Stay Off My Operating Table

Ketamine for Depression: A Game-Changing Approach to Mental Health - Johnathan Edwards 152

• Dr. Philip Ovadia

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It's called "percutaneous hydrotomy" and it's billed as a revolutionary pain treatment. Dr. Jonathan Edwards, anesthesiologist and polymath, shares groundbreaking insights on alternative pain treatments and metabolic health.

In this episode of Stay Off My Operating Table, we dive deep into cutting-edge medical approaches with Dr. Jonathan Edwards. Learn about percutaneous hydrotomy, a French technique for treating musculoskeletal pain, and its potential benefits for athletes and chronic pain sufferers.

Dr. Edwards also discusses his work with ketamine in treating depression and suicidal ideation, offering hope for those struggling with mental health issues. The conversation touches on the fascinating lean mass hyper responder phenomenon, challenging conventional wisdom about cholesterol and heart health.

Key topics covered:
00:00 Introduction
05:30 Percutaneous hydrotomy explained
15:45 Ketamine for depression and suicide prevention
25:20 Lean mass hyper responders and cholesterol
35:10 Alternative approaches to metabolic health
45:00 Controversy in alternative medicine

Connect with Dr. Jonathan Edwards:
Website: https://jonathanedwardsmd.com
Twitter: @johnedwardsmd
Substack: johnathanedwardsmd.substack.com

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Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings

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Dr. Johnathan Edwards:

All right.

Jack Heald:

Welcome back, folks. It's the Stay Off my Operating Table podcast with Dr Philip Ovadia. Our guest today is Jonathan Edwards, who shares the distinction of having the same name as a famous 18th century evangelist. That's probably not the first time you've heard that, and I don't mean to send the listeners down a rabbit hole because don't bother and I don't mean to send the listeners down a rabbit hole.

Dr. Johnathan Edwards:

Cause, don't bother.

Jack Heald:

Uh uh Phil why don't you take it from here, man?

Dr. Philip Ovadia:

Sure thing, happy to have uh, as uh, anyone watching on YouTube, we'll pick up. We got another guy in scrubs here, uh, not a surgeon, but uh, on the other side of the uh, dra, the other side of the drape, as we call it. We got an anesthesiologist on today, a good friend of mine, who I'm excited to have this conversation with, dr Jonathan Edwards, and I think, like many of the guests we've had on, jonathan's got some unique perspectives on health, on pain, which is an area that he deals with a lot as an anesthesiologist, and going to be a few very interesting topics for us to jump into. So before we get to that, john, why don't you give a little bit of your background to our audience?

Dr. Johnathan Edwards:

no-transcript. Like yourself, I've written my share of books. I've got a. You know, my latest books is Stopping Pain and that's on a French technique called percutaneous hydrotomy, which we'll get into. And then the other book before that is another dear subject of mine, treating suicide depression with ketamine, which is, you know, as you know, a drug anesthesiologist use all the time and that's, you know, kind of my segue into that. But yeah, that's, that's a. That's a little bit about a little bit about me and I'm just kind of a polymath but I love it all.

Jack Heald:

You've already used three words that us average people don't know, but we'll come back to that.

Dr. Philip Ovadia:

Yeah we'll definitely get into some of those things that you talked about about. I guess you know, maybe a little kind of primer here for our conversation will be. You know, we met at a metabolic health conference and, honestly, I knew your name prior to that and knew of you prior to that because of your association, of your association with, uh, dave Feldman, who we've yeah, I am, yeah, that's great Talk a little bit about that, uh, that kind of background and then, uh, maybe we can get into some of the interesting areas that you're, uh, you've been exploring.

Dr. Johnathan Edwards:

Yeah, yeah, no, I've been going to the metabolic health conference since its inception in San Diego. Uh, way back I think 2018, if I'm not mistaken, was the first one. Uh, I went to that one, then the tampa one and then, um, I didn't get to go to the other ones because of the covid and all that kind of thing. Um, so I've been, I've known dom's um since way back then with, uh, they dave feldman, and he was a speaker there. Dave and I, circuitously, were introduced through a mutual friend who was also a speaker at that conference, named Peter Defty. He's optimized fat metabolism guru guy and anyway, he introduced Dave and I, just out of, he knew we would be a good fit.

Dr. Johnathan Edwards:

And then Dave started getting into the testing and he was starting to to, to show all his cholesterol data and that he could, you know, drop his cholesterol from you know 300 to 100 and you know seven days. And he was showing me the graphs and and he was saying, but man, the testing is just so expensive. And we were both in Vegas and I said, just use my account, I have great cash prices. And so that's where we started, you know. And then I started letting him, I started helping him with that and made it possible for him to do the testing. And so I've been with Dave as a kind of a founding partner in the whole ownyourlabscom business since its inception and I've supported Dave and everybody Dave, nick Norwitz and everybody involved and it's been one of my great achievements with that.

Jack Heald:

Well, that's cool to make that connection.

Dr. Philip Ovadia:

finally, yeah, so, and that's how John and I got introduced, dave.

Dr. Johnathan Edwards:

Diamond.

Dr. Philip Ovadia:

It may not seem intuitive to people in our audience. They're here thinking okay, you're an anesthesiologist, you put people to sleep in the operating room and manage them in the operating room. What is this other stuff? Why would you be thinking about metabolic health? How know how'd you get into some of these other areas that aren't maybe aren't on people's radars when they think about anesthesiologists and what they?

