Episode One-Hundred-Thirteen – Together Again.mp4: Audio automatically transcribed by Sonix
Episode One-Hundred-Thirteen – Together Again.mp4: this mp4 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Kevin:
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Dr. Carol:
Hi.
Kim Pittis:
You’re here?
Dr. Carol:
I’m home. Yay!
Kim Pittis:
I don’t have to do this alone anymore.
Dr. Carol:
Yes. You were so brave. Okay, let me.
Kim Pittis:
I had my big girl pants on.
Dr. Carol:
Yes, you always do And somebody said whoever. Oh, Alf. Of course, Alf would say that. You did a great job.
Kim Pittis:
Oh. I appreciate that we have a very kind audience. I tried to cover all different things while you were gone. So we had Dr. Musnick, of course, on. We had Dr. Charlie Weingroff on.
Dr. Carol:
Oh. How’s Charlie?
Kim Pittis:
He’s great. Charlie’s always great. He’s very intense practitioner. He’s very smart. He’s brilliant. He’s opinionated.
Dr. Carol:
A talent for understatement.
Kim Pittis:
Yes.
Dr. Carol:
Okay.
Kim Pittis:
And then I also thought I would change trajectories. And I had a patient of mine on. I thought it would be neat to hear. She’s an Ironman world championship Athlete, and she’s been using FSM for years since her concussion off of a bike. So I thought it would be neat to hear the other side.
Dr. Carol:
That’s really neat. How’d that turn out?
Kim Pittis:
Great. You can watch it and hear it and we’ll see what people say. But I just thought. Just to hear another side of it, because we talk about two patients. But I thought it would be nice for the patients listening to hear from a patient.
Dr. Carol:
That’s a great idea. That’s a great idea.Oh, yeah. We had so much fun.
Kim Pittis:
Of course. Yes. Let’s talk about you and all the places you went. And then we’ll get the train on the track at some point.
Dr. Carol:
We did a five-day Core in Sydney.
Kim Pittis:
Yes.
Dr. Carol:
And it’s interesting, almost everybody in the class has taken the course in the last 2 or 3 years on video, at least once or twice, and then we got to do the practicum and I think I’ve still sent them the slides yet. I finally figured out how to move the Core slides so that it flows right into the practicum. And it actually worked.
Kim Pittis:
Wow!
Dr. Carol:
For everybody that thinks they took the core already, it’s totally different. Again, it’s getting there though. One of these days it’ll be finished.
Kim Pittis:
No.
Dr. Carol:
I’m not sure when that’s going to be, but.
Kim Pittis:
I don’t want to be finished because we’re always learning and we’re always evolving and we’re always, I don’t want to say, changing things. We’re just getting always improving, I think.
Dr. Carol:
Trying to get it cleaner, easier to understand is not.
Kim Pittis:
I don’t know that I have it easier to understand. I had it in my own brain after all these years. I feel like the expectations are much clearer now with the course. Right? Like you’re not expected to memorize a recipe and to close cases the minute you get on your plane to go back home.
Dr. Carol:
And what’s interesting is, since I now start the core by saying you don’t have to memorize any frequencies, that’s not the point. The point is to teach you how to think.
Kim Pittis:
Yeah.
Dr. Carol:
Everything when you have frequencies to use as a tool. So you have this big complicated, scary case that walks in and we have one webinar from three years ago that says take it apart. Yeah. So you take this big, complicated, scary case and you take it apart into that’s just 40/10. So I can fix that. And this is probably the Vagus is it on? So I can do concussion, I can do that. And then that’s a disc and nerve pain. That’s easy. So, we’ll do that. And to take it apart and do pieces that you can manage. And then that leaves once you fix those what’s left. So that’s where we were with that.. Oddly enough, we did the Advanced twice in Australia because the group that came for five days, wanted one day off and then a two-day Advanced. And then there was another group, 17 or 20 or so that wanted an Advanced on the weekend. They didn’t come to the Core. So we did two Advanced and then Monday we left for Taiwan and there’s only a three-hour time change and it’s only an eight-hour overnight flight. So it was like no drama, but the Core in Taichung is all MD and maybe six physical therapists, one neurologist, mostly physical medicine and rehab. And it was approved sponsored for category one continuing medical education credit through the Taiwan Association of Physical Medicine and Rehab.
Kim Pittis:
Wow.
Dr. Carol:
And say, yeah, it is unusual for me to have students, writing notes and attend. I’ve never had a group so focused for so long.
Kim Pittis:
Wow.
