bone marrow. And if I pull fat, I mean, everybody will be happy. If you can get it from fat, why would you ever get it from bone marrow? Okay, so there are some important distinctions. And these are just the common sources, you know. Mostly I use the blood and and the bone marrow because bone marrow as i mentioned is a factory that does this job really well of producing cells so their natural growth factors the natural hormones and natural stuff that's really bone marrow is

rich in so if you can really get a good sample of bone marrow, it gives you a lot more than just stem cells. So that usually is my preferred way. Fat, because the sheer quantity, right? I mean, you can take 40 cc. Not me. I'm not having no one in here. We can always find you right there. He's squeezing my love handles.

Right to the muffin top. Oh, my God. My ego is just my self-worth right now because of your antics earlier, forgetting about me, and then that antic. Boy, Tosh is going to have to tell me how pretty I am later tonight. I'm going to ramp you back up. The love handles are always there. But because it can be collected in, you know, 100, 200, 300 cc,

some patients say, keep going on. A couple kilos. Right. Just by sheer quantity, the numbers of cells you can get is really high, you know. And that's important, too, although we're can get is really high, you know. And that's important, too, although we're still learning what would be an optimal number. But general sense is, you know, more cells you have, better shot the patient has. And then it also depends upon how much damage you're trying to heal, right,

and what is patient's expectations coming out? And that's why I feel like this, as time goes by, hopefully a lot of these questions would be answered. And people would both on within the medical community and the general public would really start seeing where this procedure is really helpful. You know, because right now, sometimes it's used as a silver bullet and like you're going to get one injection and everything's going to go away. Like when I was on the WODcast podcast, you know, those guys were talking and people were asking like, can I use it for performance enhancing? Like, I don't have a problem, but why can't I get more cells? And I'll have a stronger knee or a shoulder. Can you put faster cells in me that

would be cool so so but that's not you know what we're trying to do here we're really trying to heal um you know injuries and and relying on body's capability to heal itself yeah so if you if you have an injury something like if you have bone on bone in your knee all not all but a large chunk of the cartilage or the meniscus is completely missing does does there need to be a bit of that tissue in there for the cells to kind of grab onto so to speak to build it back or or does it just know where to go you know that's a fantastic question because that's exactly what's happening in my right knee right now doug so i was looking at you i was kind of giving you the wink like hey this is for andy let's get you fixed up hold on a sec sec. We're going to take a quick break.

Oh, the suspense. Then we're going to come back and look at this. And we'll spend the rest of the time just diagnosing me. Running into my reactions. Yes. All right. We're taking Galpin's marrow when we come back. And some fat.

Oh, God. Don't you love learning all the things about the stem cells? So cool what they can do in modern medicine. We're all going to live until we're 120. I'm positive of it. I'm already planning out what my training program is going to look like when I'm 116 and smashing it in the nursing home. All the people are going to be like, man, that Anders guy,

how did you get so yoked for a 116-year-old? God, I can't wait. I'm going to be so popular on Instagram for old people. Instagram won't even be around in like 60 years, but I'll be on it smashing. I'll probably have like 20,000 people follow me. All of them will be nursing home people loaded up on stem cells. Damn, life is going to be good. Get over to Viore Clothing.

I swear, even if I'm not yoked at 116, I'll still be wearing these comfortable ass clothes. Vioriclothing.com. V-U-O-R-I clothing.com. Shrug 25, save 25%. And if you have not yet, that would make you one of the very few people in this whole world that has not gotten

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in our country is that it's these insurances. We're back, by the way. Good. Welcome back to Barbell Shrug. Keepances. We're back, by the way. Good. Welcome back to Marlboro Shrug. Keep going. Keep going. We just harvested Dr. Galpin's back fat and knee bone marrow. Turns out it was all muscle. It just looked like that.

There you go. I need a cupcake. Keep going. I need a cupcake. Yeah, sorry. A lot of it is obviously dictated by the third-party peer system. Even mainstream medicine is practiced. I mean, I had a young kid with possible ACL injury and wasn't a complete tear because obviously that would be easy to diagnose. It was a partial tear.

But they wouldn't clear him for an MRI of his knee to figure out what the status of his ACL is until he went through physical therapy for six weeks. And still, if he's having pain, is when they will clear. This is an 18-year-old kid is at the cusp of making it his career. And so it's unfortunate. Well, I would love to get into a lot more questions about the legalities and the cost and all that stuff and where it's at. Is it legal, insurance covering, all those things. But before we do that, I think it would be best, you were talking earlier about the devils in the details. And one of the reasons why stem cell treatment is such like a 50-50 or hitting this thing is because a lot of people use different things. But you here are using a different type of stem cell treatment is such like a 50-50 or hitting this thing. It's because a lot of people use different things. But you here are using a different type of stem cell.

So maybe if you could tell us what that stem cell is, why it's significant, and if you're seeing better results than the classic 50-50 number. Yeah, so I wouldn't necessarily say, I mean, the stem cell, obviously I like to harvest the stem cells from the patient or the athlete's own body. So like we mentioned, blood, PRP. The problem is that there are 20 different ways of making PRP and 17 don't work. Awesome. Because nobody's taken the time to really study and figure out what it is.