Dr. Johnathan Edwards:

do. Yeah, yeah, no, my backstory and that's pretty interesting. So I used to race professional motocross before medical school, so I've always been, I've been a professional athlete and then I actually got in the heavy end of bike racing in my thirties and actually went very far in that, went up to become a cat one cyclist and even raced against like Floyd Landis and some of those guys you know and local pro races. I had a bad fall in cycling, fell out at about 40 miles an hour. I had a bad fall in cycling, fell at about 40 miles an hour coming down a hill with a good friend of mine, sustained a bad concussion and I got what's called a sixth cranial nerve palsy. So I had a definitive concussion plus brain trauma, ketogenic diet and using that for brain injury and brain trauma. Because in my rehab my rehabilitation residency, which is physical medicine and rehab in utah we were using ketones uh, for brain trauma. That we would often see. You know a lot of the skiers get brain trauma there.

Dr. Johnathan Edwards:

I was at the university of utah for one year so I knew from that and I got real aggressive and I went on a strict, strict ketogenic diet and I mean I was measuring ketones, my glucose. I was already in its very good shape, you know, but I was seeing double vision. I mean, I had to stop practice for for a good bit and I was determined to do something about it, and so that was my foray into, say, the ketogenic diet or this lifestyle. And I have to say, once I started, I mean sugar, my, my glucose readings would be 50s like all day long and I'd be no, no brain fog at all, but in any case, my, my symptoms were getting better.

Dr. Johnathan Edwards:

Um, my double vision finally corrected itself after a couple months and, and I just stuck with it and, and that's that. And I've been a proponent of the ketogenic diet, uh, and that lifestyle ever since, and I could have never guessed how it would have, um, played out up to my life until now, which we'll get into. So, but that's my that, that's how I got into it all I just want to want to put the pieces together here.

Jack Heald:

You sustained a physical injury.

Dr. Johnathan Edwards:

Yes.

Jack Heald:

Explain what that injury was again.

Dr. Johnathan Edwards:

So I hit my head at about 40 miles an hour on a bicycle with a helmet destroyed the helmet, of course. With a helmet destroyed the helmet, of course. Um woke up. I woke up in the back of a truck and then, um, you know, I got a head MRI. All you know, all the CT and um and um, and then it revealed a, an injury to my cranial nerve in my head which, can you know, is one of your sixth nerves that control your eyes.

Dr. Johnathan Edwards:

And because that nerve was injured and that caused double vision, and I mean I thought I mean my career could have been done right there, you know.

Jack Heald:

And so going to a ketogenic diet.

Dr. Johnathan Edwards:

For brain injury. Yeah, yeah, there's lots of literature and there's lots of peer-reviewed research showing ketogenic diets helping brain injury and brain inflammation through ketones by Steve Cunane, for example, at the Metabolic Health Conference and many, many, many others that ketones can indeed help brain trauma and brain inflammation and so, yeah, that's where I've been a huge proponent of it ever since, and so a lot of people I work with I steer them that way.

Jack Heald:

Wow, okay, phil, I get it. Now I understand why he's here. Okay, I didn't mean to interrupt, but I was just trying to connect the dots there.

Dr. Philip Ovadia:

Yeah, and that's just really a brief foray into some of the things that Jonathan has done that I was looking forward to discussion. So, you know, that kind of leads into one of your interests, which is, you know, working with professional athletes and dealing with, I guess you could say, injuries, and the inflammation and pain that goes along with oftentimes these high level athletic pursuits has led you to pursue some other treatment modalities, and you've mentioned the book that you recently wrote Stopping Pain and Percutaneous Hydrotomy.

Jack Heald:

Okay, you guys are going to have to explain that one.

Dr. Philip Ovadia:

Well, we're going to dig into it because I fully admit I had never heard of it and had no idea what it was prior to talking with Jonathan. So let's talk about what that is, how you got interested in it, kind of the history of it and then we'll talk about some of its potential benefits.

Dr. Johnathan Edwards:

So, yeah, I'll just give you some some background. It's called percutaneous hydrotomy, you know, percutaneous infers that you're going through the skin, into the subcutaneous portion of the tissues. Hydrotomy is simply using water. And but to back up, yes, I work with many professional athletes and it's one of the reasons I I wanted to learn this, um, this technique, for for many reasons. But I work with uh UFC fighters like TJ Dillashaw, uh Francis Naganu, um Bo Nickel I've worked with Francis Naganu, um Bo Nickel. I've worked with um David Taylor he's an Olympian, these are all wrestlers. And in the UFC world and motocross, you know, there's Zach Osborne, um, you know, and I've I've worked with some tennis guys, um, I've worked with Roman Bardet and um you know, in cycling I've been a team doctor for those guys.

Dr. Johnathan Edwards:

So so, anyway, yeah, my, I have a big professional um clientele, if you will, that you know I need to be pretty innovative and and and help them in any in in ways, and what I do from my rehabilitation and anesthesia background is I help them guide their rehabilitation, their nutrition, their recovery and strategies to optimize themselves, you know, in, you know within their guidelines and rules. So so I guess that's what you could say I bring to the table, versus say you know somebody else, who, who, who hasn't been a professional athlete? Um, you know, like, when it comes to nutrition, for example, I can, I'll put myself up against any dietitian, anybody. Um, you know, I've been into it since I was in. I was one of those guys in medical school who delved into the nutrition really hard on my own. Um, cause, I knew medical school wasn't going to teach it to me and I took it upon myself. And I'm, you know, I'm proud to say I'm one of those guys like yourself.

Dr. Johnathan Edwards:

Obviously. Who's you know who? Who can say, as a medical doctor, I know the nutrition, I know the science, I know the metabolites, I know the Krebs cycle, I know, you know, I know the Krebs cycle, I know you know so. So, anyway. So in my training in France, I came across many different modalities, as you can imagine, and one is that one of them was mesotherapy. So mesotherapy is the art of using subcutaneous injections locally over the area of pain, and it was originally designed for musculoskeletal pain. So in France is where I learned percutaneous hydrotomy, which is basically just a form of mesotherapy which involves tumescent anesthesia.

