Full Transcript Podcast Introduction and Exosome Overview 0:01 Hey there, welcome to the Recharged Biomedical Podcast. 0:04 I'm Dr. 0:04 Edward Park, and if you're curious about regenerative medicine, you've come to right place. 0:09 We're diving into the latest breakthroughs in telomeres activation, stem cell exosomes, all the cutting edge science that's shaping the future of healing 0:16 and longevity. 0:17 Let's get started. 0:19 Hi, everybody. 0:20 This is Dr. 0:20 Ed Park. 0:21 Thanks for joining us. 0:22 And this is another episode of Recharged Biomedical Podcast aimed at providers. 0:26 So today, we're going to talk about exosome therapy and answer nine questions that are frequently concerns. 0:32 The first question is, what are exoseomes? 0:34 As you may have learned over the years, they are 30 to 160 nanometer bubbles. 0:40 You can see from this electron microscope they've had for over 100 years. 0:43 They saw these bubbles coming out in batches. 0:45 And they thought, Ooh, this is just poop, but it's not poop. 0:48 When you analyze them and milk the phospholipid bilayer, you find largely micro RNA, also a best RNA of proteins. 0:56 The manufacturer that I use to size exclusion and inclusion. 1:00 And that means all the little gritty stuff. 1:02 It's all invisible below 200 nanometers, they do extra. 1:07 size inclusion as well. 1:09 So this is the final common pathway that you use to heal, whether you do PRP causing inflammation, causing stem cells to come in and finally secreting exosomes. 1:18 But the difference is you heal like a newborn baby, not like your old self. 1:22 In a way, it's the highest potency we have for cell-cell communication, and it is a biohack. 1:29 Why do they work? 1:30 I refer you to this diagram of Pac-Man, things you don't know that A large portion are things that we realize we don't know,
What Exosomes Are and How They Work 1:39 and things you realize you know is very small. 1:42 and largely just a matter of interpretation. 1:45 So there are microRNA messages largely. 1:48 The main mechanism seems to be shifting the immune system from Th1 to Th2, that's antibody production, to regeneration. 1:55 And concomitant with that is a shift from the M1 inflammatory macrophage phenotype to the m2 which is regenerative and suppressing inflammation. 2:05 In my mind, I think that what's happening is it's coaxing local stem cells, whether it be your cartilage, your nerve sheath, 2:13 what have you, into de-deferentiation for a short time, acting more primitive and regenerating. 2:19 I don't expect anyone to read this slide, but if you want to, you can. 2:24 And these are some of the peer-reviewed published microRNA cargo inside. 2:29 If you find MSCs and they're doing their thing and you isolate their exosomes and analyze them, you'll find these micro RNA. 2:37 And if you go down again, they seem to strongly guide the immune system into a sort of regenerative phenotype. 2:46 That's one of main mechanisms, albeit not the only mechanism. 2:49 We also have things like brain-derived neurotropic factor, VEGF, a lot of different things in the soup to make cells and tissues regenerate. 3:00 The question is, which brand should I use? 3:02 Now, I used this analogy a lot. 3:03 You and I could do home brewing ourselves with a brew kit, and we might make a decent safe beer one time. 3:12 But given the fact that we don't have sterile facilities, trained professionals, all the testing, eventually we'd probably make bad batch of beer, 3:20 but if you're talking about something injecting into human beings, who are paying money and don't want complications, then there is a whole list of unknown, 3:31 unknown mistakes that can be made. 3:34 And so it's very scary to buy from someone who's just in the business. 3:38 So the company I've used, obviously the original company, the first manufacturer 10 years ago, Climera Labs, and here is a FDA warning letter from three years. 3:48 And I think it's kind of like, you could look at it as a badge of honor. 3:52 I mean, they went through the inspected according to the people that know they didn't ask for the sterilization things and they just left. 3:59 So we're talking about, 31 year old kids that don't really. 4:03 You know, have a science degree and they're just inspectors. 4:06 And so there was some dirt cast upon them now. 4:11 At this time, I think Chimera has probably made all the mistakes they could make, knock on wood. 4:16 That said, it's been a safe and effective product for the time the seven years that I've used it. 4:20 Not only do they send every batch from the single donor to third party QA, they intermittently test the potency and the contents. 4:28 Every lot is traced and archived. 4:30 And that's why I keep track of the lots. 4:33 It hasn't been problem, but if you go and visit the Chimaera facility, you'll see they have like a dozen very expensive large cryo freezers. 