Stay Off My Operating Table

Dr. Jeffrey Gross: Heal Without Surgery with Stem Cell Therapy 163

• Dr. Philip Ovadia • Episode 163

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Dr. Jeffrey Gross reveals how stem cell therapy is revolutionizing medicine, from reversing joint pain to potentially regrowing limbs.

Learn about:

• How stem cells can repair damaged knees without surgery (3:45)
• The truth about stem cell treatments in the US (11:20)
• Regenerating heart tissue after a heart attack (18:30)
• Using stem cells to fight cancer and reverse aging (23:15)
• The future of regrowing limbs and repairing spinal cord injuries (27:40)

Dr. Gross explains the science behind stem cells, debunks common myths, and shares incredible patient success stories. Discover how this cutting-edge therapy could help you avoid surgery and recover from injuries and chronic conditions.

Is stem cell treatment right for you? Find out in this interview with one of the industry's leading regenerative medicine experts.

Connect With Dr. Gross:
Instagram: https://www.instagram.com/recellebrate/
Website: https://recellebrate.com/



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

Any use of this intellectual property for text and data mining or computational analysis including as training material for artificial intelligence systems is strictly prohibited without express written consent from Dr. Philip Ovadia.

Speaker 1:

Welcome back, folks. It's the Stay Off my Operating Table podcast with Dr Philip Ovedia. We've got a guest today, phil, who's going to talk about a subject that I, frankly, have heard about for a long time In fact, my dad even had a doctor recommend this to him, but I have just literally told you everything I know about it, so I'm really looking forward to learning what Dr Jeffrey Gross has got for us today. Set it up, let's go.

Speaker 2:

Yeah, I am excited to have this conversation as well. We're going to be, among other topics, talking about stem cells, and that's an area of medicine that I also have had interest in but honestly don't have a lot of experience in, and so really honored and excited to have one of the experts on the topic with us, dr Jeffrey Gross. And before we get into the nitty gritty of that, jeff, why don't you just introduce yourself to our audience, give a little bit, give some of your background, and then we can kind of talk about all that you're doing today. Great.

Speaker 3:

Thank you so much for having me. It's great to meet you. I've been following your journey as well along the way and this is the first time we've been able to connect, so that's really cool. I'll also point out we have some parallels, I think, in our journey. I know you could see at the bottom of the screen there your handle is iFixHearts and I started out as a neurosurgeon with a spine fellowship and my domain was iFixSpines and you know we've been sort of running these parallel tracks for quite a while, so I'm glad to converge today. Yeah, I was practicing neurosurgery for this my 26th year. I was mainly doing spine work. I have a fellowship in spine.

Speaker 3:

I took care of neck and back problems and that is a very big issue. Many people have back pain, neck pain, what have you? I'm most certain you've seen many of your own cardiac patients who probably have their own collection of neck and back troubles and vice versa. A lot of my neck and back pain patients, if they weren't taking care of their bodies, were likely to also have cardiovascular illness. So it was noticed to me a couple of things.

Speaker 3:

First, so many patients would go through the non-surgical treatments for their spines. Patients would go through the non-surgical treatments for their spines. They would try therapy and diet and exercise and anti-inflammatory medications and other medications, and even spinal injections, such as epidural injections, which many people have heard of. And those things help some, but they don't always help everyone adequately. They might last for a little bit or just not be enough. And patients come to me and say, ok, doc, these things aren't working. What's left? And I'd say, well, the only thing left on my menu is surgery. And they would say, yeah, I'm really not ready to have someone stick screws and rods in my spine. And I would say, yeah, I'm kind of not ready to offer you that either.

Speaker 3:

There was this big gap between non-surgical and surgical treatments for the spine and patients would say to me, how about trying this? How about a laser? How about this, doc? How about stem cells? And you hear that enough, and it's like kind of being hit on the head with a rubber mallet. Enough, you finally go yeah, maybe I'll look into that. So about six, six or more years ago, instead of going to the annual neurosurgery meeting where you know guys wearing bow ties pat themselves on the back for doing the same thing for 50 years, I, I, I went to. I started going to regenerative medicine conferences, which is the, which is, you know, the fancy term for stem cell type things and and I learned, and I, I reeducated and I I did this to offer a new tool to my spine patients that we wanted to help keep out of surgery, keep them off my operating table, just like you. But it's blossomed into so much more. So that's, that's my journey.