Jack Heald:

It involves- what kind of anesthesia?

Dr. Johnathan Edwards:

Tumescent. So tumescent means to make, to swell up the subcutaneous tissues. It's used often in plastic surgery. Okay, so you know, like when Dr Avalia, does you know lidocaine under the skin? I mean you're making a tumescent. Basically, right, it's just you know that peau d'orange, it's, you know, but it's much more than that. So, but to give you an idea, that's what it is. So it involves tumescent anesthesia, oligotherapy, hydrotomy, and then imagine, say you have knee pain or shoulder pain, now we're going to place subcutaneously a volume of fluids, a volume of local anesthetics, a volume of anti-inflammatories, some other medications, plus some vitamins, plus minerals, plus amino acids. Um it, it depends on what you're trying to treat.

Dr. Johnathan Edwards:

You know whether, whether it's knee pain or shoulder pain or back pain or migraines, it's, it's um, you know it's all. It's all different. So, so you know it's all different. So you know, long story short, a couple years ago or well, actually 2020, I went during COVID and I actually trained with Dr Gez, who kind of created this technique in France of these procedures and and I was just, I was just amazed that it was it never got to english speaking countries or even america, and and and the reason is is because it's only taught in french and I'm a friend and since I speak french and I'm fluent in french and you know french medical, all that, I went over there, learned it in French and then, and that's and we just lost him, sean.

Jack Heald:

We lost your video and your audio yeah, I'm back now all right there, no worries. Okay, very good all right back.

Dr. Johnathan Edwards:

So all right, so we're back. So that's why, and that's when I I got and I wrote this book about percutaneous hydrotomy, because the only other book available on it was in. So I agreed with Dr Gez and, and we, yeah, I wrote it up. It took me about a year, um, you know, and it's one of those things that, uh, you know, I don't, I don't think a pharmaceutical company is ever gonna come and, you know, monetize it just because it's, it's just such a basic injection procedure.

Dr. Johnathan Edwards:

You know, it's um, a, um, you know, subcutaneous injections have been done for decades, you know, uh, you know, back in, even back in the 1800s. You know, back in, even back in the 1800s, um, so, you know, it's not, it's nothing new, uh, and and and, almost all drugs are safe to inject, but we're just it's, it's something that's not taught, so, so, anyway, but it's a simple technique to treat musculoskeletal pain, especially, especially osteoarthritis, and, and it and it goes well with the other reach. You can consider it one of the regenerative, you know, therapies like PRP, stem cells, prolo therapy, um, you know, and then, and then now you got this thing even called a percutaneous hydrotenotomy, and that's just, it's using water to separate tissues. I mean, it's a it's, it's, it's an out there term, but anyway, you get, this is nothing, this is nothing way out there or out of the realm of what we already do in medicine or surgery or pain medicine.

Dr. Johnathan Edwards:

Already, and I've had, and if you just if, in the book there's like dozens and dozens of patient testimonials, you know, and, and Phil has seen some of these and that's how he knows about it and it's, you know, and I'm just teaching one person at a time, really, you know, and then I think it'll take off on its own, it'll grow organically, I think, and that's my goal with it, right, really, you know, it's not like it's a yeah, it's a great little technique and it can help a lot of people and it's like I said.

Jack Heald:

So this is actually regenerative?

Dr. Johnathan Edwards:

Yeah, well, I mean you're giving yes, there's actually studies from UCLA in like 2016 with Dr Roy Altman, who's passed away now but he showed that saline is not a placebo. Almost all studies were done against saline and he showed in a meta-analysis and it's all in the book, all the references are there that saline is not indeed a placebo. It actually helps the pain, it actually helps the injury and every study he went over there was an effect of just injecting saline. You know, and so what you know, you can theorize what.

Jack Heald:

I'm guessing Big Pharma is not interested in this particular treatment?

Dr. Johnathan Edwards:

Okay, no, but, but let's but the but. Things like Humira and monoclonal antibodies are also administered in this fashion, with large tumescent subcutaneous injections, so like. So, like I said, there are other avenues of medicine using this already. And just think of it. You know it's, it makes sense. It's a slow release, deposition of products to the injury. That's it, I mean it's, it's, it's not harder than that. You know and and and, and. I think that's it's simplicity, is it's it's power?

Jack Heald:

really, um, I guess I'm more interested in the regenerative part. I can understand Cause when I think about, okay, an anesthesiologist, he's going to help me, uh, sleep through the surgery, uh, which is great. But but what would be better would be if this, this torn up knee that I've got, was actually healing, and get you know whatever injury I did to it, if there was a way to get it back to healthy.

Dr. Johnathan Edwards:

that's what I'm hearing.

Jack Heald:

Am I hearing?

Dr. Johnathan Edwards:

this right? Yeah, so if we decrease the inflammation and we give your cells that are pissed off, like you know, the ability to to take in nutrients, and then? So there's many factors, so think about this we're going to block your pain cycle. So there's many factors, so think about this. We're going to block your pain cycle. You know you're hurt, your cells are making. You know, tnf alpha, all these mediators, the bradykinins, all these things that tell your brain hurt, hurt, hurt.

Dr. Johnathan Edwards:

Well, the local anesthetics break that pain cycle. That's well known. Every pain medicine, every pain doctor does that, you know. So you do that. Now what else are you doing? Well, you're giving the cells water to exchange because you do create, you know, water movement when you create, to get technical, a hypertonic environment outside of the cell which promotes water movement in and out of the cell. So you're doing that. You're also letting you know those cells, in some capacity, take up the minerals, take up the amino acids. Uh, so in that sense, you know those cells are sick for a reason. They have to be sick, right, they're hurting, they're non-functional. Those are your chondrocytes, those are, or whatever you know, the cells making up the you know, and your tendons and ligaments and things and your meniscus, for example.