Dr. Carol:
We didn’t get to the visceral stuff until 2:00 on the fifth day.
Kim Pittis:
Wow.
Dr. Carol:
All of the visceral in 2.5 hours. It was crazy. The Practicums were so cool. One of the students had a double hernia and for some reason, known only to her surgeon, he put the mesh in with 15 screws.
Kim Pittis:
Ooh.
Dr. Carol:
Ilium. ASIS. And across the pubic bone. And then over the years, she finally found somebody who would take the screws out. And so she had all the metal out, but her abdomen was painful and adhesions up to dense. And as I was resting at lunchtime in one of the back rooms in Frederick Lynn’s clinic. I said, is that an ultrasound? Yeah. Can we do an ultrasound on that girl before I do her as a demo? Because the other reason the Core was time intense in Taiwan is that 3:00 they would schedule a demo and they would take the camera that they were recording the course with and move it in on what I was doing with my hands. So, we have an ultrasound showing the scar tissue in this poor girl, and she had a Pseudomonas infection on the screws. And so, there were patches when they switched to the Doppler on the ultrasound. There were patches of intense red and patchy inflammation that you could see on the ultrasound. Then, we treated her. And you could see the scar tissue in between layers of fascia and specifically scar tissue in the fallopian tubes.
Kim Pittis:
Oh.
Dr. Carol:
Belly was full of scar tissue. I treated her the next morning. They pulled out the ultrasound again, and we re-ultrasound her. You could see that the line of scar tissue was gone. All the red stuff on the Doppler was gone. It was so cool. I have this picture with this girl who had Ehlers-Danlos. And came to a practicum like all the schedule practicums were done and the team at her table said, what should we treat her for? And went, she has Ehlers-Danlos, fix it. Excuse me. Here. So we collected enough machines and we did 124/77, torn and broken in the connective tissue, 40/10.
Kim Pittis:
For the pain.
Dr. Carol:
Just for the body pain and then concussion and Vagus. So she gets up off the table and her thumb stops here instead of laying there. And I bend her finger up and it stopped there and her elbows. And then she had she put her sneakers on, No shoes in the clinic. That’s the other thing. Outside the clinic room, 35 pairs of shoes. Anyway, in her stocking feet, she ran around the clinic and she came back and she said, I ran. It doesn’t hurt, I ran. And it’s like the posts on Facebook. There is a group on Facebook, our FSM practitioners, if you really want to see some enthusiasm. Not we’re enthusiastic, but the guys in Taiwan are just over the top. The comments on the FSM, what’s it called? Taiwan? FSM Taiwan, right.
Kevin:
For their?
Dr. Carol:
Yeah, for their group. FSM Taiwan? I’m pretty sure.
Kevin:
I can’t remember.
Dr. Carol:
Anyway. It was fun. And then the Advanced, since I actually had to do it in two days the Advanced is going to be different this year too. Just so everybody’s ready. We had a great time. It was really fun. Oh, wait. And we had a neurologist. We had a girl in the class. She was a DPT. She physical therapist, and she had a very odd presentation. She couldn’t turn her head to the left. That’s interesting. And her left arm. And she just woke up that way one morning and her left hand did some sort of spasm things. I ran 40/396 and she went from hyperesthetic to numb. It’s supposed to go the other way.
Kim Pittis:
Right.
Dr. Carol:
Okay. Thank you. Good. That’s what I thought. And then there was a neurologist in the class and they made this girl the demo. And the doctors who’d been treating her were also in the class, and they’d done prolo, and they’d done nerve hydrodissection to get the nerves free from the fascia. And they’d done this, and they did all this peripheral stuff. And later on the tape, her reflexes were normal, no plus 3s. And her sensation was not quite right. And when I had her lay on the table and I said, turn your head to the left. So, she went to turn her head to the left and her right trap and SCM just spasmed and cranked her head to the right, and I went like this to the neurologist and said, I am not good at central nervous system exams, if you would please. So she checked jaw-jerk. It was okay. But the agreement was that this is not peripheral. This is not because of something in her neck. You turn your head to the left and you try to turn your head to the left and your right trapezius does this. And I looked at the two doctors. And I said, you are not to touch her neck until you have an MRI with contrast. And the neurologist said, oh, we do the contrast. If something bad shows up normal in the regular MRI. because it’s going to take you a year to get approval for the new MRI.
Kim Pittis:
Just do it.