Speaker 2:

Yeah, that's very interesting and, like you said, a lot of parallels, I think, between the journeys that we have been on. Maybe, maybe let's start with some basics and maybe let's start with some basics. You know what are stem cells? Thank, you.

Speaker 3:

And why do we think they may have benefit, you know, in this disease or other diseases? Well, first just a little mini biology class for the listeners. You know, stem cells are the basic building block, cells that created us in the first place. When you are a fertilized egg inside of your mother, and then that cell divides into two, into four, those are all stem cells. That embryo is a stem cell, is made of stem cells. Then the embryo becomes, has shape to it, becomes a fetus, and the fetus is made mostly of stem cells. Then the embryo becomes, has shape to, it, becomes a fetus, and the fetus is made mostly of stem cells. And those stem cells are very powerful. They can create a limb or much more.

Speaker 3:

But as the fetus grows and develops and is born into a baby, only a certain population of those cells, those stem cells, still exist. Most of them are called multipotent, so they can't make a new person, but they can help replace, grow, restore, regenerate things and even as adults, when we stop growing, we maintain a population of stem cells that we tap into all the time without really knowing about it. We regenerate skin cells, we regenerate hair follicles, we regenerate liver cells. If you cut yourself or have an injury, you call for these cells to help replace, restore and heal that area. So from a regular use perspective, we tap into our stem cells all the time. And then, dr Phil, the second part of your question had to do with what do we use these things for right? How can we use that strategically to help something? And just a quick disclosure you know the FDA has not yet approved for marketing claims that stem cells or any regenerative biologic material because stem cells is only part of it can be advertised to treat or cure a disease or condition.

Speaker 3:

So what I'm going to tell you today is based on good science, good published science and peer-reviewed journals throughout the world mostly not in the US, because we're the last to be able to do this, but and also based on some of my own patient stories. So for educational purposes. So no one, no one here, gets in trouble. Right, we want to do it right.

Speaker 3:

So you know, anything with an inflammatory component, where a body cannot heal that properly, might be a target for a stem cell type benefit, whether that is a plaque in the coronaries, whether it's osteoarthritis, pain in the joints and degeneration of the cartilage. Some people call that bone on bone or they call it arthritis. You know, sometimes, generally, even though that's not fully accurate and even Alzheimer's disease and other problems have an inflammatory component. We also help people address inflammatory diseases that aren't necessarily age-related, like autoimmune syndromes, which are heavily inflammatory, and when you really look at the process of chronic inflammation, it is an acceleration of the body degeneration process. So anything we can do to slow that process is what we're really doing through regenerative medicine.

Speaker 1:

I don't even know where to start with the question that I've got, but I think the first one, following on what a stem cell is. What differentiates a stem cell from the other kinds of cells that we've got in our body?

Speaker 3:

Yeah, I did skip over that. So great question. I set you up perfectly if I had meant to, but I didn't. So most of our cells have assigned jobs. You know a liver cell, or you know a skin cell or what have you, or you know a muscle cell. Stem cells haven't really been fully assigned their job yet. They're standing by in a vocational program ready to be assigned a job when called upon. So it's like a temp agency, except you're going to probably hire them permanently and those cells have the ability, upon need, to be recruited and help that tissue. Now some of the cells also have an anti-inflammatory and healing role, because and these are almost similar used in parallel these words. So, whereas you know, the whole concept of aging is really this accumulated inflammation. Therefore, the concept of slowing or reversing or anti-aging is an anti-inflammatory or an anti-degenerative mode, and the opposite of degeneration is regeneration. So stem cells are the source of regenerative cells in our body so, um, what?

Speaker 2:

so you mentioned that you know we start as basically all stem cells essentially, and over time we kind of get less and less stem cells. Uh, you know, in terms of the sort of percentage of cells in our body, we can think of it as, um, when people get these conditions, you know why? I guess what are the barriers to the stem cells that we all have in our bodies being able to repair this? Why do we have to, you know, sort of go through some special types of procedures that we'll talk about? But why doesn't the body just do this on its own?