Dr. Johnathan Edwards:

Is it a miracle? Are you going to like? Is it like miracle grow? No, is it something that? Can it like miracle grow? No, is it. Is it something that can help towards the regeneration? Yes.

Dr. Johnathan Edwards:

Are there like microscopic studies, no. But but you know, we don't even have those studies for stem cells nor PRP, right, they all say it happens but I'm sorry, those studies are not. I mean no, not, I mean nobody's really shown 100, those studies like on electron microscopy. Here's your cells regenerating, on stem cells or exosomes or prp. So which, which?

Dr. Johnathan Edwards:

Which brings it into the picture when you combine, like perky, something like percutaneous hydronomy along with stem cells or prP, which I do, and I mean, I can tell a story. I had a motocross racer come in with a rotator cuff injury and I used a combination of the percutaneous hydrotomy and PRP on him each time. So on the surface I would do the percutaneous hydrotomy, you know, know, and it looks like his shoulder just got out of arthroscopic surgery in a sense, not as big, but and then in the joint or in the areas where he hurt his tendons, and I would do it with ultrasound, I would inject the prp there, and I mean this kid went from having his arm pinned to his side because of the rotator cuff to racing in four weeks.

Jack Heald:

Holy smokes. My brother-in-law just ended up with a torn rotator cuff and he's been out of business for weeks.

Dr. Johnathan Edwards:

Yeah, for frozen shoulders it can actually do things and for back pain, I mean, I've seen it do things. Now, if you have bone on bone arthritis, it's not going to do much for you, but nothing is going to do much for you, you know. So there's it's. Knowing its risks, benefits and alternatives and being realistic with the outcomes, I think is you know the power you know of these kinds of techniques, and that's what. I don't try to sell this as a miracle. I tried to sell it. I don't try to sell it. I just state that it's a technique which can be used in between some injury and the endpoint of surgery.

Dr. Philip Ovadia:

That's all yeah. And, as you alluded to, you know this, this, this has actually been used quite widely in France for over 20 years. Dr Ghez has, you know, developed the technique and, and you know, has large clinics and has trained many other practitioners in France. But there was this barrier that you had, a you had to know French to go learn from them. It was kind of fortuitous in some ways that you had to know French to go learn from them.

Dr. Philip Ovadia:

Pretty much it was kind of fortuitous in some ways. Now we should mention there has been some controversy around this technique in France.

Dr. Johnathan Edwards:

I can go into that and I've written a lot about it.

Dr. Philip Ovadia:

Yeah, talk about that a little bit, because if people look this up, they'll certainly come across that.

Dr. Johnathan Edwards:

Yep, and then so that has to do this all came post-COVID. As we all know, there was a big change in the landscape of medicine in Europe, and not so much the states too. But you know, medicine started following this narrative that you know it had to be studied or it wasn't any good. You know, no longer was it good enough to have their, what they called their, their fight against what they call fake medicine and and I mean they included chiropractor, osteopath, naturopathy, a lot of things, hypnosis, fasting, and then they also added percutaneous hydrotomy in there. And it's not because there were patient complaints, it's not because there were patient injuries. You know it was.

Dr. Johnathan Edwards:

We don't know why this came up. Who's behind telling the Board of Medicine? You know, basically it's one board because it's a state of, it's a country of France, so in a sense you could think of it like a board of medicine, but it's really the federal French Board of Medicine. And yeah, they I mean you can go to it they listed 25 different like alternative specialties and basically said, nope, we're not supporting these anymore. And you know they were. And it's kind of ironic because France has always been the bastion for alternative medicine. The French hate taking medicines. They will take plants and herbs before taking any kind of medicine if they can help it. And over there the pharmacists can help you with this. So that's what's going on over there, and it's true. I mean, the French Board of Medicine has taken things like mesotherapy and others and say, well, there's no studies for this and there's a risk of infection. And based on that, I kid you, not based on just that, not injuries, not patient complaints, not anything. And it's been, and they've actually threatened doctor's licenses because of it. And it's been, and they've actually threatened doctors licenses because of it. And it's getting pretty bad. I don't, I hope it. I hope it changes. And so I think in the US we're, we're still progressive enough that, hey, if the patient wants to pay cash, and you know you're not going to like, submit this kind of stuff to Medicare, I don't think there's going to be a problem with it. Like, submit this kind of stuff to Medicare, I don't think there's going to be a problem with it. Um, but it's important to bring it up because if we I mean, I've gone to a chiropractor all my life, um, and I don't go all the time, but when I need a chiropractor I like going to a chiropractor, you know it, it, they do what they do, they, they release your joints and I've always benefited from it. Uh and but, but france is actually suppressing those kind of practices.

Dr. Johnathan Edwards:

And then, and then to tie it in with article four. So article four is, as you may have heard, you know, the it's basically their fight against medical cults. In a sense, there it's a derive sector and it's and it's uh, they want, they, they want to stop like these fasting cults, if you will, you know. So they, they, you know, and they've had some suicides and deaths because of it. Not, I mean, not on a grand scale. You know, it's sad, but they basically said that if a healthcare practitioner tells a patient advice off of the mainstream narrative of medicine, that they can be fined $45,000 and up to three years in prison. So you don't have to guess where.

Dr. Johnathan Edwards:

You know the spirit of that law and I watched the whole thing in French for three and a half hours, and the spirit of Article 4 is as it says it is it's to stop sectarian cults. You know from this, you know what anybody would call an unreasonable, charlatan practice of healthcare, you know. But that law is equally written. It can be. It can be used for anything and that's the problem with it and that's why it was so controversial and it barely passed, apparently, and it's um, it's a big topic. I've been writing on my sub stack um, I love france, it's my second home, my second culture, um, but uh, yeah, I don't know, a lot of people are, are are against this article four. Um, you know it comes down to the mandate. I mean we can. It comes down to the mandates that you accept today are going to be there five to 10 years from now and you don't know what's going to happen in the future.