Dr. Carol:
So it, it brought to everybody’s attention that we have to know our limits. So, I ran usually to relax the upper trapezius. We do 40/94, relax, quiet the activity of the Medulla, and quiet the activity of the accessory nerve. Didn’t do anything. Zip. And because of all of the things and all that happened in the Medulla and all of the cranial nerves in the medulla, I did not do increased secretions in the medulla. That one just makes me nervous.
Kim Pittis:
Yeah.
Dr. Carol:
Not so much. Oh, and. You see my koala on it?
Kevin:
Pretty.
Dr. Carol:
Isn’t that cool? And that’s what.
Kevin:
That’s a kangaroo.
Dr. Carol:
That’s. Oh, this is a kangaroo. I don’t have my glasses on because I can’t get them clean. That’s a kangaroo. And a little green one. Here is the koala. Here’s a little koala.
Kim Pittis:
Oh, beautiful. And it’s the FSM blue.
Dr. Carol:
It’s in blue. And then see all the little dots. That is how Aboriginal art is done. It’s all with little dots. So every time I travel, I bring a Christmas ornament home. So there is an Aboriginal Christmas ornament.
Kim Pittis:
Oh, pretty.
Dr. Carol:
And then because I love Australia, there’s another Aboriginal Christmas ornament.
Kim Pittis:
Beautiful.
Dr. Carol:
Yeah.
Kim Pittis:
Australia was lucky to have you, but we’re lucky that you’re back.
Dr. Carol:
I’m happy to be back.
Kim Pittis:
We had quite a few questions that rolled in while you were gone. Some of them that were emailed to me, I just said, this is more of a Dr. McMakin sort of question. I’m very comfortable talking about all the physical medicine stuff, but when it comes to a lot of the other things, I think this is more your arena. So, I did promise to mention some of the ones while you were back. So, I want to jump into a couple of those things. I also have a couple cool stories to share that happened to me with nerve pain. And then I want to talk a little bit about post injection support that we can do for PRP and Prolo and all those other things, because that’s very common right now, especially in my neck of the woods. So, one of the first questions, this is a bit loaded, and I want to just preface it by saying you don’t have to talk about all of it, but this one practitioner says we’re hearing a lot about the vagus nerve. And can you explain your theory on the vagus nerve versus the polyvagal theory? It seems to be different.
Dr. Carol:
Oh, Stephen Porges theory. Okay. Oh, yeah, that one’s easy.
Kim Pittis:
Okay.
Dr. Carol:
Okay. Stephen Porges, the first thing to know about him is he’s brilliant. Excellent. But he’s a psychologist. He’s not an anatomist and he’s not a neurologist. And he talks about the dorsal and ventral vagus like it’s two nerves, dorsal being in the back and the ventral being in the front. There are dorsal and ventral nuclei of the vagus in the medulla. I’ve never been able to make it all the way through the book because the neurologist in me just goes ain’t at time. Can’t do it. The dorsal and ventral Vagus we have the fight or flight response, which is sympathetic. And as I understand, his vagal theory. There’s fight, flight and freeze. And he’s saying that the freeze response is vagal. And that the challenge that I have is twofold. That is, once the Vagus leaves the skull, it’s one nerve that does six different things. So, if you look at the Vagus webinar, it’s secretory. That’s why you have saliva and the Vagus is able to be shut down by the sympathetic nervous system. So, the vagus is inhibited by infections, stress, and trauma. Porges says that the Vagus is in charge of this freeze response. So when a rabbit gets super scared, it just doesn’t move, and somehow that carries over into human behavior. But outside the skull, there is only one Vagus.