Speaker 3:

Well, just like our own cells, over time and age, become less functional, less metabolically efficient, if I can overlap into your sphere and we're exposed to things in our food pesticides, chemicals, electromagnetic radiation, all kinds of pro-inflammatory forces in the world Our cells, including our stem cells, just become less efficient at healing us and maintaining our youth the way we would want them to, and that's why the whole strategy of tapping back into either a concentrated use of these cells or a more youthful source of these cells has a strategic regenerative advantage.

Speaker 1:

Okay, that implies you said something. A more youthful source? Uh, that implies you, you're I. What little I know about stem cell therapy is you inject it, I think. Um, that implies that the source is not your own body.

Speaker 3:

It can be. So your question's proper. There are two sources of regenerative biologics and I use that phrase generally because stem cells is not the only stem cell thing that we do, but keeping this kind of at this level. Stem cells can be obtained from your own body. Even an octogenarian, nonagenarian, centenarian has active stem cells and you can harvest them, usually from the bone marrow or fat tissue are the most common sources, and they can be concentrated and used in an area of need and that can help accelerate an improvement or healing.

Speaker 3:

It's very similar to the lowest level regenerative medicine offering, which is called prp or platelet rich plasma, which is the same kind of thing you draw from the blood and you take. You spin the blood in the centrifuge and you not. You stay away from the red cells, you stay away from the blood and you take. You spin the blood in the centrifuge and you stay away from the red cells, you stay away from the plasma. You take just the platelet-rich plasma, which is the kind of the small area in between those, and you concentrate that together and you use it for good. So, stem cells, you can do the same thing. The other source, jack, is from a more youthful, donated source, so these are ethically donated. Usually, after an elective known C-section birth, a mother receives her newborn baby. Congratulations, by the way, instead of throwing away all this stuff you're not using anymore the amniotic fluid, the umbilical cord, the placenta. Instead of this being medical trash, can we have it Because it's medical treasure?

Speaker 1:

Interesting. Okay, I would love to hear, just because you're in this practice. I'd love to hear some stories.

Speaker 3:

Well, of course. So we generally have three main buckets of things we tend to address, at least here in my office. First and foremost, I think the low-hanging fruit of regenerative medicine is musculoskeletal. So we're talking joints and I went into this because I wanted to add it to help people with spine problems. But now I do all kinds of joint work besides the spine and we follow protocols that have published over 15 year follow up in Europe. So we're not just winging this.

Speaker 3:

These are well-demonstrated, safe, effective protocols whereby we help people who want to stay off an orthopedic surgeon's operating table and we help people with degenerated cartilage in the knee, for example, who want to avoid a knee replacement.

Speaker 3:

We help people with fingers and toes and ankles and shoulders and we inject directly into the structures and typically the better results if you follow the studies in France the better results come from injecting and activating the cellular health and cellular metabolism of the very cells that created the joint in the first place, and those are the stem cells and what are in the growth plates of the bones. For example, if you want to make cartilage, you tap into a cell called the chondrocyte, which we might remember from med school. Are those little cells just adjacent to the cartilage. We don't inject the cartilage itself, although some doctors still do, because injecting the cartilage there aren't a lot of cells there, so you're sort of going indirectly. So the French studies have proven that injecting the bone edge, where those cells exist, help regenerate the cartilage exist, help regenerate the cartilage. And we do have wonderful examples of pre and post-treatment MRI scans showing return of the cartilage and growth and thickening of the cartilage in patients who were previously called bone-on-bone.

Speaker 1:

I can tell you're not a marketer. I can tell you're not a marketer. I know what you just said probably answers the questions of the scientific medical people, but for the rest of us I'd love to hear a story about a person who had a problem and came and got this treatment and we know it's going to be a good story. We know the outcome's good. But give me a specific. Somebody came in with a screwed up shoulder or a messed up knee or whatever.

Speaker 3:

And there are so many Before and after Pick one, pick a good one.

Speaker 3:

I have. You know, I've become friendly with a patient of mine. He had horrible knees. He couldn't work. He's an electrical worker, part of the brotherhood of electrical workers, you know, great guy. He could barely work, he could barely walk. He, you know, got a little bit overweight. We're working on that. He's got some other health issues we're going to attack.

Speaker 3:

But he couldn't even exercise because his knees were in so much pain, couldn't even get up the stairs. Every time he got out of a chair he was so stiff it took him a while to loosen up and get going. So we did some specialized MRIs. We took a look at his knees. He didn't want knee surgery. In fact he actually had one of his knees, had an arthroscopic knee surgery.