Jack Heald:

I would love to comment but it's more of the same. We know what's going on. Let's not pretend we don't know what's going on. This has nothing to do with making sure people get well and stay well. It doesn't have anything to do with that.

Dr. Philip Ovadia:

It's a scary precedent that's being set and, quite frankly, it's not too far from us, california tried to pass a very similar law 298 2098,. I think Actually, I believe it did get passed, but they had to repeal it. But it was basically going to give that power to the state to decide what they wanted to label as medical misinformation, and then, you know, have a way to persecute or prosecute, I guess, depending on how you want to look at it, you know.

Dr. Johnathan Edwards:

I think yeah right, yeah, so anyway, we can, you know, we can kind just leave that at there, but that's what that's about. It is happening in other countries, but France is. France is in the spotlight right now for that, and that's it's. It's, it's one of my things I'm trying to raise awareness about, you know. But it all goes back to you know what is the controversy behind percutaneous hydrotomy in France, and that's it. You know, and, and, and I can, I can tell you I've talked with Dr Gez at length and I and I really have gotten to the deep questions. There's not a single injury or a single complaint. I can tell you that, not, you know, you know like, you know nobody's, you know, like, sent complaints to the board and it just hasn't happened. Um, so it is what it is, and, um, you know, and, and all we can do, I think, is raise awareness and practice as we do and do what we do.

Jack Heald:

I think we can do more I think. I think we can mock anyone who says this is just good science.

Dr. Johnathan Edwards:

Yeah, that's.

Jack Heald:

that's a yeah, How's it pronounced Iotrogenesis, iotrogenic uh. Physician induced injuries and deaths.

Dr. Johnathan Edwards:

Yeah.

Jack Heald:

There are hundreds of thousands of those every year Following the guidelines, doing what allegedly the guidelines tell us to do.

Dr. Johnathan Edwards:

Yeah.

Jack Heald:

It's high time we started mocking. Yeah, it's high time we started mocking this there. It's absolute folly.

Dr. Johnathan Edwards:

Yeah, and then people, a lot of people have, you know, I mean it's, it's, it's definitely I'm not a physician.

Jack Heald:

I don't have a license to lose. So I understand why, where you guys are and I don't fault you in the slightest for for being more careful than I'm being, and I don't fault you in the slightest for being more careful than I'm being and I realize I'm not being careful- but you're being.

Dr. Johnathan Edwards:

It's got to be out there.

Jack Heald:

I'm so done with pretending that that these people are actually, that the that the driving force is, is altruistic. It's not.

Dr. Johnathan Edwards:

No, it's, and it needs to go back to that, because if you're not, you're not taking care of patients, you're not, you're not aiming for the highest good, to to, to, to treat that human being. You know, and we're getting away from that and you're right, that's.

Dr. Philip Ovadia:

It's something that before on this program, you know, on the podcast with some of the guests that you know, one of the biggest, I would say, problems with the health care system is that, you know, the physicians are not in control any longer. Really, the physicians have largely, you know, given up and or had taken away their autonomy to decide what's in the best interest of their patients and instead we have, you know, other forces like politicians trying to dictate medical care that gets delivered and, as Jack said, clearly that is not based on what's best for the patient. You know, and while that gets put forth as the excuse for it, we know that there are other interests here that are interfering with doctors, with practitioners' ability to deliver treatments to patients that can help. And you know, percutaneous hydrotomy is really ends up being a great example of that because you look at it, it makes intuitive sense.

Dr. Philip Ovadia:

You know you have an area that's injured and inflamed and you're going to bathe it in. You know nutrients and anti-inflammatories and you know anesthetic agents that can help numb the pain, to aid with healing. And you would say, well, how, how can that be? You know, harmful or dangerous At worst. Maybe it's a sham, maybe it doesn't work, but you know it's really not going to injure anyone, and yet we see a technique like that being attacked. It really gives you insight into what's going on in the system.

Dr. Johnathan Edwards:

Yep, yeah, that's well said so so let's, let's get positive now.

Jack Heald:

Um, what's the? You know, we've got an audience that that's split between, uh, healthcare practitioners, um, who are just trying to see what everybody else is doing and enjoying having and enjoy the, the education that happens, and everyday folks who are, you know, want to avoid sickness or or want to recover from something. Yeah, so what's the message that you've got? What's the positive? Uh, here's something you can do. Message for that second group If you're stuck with this kind of problem, here's a possible solution.

Dr. Johnathan Edwards:

Yeah, the um, I mean from a. I mean it depends what you know from a dietary standpoint. I mean I'm, I'm, you know, like I'm totally in line with you, know what you guys, what you guys are doing on the podcast and others, you know, with Dave and um, you know I just been eating a whole food diet and I mean I have an interesting story. You know, I've been eating. I eat pretty much carnivorous, but very I I order all my stuff from, like, joel Salatin. I've been to his farm, um, I've been to white oak. You know I I white oak pastures, uh, us wellness meats, all that you know. So I eat a lot. That's mostly what I do. I just eat, you know, just fish, poultry steak with some vegetables, some butter. That's what I've been doing for almost 15, 20 years and I'm one of those lean mass hyper responders.

Dr. Johnathan Edwards:

So I think my story is a good one to tell and it will lend to this recommendation. So I've been one of those guys and I am in that group. I was not in the study but I am in that group. I've had LDLs. My LDLs are in the 180s, 220s I think the highest I saw was 253 or something like that, and it's always or something like that, or you know, and it's been, it's always been up like that. And then I've done all my nmr, you know, lipo, lipoprotein, testing, my apob's, all that are pretty much elevated um, and so interpret that please so these are all your, your cardiac, these are all your lipid tests.