Dr. Carol:
So it’s motor. It operates your palate. It raises your uvula, gives you a gag reflex because it’s the way it’s connected is sensory. So when you touch your eardrum, the Q-Tip, you cough, you get a crumb in the back of your pharynx. And the 3, 4 and 5 are connected to the diaphragm. And the fibers of the sensory part of the Vagus interdigitate connect directly to that diaphragm. So, when you get a crumb in the back of your throat, the Vagus sensory fibers tell those three nerve fibers to make you cough, to get the crumb out before it ends up in your lungs. Then, its motor operates the muscles of swallowing. It innervates every muscle, so its motor in the vocal cords except for the one that lets you scream and it does motor to the esophagus. It does mucus and saliva to the esophagus and the mouth. The right vagus regulates the heart rate for the atria. The left vagus regulates the heart rate for the ventricles. The bronchi are innervated by the vagus. Then, it goes down through the diaphragm. One branch goes to the immune system in the spleen and suppresses T cells and macrophages so that when there’s no stress, there’s no infection, there’s no tiger. It suppresses the T cells and macrophages from the spleen and controls the immune system. So, you don’t get autoimmune diseases or inflammatory diseases or inflammatory conditions. So, the only difference between somebody with terrible-looking x-rays and no pain and okay-looking x-rays and a lot of pain is the vagus nerve, is inflammation. So the vagus is in charge of suppressing inflammation. It is also in charge of suppressing the release of glucose from the glycogen that is stored in the liver. When you’re running away from a tiger in the woods, you need lots of sugar, so you get under a lot of stress or in a lot of pain, and your blood sugar goes up because the Vagus goes down. And then, it innervates all of the sphincters, the lower cardiac, the esophageal sphincter, the ileocecal sphincter, rectal, all of that. All of the sphincters and the gut squishing your food along. Okay. Now, this freeze response the Porges is talking about. I’ve never made it all the way through the book, but he must be very eloquent about it because people believe it even though if somebody is able to walk in your office and they have digestive difficulties, elevated blood sugar, a heart rate of 92 and dry mouth and eczema and IBS, their vagus nerve is not working. They’re not in the freeze state. They’re in the state that happens when the vagus is turned down. I have to do it. The mend device. The vagus protocol on that device is dangerous. The whole protocol turns the Vagus down. I get rabid about this because when you look at what the Vagus does in the brain. So when we’re talking about early cognitive decline, when we’re talking about memory and recall and brain health, the vagus nerve in the brain increases nitric oxide and increases vascularity, blood supply to the brain. That’s a good thing. The vagus has to be on. The vagus increases brain-derived nerve growth factor, which increases the number of synapses and their receptivity to synaptic information. It decreases glutamate, which is the primary inflammatory neuropeptide, if you will, in the brain. And it decreases all of the inflammatory cytokines in the brain directly and indirectly by its effect on the spleen. And then, there were some other really cool thing it did in the brain. But so there’s actually ha, one of the students in Taiwan is in the physical medicine and rehab department at the hospital dealing with brain injuries. He has submitted a proposal to the IRB from the hospital to do a control trial on FSM in brain injuries.
Kim Pittis:
Wow.
Dr. Carol:
Yeah. And since we don’t have any case reports, anybody out there, in TBIs, the IRB says you have to do a proof of concept by doing 52 patients. I don’t know how they came up with that number, but 52 patients. And he said, what protocol should I use? He said, I’ve been using just the concussion protocol. I said, use a concussion and Vagus.
Dr. Carol:
Because the major problem in traumatic brain injuries is inflammation. And so that’s and that’s coming, it’s going to take him a year to get the 52 TBI’s. But once he has the preliminary data, I will be planting seeds. I already planted seeds about… Do you think maybe they’d let you publish that preliminary data possibly? So that is my difficulty with Porges’s theory. There is no fact that I know about that supports it and everything that I know about the Vagus. If the patient is able to walk in your office, they are not frozen. There are times when you’re so terrified that you can’t move and everything does freeze. But that’s when the sympathetics shut the vagus down and everything stops. Digestion stops, hormone stops. The vagus has fibers to the kidneys and antidiuretic hormone. Anyway, I get a little excited about the vagus. So if they walk in your office and they’re sick, it’s because the vagus has been turned down by infection, stress, or trauma. And if the vagus stays turned down, it’s usually because someone has been sensitized in utero, in childhood or in adulthood someplace where they’ve been molested, raped, assaulted, kidnaped, combat, all of the things that create infection, stress, or trauma. It’s like when the midbrain is sensitized. The way the Vagus works is it sends information from the body up to the medulla.
Dr. Carol:
And the medulla has to clear it with the stress centers in the midbrain, the amygdala, the hippocampus, the thalamus and the hypothalamus. Hypothalamus runs the hormones that you need to coordinate everything. The hippocampus remembers. I remember that thing. That thing is really bad. And the amygdala just goes… And the thalamus goes, okay, I’ll send the message out to everybody.. We’ll figure it out. So the message goes up from the Vagus to the brain. The efferent fibers go down using epinephrine and norepinephrine to turn the Vagus down so stress hormones turn the Vagus down. The vagus uses acetylcholine inside of its own circuitry and acetylcholine to send the message up. Stress hormones turn it down and then. Yes. Whoever DNA is. DNA says. I’ve noticed a lot of Vagus downgrade in people who use Adderall, so perhaps chronic stimulants eventually cause. Any stimulants. The thing about Adderall or Vyvanse or any of even Sudafed, Sudafed is pseudoephedrine. The Vagus is turned down by infection, stress, and trauma. If you could memorize that mantra, it will help you do your patient histories. This is turned down by infection, stress, and trauma. So, the Adderall has an 8 to 10 hour use life. And during that daytime, that’s why it’s a weight loss drug. Before it became an ADD drug. It was for weight loss.