Speaker 3:

That didn't help him because they weren't really attending to the problem. They cleaned up a few things. Maybe that was helpful, but they certainly didn't enhance the underlying root cause of this degenerating cartilage. So we did stem cell derived signaling factors called exosomes. We injected these into the subchondral bone, which is the fancy term for the bone layer just adjacent to the cartilage in the knee, and within about three to four months he's able to walk five miles without any pain. Wow, exercising, he's back to work so that is one of my favorite stories because he's kind of become a friend of mine so I get to talk to him all the time so I can enjoy the benefit of. You know, doctors love a good result.

Speaker 2:

Right, we're probably wired that way right, love getting the follow-up. So you just kind of mentioned something that result of the problem but don't really address the root cause of the problem what led to the problem in the first place.

Speaker 1:

Welcome to another one of my tutorials.

Speaker 2:

You know a lot of what you're doing with these regenerative therapies is trying to really attack the root cause and not so much focused on the end result, the structural issue that has resulted from that root cause.

Speaker 3:

I think that's right and I didn't go into this field to do that. I didn't go into this field to do that. But yes, that is what we're doing and it's wonderful because if we can help someone reverse at the root cause level, then we're moving them away from the need for surgery, not just staunching the bleeding, you know, or making them feel better. Doctors use this term palliate make. Just make them feel better. Right, just keep it. Keep them comfortable right, you know.

Speaker 1:

it occurs to me that if you're trained as a surgeon um you you know that old saying if all you've got's a hammer, everything looks like a nail. Suddenly, with this regenerative medicine approach, you've got an entire, not just a different tool, but an entirely new category of tool. I'm assuming there was some sort of mind shift that had to take place. How has that affected you Talk through that process of going from surgery being the solution to having an entirely different kind of non-surgical way of thinking about solving problems.

Speaker 3:

Well, you're right, surgeons are always known as the hammer just looking for another nail. And now I feel like I'm the hammer, looking for all kinds of new nails in different ways, so through regenerative medicine. And listen, I was stale. You know, I look back at my field and I was trained by surgeons, you know, in the 90s, you know in the 90s that's the 1990s that were trained by surgeons in the 60s and 70s and I was doing things that not just my professors taught me but their professors taught them. Nothing had really changed drastically in spine surgery. Yeah, there's a new widget or how you do something or a smaller incision, but the thing is the same. So I looked at that and I thought, wow, and we go to these national meetings and they all congratulate themselves on republishing the same thing and I thought this is really stale.

Speaker 3:

And you know, chance favors the prepared mind. So you know, if you're anything like me, you went to undergrad, you had some interesting things you studied, then you went right to med school and right to residency and before you know it, you're kind of going down this narrow corridor and this is all you do now. But when I got back and I looked at regenerative medicine, I got to tap back into all that cool bio nerdy stuff I loved so many years ago. So I think it's a renewal or a renaissance of my own situation. I stopped drinking the Kool-Aid that all my colleagues were drinking and we made something new. So I guess it's a refreshment of my career at this point. So I love that. It gives me new interest and hope for people. That's a new tool.

Speaker 2:

Yeah, certainly so, and I think the listeners of this program know that the similar journey and similar shift in mindset that I have certainly gone through, and I think it's really refreshing to see doctors that are able to do that, because in a lot of ways our educational process and our sort of work environment discourages that. Now you mentioned that. You know you got into this really with an interest in musculoskeletal and the diseases that you had been, you know, trained to treat. But it's branched out, it's led to a lot more. What are some of the other areas that these regenerative therapies have applicability in?

Speaker 3:

that these regenerative therapies have applicability in, you're right. So the second bucket of the three main buckets, first being musculoskeletal. The second is different types of IV approaches. So those would break down into two groups. We have the biohacking health enthusiasts that want to prevent, you know, accelerated inflammation, whether they have risk factors or they're just enthusiasts and ahead of the game. And then we have a whole group of people who have some type of inflammatory problem. It could be rheumatoid arthritis, it could be thyroiditis, it could be, you know, they have a metabolic syndrome. I've had people with chronic renal failure and we will try IV to reduce the inflammatory burden and help them improve and let their healing stem cells do the work that they did when they were younger. So that's one group. And then the third bucket is probably things we're really kind of pushing in the development stage. So you know this has opened up doors to.