4:40 So everything that they've ever made or done has been archived there. 4:45 So I think they have a critical mass of good human results, scientific data, and manufacturing chops. 4:51 30,000 square feet, 44 employees, six PhDs. 4:56 They really take care in what they're doing. 5:00 The big question is, is it legal? 5:02 Above me, there's at least a dozen FDA trials of MSC exosomes going through. 5:09 And this, quite frankly, has changed the FDA's attitude. 5:12 Of course, they're always looking to protect consumers by doing lab inspections and ensure a base amount of safety protocols, 5:19 manufacturing, and auditing, but again, most biologics are not approved by the FDA. 5:25 But then again that doesn't make it illegal per se. 5:29 I mean, you sleep every night, give hugs, do deep breathing, none of these are FDA approved, and yet you are breaking the law in my opinion. 5:38 Again, now that the FDA is cashing multiple checks from multiple companies, their attitude is a bit more sanguine and a little less hostile. 5:48 And the question really is, you know, are exosomes even something that can be owned? 5:55 I don't know that it's way above my pay grade, whether intellectual property can really cover a secretion. 6:02 Like, can you own a type of milk? 6:05 There are many brands of milks, they're all made by cow mammary glands. 6:08 And so is that really something people can own? 6:11 A question that nobody, including those writing and cash in the checks is asking. 6:16 If you think about epidural steroids, which is standard of care, it's not only not FDA approved, never been cited to be shown to helpful, 6:24 is theoretically and practically harmful to the stem cells. 6:28 It has totally reimbursed no one ever questions, despite a 16-year-old FDA black box warning against using epidurals steroids because of risk of toxicity, 6:38 paralysis, and death. 6:41 So let's look at the risks and contraindications. 6:43 Above me is a very old tally sheet I use. 6:46 And so we have names. 6:48 Every person gets a unique identifier and I keep a talley of how many encounters. 6:52 It's not a perfect system. 6:54 How many procedures you could see. 6:56 I'd keep track of, how may IVs we've done. 6:59 945 nasal injections are most popular treatment.
Brand Selection, Safety, and Legal Questions 7:03 and some of the minor complications that have ensued. 7:06 And we can talk more about that. 7:07 There's an archived video about complications and downsides. 7:11 One thing that I like to be very cautious with because it does cause stem cell de-differentiation is when someone has an active untreated malignancy, 7:20 I will definitely shy away from that, it's not like it is an absolute contraindication. 7:25 We've had some anecdotes of incredible help and If you're in some sort of N-organ failure, then sure, maybe it could be indicated. 7:33 The major reason some people don't have a good response is probably immune disruptors. 7:38 And if we look back and we see the way that these exosomes are using immune system in a sort of coordinated way. 7:46 If someone's on high dose steroids, if they're very stressed out, they have chronic mold, Lyme, yeast. 7:51 Uh, and if there on biologics, specifically antibodies to block the immune function, you can anticipate a lower response rate, 7:59 I think. 8:01 Common adverse reactions. 8:03 You know, most people get a little sleepy. 8:05 Uh, you can get an ache or a heaviness day three or four, about one in 30 or 40, uh, herpes reactivation. 8:13 And so it's really important that you do no harm and you keep a good record of who got what and where. 8:19 and I'll show you what that looks like in a moment. 8:21 So a big concern, obviously, you shouldn't do anything that you wouldn't yourself. 8:26 So I first started seven years ago with my own self-treatment, decided it was safe and effective, and then started to expand it. 8:34 If you do go the full malpractice route, my coverage happens to be 14,000 a year, which is a lot. 8:41 But there is a referral I can make for you. 8:44 But to my side, you can see this consent. 8:47 Every person has to read and sign this. 8:50 And so it just says that there's no guarantee. 8:53 It's not FDA approved. 8:54 Not standard of care. 8:56 Although in the eyes of Mother Nature, it is standard care, this is the core mechanism by which you will heal from anything from a paper cut to being hit 9:03 by a truck. 9:05 So one of the three pillars of this stool of malpractice, when you have to have an informed consent, you can't just promise the moon and just say, 9:13 oh, everybody does great. 9:15 You must also not have malice. 