Dr. Johnathan Edwards:

You know that we do at ownyourlabscom, say, for cardiac risk stratification or or to you know, kind of like it's a first look. It's. There's many layers to looking at cardiac risk, you know, as dr vario will tell you. You got, you know, and so. So one of the easy ones is lab testing, right, so you know your insulin levels and your fasting glucose and your CRP will kind of tell you your inflammation, you know. And then you have your lipids. You know which are cholesterol, your LDL, your HDL, which are, you know, various types of cholesterol and I won't go into which ones are good or bad, because you know, frankly I don't think we really know. Then you have ApoB, which is a protein on the LDL. It makes it ApoB. Then you have lipoprotein little a, which is, you know, it's a protein on the, on the LDL. I may be a little off on that, but that makes it lipoprotein a. And then you get all these levels on a lab test and statistically, you know, we take those and say X, you have a risk, or your risk is low or your risk is very high. And that's how doctors have practiced, you know, for years, and basically it is take your total cholesterol. And you know, and I've been offered statins forever and I'll never, I'll never take them, but but anyway. So I wound up doing so.

Dr. Johnathan Edwards:

I went further. I did a coronary artery calcium scan. It was zero of, of course, um. But then in um, you know, and I've been an athlete all my life, you know, as I, as I stated, and but in in um I got. When I got, uh, I think I think it was COVID the first time or second time. I only had two of them, but I had it for a good amount. And then I had myocardial, I had bad chest pain and this is a story I was telling Dr Avadia. I had, I mean, crushing chest pain. I thought I'm having a heart attack. There's no, you know, I mean I was out running and I just like this, I knew what it was, I mean, and it I stopped, chest pain went away and I was like, ah, maybe it's just indigestion. Nope, started again and I mean, elephant, chest pain stopped, went away and I was like, oh boy, and then, stupidly, I actually went for it again just to make sure. And yeah, you know, that's the knucklehead in me, of course, you know the physician like

Dr. Johnathan Edwards:

right, yeah, maybe. So sure enough, it came back. I walked home with my head between my legs, my tail between my legs, and but you then? So I got a ekg right away. I got tests, um, and then all that was kind of normal, it's like didn't show any bad st elevation or anything. I was like what the heck is this? So then I got a cac scan and then I got a um. I did a stress test and, um, nothing really showed up. And then, know, I got with my cardiologist, who's a very good friend and colleague, and he just said Jonathan, you probably had myocarditis. You know, just that's all we can think of, you know.

Jack Heald:

Which means just a swollen heart.

Dr. Johnathan Edwards:

Well, you could have a swelling of the lining of the heart or in the muscle of the heart and the, you know, and it's a gray area between which of the two you have, or if you have both, or to the extent you had it, I don't. You know I didn't have a severe case. I mean, I had a case that caused chest pain though, and then one doctor brought up like it could have been Prince Mental's angina, but it wasn't that. You know that, um, the uh. You know I didn't have any AKG findings, nothing to suggest that. So, um, anyway. So you know it's, it's just a diagnosis of, we don't know. And was it myocarditis from having COVID itself Probably was, because the last vaccines I ever got were over a year and months before that. I don't know if that could have contributed to it. Possibly that's a rabbit hole I'm not sure we want to leave it's. The possibility is open, but I just think I had a pretty bad bronchitis during that episode. So, anyway, I really do a big, deep dive with my cardiologist and he goes Jonathan, you're fine, just rest six weeks, take colchicine and, you know, treat it like a regular myocarditis. And that's what I did.

Dr. Johnathan Edwards:

But then I called him back and I said no, I want a heart cath. So and I said, you know, I have a 12 year old daughter. I'm an athlete, I'm not going to kid myself that I might have heart scarring. Or you know, I've been an endurance athlete my whole life and you know, and I know, scarring of the heart can occur and you can have other cardiac abnormalities from, just you know, from an overdosage of exercise, which I've done. You know I'm not going to sit here and, you know, aspire to all. You know that much exercise is good for your heart. No, it's not, and I actually we have another story I did with that, but anyway. So I got the heart cath and of course, you know, as a typical anesthesiologist, I go in awake for it, no sedation whatsoever. He put some little local anesthesia, he fishes the catheter into my heart. I feel it tickling in there and then, and I'm looking at the screen and he goes oh, jonathan, you're gonna have something. Your ldls are like 250 and I think you're really gonna have something.

Jack Heald:

We'll fix it for you, don't worry so so the, the, the stent was just exploratory no, the catheterization, yeah, was was exploratory okay, they're just looking for stuff, all right correct.

Dr. Johnathan Edwards:

So he injected the dye and I'm looking at it with them and it's like completely clean and he goes. And he looks at me, he goes.

Dr. Johnathan Edwards:

I don't believe he just shook his head and said I don't believe this. I have to do this a second time. And I say go ahead. So he does it a second time. And I mean, I kid you not. My cardiologist colleague looked at my scans over and over and over again for over five minutes and he basically came back and looked at me. He said Jonathan, not only do you not have atherosclerosis, but you don't even have age appropriate atherosclerosis have atherosclerosis, but you don't even have age appropriate atherosclerosis.

Dr. Philip Ovadia:

Despite the fact that you've had this high cholesterol for your 15 plus years, yeah.

Dr. Johnathan Edwards:

Which was what was so baffling. Uh, to your cardiologist, he, he really thought he was going to be putting a stint in me that day. He really did Um and and uh, it was, you know, it's just that's. And so, anyway, to to circle back, so I fit in that lean mass hyper responder. You know, I'm a lean mass build, I have high LDLs, um, you know, and I, yeah, basically a high fat diet, Um, basically a high fat diet, and yeah, so it's, you know.