Speaker 3:

You know there are certain type of immune cells, which are white blood cells that help your body stay healthy. Some of those cells, you know, look for infections and cancer and other deranged cells and remove them from our system. They're constantly, you know, acting as a security force in our body. Well, there are signaling factors from those cells that we can tap into. Those aren't yet available but they will be soon. There are also coming these regenerative products that will have more mitochondria in the cells, so cells that could help convert white fat into brown fat and brown fat, as you know, is more metabolically active and it's easier to burn when you exercise. And so these are all uses of regenerative medicine that are coming. Stem cell medicine that's coming to help these other problems, you know, get kind of hacked and attacked.

Speaker 2:

Very interesting. So I mean and again to be clear, this is future, this is research that's undergoing, but we can imagine that, you know, perhaps an additional tool we might have against cancer one day is, you know, being able to augment the cells that naturally fight off cancer in our bodies, as opposed to turning to, you know, chemotherapy, these you know sort of toxic substances, and this might be another avenue that we can use against these things.

Speaker 3:

That's right. That's right. These are, these are natural, naturally occurring. You know biologicsologics, so it makes sense. They know what to do. We're learning from them.

Speaker 2:

Yeah, very, very interesting and again kind of thinking about root cause. You know, rather than trying to treat the end result of the root cause issue, of the root cause issue Maybe getting into a little bit, you know again some of the specifics, you know where there may be applicability. Obviously I have an interest in heart disease you mentioned. You know and you know obviously I talk a lot about how inflammation is a root cause of heart disease and so you know what has been done in that front to try and attack, you know, heart disease, atherosclerotic heart disease specifically, and the inflammatory component that goes into that.

Speaker 3:

Well, there are a couple areas. First, IV approaches using stem cells tend to accumulate in the heart and lungs preferentially. Cells are sticky, they have receptors and if you have an IV as of course you know and I'll remind your audience that something goes in your vein the first place that travels is to your heart. That's the first collection pump, right. So it goes to your heart and the heart just gets a preferential uptake of stem cells. Then of course blood goes to the lungs to get oxygenated, comes back to the heart, so the lungs get quite a bit and then the rest of the heart gets quite a bit. So there are different strategies when we want to get IVs to the rest of the body. But the heart is a wonderful sink of stem cells. It can get stem cells. So IV stem cells in the coronaries when it circulates through the coronary arteries because of the cellular mapping, the epigenetic effect on the cell-to-cell communication to our own cells can slow and even stop the production of little pro-inflammatory molecules called cytokines and most of us have heard that term cytokines, because during the COVID pandemic the sickest patients had what was called cytokine storm. They had this huge inflammation right, Because these small molecules called cytokines were recruiting the immune system over abundantly. So, be that as it may, if we could turn off the inflammatory cytokines and that's what stem cells do we can stop the process of, of you know, plaque buildup and because it is an inflammatory process, as you noted.

Speaker 3:

In addition, recovering from myocardial damage, the healing process involves inflammation and there have been wonderful publications of people who have had heart attacks with some element of heart failure and they might have reduced heart function. On an echocardiogram, which is an ultrasound test, they might have other, they might have other, uh, your ramifications meaning they, they, they lose energy, they, they can't breathe much, they just struggle to to, you know, pump blood efficiently. Uh, there have been wonderful publications, uh, mostly from Asia, showing the use of stem cells to help people's heart function recover and become more efficient and reduce the symptoms after a heart event, a cardiac event that leads to some element of heart failure.

Speaker 2:

Yeah, I'm certainly familiar with many of those studies and they certainly seem to show promise in this area. Post-heart attack recovery is, I know, an active area of investigation when it comes to stem cells and seems to have promise.

Speaker 1:

Can I jump in with a question real?

Speaker 2:

quick yeah, go ahead and jump in.

Speaker 1:

and then I got a doozy to ask Can I jump in with a question real quick?

Speaker 2:

Yeah, go ahead and jump in, and then I got a doozy to ask.

Speaker 1:

Well, we may be thinking the same thing. You gave us a disclaimer earlier the lives of people who are suffering in one way or another from the disease process or the aging process, or or a combination. Um, and this is also not approved by the fda well, let me restate it, so we're super clear. The.