So I think it's not so much sometimes you have to refine the technique to get to what you're really trying to do. I mean, the fundamentals of medicine are the same, good diagnosis, you know, you need to have good diagnostic skills and you just can't rely on imaging because a lot of the radiologists obviously don't see the patient. They call things that are on the imaging. They're supposed to, and which is good. I mean, they're thorough with their reading, but we have to then figure out how that translates into patient symptoms and what we are ultimately trying to achieve, you know, what the end goals are. So I think it just starts again, like with anything, better patient selection and having a good idea of where you can help the patient. And a lot of time also setting

patient expectations. You know, I have patients who walk in and say, oh, next week is my knee replacement surgery. I just heard about this treatment. Can you do something? And the answer is yes and no. Again, it comes down to where you are, you know, and a lot of time the word bone on bone is thrown around. That's a term from the time when we just had x-rays, you know, so two-dimensional imaging. If you don't see any cushion, bones coming together, it's bone-on-bone. But in our joints, three multidimensional, and there's cartilage all over, and, you know, there's suddenly room. And so even that doesn't really tell me anything, you know, because it's just a term that people throw out one on one. So again, it comes down to really examining them,

doing proper diagnosis, really seeing where they are, and then seeing, you know, what their expectations are. Now, I must say I have patients who have want to avoid major surgery at any cost. You know, they don't want to undergo surgery. And it could be, and I tell them joint replacement surgery itself has become very common. And there are some exceptional surgeons out there who do a very fine job. So, you know, if that's what you need, that's what you should get. But major surgery comes with hospitalization, risks of DVT, some other complications, infection. So people obviously, if it's up to them, they really want to avoid it.

And then it comes into really making sure that the patient understands that this is not going to be a one-shot deal when you are that advanced. So what are our goals again? Less pain, more mobility, and keeping you away from major surgery. So in that case, the patient has to know that this is something, along with taking care of their bodies, there'll be some ongoing management of the joint that will be needed. So every patient's different, every patient's treatment structure. So again, it's not so much doing something different with the cells. It's about how we are going to apply them and how we're going to make sure that the patient understands what the role of this treatment would be. Under 40 years or a 20-year-old basketball kid injury is going to heal very differently

because he has a very targeted damage. Maybe his ACL tore partially or his ligament got strained or maybe a part of meniscal tore, but we're only trying to treat that. As we advance in age, our joints have multiple issues. So that's how we or I like to address this. And then, you know, just have a good idea whether we're just going to use blood or we're going to use blood and bone marrow as a source. What is the price range for a typical stem cell treatment or series of treatments and how

does that compare to having surgery or doing prp or other things that are on that spectrum that'll be what's the price of your freedom to walk and do things what are you really selling but again you know it's it's kind of just like the protocol is all over the place. The price that you hear is also all over the place. And, you know, again, you know, I'm not privy to what every clinic does and what their costs are joint or site treated, you know, that I think would be reasonable. I mean, I've heard numbers as low as $2,000, $1,500 to $15,000 too. And I believe that either the $15,000 guy doesn't know what he's doing or maybe he's selling something else or the $15,000 guy doesn't know what he's doing and is selling something else or maybe that's

their clientele i mean five thousand dollars like i had a slap tear so i got my labrum repaired on my left shoulder and i paid more out of pocket than five grand for that surgery and i had insurance the insurance came back and said no no really you actually got three procedures done it wasn't just one procedure and so we're going to cover 80 of the cheapest one and i had to pay full price for the other two surgeries that i got that day yeah right so i paid way more than five thousand dollars when i thought i was going to be i was told initially it's gonna be like 800 bucks so so this doesn't seem like it's that much different than getting surgery yeah and you know for us here you know for me and for my staff as you can see we our goal has just been to we're

also curious about what the potential of these treatments are and what kind of results they can bring so we are very mindful of the fact that we do not um you know, put an onerous burden on somebody to spend. So I'm not a good businessman. So I just try to do, you know, keep the cost as reasonable as possible. And, you know, just the results are the biggest rewards, you know, because I think we need more of that there now. How close do you think we are from getting insurance to cover these things? Well, I mean, you just heard about things that the insurance even covers.

It does not necessarily mean, I mean, you know, I'm not joking when I say I'll make real money when insurance starts covering this procedure. Oh, no kidding. I'd be here weekly. Because this would be... Just for fun. Because this is a highly complex and technical procedure. And having been in the field of doing procedures all my life, I can tell you this would... That's when I tell my staff, hold on. That's when we'll make serious money.

Because it's... But yeah, I think we are still ways from getting insurance companies on board, primarily because we don't have enough data to show. And before we even get to the point of the data, we need to come up with a standardized protocol, at least some sense of standardization. It'll still be different for

every patient depending upon the condition we're treating. And the Europeans have actually done a pretty good job. I mean, there is enough published scientific evidence. Yes, we don't obviously have very large studies and we don't have any randomized control trial. So it's not the hocus-pocus that people sometimes make it out to be, if it's done correctly. There is, you know, I mean, anybody can go to a PubMed website and enter a word PRP or platelet-rich plasma. I mean, last time I checked, there were over 1,000 publications. And I'm not saying necessarily that that again translates into,

but it's been around for a long time and we know it works. And our practice, I mean, 80% of my practice is my old patients referring us more patients. I mean, we literally don't believe in doing, I mean, at this cost, I can't afford to be doing big advertisements and campaigns, so I certainly appreciate the opportunity you guys are giving me to just kind of spread the word. The stem cells usually, for years, if you look at the data,

it's like literally 50-50 is the number they always say, right? And I think you've explained why that is. It's because the treatments are so random, and that makes total sense. Are you finding in your practice or in other people that are using mesenchymal that the number's higher? Do you have an idea what that would be? If you don't, that's totally fine.