Kim Pittis:
I’m sorry I hit you with the Vagus, like, right out of the gate, but I just feel like our important role of doing this podcast is obviously to have fun and be entertaining, but I feel a big part of it is to share important information and the Vagus, like I said, it is very hot word right now. Everybody’s talking about Vagus this, Vagus that. I have new patients that come in that says I just want the Vagus protocol. I’m like, what’s the Vagus protocol in your opinion? Like where is it coming from? What do you hope to achieve? What can I help you with? Because I assist you in your journey. Right. Because it’s not a magic wand. And just let’s treat everybody’s Vagus. And when we’re saying, I’m going to treat your Vagus, what does that mean? Even without FSM, manual therapy, like all of this stuff, helps someone’s vagus nerve function better. So, if you just think about it in that simple terms, we’re here to help support the vagus nerve function better. And then if we think about that with frequency. How could it be 40?
Dr. Carol:
I don’t know unless you read Stephen Porges’s book and that’s all you knew about the Vagus. If you look up the medical literature and the scientific literature on the Vagus, Porges’s out someplace else. When you’re managing a patient who says, I want you to treat my Vagus, yes, I can treat your Vagus. And the Vagus is turned down by infection, stress, and trauma. Treating your Vagus, there’s no point unless we treat what turned it down. So tell me, when you started having problems with digestion, with pooping, with blood sugar, with inflammation, with allergies? I was about 19. What happened when you were 19? I was in college. Huh? Was college really stressful? That was pretty okay. Did you get raped in college? Oh. And that’s infection, stress and trauma, if you can remember that mantra. And yes, we can treat your Vagus and yes, you’re going to feel better. And just the fact that we ask. When did it start? I was six and I had this horrible virus infection. And all the viruses in the Vagus and the gut and the immune system. Right? I got COVID and then after that, whatever. I lived in a moldy house. Do you know what I found out? I still don’t have a gag reflex. Remember when I dealt with all that mold stuff?
Kim Pittis:
Yeah.
Dr. Carol:
I checked it today, and I had my annual physical with my GP, and I gave her the short version of the Vagus webinar.
Kim Pittis:
Yeah.
Dr. Carol:
And I said, you got to look at this. Look at my tongue. Ah. And she said, it doesn’t move. I said, no, I have no gag reflex. Ever since the mold infection and I got a negative urine mold sample back, I’m going to go back and check because my I treat my Vagus every single night. So, I still have to go look.
Kim Pittis:
Yeah.
Dr. Carol:
What’s turning it down.
Kim Pittis:
Interesting. Turning it down. Yeah, because it’s never off. It’s not a switch. Nothing in our body is absolute like that.
Dr. Carol:
Completely off. You die because it runs your heart.
Kim Pittis:
Totally. I just see the vagus nerve as. And I guess it’s just from being an anatomy geek, looking at the pathways, seeing its complexities, respecting how intricate it is, the branches, the just, the volume of the nerve. It’s just a mess.
Dr. Carol:
There’s no other nerve in the body that is motor, secretory, sensory, pre cardio motor. Nociceptive. If you have pain any place between your pubic bone and your Adam’s apple, it’s the Vagus. Unless somebody puts a pin in your skin. But if you have visceral pain, it’s a nociceptor too. So it’s motor sensory secretory nociceptive.
Kim Pittis:
And I think so when we break it down like we talk about complex cases, breaking it down into little bite-sized pieces, when you think about it’s nociceptive qualities, I can understand a little bit of wanting to quiet that down. Only in that one, because I’m trying to just understand the thought process behind using 40 with it. But that’s.
Dr. Carol:
But no even when it’s nociceptive, even when it’s painful. Yeah. It’s in one case of visceral CRPS.
Kim Pittis:
Yeah.
Dr. Carol:
Complex regional pain. She felt like she was urinating shards of glass. CRPS is when a nerve disconnects from the periphery. So the way to get rid of her POTS. way to get rid of pain when urination and defecation was to increase secretions in the Vagus and turn it back on. And then, the other thing with the Vagus and the belly is scarring in the Vagus.
Kim Pittis:
Thank you. So I think so many times we just think about treating pain as using 40/10, 40/396 and that is super myopic. And yes, it’s a good place to start. And I have two places I want to go with this. So I had a patient who had numbness pretty much from the elbow, affecting index and thumb. In less than an hour, got it back to just numbness on this one-quarter little part of the index finger and like, maybe a 130 of the thumb.