Speaker 3:

FDA has authority on marketing claims, meaning they can tell companies about products, drugs, devices, of what those claims can be or not be. The FDA has not yet rendered an opinion one way or the other as to the claims that can be made for regenerative medicine like stem cells. Therefore, I don't want to make any claims that have not yet been approved by the FDA.

Speaker 2:

So but to clarify that further, it's not that stem cells themselves are legal to use in the United States. The FDA hasn't said you can't use stem cells. It's more a matter of the FDA has said, or maybe just not commented on, what claims you can make as to what benefits stem cells may have to people.

Speaker 2:

That's right, but, if I'm correct, my understanding is there is some restriction in the US that is different from other countries as to where you can get the stem cells from and maybe even some of the uses of the stem cells.

Speaker 3:

There are restrictions on where we can get them from in terms of they cannot be manipulated, they cannot be changed, affected or modified. That's why some of these things I told you might be coming soon, those would be potentially manipulated so we can't use those here in this country. They're available elsewhere. But you can have stem cells anywhere in the. On may 1st, utah went as far as to put in effect an approval law. There's a certain disclosure that has to be made. But even though you can get stem cells and other regenerative biologics anywhere in the US as part of your relationship with your doctor, as long as no marketing claims have been made that you are curing or treating a disease or condition you're okay.

Speaker 2:

Okay, all right, very good, talk about so you know you're largely treating inflammatory disorders with these regenerative therapies, including stem cells. How much do you incorporate other strategies to kind of combat inflammation? And you know, obviously we have a lot of focus on diet and lifestyle interventions. How much of a role do you see those playing along with these regenerative therapies?

Speaker 3:

A big role. If anyone is going to want the best benefit from a regenerative approach, we want that person to be as optimized as they can be going into it. So all the strategies you mentioned diet, sleep, nutrition, exercise, everything and anything that we put under the lifestyle or epigenetic factors, because we want the cells, you know, to be able to receive them with the open arms, the regeneratives, so that might also include bioidentical hormone optimization. That seems to be a big factor as well. What's the downside.

Speaker 1:

What's the risk?

Speaker 3:

The risk of having any procedure would be the infection, pain or soreness from the injection site, putting them in the wrong place, perhaps what?

Speaker 1:

would happen if you put them in the wrong place, perhaps, um, what would be? What would be? What would happen if you put them in the wrong place?

Speaker 3:

well, they probably wouldn't get the desired benefit that they were seeking. Um, but you could put them in a bad place, like if, if you were, uh, if I were aiming for a part of the spine and I I put them in a nerve, for example example which I've never done knock on wood, but that would cause pain in the nerve and probably a nerve injury. We wouldn't want that, but theoretically this would be part of the informed consent process we would go through. Are there?

Speaker 1:

any unique risks here? If you stick a needle in somebody's spine, regardless of what you're doing it for, there's the risk of that. Yes, sir, are there any risks unique to this particular type of treatment?

Speaker 3:

So interesting. There is a theoretical rejection risk, although I've never experienced that, because stem cells are pretty naive and innocent. They don't have many cell surface markers, so they're generally well received by a host if they're from a foreign source, foreign being, another person, and of course, if they're from yourself, you wouldn't have that. And there are even other biologics. We use these growth factors and signaling factors called exosomes that really cause no meaningful rejection risk. The other thing we do see, particularly in people who have a significant inflammatory burden already, whether it's some disease state or just their body's just been over inflamed, maybe from longstanding COVID or something. These people tend to have a few days or up to a number of days of a flu-like syndrome as they purge all the cytokines out of their cells into their bloodstream. So they get sleepy, they get achy, they get a low-grade fever. It's not the flu, it's a flu-like syndrome and that tends to take care of itself.

Speaker 1:

That's kind of the getting worse before you get worse to get better, kind of thing.

Speaker 3:

Yes, although that's in the minority of people. That's just something we warn about, but we uncommonly see.

Speaker 2:

So let's go through sort of the logistics of this. Let's say I got a bad knee and I'm coming to see you to get this therapy. What actually happens, what's the process that I'm going to go through to get this therapy done?