9:19 So malise the second leg. 9:20 If a patient thinks that you are over-promising, under-delivering, just in it for the money and don't care, don''t answer their calls, 9:28 that is the strongest indicator of something bad coming your way. 9:33 The third is deviation of from standard of care. 9:36 Of course, this is as it's mentioned in the consent, a deviation from the standard care as per the medical establishment, 9:44 not as for mother nature. 9:45 This is healing like a newborn baby. 9:48 But I was telling a story last weekend to a group of high network individuals about my 93 year old patient, and she had horrible arthritis right after 9:58 her COVID booster. 9:59 And it's kind of ironic. 10:00 It's not FDA approved. 10:01 Her daughter-in-law doesn't know she gets them. 10:03 But not only did it get rid of arthritis, but she started growing black hair. 10:07 And the irony of ironies is that her son has a company which allows hospitals to overcharge insurance companies. 10:15 And apparently mom doesn't know what her sons company does, which is weird. 10:19 But I'll leave it to you to decide whether it's unethical to use mother nature to improve people's healing. 10:28 So the thing that is hard to learn and really kind of intuitive is how we dose. 10:34 So topical skews or shopkeeping units from this company include Veve, which was formulated with amino acids and fragrance, 10:42 rose water to combat the sulfur smelly sort of amino acid. 10:47 That's really only topical use. 10:49 Chiara arguably is not size inclusion. 10:52 So it's the broth that the stem cells are in with only size exclusion. 10:59 Because it is more expensive to size include, like an extra step, you get all the finer little proteins, amino acids. 11:07 Anything smaller than 30 nanometers is still going to be in there, invisible, but still in their. 11:13 Think of it as less filtered. 11:15 And this we are recommending mainly for hair and beauty or aesthetics. 11:21 The other Luxier is a pure size exclusion inclusion product. 11:25 And so if someone's going for a systemic response, you know, probably the low dead space in the higher volume is better. 11:35 Five mil IV. 11:37 If they have the funds, then five mil triple concentrate is also quite good. 11:41 And we've given up to three of those in one sitting. 11:44 It can be immunosuppressive, but another way to do it is to break up the five into say multiple treatment areas, a knee, 11:51 maybe a shoulder, and that's a good way. 11:53 When we're talking about joint spaces, I prefer the one mil or five ml triple concentrated just because joint space is, you know, 12:02 they don't like a lot of volume. 12:05 it's worth it for the higher efficacy. 12:08 The 1ml is good for little, you know, digits and little tendons. 12:12 But again, it is all the same product in 1 in 5 single and triple concentrate. 12:18 And you can curbside me anytime you want to know what I'm using. 12:21 Generally, It kind of depends on the person's price sensitivity, how many areas you're treating. 12:26 I don't like to treat more than 6 areas at a time. 12:29 It's too much homework for your body. 12:31 But in general, the five mil is good for stomach IV and I will use, if they can afford it, they're good stuff on the face and hair as well. 12:41 For joints, again, a one triple is usually good. 12:44 And then, yeah, you can just customize that. 12:47 What you see here is sort of a redacted tracking sheet I use. 12:51 So every person has that individual number, their first, last name, and the date of treatment. 12:56 Then I create this hybrid identifier out there. 12:59 Patient number, dot, their encounter number. 13:02 And so mine would be in the forties, mom would in be the 40s. 13:06 It would the number for me, one dot 46 dot whatever, and each different treatment area is another dot. 13:13 So a sex, age, lot number and my approximation. 13:18 Again, I'm going by and I haven't been told otherwise because trillions of particles is not really quite that useful. 13:26 It's a marketing thing, but it's about 1.4 billion exosomes per cc, roughly. 13:32 And then I go into the laterality, right or left shoulder joint in that case, whether it is degenerative, inflammatory, other, 13:39 the degree mild, moderate, severe, and then no glenohumeral. 13:45 My note keeping doesn't distinguish between sabrochromial bursa and glentohumeral, anyway, it just for my own records. 13:53 any complications that may have happened. 13:55 What to charge? 13:55 Well, you know, most people look at it kind of like 2x wholesale price. 14:00 Of course, if they buy multiple vials in the same sitting, then you can discount the second and third vial. 14:06 Your goal is to make people happy, fix their one area so they'll come back to you for their other area because Russ never sleeps, 14:13 we always get new problems in new areas. 14:15 Once they're a true believer and they feel that you're on their side, they will come back over and over again. 14:19 The majority of our patients are repeat customers, but in different areas, right?