You don't have enough data. I get it. Yeah, I mean, I can just obviously talk about my practice, and I would say that overall there's about a 75%. That's pretty good. But it does, again, comes down to a specific condition. I would say that overall there's about a 75%, you know. That's pretty good. But it does, again, comes down to a specific condition, you know, and where the patient is and stuff like that.

I like to, you know, offer it to patients where I really feel I can help them, you know, so I might be a little bit more choosy out there. And, but, you know, it's just a pleasure to work with athletes and people who are really taking care of their bodies, you know, because ultimately here we're relying on your own cells. So that took me actually, I mean, I'm not a nutritionist or I'm not a, you know, I'm not into health foods and stuff like that, but clearly that plays a big role. I can technically do the same procedure and see two different outcomes.

And so I think part of the realization is also on how well the person is taking care of their body. And I think that is very, very important to the ultimate success. I mean, my staff doesn't like this, but I tell when a patient comes back and says, well, Dr. G, you're great. You helped me, this and that. I tell them, no, we are equal partners because you took care of your body and you did. Because I'm not going to take the blame on somebody who is not really taking care of their body and not doing the things that they should be doing because their outcomes are not going to be as good.

So I think we have a small role to play. I mean, we might get a lot more credit than we deserve, but ultimately it is the person. And if they're healthy, then their capacity to heal themselves is strong too. How far away is the FDA from buying into this as kind of a standard form of treatment? And I guess, will they ever get behind something like this? Yeah, so I think the first thing would be to actually drop the word stem cell because it's so many different things under one. You know, I mean, we call it regenerative cell therapy.

And that's not like people are like, oh, you're trying to skirt it. It's the same thing. Well, I mean, the science behind it is the same. But trust me, I'm not sitting here with an electron microscope and looking at yourself. I just, you know, I process, filter them out. And, you know, that's what goes into your body. So I think even it'll be the same battle, standardization and presenting evidence. And there are people.

There are some bigger clinics and practices who are really trying to engage the fda in a dialogue and explain you know some of the things that are out there doesn't the standardization of it though like hold the practice behind a little bit in that if you're already working on like what are you learning currently and where does this thing go because as soon as you figure out where it's going, the government may just be catching up to what you were doing five years ago. So what are you learning? Where does it go?

How far can you take it? And I mean, will it, does it even matter if the government is behind it or not? Because you're operating at a level and a speed that they're never gonna catch up to. Well, I mean, you know, first of all, everything is consumer-driven, right? I mean, we have to see why is there such a need among people because mainstream medicine has not served us well.

We are forced to undergo cortisone injections or the gel injections and we are you know told arthroscopic surgery and as you just gave an example you know just put a scope just to look if you would be a candidate for getting approved for something i mean it just seems like you know that there's such a dissatisfaction level of dissatisfaction and this is in the general population. For the athletes, it's a totally different equation because they're looking to perform. You know, that's their livelihood. They can't afford to be out, you know, having surgery and taking a year to recover.

So I think that is the main issue that has to be addressed. And then the issue is about the science behind this treatment. I mean, I can tell you when I went on this journey, visiting clinics and talking to people who are already in this field, I actually came back and pulled out my physiology textbook, which was like the first year when you go into medical school. And I still carry my now almost 25, 30-year-old physiology text. And I opened the chapter on platelets. And there in the first page itself, they've written about 10 anti-inflammatory agents or properties that platelets have. So we're not discovering anything new. We're just getting to a point

where we can now harness your own platelets and get them to the right spot to heal. And these mesenchymal stem cells and their anti-inflammatory properties have been known for ages. So there's nothing new that's happened on that front. I mean, Tesla already wrote the electromagnetic theories on which steve jobs and elon musk were able to then develop products right but that

knowledge was their wireless communication knowledge is you know tesla wrote about it but the speed of implementation that you're able to act with and get people healthy or you know take the next steps to where people need to be, the systems that need to be a part of that to make it so mainstream are going to be so far behind. So where do you combat that or how are you, I guess, where are you going in your practice? And honestly, I want to know how far you can take it.