Speaker 3:

Well, we would start remotely like this you have a telemedicine practice, I have a telemedicine practice. In part. We would start remotely because many of my patients come from not Las Vegas, where I'm located. So we start, we get the records, we get their labs, we do a full history, we get to know them, we dig into the epigenetic lifestyle factors, seeing where we can tweak Although most of the people who have a little inclination about looking into stem cell medicine are generally a little bit more health conscious already.

Speaker 3:

So you know, they're already sort of inclined to have done some good things. And then and then we, we, if they don't have a good MRI of that knee, if you don't have a good MRI, I will order one for you wherever you live. I, I'm very particular about it, you know, and you're a surgeon, I'm a surgeon. We're very particular people about how we want our operating room and how we want certain things. So I, I get the MRI done with a what's called a three Tesla MRI, which is sort of a higher resolution MRI, and I get it done with what's called an inversion recovery sequence, which is an additional bell and whistle that doesn't cost anymore but isn't part of the standard. And once I have that result here, I'll bring it up on my screen, I'll screen share with you and we will do what's called the clinical correlation, which you and I learned to do in medical school, where we try to match what hurts with what we see on the test. And if we can match those and there are targets for a place to put the regenerative biologics, the stem cells or whatever we're going to use, then we start to talk about the candidacy of that procedure, what it would take, and then, if that works, we invite you to come here in town. We would schedule ahead of time. Usually people come in. We try to do something on a Friday, they stay the weekend, or vice versa, they stay the weekend. Try to do something on a Friday, they stay the weekend, or vice versa, they stay the weekend. We do it on a Monday, whatever. And most people like to come to Las Vegas, you know, see a show, have a nice dinner, whatever.

Speaker 3:

So we, we, we do this at a local surgery center under sedation, and just you know, you know this, but your audience just to clear, this is not general anesthesia, it's just a little twilight sedation because I don't want you to feel the needle going into the bone and again, the bone injections have the best results. So the procedure usually takes 10 to 15 minutes per joint. You know, you know, if it's just the one knee, then we sometimes it's one or two spots we're done. We put some ice on it. There's no downtime. Once you go home, we want you using the knee, we want you walking on it.

Speaker 3:

You don't necessarily have to have a specific physical therapy. Often people have an initial anti-inflammatory benefit where pain is suppressed. We don't like people to take other anti-inflammatories. So if you're taking a lot of Advil or Aleve or Voltaren, we would stop that as long as possible and we want to avoid steroids as well. And then in the knee situation, somewhere between the third and fourth month, we start to see the regenerative benefit kick in and most people with knees by six months are happy they did it. So it's not a quick fix.

Speaker 3:

No, I mean, it's not a quick fix, but a surgical recovery is at least a number of months.

Speaker 1:

So I would say I mean, in my mind, it's a good thing that it's not a quick fix, these things that are like oh, it's a magic bullet, or never work out that way.

Speaker 3:

It's very exciting and sometimes I'm amazed with the results and how easy it is to do the procedure, because the hard work is done ahead of time. You know the workup, the targeting, that's the hard work. But yes, it's not a quick fix. It does take a number of months to start to really benefit. Yes, it's not a quick fix.

Speaker 2:

It does take a number of months to start to really benefit, and is it usually a one-time thing or does it oftentimes need repeated treatment? Like over time will it start to lose its effects and you need to go do it again?

Speaker 3:

So the long-term follow-up study out of the French literature has 15-year follow-up. I'm waiting for them any time now to publish their 20-year. But their results in knees show in the low 80%. We're still doing great clinically at 15 years. So if I'm a true objective scientist I would say I would strive for at least that result. I can't answer with any scientific background beyond that. But you're right. That means if 82% of those patients were doing well, 18% of them started to have problems again. Could you repeat it if needed? The answer is of course you could. You know you would do a new MRI, you would check it out. But the goal is one and done.

Speaker 2:

And what you described sounded like using, you know, stem cells from someone else, something else you know. Talk a little bit, if you're going to use your own stem cells, how those get harvested, because that ends up being part of this as well well, sure.

Speaker 3:

So there are companies that you take a little bit of a fat and you send it off to them and they put it in their freezer. You have to pay them to store these, but you can tap into those anytime you want them. Going forward, I don't do stem cell harvest. I'm focused on the more youthful donated sources, because when I take my car to get the oil change, I don't put the old oil back in Because our stem cells are affected by the chronic exposure to whatever we've been exposed to over the years.