Dr. Carol:
Okay.
Kim Pittis:
Teeny tiny bit. And I use magic markers and I always just use my pinwheel. And then I put the marker. Pinwheel marker. This person had seen a FSM therapist who did a lot of the heavy lifting already, but still couldn’t do the nerve. I’m like, usually the nerve is the easiest. All the protocols. Disc, facet, 43/96, 124/396. All those things. And I said, but did you run 81/396?
Dr. Carol:
Thank you. Like.
Kim Pittis:
No. Why would I do that?
Dr. Carol:
Because that’s how you get the sensation back.
Kim Pittis:
So this just tells us that we need to do a better way of explaining. It’s not just 42/96. It’s not just trauma. It’s not just torn and broken. Don’t be afraid of using 81/396. You’re not going to make pain worse. But when there’s numbness, getting that nerve, feeding it like just.
Dr. Carol:
Telling the nerve you will secrete.
Kim Pittis:
Yeah.
Dr. Carol:
End of discussion.
Kim Pittis:
Yes.
Dr. Carol:
And honestly, the basics in the nerve. I teach that in nerve pain. The basics in the nerve are 40/81 period.And 13.
Kim Pittis:
And 13 for sure. I have a hard time with 124 because the nerve doesn’t tear or break. It can get traction, but we never will traction a nerve. Everything will splint those muscle spindles, will jump in and create spasm before that nerve actually tears or breaks. So that’s my thought process between not a lot of 124/396.
Dr. Carol:
And if a nerve is truly torn. So I’ve had patients 2 or 3 back when I had a neurologist who I co-treated a lot with. When somebody has a torn nerve, it’s phantom limb pain.
Kim Pittis:
Oh yeah.
Dr. Carol:
40/89. So that’s what phantom limb is. You cut a leg off and the foot that isn’t there hurts, burns and itches. Yeah. You run a 40/89 in the phantom limb pain goes away.
Kim Pittis:
Yeah.
Dr. Carol:
So if you have a nerve that’s torn and broken. That’s one of the things I’m rethinking in the nervous system section of the Core is to take out 124 and put 124 if the nerve is torn, you can’t fix it anyway. You can’t put it back. It’s not there.
Kim Pittis:
And again, just going back to the structure of the tissue. Many other tissues are going to tear and break before the nerve tears and breaks. So for sure go after the fascia, go after the adipose. Go after the connective tissue, go after the muscle belly, the musculotendinous junction, all of those pieces. And that will that can help. Right. So this is going to be my beautiful segue into not using 40 after PRP injections, or because PRP is the creation of inflammation. So we don’t want to mess with that too much. Let the good inflammation do its thing. It’s just like using ice baths and I’m going to get crucified first, because every podcast that I open up my mouth and say I don’t like ice baths, my inbox gets inundated with the people who love ice baths. Okay. It’s great. There’s a certain amount of inflammation that our body needs, especially in that repair process. And it’s very simple. It’s called macrophages. We need our body, our little Pac-Man, to come in and clean up the debris. If we don’t get that, the debris just stays there. So, it’s when inflammation goes crazy. That’s when we get too much swelling. That’s when we get pain. That’s when using a little bit of localized ice can help. However, we also need heat and movement to help vacate the area. So going back to FSM role with acute injury, with recovery, with repair and using it with post biologics with injections, we don’t want to take the good inflammation away. We want to let it do its thing. But when there’s pain involved after these procedures, 40/396 isn’t what would help anyways in this case. So it would be a lot of 124 because that’s what got you into the mess in the first place. Something tore and broke.
Dr. Carol:
So when you do, the PRP is and I want to ask you about the difference between PRP and stem cells. But the PRP is a glucose solution. They used to use a high percentage glucose to create a lot of inflammation. The last couple of meetings I’ve gone to, they’re using like 2%, 5% like almost slightly above normal glucose levels to more physiologic to support tissue, feeding the tissue and feeding repair. The high concentration of PRP creates a lot of inflammation, hurts like crazy, and its goal is to create scar tissue. The goal of the low concentration is to feed the tissue and allow it to heal. And the low concentration stuff is not painful.
Kim Pittis:
Right
Dr. Carol:
The high concentration is supposed to be. Is there anything that we can do to… my suggestion has always been just run 49 and.
Kim Pittis:
Yeah. So not yeah. So using platelet-rich plasma right? Not prolo. Yeah.