Dr. Johnathan Edwards:

And then, as you know, the Matt Budorf study with Dave Feldman and Nick Norwitz, all that just showed the lean mass hyper responder after five years. And I wrote that up on my sub stack and you know, and a lot of those people are on own your labscom. But yeah, they showed after five years and 100 of those people matched to controls also didn't have an increase in atherosclerosis despite eating a high-fat diet outside of the guidelines. So after five years, and that's just, that's just a small subset, I mean, you know, and there's there's many more people like that and I, and it's interesting to see how this has kind of flipped the whole lipid hypothesis on its head, at least in this population.

Dr. Johnathan Edwards:

It can't be, you know, we got to be careful here because you know, you got somebody you know who's kind of obese and has an inflammatory syndrome. They're pre-diabetic, their insulin's high, their fasting glucose is high. They have other inflammatory mediators that's probably you know, that's a different animal. Mediators, that's probably you know, that's a different animal. But in those people who are what we'll call what dave feldman coined, lean mass hyper responders, uh, apparently having eating, practicing a high fat, ketogenic lifestyle, is not detrimental to the coronary arteries.

Jack Heald:

That's just awesome all by itself.

Dr. Philip Ovadia:

Yeah definitely so, and we're eagerly awaiting the further results from that study to look at the follow-up on these patients. Before we kind of run out of time, I did want to talk about one of the other interesting areas that you explored, and your other book is talking about ketamine. People may be familiar with ketamine. It's a drug that is used as part of anesthesia protocols. Um, it's uh, I guess, gotten some notoriety as, as you know, it's also become a drug of abuse.

Dr. Philip Ovadia:

uh, in some circles Um yeah, again, or has a history as that. Uh but, um, you know, you've, uh, you're one of your books is uh looking at the very uh interesting, uh and um you interesting and the therapeutic potentials of ketamine when it comes to depression, and so I think it would be great to talk about that some as well. Uh, you muted yourself, john yep, you're muted, you.

Jack Heald:

You've muted, yourself, john. There you go, all right I need it.

Dr. Johnathan Edwards:

Sorry about that. Um, so, yeah, I did the right. I wrote the revolutionary ketamine, uh, and I wrote it with gavin decker. So Gavin uh DeBecker, he's a well-known security specialist. Um, he's been on Joe Rogan, tucker Carlson. He's pretty, he's been in movies. Um, he, uh, he provides the, the, the secret service for Robert F Kennedy Jr, if you will. He also provides security for Jeff Bezos. He's, I think, elon Musk and like those genre of people, if you will. So I work for him and do some consulting and anyway, he's a good friend.

Dr. Johnathan Edwards:

And we got to talking about ketamine and he gives he sponsors ketamines for his women's battered shelter and what ketamine can do is stop suicide. Ketamine can stop suicide in its tracks and it's the first drug we have in over 50 years and one of the first drugs ever to really be effective against suicide and depression. Before ketamine and those class of medications we've only had serotonin uptake, ssris, serotonin specific uptake inhibitors, you know, reuptake inhibitors, um, you know, and there's been many of those tricyclic antidepressants. You know those kinds of things. You know, and there's been many of those tricyclic antidepressants, you know those kinds of things. But we've known ketamine can work since the 1970s, but it really wasn't elucidated until the 2000s in Yale and Dr John, crystal and Berman and some other colleagues. They elucidated in a landmark study called the will to live or the will to die, and they showed conclusively, uh, and repeatedly, uh, that ketamine stopped suicidal ideations. And then I, so I went on to write the book about that and then I also did a speak, event talk, which is a ted talk basically, uh, they're a break off of Ted talks, and I did that talk in New York, uh, last, uh, november, and that's on YouTube.

Dr. Johnathan Edwards:

Um, so that's, if you ever want to, that's a really good 10 minute view and gives you, gives you an idea. And and and the other reason is my grandfather committed suicide when I was seven. Um, I've always been interested in why suicide, how suicide, and I mean, you know, as a young child, seeing that it sticks with you going into medical school. I'm sure you know Phil can attest that you know we all were in psych rotations and we also saw people just kill themselves for what we think is nothing, but for them it's, like you know, walking in the fog, disoriented, in lead boots, and so to be able to provide this kind of treatment, especially to, you know young adolescents, where you know we're seeing a lot of increase in suicidality in 15 to 24 year olds. In fact, it's the third leading cause of death right now in that age group and you got to ask yourself why you know. And, um, I recommend Jonathan hates Heights um book. Uh, an anxious generation if you want to know more about that.

Dr. Johnathan Edwards:

But anyway, our point is is I'm seeing a lot of these kids. Uh, I've had some 17 and 18 year olds just like that and I mean it's no joke, yeah, and it's, it's. It's sad to see a generation go through that, but I've had. You know, it's not a huge part of my practice. I practice in conjunction with the psychiatrist, but it is one of the most rewarding things to see somebody in that state of mind be able to come out of it. And you know, and they're at one point they're nine out of 10, give me the gun, I want to commit suicide. And then, after the treatment, you ask them what their number is and they're like I'm not sure why. I was thinking about that.

Jack Heald:

So is two questions Is it a one-time treatment? And two any any idea what the mechanism of of action is?

Dr. Johnathan Edwards:

absolutely. Yeah, yeah, both are known. Um. Uh, most cases, if you're suicidal no one you need at least uh three to six treatments. Um, laurie calabrese has done a lot and she was at the metabolic health conference. She she's shown the ketogenic diet along with ketamine therapy um to help in like suicide and all that and she's a she's a great person. I enjoyed meeting her. Uh, I really enjoyed meeting her at the health conference and um recommend looking at her. Uh, so you definitely need more treatments.