Risks, Contraindications, and Dosing Basics 14:25 You do what's comfortable for you. 14:27 Of course, it's illegal to fee split or give patient referral or kickback. 14:32 So be cognizant of that. 14:34 But obviously, you have flexibility in your pricing. 14:37 My mom who carried me for nine months and gave birth to me and paid for much of my education doesn't necessarily pay the same. 14:44 Then again, I have billionaires, at least three of them who don't pay any more. 14:49 But everyone's ethics and their overhead and guidance is as per their conscience. 14:54 So it's fair and right that you should make some money. 14:58 And so I leave it to you as to how much money that would be. 15:04 So the course that we created a few years ago is an online masterclass. 15:08 You can see the contents on the left we go through. 15:11 Does it work? 15:11 Will I get in trouble? 15:13 Which brands? 15:14 How much should I charge? 15:15 And then all the regions like muscles, tendons, fascia, ligaments, knees, shoulders. 15:19 And over the years, we've added demonstration videos. 15:22 We've had one sheets for you and your medical assistant to know all of the supplies and the steps, the videos you can watch over and over again. 15:29 One sheet's our great prep. 15:31 We also have Consense, the one I showed you, aftercare instructions, and even a demographic form that I use. 15:38 Very excited that several months ago, Dr. 15:41 Armin Nikadoshian, who took the course and for over a year has been treating autism spectrum patients, added three modules, 15:49 which very beautifully describe what autism is. 15:53 why exosomes work and how to administer exostomes in his practice. 15:57 So you go to rechargeclimaticbuild.com slash masterclass and you will see some of the other information and link to the actual courses there. 16:07 And once you purchase the course, you'll have a never expiring credit that Denise will keep track of. 16:13 And over the years, you can experiment first on yourself and then loved ones. 16:17 And you could always get that full course tuition back as Chimera Labs credit. 16:24 So I hope that makes sense to everyone. 16:26 I'm ready and willing to take on your questions now. 16:30 If you want to do that, let me stop the sharing. 16:34 Okay, so enter your Q&A or into the chat. 16:37 Q & A is probably better. 16:39 Are there any questions? 16:41 Ah, here we go, Teresa. 16:44 I have some exosomes out in our medical freezer, but we've had a 12-hour power outage last week that may have impacted the temperature. 16:52 Will not use, do you think they're okay? 16:54 Great question. 16:56 Okay. 16:57 So here's what we know. 17:00 Just like the coronavirus, exostomes are 100 nanometers here that don't do well in Room temperature. 17:09 So they can last a day or two at refrigerated temperature for a year. 17:14 You can put them in a regular freezer. 17:16 They probably won't degrade more than 5%. If you put the at a minus 80 freezer, they'll probably last many years. 17:23 I am very suspicious. 17:26 Once got a melted shipment in Hawaii. 17:28 It was only three hours at room temperature But I couldn't feel anything and I did a lot of vials at once. 17:34 So I think they do get sort of deactivated because remember the whole mechanism is it's a phospholipid sphere. 17:41 It has to dock with cells and inject the contents. 17:45 They've been lysed, they've melted, and there's this random microRNA which really can't find its way into a cell without the docking mechanism of the phospho lipid. 17:56 which is a long-winded way of saying it's probably dead or inert, right? 18:01 So yeah, you could use a top of it. 18:03 It's not going to do much. 18:05 In fact, this is one of the things I don't even recommend putting in a IV bag with your stem cells. 18:10 I don't first of all like combining them. 18:16 But even that time 30-40 minutes in the bag, they can degrade. 18:21 So you want to get that potency right in there with an IV push. 18:25 They are very temperature sensitive. 18:28 One thing you can note is that These things are frozen. 18:32 So if the meniscus is ever diagonal, it's not like the original flat meniskus, you know you're no good. 18:38 If it starts to melt and sweat, arguably it is not the kind of thing you want to ever refreeze. 18:46 It's kind like pork melted, that's it. 18:48 You can't reuse it, your risking infection, lack of potency. 18:54 Once you've melted it that is it! 18:57 So yeah, and the way, just a little pro tip. 19:00 I don't know if it's right or wrong, but I do not want to temperature shock them. 19:04 So instead of using hot water or anything like that, I just put them in ring temperature water. 19:08 And the little vials will be totally melted within three minutes and bigger vial maybe five minutes. 19:15 But yeah, you don't want to be shaking them up. 19:17 You don' want be freezing and thawing them. 19:20 And yeah. 19:21 Once they've been at room temperature for a couple hours, they'll probably inert. 19:24 Good question. 19:26 All right. 