Like right now is just elementary to where you're going to be in five years right so um and that's why you know sometimes feel like i learned medicine and you know 12 15 years of training and then another 10 years of practice before i really started dwelling into this so i tell people this seems like that 20 20 years of learning and now the next 20 is unlearning what I had learned. And now that I've gone into this regenerative path, you know, obviously the mind is constantly thinking. You know, right now the focus is obviously at the end of the day, I have to do the procedure well. You know, I'm not somebody's trainer. I'm not team physician. I'm not, you know, I mean, people usually come to me

after they've already been to a bunch of doctors and they already have an entourage of these people in their life and they're still hitting a ceiling or a roadblock and I can help them. So my focus is continuing to actually expand on how we can get a better platelet sample, right? And that has also a little bit taken me to the path of how we can get the patient prepped and be in optimal health on the day of the procedure when we are harvesting cells, you know, so some of that, so connecting with, you know, people, even you guys who are, you know, expounding that knowledge, you know, in your other podcast about nutrition and, you know, fitness in general, I think all plays a part into it. So I think there's a lot of moving pieces to the puzzle, I say, and then trying to optimize those things. And the rehab post, I mean, there is actually a post-regenerative cell therapy rehab

that, you know, we've written a document on because it's still an important part of healing and coming out of it. So it doesn't have to be as elaborate and as extensive with surgery. And primarily it's because, again, in surgery you're dealing with scar tissues. You don't move anything for three months or six months because you're letting the sutures heal. Then the rehab becomes more extensive. thing for three months or six months because you're letting the sutures heal right then the rehab becomes more extensive here you can pretty much in six to eight weeks get back to rehab but

yeah we need to get those muscles to fire again because they're part of the equation so what does that whole process look like if i come to you and say man my shoulder's been hurting me for years and nothing seems to work i don't want to have surgery i'd imagine i come in and get some type of a consultation or an eval, and then you lay out options, and then you have some type of procedure, and then there's a follow-up period where you're recovering. So it starts, obviously, with a sound clinical exam. And I do do my own ultrasound,

so some of the imaging can be done in that initial consultation itself, and we obviously have our own x-rays on on site between the two of those if i have a fairly good idea of what the damage is what you're dealing with but if not then we'll recommend getting an mri because the beauty of this treatment is also that like i mentioned you as we have, as the condition becomes chronic or as we age, the damage is going to be in multiple areas. Just talking about the shoulder, you could have a little tear in your labrum. You could have a little piece of cartilage missing from, you know, the arm bone. And you could have a rotator cuff tear too, which is the muscles that support the shoulder.

Now, these are three or four things going on. And if we are able to diagnose those properly, then we can actually do targeted injections and delivery of these cells into those areas. So it makes the whole treatment really interesting. It makes the outcome because we want to get your whole shoulder, you know, healthy. I mean, sometimes surgery, the focus would be rotator. Suppose you have a rotator cuff tear. Yes, we'll do the surgery to stitch the rotator cuff back. But then you still have a little bit of the labral tear,

or you might have some cartilage missing. So your overall strength and recovery may not come back because, yes, you got one part fixed. But with these treatments treatments we have the capability of diagnosing all that's going on and then going about fixing as much as we can you mentioned earlier autoimmune diseases is that the same procedure is that a different path that you take with people yeah i mean i i generally don't treat a whole lot of autoimmune diseases just because that becomes a systemic condition. And, you know, we don't know how

we are going to address that part, you know, because say somebody has rheumatoid or somebody has lupus, multiple joints can be affected. You know, now I have treated those patients where, again, the joint is really damaged. You know, we had an 18-year-old girl with lupus who had bad bilateral hip joint pain for years and was actually recommended hip replacement surgery at age 18 because they felt that the hip joints were going to be so bad that she's just going to, you know. So, you know, obviously the parents got anxious and started searching the Internet and looking for. And so we, you know, again, obviously treated her hip joints with careful consultation with their physician

because the rest of her lupus has to be kept under control. So, you know, we try to make that very clear to the patient and we try to engage their primary doctors also because they're, you know, they have to keep an eye on the whole patient. And I was very, very, about whether this will work or not. And we've been following her up now. She's about, oh, April, she'll be a year out. And she's cycling and she's swimming. Nice.

And she started to be more mobile. And, you know, as a teenager, she's gaining her confidence back because it's a very critical age. And she really was, you know, she came in so much pain and crutches. So it's gratifying to see that. Where are some of the limitations on where you feel comfortable and then not comfortable treating people? Because I feel like sometimes you show up to the doc and they're like, I have the answer. I'm like, are you sure? There's like nine doctors that have the answer right now. Like, are you really the physical therapist I need right now? But what are some of the limitations on

the procedure, stem cells, and kind of where you may be in the gray area and not... We get a lot of people inquiring about multiple sclerosis, Alzheimer's, and that's outside the scope of my practice. But they hear that there are clinics that are offering those treatments and what our take would be. I generally speaking do also keep... you know, we keep track of some of the clinical trials now. I mean, there's actually a very good clinical trial on multiple

sclerosis MS patients that was going on at Northwestern University. So I try to hook them and get them that information so they can, you know, if they're candidates, they can be part of those trials because we clearly don't have clinical evidence. So even for diabetes or renal failure, I mean, and that's where I think we have to be careful because if we start, you know, saying stem cells is going to be the end all be all of everything, which nothing really is. I mean, even, you know, you have to do a bunch of things to be fit. You have to have a bunch of things in your diet to yeah um you know gain the optimal nutrition so similarly you know i don't think and then we don't know what kind of cells right i mean brain cells might have their own ways of regrowing and regenerating let's talk

about that can we get into the brain cells i would love that'll be ultimate yeah we'll all take like an ivy shot i'm into that we're down we're guinea pigs let's do it that's why we're here yeah i want the newest new stuff um you mentioned the untested yeah i wish i'll do anything i wish i could make it more interesting than that but you know being realistic and i think uh you know cautious and as guarded as you can be. But certainly, you know, I tell people all the time, what is driving this? Because we don't have any solutions for a lot of these problems, right? So a person who's desperately dealing with somebody with Alzheimer's or Parkinson's or MS, I mean, the challenge of taking care of them, forget about, I mean, joint injury or muscle sprain looks, you know,

child stuff compared to that. Autism, you know, it's such a huge problem for parents and a lot of these individuals. And we don't have any solution. Can we get there, though? Is that the future? I think so. I mean, some are claiming they're already there, but that's not right either.