Dr. Johnathan Edwards:

One is in almost never enough. Sometimes it is in like depression, that kind of things or OCD, and the mechanism is glutamate. So glutamate is the master neurotransmitter. Glutamate's the reason you can ride a bike after 20 years of not riding a bike. You know glutamate's the reason your energy levels, like you know, glutamate's the reason your energy levels. There's a guy named Mark Mattson. He was on the IHMC podcast, did a great podcast on glutamate and that's the master neurotransmitter. And then you have GABA, which is kind of the inhibitory neurotransmitter, and those are your yin and yang of your neurons, or your neuroplasticity in a sense, of your neurons, or your neuroplasticity in a sense.

Dr. Johnathan Edwards:

So I mean, without going too much in the weeds, ketamine is like fertilizer for the brain. It prepares your brain to be able to, to, to change its tracks so that neuroplasticity can take place. And what? And you can? By being able to achieve that neuroplasticity you can. It's called the default mode network and basically it's pretty, pretty obvious. You know, people go right back into that line of thinking when they're suicidal, right, they, oh my, you know, I want to be happy, no suicide, I want to be happy, no suicide, no suicide. I want to be happy, no suicide. Um, same thing with depression. So ketamine takes you out of that um, and there are ways it does it and it's all through. You know, it's a um blocks the nmda receptor, so it's an nmda antagonist and this in turn increases glutamate for ironic reasons actually and it also increases brain-derived neurotrophic factor, bdnf. So that is something that increases neuroplasticity. And another one is mTOR, the mechanistic target of rapamycin. That's also a protein produced by the brain that's upregulated when these types of drugs, and it just doesn't happen with ketamine.

Dr. Johnathan Edwards:

Ketamine is a psychedelic, like it also happens with MDMA, it also happens with psilocybin, it can happen with ayahuasca. You know those kinds of things. It's most studied in ketamine and what I would say is most special about ketamine is it's the one drug we have now. It's available today and it's legal, through a prescription in a properly medical clinic that everybody can access. That's not true with the other psychedelics technically right. So that's the power there there.

Dr. Johnathan Edwards:

Might you know it's one day there's going to be things way better than ketamine, I'm sure just from seeing the research. But it's what we have today. It's what we have that's effective. And I mean, if you're having problems, you know, um, and you're a, you're the, you're the mother of a child, um, why wouldn't you try it? You know it's not, or at least consider it. And that was the whole point of the book the revolutionary ketamine. And and um, you know it's not like I've sold millions of copies of it. You know I've, I've just I I've written it and and the people it's affected, it's it's been a it's been a wonderful part of my medical career I can imagine.

Dr. Johnathan Edwards:

Yeah, wow, yeah, so I would.

Jack Heald:

I would love to just take a deep dive on all of that, Anything that has to do with the brain and the neuro plasticity and the, the, the chemicals that scored around inside there and changing behaviors and attitudes and perceptions. I love all that stuff. Maybe that'll be our second conversation.

Dr. Johnathan Edwards:

Yeah, yeah.

Jack Heald:

And we've had an illustration here in the last hour of what a polymath actually is.

Dr. Philip Ovadia:

Okay, thank you so much.

Jack Heald:

This is fascinating, thank you, and you're an anesthesiologist. Wow, yeahologist, wow, yeah. Okay, phil, this one's been fun.

Dr. Philip Ovadia:

Yeah, real interesting thinker as we got to, and just exploring some of these different areas, I think exemplifies the journey that many of the physicians in this kind of space have gone through. Where they start, they start pulling on that first little string about something doesn't quite seem right about what I've been told, and it really leads to to all these different areas. So, yeah, definitely Thank you, jonathan. These different areas so, um, yeah, definitely Thank you, jonathan. So, uh, let people know how they can uh get in touch with you.

Dr. Philip Ovadia:

Read more of your work, uh, working, uh, maybe uh exploring some of these techniques with you. Yeah, I'm reachable.

Dr. Johnathan Edwards:

Um, I have, uh, you know, my sub stack, Jonathan Edwards mdsubstackcom. And's uh with an h jonathan with an h. Um, I also have, and my website's the same, jonathanedwardsmdcom um, again with an h. Uh, you know I, I'm on twitter at john edwards md. I'm on instagram at john edwards md. Um, you know I, I'm not as good as you with the social media, it's all. It's an undertaking. Maybe someday I'll get there, but you know, I just do what I can. Now I am reachable. You could go on my website, find my email, reach out to me and then you know I can do a Calendly appointment. You know those kinds of things and yeah, so it's, it's pretty simple and I'm happy to talk and um, you know, but happy to help, and man, that's uh, this has been great, that's uh. Thank you.

Jack Heald:

Well, this is, this is very cool stuff, um stuff, um. You're probably going to get some calls.

Dr. Johnathan Edwards:

Oh boy, well, the um, yeah, I hope so. Um, you know, I just keep it real. And um, you know I'm, I'm here, but man, that's I. What you guys are doing is is great, um, and it's um, yeah, I, I've been in the business long enough. This, you know, having having this kind of uh option for you know, for health optimization, is, you know, yeah, it's great and I've, and I actually I've started, I'm starting to pitch a lot of people to Dr Ovadio as well.

Jack Heald:

So well, we appreciate it.

Jack Heald:

Oh yeah, absolutely All right. Well, we will make sure the contact information is in the show notes, as always, and I encourage y'all, encourage listeners. I've been looking at Jonathan Edwards' website and these books. This is just fascinating stuff. The videos that he referenced are also on there. Really cool stuff referenced are also on there. Really cool stuff, and especially for those of you with a loved one who's struggling with suicidal ideation, check it out. Check it out All right. Well, for Dr Philip Ovadia and Dr Jonathan Edwards, this has been the Stay Off my Operating Table podcast. We're grateful you are a part of our audience. Thank you for joining us and we'll talk to you next time.

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Dr. Philip Ovadia

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Jack Heald

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