19:26 So next question, do you know of any malpractice insurance policies for this space? 19:30 Yes, I do. 19:31 If you contact me, i can refer you to my broker. 19:33 Again, it's not cheap, but something that will definitely be covered. 19:39 All right, another question. 19:41 Andy, thank you for your presentation. 19:43 Two questions. 19:43 Is the FDA developing regulations or guidelines? 19:47 Second, regarding doses is typically calculated by particle count. 19:51 Why are the specifications of this purity are standardly required? 19:56 Okay, so nobody knows. 19:57 I go to, I've been to a couple of these exosome conferences and one stem cell conference and nobody know anything, you know, 20:06 I think the most shocking thing I've done one and there's another podcast ready to publish about the fact that nobody can count exosomes. 20:14 So why did Chimera Labs go to trillions of particles? 20:16 Well, because the majority of their clients, not knowing better, switched out for other brands. 20:22 So the scary truth is that when you're measuring something that's literally invisible below 200 nanometers, it's below light detection or Abbe's limit. 20:29 You have to use something called an NTA or nanoparticle tracking analysis device. 20:34 And using Brownian motion, light scatter, you can estimate the size and number of particles. 20:39 But the sensitivity of this can be adjusted at will. 20:43 So you could take perfectly distilled water and say you have trillions of We have to go back to basics. 20:52 You cannot really do QA. 20:54 Chimera attempted to do qa. 20:57 What that looked like was measuring the amount of RNA, which is measurable, and doing it in a ratio to proteins. 21:04 But this is not industry standard. 21:07 And again, one of the true scientists in the area jumped on one on my LinkedIn posts that Denise put up. 21:14 basically said, you know, this isn't a good technique either. 21:16 So the shocking truth is no one can measure potency accurately. 21:20 They don't even know what living creatures, as stem cells, living creature are making and why they make it. 21:26 A lecture we went to a month ago was suggesting photobiomodulation, i.e. 21:31 light, can really change what the stem cell are make and we've known that oxygen CO2 definitely contributes. 21:38 Believe it or not, it's like wine making. 21:40 You want the terroir. 21:42 or the climate of the grapes to be traumatic, to have a good wine. 21:46 Same with MSC, you want to simulate kind of this negative inflammatory where the repair signals will be greater. 21:54 But the scary thing is you can't know how many exosomes are in there and they have every reason, every motivation to make a batch and then dilute the hell
Tracking, Pricing, and Course Overview 22:02 out of it. 22:03 diluted to get a lot of profit. 22:05 So those are good questions. 22:08 The trust factor is really huge. 22:09 Another question from William. 22:11 My friend got X-sum injection in his right knee. 22:13 One, two billion, 2 cc's. 22:15 He's felt much better after a few days, but after two weeks, he seems to not feel as good as the first 10 days. 22:21 Do you have any advice on how many treatments he will need in total and at what frequency? 22:28 I mean, there's a lot of things to parse out there. 22:31 You know, it's impossible for me to know. 22:34 There are three scenarios, you know? 22:37 And one scenario is sadly very common. 22:40 If you treat somebody and they're patient, pain goes away. 22:43 So, well, basically I could have just overdone it. 22:46 Pain went away and he went on a six mile hike. 22:48 That was one thing that could've happened. 22:50 Another thing is that it just too severe and the damage is ongoing. 22:57 It's hard to say, you know, we don't have real-time radiographic analysis of what's happening in the knee. 23:02 But, a lot of people do feel immediate relief. 23:06 Just because you're washing a certain protein, I forget what it is, awful pain receptors. 23:11 So it could feel better right away and patients will say, oh, you must have given local anesthesia. 23:14 I thought we didn't get local. 23:16 It just rewashed off this fiber nectin thing or something, some dimer. 23:20 And then secondly, again, people get achy around day three or four, which is on the post-care instructions. 23:26 That's very normal. 23:27 and I think it's neovascularization. 23:29 i think is some kind of increased immune action activation. 23:34 But, you know, for me, it wasn't one and done. 23:36 I had a torn meniscus for many years. 23:37 It was clicking and hurting. 23:38 And I did the shot. 23:39 Not that active of a person. 23:41 So one shot has been fine for seven years, my 23 year old at the time tore his meniskus quite badly. 23:48 and then he needed one to get 90% better and the second shot got him to a hundred percent. 23:53 So, you know, there's meniscal terrorists, ligaments, ACL, PCL, osteoarthritis. 23:59 There's a lot of things we could be talking about, so it would be difficult for me to speculate. 