Dr. Carol:
Yeah chemicals and PRP. Is PRP as inflammatory?
Kim Pittis:
It can be. Yes. But not in the same way. So like you said you’re injecting that platelet-rich plasma into the area. So, again, creation of natural inflammation that’s coming to repair the area. We don’t need to run 40. The pain that these patients are in that we’re helping with FSM is more of that torn and broken. That’s what got them in that situation in the first place. So Kathleen just replied because she actually helped prompt this, because she had reached out to me about what I use a lot of the athletes. She had a patient whose pain wasn’t being helped running. I can’t remember what she was running in the first place, but we try not to run for the two sessions. 30 minutes total 6 out of 10 to 2 out of 10, 4 out of 10 to 1 out of 10. And the other good abduction range of motion.
Dr. Carol:
That’s using 124/77.
Kim Pittis:
Yeah, the patients had a lot of pain. So I like using trauma 94/294 on those A channels. Again that will take the pain down. So again there’s always two folds, right? We want the patient’s pain down and we want to like mechanically help healing and help repair at the same time. You don’t necessarily need 40 in that case because we just want to let those injections do its thing. So, I think my recipe has changed a little bit. I can post that somewhere for people. I use a little bit of the wound healing also in that case. So, I have a lot of doctors that are using it with CustomCare’s and they’re waiting room right after they’re getting injected. They don’t know what’s on there. Like you just run your thing. So yeah, 124/294 with 191 is what I typically like.
Dr. Carol:
I have a question. Yes. Platelets make blood clots. That’s one of their roles in life is to make blood clots. Make scar tissue?
Kim Pittis:
Yeah.
Kim Pittis:
Okay. Platelets are to make blood clots. How about hypoxia?
Kim Pittis:
Yeah. So that’s so funny that you say that because back when I first started putting together these post-PRP recipes, I wasn’t using hypoxia. I wasn’t thinking about the hypoxia necrosis stuff that kind of came in after. But yeah, absolutely, why wouldn’t that help?
Dr. Carol:
I don’t know. When you think about PRP, the other challenge I have when I only see the people that fail with Prolo and PRP and stem cells. But the challenge I had was typical of a patient who had pain at T12-L1 and low back pain. And so she had an appointment to go up to Seattle, and they were going to Prolo L1 through L5. And I said prolotherapy is to create fibrosis and help hypermobility. How about if we do some flexion extension films and side-bending films and find out if you’re hypermobile because there are some doctors who do prolo or PRP, they shoot where it hurts. Patients are getting prolo in between their shoulder blades when they have a disc bulge. But this patient, when we did her lumbar films, nothing moved between L5 and S1. It didn’t move at all in flexion, extension. Nothing moved. So where she had her pain was T12-L1 and he wasn’t going to prolo that he was going to prolo the whole L1-L5. And I said, how about if we spend a couple of weeks, postpone the appointment and let’s see if we can get L1-L5 to move to take the shearing stress off of T12-L1.
Kim Pittis:
Yeah.
Dr. Carol:
In four weeks, she was out of pain. So thinking it through, I there is a wonderful. You’ve had at least 30 PRP treatments. Yay, elf! I got a question. So the PRP Association, the Prolo Association is part of the team that invites me to Taiwan. And I was told by their president, if 3 to 5 Prolo sessions haven’t fixed it, it’s not going to. So why did it take 3 off?
Kim Pittis:
I don’t know. Julian has another quick question before we end for the day.
Dr. Carol:
No. Okay.
Kim Pittis:
Julian had, I believe, a laminectomy. I can’t remember the surgery that he had. So, he was in the ICU overnight, couldn’t use FSM because of bleeding. He started the post-operative c-spine protocols mostly pain-free. Now, have some skin infection due to sensitive skin from strong adhesive on the tape. He’s on antibiotics. Still has finger tingling and numbness. Hopefully, this will decrease over time. He’s going to try 81/396. So, he had level three, level ACDF and laminoplasty from C2-C7. That’s what Julian had.
Dr. Carol:
I’m. Wow.
Kim Pittis:
Yes, but, Jillian, you’re going to do great. Jillian came to see me in the clinic. He’s such a good patient. He’s got all the tools.
Dr. Carol:
It’ll be fine.
Kim Pittis:
Yes.
Dr. Carol:
That’s. Wow. I’m glad you did. Well, congratulations. Yay! Yay! 26. There you go. I love osteopaths. So in world championships from age 51 to 65, created many tears. Okay. If you break it, they fix it. That is the role of physicians who treat athletes.