So, yeah, we would love to be there, but it's going to take time. But I think we are finally looking at what nature has given us, our bodies, and how they can be a tremendous source of healing. You know, we do not need anything external all the time. Yes, there will be certain things for which surgery is needed. You've got infection, pus, tumor. Somebody has to go and take those out. So let's not kid ourselves, you know, that this is going to be solution for everything. But yes, certain other conditions. We need some answers. You know, we've spent too much time with these medications. I mean, high blood, we don't even, we need some answers. You know, we've spent too much time with these medications. I mean, high blood, we don't even, we don't treat anything. High blood pressure, you get a new medication added

every five years. Diabetes for life-taking. So these are really concerning situations, and I'm not saying that we are there yet to really start treating these things just because we have this new tool. But I think the path that this will put medicine on and hopefully future doctors and physicians into thinking would be to really look at nature and what our body is and what's the capacity to heal what goes. So really start thinking at a cellular level rather than just you know looking at a disease and trying to suppress so with surgery oftentimes you want to wait as long as possible like if you're gonna have to get a total knee replacement you're gonna put that off as long as you possibly can at what point should someone start to consider this type of treatment you're

like if i if my knee just starts hurting one day, like I kind of want to wait for it to go away, see if it's a big deal. But years later, I might be like, okay, now I want to get surgery. Like at what point do you say, okay, stem cell is probably a good option? Excellent question. That is actually the best question. High fives all around, huh?

Crushed it. Boom. Killing it. Best question of the day. Judy in the background that nobody knows is here high five this really crowd this is really where we are with this right one of the things that's most important for people who lead an active lifestyle is the quality of life right i mean this just this past weekend and i posted it on our social media, was a study.

I forgot the name of the institute, where they correlated knee pain and depression. And obviously, right, because your freedom, your ability to move around is going down, and that will lead to depression, right? So what happens is long before, forget about, we get to the point of major surgery or joint replacement, the quality of life starts to slowly go down. Yes, I could run or I could play tennis three times a week and now I cannot. So that's where I feel that people who value

what they like doing, love doing, don't have to necessarily wait till it gets to the point where they start, you know, having restriction of activities. And then again, it's different for everybody. But that's where we can really help with these treatments, you know, where if you start to notice a decline in your level of physical activity

and the quality of your life, you should definitely look into something. Yeah, you're not there where somebody's going to give you surgery or you're ready to have surgery done. But why those intervening three, four, five years are really the precious time. So that's where. So if someone does tear the labrum or the meniscus, something like that, what's the likelihood that they're going to get back to 100 percent that they're where they were before if they're a professional soccer player they're sprinting they're doing agility you know they're kicking like is that person likely to get back to where they were or is it like 90 percent or what are your thoughts there so again we look at the extent of the damage and the general condition of the patient, what kind of rehab we'll plan for them.

If they're able to go through all of these things correctly and if the damage looks like something that's manageable, every labral tear is different. And if it's one of those extensive tear, if it's a tear where the piece of labrum is hanging loose, obviously we're going to recommend go and get that surgically fixed, you know. But here's the other interesting thing that's happening is a lot of these patients who get educated on these things have actually been going and then coming back and getting, you know, so this treatment might even have a role complementary to surgery, not at the time of surgery because you're washing and creating so much inflammation. If you put cells there, you know, you might just, you know, they might be in the suction bottle. But there's certainly a role where something major gets fixed. And like I said, but there's still other issues in the joint.

And if somebody is really looking to optimize, you know, and sometimes I find like a lot of loose bodies in the joint and if somebody is really looking to optimize you know and sometimes i find like a lot of loose bodies in the knee you know just from chronic damage so it's it's it's and if they're interfering with the emotion they have to be mechanically removed you know so i think when the dust settles there might be another area where this treatment in more advanced cases will have a role as a complement to surgery. I generally tell patients to wait about six months after surgery so that all of the inflammation because of surgery has gone down and then we can do the treatment. So that'll be one. Now again, sorry about the long answer to your question about what percentage of, and again, I would generally say

there's a good chance about 70 to 75% if the treatment is done correctly and all of the other factors are optimal. But like I said, it really comes down to a customized treatment plan, which I just alluded to. I might tell you, hey, this liberal tear really needs to be taken care of surgically. But yes, you do have a tear or partial tear in your rotator cuff. You have some damage to your cartilage, a lot of those things. Because ultimately, for you to be able to perform, and that's where when we first talked, there's one thing of return to play, and then one thing is return to performance, right? I mean, yes, you can go and play baseball but you know i mean i've got people who are playing tennis but underhand because obviously the shoulder has lost