24:04 But my rule of thumb as you learn in the course is if it gets better after one shot, wait four to six weeks and do another shot. 24:12 If it doesn't get better, then don't. 24:14 But oftentimes, you know, it's good enough, but don�t kid yourself. 24:17 It's not 100%. But again, over the years, one of the biggest problems has been people feel bad after two or three weeks and they do their personal best 24:26 and crossfit. 24:26 And then what the heck? 24:27 You got a new injury or you re-injure it. 24:30 So, this is all kind of terrancognita. 24:33 it�s all clinical medicine. 24:35 Although patients don´t like it, You have to really read them the Riot Act. 24:39 All right, so we have another question. 24:41 Jenna asks, do you mind sharing your ideal knee protocol, product volume, grafting frequency, and how patients have reported? 24:48 Sure, love to. 24:50 You know, initially, I think I only did 1 out of CC of regular XL Glow, the older product, in my knee and that seemed to do it. 24:56 Because the knee doesn't like a lot of volume in most cases, I like to do the triple strength. 25:01 So at least one, maybe two cc's of triple-strength Luxir. 25:05 I think improvement is probably around 80%. You know, the one and only serious complication I've had has been a knee infection. 25:12 But again, that could have happened with any hyaluronic or steroid injection. 25:16 So I actually stopped doing hyaluronic acid. 25:19 I didn't think it added much. 25:20 And so, yeah, I'll do a shot, see where they are in six weeks. 25:25 Oftentimes they're like, it feels fine, but let's not kid ourselves. 25:28 You may have regrown something, some cartilage doesn't hurt anymore, But, you know, i'll never forget the son of the governor of Hawaii, 25:35 martial artist, very active. 25:37 He had no pain after the first shot even though he had very advanced arthritis. 25:41 They came back for four more shots because he quite rightly wanted to be more better. 25:45 So I think that's also a rational approach, although most people don't see it that way. 25:50 Question. 25:51 I saw some other sources, exosome products in cosmetics, how plant milk derived blah blah. 26:00 How does it compare to adipose-derived MSC? 26:03 So, okay, good question. 26:06 I mean, everything that's alive makes exosomes. 26:09 We didn't know this until about 24 years ago. 26:11 So plants do make exoseomes, there's exosesomes in raw milk. 26:18 Typically army health recruits, they always do better from states where kids drink raw milks, expressing, I guess, strong bovine proteins. 26:28 Who knows if the compatibility between plants and animals is that great? 26:32 When you say adipose derived, that's usually liposuction. 26:37 either from yourself or some obese Korean men. 26:40 And the Benev brand is just that. 26:42 That's a cosmetic brand. 26:44 I think that in point of fact, the lyophilization destroys quite a bit of the exosomes and it needs a lot of debris. 26:51 So that's not, Beneve is, lyophyllized is not something I'd ever use entirely. 26:55 Not entirely, in terms of injection, perentually. 26:59 Again, standard of care is MSC exostomes. 27:02 Someday you might have urologic cartilage derived exoseome, Schwann cell. 27:07 you know, kidney. 27:09 Yes, yes, and yes. 27:10 But right now everyone's dumbing it down to just the master repair of signaling cells. 27:15 That's the MSC's, Arnold Kaplan's medicinal signaling. 27:19 And they seem to be oftentimes one size all for regeneration and decrease inflammation. 27:25 Okay. 27:25 Something I was unclear about, I think he's recommending one to two cc's of Luxir.
Q&A: Storage, Insurance, and Potency Testing 27:30 Plus yes exactly. 27:31 One to 2c of luxir plus in the knee. 27:33 I always do anterior lateral approach. 27:36 Why? 27:37 because the technique I learned in ultrasound guidance is not good, because 15% of the time, the super patella bursa does not communicate with the knee joint. 27:47 Secondly, if you fail immediately, you can run into the anti-acrushia ligament, which you don't want to inject into. 27:54 But if have a 1 3⁄4 to 27 gauge needle and you're coming in from the lateral side, the ACL and it's super easy. 28:05 It's so easy, I wish I could show you. 28:07 You just press really hard with your thumb and you're always going to feel it. 28:10 I don't care how obese the person is, always gonna feel the space between the tibia and the femur and that's your line. 28:18 And then your medial border is the patellar tendon. 28:23 So you make a pen impression or you draw on there and then you try and maintain the same sort of dangling anatomy at 90 degrees. 28:31 It's really a piece of cake. 28:32 If you miss by a little, even if it's bone on bone, you can always just redirect needle up or down. 28:36 So important to use good sterile technique, three paths of iodine, air drawing in between, wear a mask, stay not spitting, 28:45 but a very easy, easy thing to do. 28:48 All right. 28:48 We've got a lot of good questions. 28:50 Any other questions? 