Kim Pittis:
Yes.
Dr. Carol:
So they can break it again.
Kim Pittis:
Yes. That’s exactly what I love my job to do. I’m just going to patch you up for now and send you on your way. Speaking of sending you on your way, we are almost out of time. This went way too fast. I’m so glad you’re back though because we have so many things to continue to unpack. I want the practitioners listening to know a few things here. You’ve got the end-of-the-year sale for all the devices happening right now. So go to Precision Distributing and pick up your stuff because it’s the best sale of the year. Do it now. Sign up for the Advanced that’s in March in Arizona.
Dr. Carol:
Yep.
Kevin:
Early bird prices till the end of the year.
Dr. Carol:
Early bird prices till the end of the year. And I promise to get the schedule done now that I’m home. I will schedule done before the end of the weekend for sure.
Kim Pittis:
Have an outstanding faculty as always, but this year it’s off the chain, so it’s very.
Dr. Carol:
I was going to finish on Sunday because who wants to sit for three days for the Advanced, four days if you count, that you’re going to spend one day with Rob Demartino and then Jay Shah said, can I come, please, can I come? I would love to speak. I want to come, can I come? And I went, I’m full. It’s like I was going to finish at 2:00 on Sunday and I said, I usually give you a whole day, but if I give you from 2 to 6 and will you come, is it worth it? And he said, oh yeah. And he’s got all kinds of new stuff. And so I’m pretty excited about I’m pretty excited about that. And then then oh, and Shirley Hartman is coming.
Kim Pittis:
Oh, wonderful.
Dr. Carol:
Me back. And Dr. Musnick has a three-hour session and I think a 60 or 90, you’ve got three and one. And Karen Perry got her case report from last year about, remember breast density,
Kim Pittis:
Yes.
Poster and she did a case presentation. She got published. And so she has mammogram data showing that the patient’s breasts went from a type three fibrosis to a type two. Type three patients have something like 50% more risk of breast cancer than type two’s.
Kim Pittis:
Yeah.
Dr. Carol:
I’ve reviewed papers. I’ve written papers, blah blah blah. I have never, ever read a review of a paper like this paper. The reviewer was ecstatic.
Kim Pittis:
Wow.
Dr. Carol:
There is nothing that we can do to reduce There is no thing that can be done to reduce breast density and therefore reduce breast cancer risk. This treatment, this paper was so well done. Your documentation was so good, your explanation was so clear. And Candace Elliot is a co-author. Do you realize that this means that we can reduce breast cancer risk for a huge percentage of the population? It’s been accepted for publication. It’s done. So.
Kim Pittis:
Congratulations. That’s amazing. Wow.
Dr. Carol:
I am going to be giving her a check for $2,000 and giving her 30 minutes on the podium to tell people how easy or hard, how it was to do that, to take a case and turn it into a published paper.
Kim Pittis:
There it is.
Dr. Carol:
I’m so excited. Yay.
Kim Pittis:
Congratulations. Yes. So everybody go running to the Advanced. There’s still time to sign up for the sports course as well for early bird pricing. That all goes away at the end of the year, so sign up for everything.
Dr. Carol:
It’s a room in the sports course.
Kim Pittis:
Yes, we’re getting close, but there’s still room. I’ll still squeeze people in.
Dr. Carol:
Believe it or not, there are two. one’s a PT, one’s an MD who are going to come from Taiwan to your sports class.
Kim Pittis:
Oh, that makes my heart happy. An exceptionally good job. It will be worth it.
Dr. Carol:
And they were so generous to us that we are taking care of their rooms.
Kim Pittis:
Yes, that’s very nice.
Dr. Carol:
That’s you. Oh, you have no idea. I gained 10 pounds. It’s all worth it.
Kim Pittis:
Yay! All right, everybody, thanks for being back. We are back. We are together. We will see you next week at the same time.
Dr. Carol:
Bye.
Kevin:
The Frequency Specific Microcurrent podcast has been produced by Frequency Specific Seminars for entertainment, educational, and information purposes only. The information and opinions provided in the podcast are not medical advice. Do not create any type of doctor-patient relationship and, unless expressly stated, do not reflect the opinions of its affiliates, subsidiaries, or sponsors, or the host or any of the podcast guests or affiliated professional organizations. No person should act or refrain from acting on the basis of the content provided in any podcast, without first seeking appropriate medical advice and counseling. No information provided in any podcast should be used as a substitute for personalized medical advice, and counseling. FSS expressly disclaims any and all liability relating to any actions taken or not taken based on any contents of this podcast.
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