the mobility it used to once have they've had surgery and other things so so so those are the things that go into really designing a customized treatment plan because this is a tool, you know, and, you know, if every problem looks like, if hammer's your only tool, then every problem looks like a nail. So plus we have to figure out the problem and then figure out the solution. You mentioned earlier, you keep bringing up the fact that these are really just anti-inflammatories. It's not exactly. And people have a misconception that the whole idea when we first thought about stem cells is they go in,

they're non-differentiated, so then they differentiate to the local cell. That's not really how they're working, right? So can you talk about the difference between the MSCs here and embryonic and all that stuff? Right. How they're actually working? So the MSCs are, you know, the full form is mesenchymal stem cells and mesenchym is just one of the layers there are three layers from which we develop organ systems so mesenchym is the layer that's the layer from where fat bone cartilage and everything that we deal with comes from you know and so yeah so by the time we become adults our cells are pretty much

fixed you know i mean they an embryonic stem cell is it's a lot more exciting concept because that's capable of developing into any organ system and And that's why, you know, that seems to be the benchmark. But again, we are ways away from how we are going to ethically and morally address that question. And at the same time, what would a foreign DNA bring along with it? So that's a whole different ballgame. So MSCs, generally speaking, have strong anti-inflammatory properties. And it's, again, because of the variety of growth factors, cytokines, and some of the other things that they're capable of releasing. So I tell people

that a good analogy would be that suppose there's a crime going on in some town and there are a hundred cops and they're having a hard time controlling you send in a force of another thousand they will help get things in order and then they will leave and leave it and the town will be fine in the hands of you know the hundred so so in a lot of ways this is you know you have if you're alive our cells are alive and you have those cells, it's just that because of the damage or the injury, they've stopped functioning. Or it's too overwhelming for them to really complete the job, and they need some help. So you really want them for the things they can secrete, not necessarily them differentiating.

Excellent. Absolutely. And that's where new things are coming. And then even this concept has just become clear over a period of past few years in the beginning. Yeah. I mean, everybody thinks of stem cells and things going to go in and regrow everything. But yes, now that we look at that anti-inflammatory properties, there are systems that are being developed where you could hook up, you have these cells and you do not even put them into the body. And for some systemic conditions, it might have. And what they do is they run your blood like in a dialysis machine. There's blood coming through one port and going back into your body. And the blood just runs, filters through the cells

because the secretory properties of the cells itself. So when we look at systemic condition where we're trying to address the whole body, that might actually be a better way of delivering because we don't have to necessarily deliver the cells. Stem cell dialysis. Yes. Got it. There you go.

He just coined a new term. That's what we brought him for. Call our patent attorney. Killed it. Thank you. Tell me how smart I am again. No, no. That is.

No, no. That's too much. Okay. Keep going. The amount it took me to explain, you know, if I have your permission, I'm going to start telling my patients stem cell dialysis. Sure. Yeah.

It's a small notary every time. Son of a penny. He's got a paycheck account. Yeah, exactly. I am a doctor, so I can probably help that. There you go. PhD. Earlier you mentioned, as an example, if you have a loose body in the joint,

say a piece of your labrum has come off and it's just kind of floating freely in the joint, then that's a situation where you would need surgery. They've got to take that out. Right. What are some other instances where stem cells wouldn't be preferred over actually having surgery? Yeah, complete ACL tear. I mean, if some kid's playing soccer and tear their ACL and the leg is totally unstable, I think we are, there's no, you know, you have to get that leg stabilized and they have to have surgery. And that's why when something new comes on,

it's like that is one more tool in our box today. That's how we have to look at this. It's not the tool and the only tool. I mean, years ago I was involved in a procedure where we were doing urine fibroid embolization because a lot of young women who have fibroids would get recommended hysterectomy. But, you know, hysterectomy is a major surgery in the 30s and 40s. And, you know, they suffer from this benign condition of just excessive bleeding.

And we would just put in tiny particles into the arteries and shrink the tumors and they would be symptom free now that does not necessarily mean that they didn't need hysterectomy at some point in the future but you know having a surgery like that in your 60s or 70s i mean that's your choice but um having that done in your 30s and 40s is very debilitating right so i mean the gynecologists were up in arms, just like now the orthopedics are saying that, oh, this is all bogus, this doesn't work, you know, and they would, you know, really didn't give it time of the day.

And a lot of these patients had to go on, you know, on the internet and really find, and I remember when Condoleezza Rice, the then Secretary of State, had this procedure. I mean, next day our phones were buzzing because, you know, and that's why, you know, it's unfortunate because it's kind of looked upon as a threat to a particular speciality, which it is not, you know, I mean, and I think the same thing, you know, now fibroid embolization has become a more recognized procedure. It's covered by insurance. And I think the same thing, you know, now fibroid embolization has become a more recognized procedure.

It's covered by insurance. And I think it's found its place. Yes, why would a woman in their 30s and 40s have to be subjected to major surgery where they risk completely losing their organ? You know, what if they've not completed their family and, you know, other things? So similarly, I think stem cells will also evolve. I mean, you know, right now, it can keep physically active people going for a long, long time to come. And that's where, you know.

Is there any benefit for people that they don't have joint pain? They just want to be better? Like more, they want to optimize their body? Will stem cells help someone in any way to become the best they could be rather than just going from injured back to normal? Does Bo Jackson have stem cells that I can use?