28:52 Jenna asked, can you give exosomes nebulized versus nasally injected? 28:57 You know, this is all theoretical stuff. 28:59 So Armin, because he's dealing with autistic kids with court, autonomic dysregulation. 29:04 He's not going to shove a needle in someone's nose. 29:06 But you know my technique, which is the most popular thing we do, people get enhanced cognition, improved mood, decreased rumination, 29:15 addiction. 29:16 It's a real brain upgrade. 29:18 I'll use a 32 gauge needle. 29:20 And again, these are nanoscale, so you're not going to lice them like stem cells, the big catheters and needles. 29:28 So 32-gauge is an acupuncture size. 29:30 The pain is really quite minimal, especially if you numb up the area under the inferior turbinate. 29:35 It is a technique that you can learn and it's never as painful as they think. 29:39 it is the fear factor. 29:41 So, I mean, if you just do the thought experiment, you probably get a higher dose from injecting subucosally because no absorption is needed and it won't 29:49 be rinsed down the nasal pharynx or throat. 29:52 But nevertheless, the human experience, The Rat Experiments Out of Israel by Daniel Offen show that the nasal product does get absorbed and does gets transmitted 30:03 into the brain. 30:04 You could do things like low intensity focused ultrasound, which our colleague Dr. 30:08 Jordan will do, and that will even improve the stickiness from an IV administration into the brain. 30:14 But they do at the end of the day, injected or inhaled with a dart nebulizer, get to the Good questions. 30:24 Any other questions? 30:26 The technique is on the course. 30:28 Dr. 30:28 Armin talks about a lot of great pearls and tips for doing dart, how to prep the area, decongestants, his technique. 30:35 Again, he's been doing this in a lots of autistic kids. 30:39 The dart is D-A-R-T is the brand. 30:41 It's just a lure lock, little conical. 30:44 thing and that you press in and it auto nebulizes. 30:48 I've been told to use that catheter. 30:51 It's a little invasive to shiv up the nose. 30:54 So I don't see the benefit of that. 30:56 Nasal, when do I use nasal is the question. 30:59 When someone has brain trauma, they have mood problems, compulsive behavior, ASD, stroke recovery, trigeminal problems and osmia. 31:10 Any kind of thing that want to get up to the brain. 31:14 William asks, in your experience for men, what's the best way to use excellence with sexual boost? 31:18 Do you do it locally? 31:20 Yes, of course. 31:21 We do peanut injection. 31:23 Mainly we will numb up. 31:25 The penile nerves, of course, never with epinephrine. 31:28 And then we will inject maybe three to five sides on each of the corpus cavernosum. 31:35 Arguably, you can also inject into the area at 10 and two o'clock where the penial nerve and artery are coming in for rejuvenation. 31:44 Yeah, it does seem to help. 31:45 One of our patients has gotten, I think, at least nine treatments and after six years of absent erectile function, its returned.
Q&A: Knee Treatment and Injection Technique 31:57 All right. 31:58 Any other questions? 31:59 Yes, we do O-shots. 32:01 We do P- shots. 32:05 Question from China. 32:07 Exosome therapy for cardiovascular disease and neurological disorders. 32:11 Yes. 32:11 There is a literature in animals using usually human exosomes that it's good for cardiac recovery after induced heart attack. 32:20 Also for stroke. 32:22 And so there's no reason why, because we have 98% sequence homology, why if it's working in animals, of course, humans have 100% homologies. 32:33 So yeah, theoretically there is no reasons why it wouldn't work. 32:37 Now that said, you know, there are no real great data other than the people who are doing exosomes and I can refer you to hundreds of patients who have benefited. 32:46 In terms of neuropathy, we just had a guy come down from Canada who no longer uses a walker app. 32:52 Six weeks ago, he had nerve treatments. 32:54 So are these anecdotes significant? 32:57 I believe they are. 32:59 And again, if you, as I do, go to these conferences and talk to people, they'll treat you like persona non grata for doing something that's not FDA approved. 33:08 But when push comes to shove, I think they would realize that if their own mom was in an ARDS state or in a coma, we have plenty of people. 33:19 One person bought me dinner and she said her solar lentigos went away after injecting exosomes. 33:26 There's no reason to think they wouldn't work. 33:28 They seem to be working and it's up to you whether you think it is worth trying on yourself. 33:33 But again, the whole thing is we are a distributor for Chimera and its the one brand I'll vouch for practically every other manufacturer has begged me 33:42 to use their product. 33:43 And when I visit their facilities, I just don't detect the same gravitas of experience and technical ability and equipment. 33:49 So I'm very hesitant to do that. 33:52 William asks for sexual boost. 33:56 Do you do it locally? 