Now that's a question. Give me Bo's stem cells. That is what I want to know. A-B test. You get Bo. I get Herschel Walker. There you go. We'll see.

Now we've turned the whole thing upside down. If you can get us to 4-3-40s, we're in. I'll measure our fiber time and see if they change. I spent almost a whole hour telling you guys not to go after foreign cells. That's not what I heard, Doc. That's not what I heard at all. You've been talking. I've been thinking about Bo Jackson the whole time.

There you go. So if I could get some of those cells. Well, performance, you know, again, this might sound philosophical, but the better version of yourself only comes through the neck up, what the mind thinks. No. That's my only advice to anybody. Not the answer. The body follows the mind. And, you know, i i obviously would not recommend would not suggest somebody to undergo a medical procedure just in you know and then it has different aspects to it you know

your nutrition your health there are a lot of other ways of you know so it's not a performance enhancing treatment uh certainly not can it be sold as i mean obviously i'm sure i'll probably have more people lining up if that was a strategy but yeah um it's it's it's it's to treat a condition rather than you know so there's no way like if you're a baseball player and you're worried about getting tommy john surgery or something your elbow doesn't hurt yet but you you could be tearing your you know medial collateral ligament like is there a way to like make that ligament extra strong to prevent future tears absolutely i'm maybe i misunderstood your question clearly yes if you're starting to have symptoms and that's where i really felt the role of this surgery is why wait for the damage to progress right now we do that because we

want to avoid surgery we know if we go they're going to recommend surgery or they're going to, you know, do something. And we don't want to undergo that. But what happens is in the interim, the condition continues to get worse. And the quality of life starts to go down because now you cannot do or perform as much as you were. So, yes, that clearly is the time to at least look into it, go find a doctor, discuss, you know, how it can help you. I was just thinking about where people don't have any symptoms, and they're otherwise doing fine, and they think if they got a shot of stem cells, it'll certainly up their performance. And I don't think that's where, because ultimately these cells also go on a cellular level and find areas of damage and work on those areas.

How do they do that? Because whenever there is inflammation or damage, there are certain chemicals that are secreted which are attractive to these cells. So that's how they work. So if you run them through an area where there is not a whole lot going on in terms of inflammation, they're not going to. Gotcha, gotcha. I got one last little question for you. You want to take a break real quick?

You good? Okay, okay, okay. Gotcha. Hold on. You want to just take five real quick? Yeah, okay. Cool. Yeah, no problem. Gotcha. Hold on. Do you want us to take five real quick? Yeah. Yeah, okay. Cool. Yeah, no problem.

Give you a chance to tell everyone where to find your stuff and all that stuff. Check. Cool. Yeah. Had to take a quick break. We're back. You have a fun question about? Yeah.

Yeah. So as I am about to become a father for the first time, you are as well, sir. I am as well. And Doug for the 18th time, sir. I have so many kids. They just keep coming out. Doug only shoots and scores. That's right.

Every year I have a kid. Undefeated for the last three years. That's performance. And I did exactly what Andy's about to mention. Yeah, so I'm actually interested. You may not know anything about this, and that's totally fine for you to punt this question, but Doug had his kids, they stored the cord blood. Is that worthwhile?

Are there any ideas on that, any thoughts on that? Because that's something worth thinking about doing as well. Yes, yes. Now I am too. I wasn't 10 minutes ago, but now I definitely am. Well, it depends on his answer. Yeah, potentially. Am I going to

waste fifteen hundred dollars to doug waste five grand yes or no yeah probably you guys got away cheap because from what i hear um you know i've been contacted by parents who had it's been 12 years 13 years now that they've stored cord blood cell they pay a hundred dollars a month and they said the company in florida somewhere it's in a freezer and has changed names three times so i think you know again yes i mean are those potential sources of cells for your own kid in the future um definitely you know i i just don't know if storing them for that long what it does to their ability but my first take is if there is a family history of some kind of disorder for which we think potentially because cord blood

cells now there's a lot more research going on but for the longest time there's nothing really that came out in terms of clinical application you know so certainly your kids caught blood stem cells if they're manufactured for you it's a foreign source again until there's a match right but maybe that would be one potential application you know of how they might be able to be used more for other people also rather than just the kid itself, certainly a source for the kid. But again, what conditions are we looking at and how would these cells behave years out by keeping?

And what is the end point? That's what the parents ask. How long should I keep? Because after 10, 15 years of being in a freezer, we don't know. It's certainly an industry that has done a very good job of marketing itself and collecting so much money. I wish I had gotten into it 15 years ago.

I wouldn't have to do a single procedure and just keep much money. I mean, I wish I had gotten into it 15 years ago. I wouldn't have to do a single procedure and just keep collecting money. So, I mean, I might be a little bit more cynical about it to give you an answer, but that's where things are. And our own cells, at least in terms of our field, you know, sports and fitness and orthopedics, I think just relying on our own body cells would be enough for us to heal.

There are certain evolved conditions, which I mentioned. And so think of it like you're putting in research dollars. So, right. I mean, it may pan out into something. It may not. Yeah. You know, how long of commitment and you're willing to wait and pay, because there is no end point. But certainly, if there is a family history of a propensity to certain conditions or certain disorders, even though the cure may not be there right now, it's not a bad idea to at least have those sorts of cells.

The other way to look at that is when a child is born, we know very little about the child, right? So the first five, six years are very formative years, right? So maybe make a commitment to having those in storage until the child's eight years of age but at some point the question parents are having now and i get that ask anytime i'm giving a talk somewhere other parents will say hey i have my daughter's stem cell i'm in cord blood stored what do i do because obviously you're concerned about your child so so just to say toss it, it's not going to happen.

So you have to kind of look at the whole family history situation and then make a determination. And the way the field is exploding, I would say, hey, if you can afford it, why not at least have it, until the child's eight years old. And, you know, if they don't have any kind of neurological condition or something else where you wish you had their own cord stem cells, something could have been done. Because the steam has picked up now in this field. You know, for the longest time it was laying dormant. And cord blood was just a conceptualized idea with very little clinical work on it. But I think now we are in a stage where it might come back into relevance.

So that would be my best answer on that. Dr. Goswami, this has been awesome. Thank you so much. Learned a lot. I knew nothing. Now I know a pretty good amount. You know, slightly more than nothing. Slightly more than nothing.

You could basically step in for him on a Wednesday if he's... I'm actually going to be here every Tuesday. Okay. Filling in. Harvesting cells. There you go. That's my new thing. It's not on the street.

Where can people find you? Precisecare.com. There you go. That's the website. Precisecare.com. Are you on the socials? Do you do that? Yeah, I think.

We're taking socials right there. What's the social? Do you know? Yeah. What's the Instagram handle? It's Dr. Goswami. Dr. Goswami. And that's spelled?

G-O-S-W-A-M-I. Right on. And if someone wants to work with you, you do consultations over the phone and things like that? Yeah. We have international and domestic patients out of town. So instead of having them just travel here, we do a Skype or phone consultation if they can send some imaging. I mean, they can obviously call the office and there's a whole protocol of things we would need just so that I can be more informative to them over the phone or on Skype.

So I do those. All right. If you're banged up, hook it up. Give them a call. Or you can just come down to Newport. Yeah. Newport's nice here. It's not too bad here.

Dr. Andy Galpin, you're speaking on a boat tomorrow. Oh, that's right. I am. I was like, what are you getting at here, buddy? Yeah, you are. You're making a funny joke. By the time this airs, you will have spoken on a boat tomorrow. Oh, that's right, I am. I was like, what are you getting out of here, buddy? Yeah, you are. You're making a funny joke. By the time this airs, you will have spoken

on a boat. Well, a big warship. A large warship. Champion, yeah. Oh, wow. Yeah, I got a bunch of stuff, man. I'll be talking a lot

this summer, actually. That's good. Some more SOCOM stuff. Yeah. All kinds of things. Yeah, yeah. So I'll be around. SOCOM?

Yeah. I don't even know what that stands for. Well, you don't want to know. Well, maybe we're going to find out on Thursday. Yeah. No? Nope. Nope, you don't want to know. Well, maybe we're going to find out on Thursday. Yeah. No?

Nope. Nope. You can find out more on my socials at Dr. D.R. Andy Galpin and andygalpin.com. There you go. Dig it. What do we got coming up? We're going to Paleo FX. I don't know when the show's going to post.

Maybe it'll be before or after Paleo FX. We're going to CrossFit Games more than likely. So if you're at either one of those events, come check us out. Also, you can find me personally, Douglas E. Larson on Instagram. Come to movement-rx.com. Me and

Dr. Carissa doing all kinds of fun things so you can be healthy before you have to go see Dr. Goswami and get your stem cells all fixed up. Make sure you get into iTunes. Download, subscribe, like, send it to a friend, write a nice comment. Get into YouTube, hit subscribe.

All the fun things. Leave us a comment. We read them. So make sure they're friendly because I don't want my feelings to get hurt because of your comment. And we will see you guys next week. Shrug family, that's a wrap on Saturday's show. I want to thank everybody that's hitting me with the hashtag GoLong. That episode with Contreras fired some people up.

I got a lot of the practitioners freaking out. I got a lot of the people freaking out. You should go back and check it out. Wednesday's show with Brett Contreras talking about where strength coaches fit into the world of rehab, how we can empower people, how we can kind of eliminate a lot of the dysfunction that's going on in the world. Really important stuff. You should have an opinion about it. Get over to my Instagram at Anders Varner. I love hanging out with you. Make sure you tag me, take a screenshot of the show. I appreciate all the people reaching out, 2018 is coming to an end that's gonna mark my

one-year anniversary of being on the microphones talking to you every Wednesday and most Saturdays for 52 straight weeks we're over a hundred ish shows in I feel like I'm just learning how to do this thing one of the coolest parts is when you reach out tell me how much you're digging the show you can even tell me if you're not digging the show that's fine I just like hearing from the people that are listening just so appreciative that I get to fill your brain space hopefully you laugh hopefully you learn and I'm loving life right now so thank you guys for allowing me to be a part of your commute or your family

vacation or whatever else you're doing while you're listening to the show. I appreciate it. Get over to Anders Varner. Give me a high five on the internet. I appreciate it. And we'll see you guys on Wednesday.