33:57 You know, yeah, we do in the penis. 34:02 I would say that some people do get a boost in libido, maybe some kind of pituitary hypothalamic axis thing. 34:09 We did a webinar several months ago, a woman actor stopped her premature menopause of eight years just by taking repeated IV injections. 34:17 So arguably, nitroperitoneal would be even better for restoring ovarian function. 34:24 All right, we got a lot of questions. 34:26 Luce asked for heart attack or stroke? 34:29 Yeah, you'd probably just do an IV push stroke. 34:33 I mean, stroke, depending on how recent, the blood brain barrier may be open, so the penetration is better. 34:38 But I have, and we'll do intrathecal under careful sterile technique. 34:44 We can do intra-nasal. 34:46 Yeah. 34:46 And we can IV all three. 34:51 Question, would you use exhales on a dog with a heartburn? 34:54 I mean, exosomes do work on dogs just, and I've had experience with that, much less placebo effect. 35:01 As far as heart murmur, I don't know, there's a lot of kinds of heart murmers, right? 35:05 So same as humans, you know turbulence, insufficiency and regurgitation. 35:11 There is stenosis. 35:14 I have no data on that. 35:15 It probably wouldn't hurt with a help perhaps. 35:18 Question. 35:18 Neuropathy. 35:19 Okay. 35:21 Right. 35:21 So we understand that nerves. 35:24 travel from the spinal cord all the way to the tippy toes, right, or the muscles, what have you. 35:30 So you could do intrathecal, it'll arguably go everywhere. 35:35 You can also hit it along the range. 35:39 Mom just got three epidural injections that helped a little with her nerve inflammation. 35:43 Really trying to regrow the ligaments holding L3 and L4 in, right?
Q&A: Nasal, Sexual, Neuropathy, and Other Uses 35:48 So slight improvement. 35:49 She's gotten maybe 40% better after three injections, but she's trying avoid the surgeon, so I'm hoping that it's going to help. 35:58 Every time she gets it, she is immediately much better in terms of nerve inflammation. 36:02 The gentleman from Canada, he had some alcoholic neuropathy. 36:08 And so we recommended B vitamins, but we decided to use ultrasounds to locate the proximity of the nerves in the lower extremities the first time. 36:17 And this time we went for the bigger nerves, in sciatic, just above the popliteal, and in femoral. 36:24 So we will actually, under real-time ultrasound guidance, find the nerve and inject into and around the sheath of a nerve. 36:33 Happily, he has gotten much better and his endurance, his balance, proprioception much, better. 36:39 So yeah, if you can get access to an ultrasound, it's not difficult to find the short honeycomb and isotropy of the nerves, 36:49 especially the big nerves and inject it that way. 36:51 All covered in the online course for you to refer to. 36:55 Okay. 36:55 Good questions. 36:56 Thank you for though. 36:58 Yeah. 36:59 I haven't done a webinar on dogs, but I have seen some pretty interesting. 37:04 I think it's just very psychotropic for them too, actually, which is interesting. 37:08 All right, everybody, I am going to close it out and if someone has another question, thank you for all the great questions. 37:15 Yes, and just remember we have the course online, Never Expiring Credit. 37:19 It's www.RechargedByMedical.com slash MasterClass. 37:24 Very accessible to handhold, help you with any and all of your questions going forward. 37:29 And even if you are current Chimera customer, you can purchase the course and buy up to the full amount through me. 37:35 They have no problem with that whatsoever. 37:37 So, all right. 37:39 Thanks everybody. 37:40 If you have any other online, offline questions, You can email me and again, edited version of this will be provided for you.
Closing Remarks and Course Promotion 37:50 as a podcast. 37:51 Thanks so much. 37:52 Many clinicians are getting interested in exosome therapy and they hesitate for good reason. 37:58 Questions like does this work? 37:59 What forms do I need? 38:01 How much should I charge? 38:02 how do i stay out of trouble? 38:04 All these questions are addressed in my online course. 38:07 That's why I created it to help you get started. 38:10 The online course is your permanent turnkey resource to get started either treating yourself, friends and family, or to expand your practice and help more people, 38:20 as well as increase your revenue. 38:22 Thanks for tuning into the Recharge Biomedical Podcast. 38:25 If today's episode got you thinking, you'll love my book, Exosomes, Songs of Healing. 38:30 It's packed with cool analogies, full color illustrations, and all the science you need to understand how exosome are changing the game in aging and regenerative medicine. 38:40 You can grab it in paperback, ebook, or audiobook, whatever works for you. 38:45 Now head over to www.rechargebiomechanical.com to check it out. 38:50 And don't forget to like and subscribe so you never miss another episode. 38:55 See you next time.
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