Speaker 3:

It's so easy to get off the shelf biologics from screened, healthy donors here in the US who have not had the COVID vaccine and that's not a political statement, it's just we don't know what that means. So, because I'm trying to do right for everyone, we just don't use anything that's had the COVID vaccine in it. So it's also cost effective to use those donated sources. But I do have patients that want to use their own and they have them banked. It's usually a little mini liposuction that they can do in various places. I just haven't been doing those. I'm not against it in any way.

Speaker 2:

Okay, very good to understand. And you know we have to mention. You know there is cost. This is not going to be covered by your insurance. So what does a typical procedure end up costing?

Speaker 3:

You're right. So HSA plans you know you can use HSA money, which is health savings account. But you know we try all in with all the visits and the anesthesiologists for the Twilight and the facility. Usually a knee is two doses on average. So a two-dose all-in knee procedure on one side is usually between you know $10,000 and $15,000. Usually between you know $10,000 and $15,000. We have sometimes we get a good deal on the biologics If I buy more. At the same time we pass that savings on to people so it can be a little less.

Speaker 1:

I'm thinking about the Costco biologics aisle.

Speaker 3:

Oh look yes.

Speaker 1:

If we buy the five-gallon tub.

Speaker 3:

Yes, we're having a Kirkland knee special today.

Speaker 2:

There you go, and but by two doses you mean injected at the same time, not two separate, yeah.

Speaker 3:

Sorry, when I say two doses I mean typically. Let's say you have a meniscus tear and the medial compartment of your knee. We would do one above and one below. That's your two doses. But every now and then I have someone who's like you know, this knee's killing me. I got lots of problems. We'll do five doses. So, but once you've once you the first few doses, you've paid for the surgery center. Each additional dose is a smaller increment. It's like 2,500 to 3,000 more each dose.

Speaker 2:

Okay.

Speaker 1:

There's bound to be with with anything that's cutting edge. There are skeptics and cynics, and my experience is, 90% of the time the skeptics and the cynics just they're just skeptical as a matter of principle, not because they've actually investigated it Right. So let's leave those folks out of the discussion. Steel man, if you would the arguments of the informed skeptics and then address them.

Speaker 3:

Well, first, are the myths right? Myth one oh, stem cells are illegal in the United States. So no, they're not. Well, the FDA hasn't approved them. Well, the FDA approves marketing claims. So Big Pharma and the people who make titanium knee implants and spinal hardware want you to believe stem cells are illegal.

Speaker 3:

Myth two I have to leave the country to get stem cells. Classically, that was true 20 years ago. We weren't ready for stem cells here in this country. Tiger Woods and Peyton Manning went to Europe. Others go to Asia. Now you can go to Mexico and Central America and there are wonderful clinics and they do good work. Firefighters down to Tijuana, for example.

Speaker 3:

You know Tony Robbins talks about some of the great places. They're fantastic, but you can get them here in the US. We can't manipulate them. We can't do, you know, fancy things with them. Yet, and those you might be able to get out of the country. Asia is way ahead. China is way ahead of us and if you look at their literature, it's way ahead of what we're doing. Korea as well. And myth number three it's cost prohibitive. I think that if you offered a $15,000 knee procedure to someone and it kept them from missing work for two months, pain from surgery, risks of surgery being laid up, having to go to physical therapy and their co-pays, which is some money. Depending on their plan, it's probably a bargain. Those are the three main things I think the informed skeptics come with Jack.

Speaker 2:

Yeah, and to follow up on that last point, I mean to be clear. You know, yeah, and to follow up on that last point, I mean to be clear. You know, knee surgery typically is going to cost way more than $15,000 in real dollars. It's just that the insurance company is usually shouldering that cost rather than the patient. And so, you know, on the patient side of thing it ends up being more expensive. But in reality the stem cell procedure itself is less costly. But, like you said, on the patient side of things, there are the other, maybe non-financial, costs that go into it that need to be considered as well. Yeah, so I guess maybe talk a little bit. You know how the field is growing. You know how well accepted is this becoming. What have you seen? You know, in the time that you've been doing it, that has kind of changed.

Speaker 3:

Well, I think that as a new field of medicine, we're a little disconnected, in part because we don't know everyone. We don't haveate there, because it's a nice, big, good meeting with a lot of colleagues here in our town of Las Vegas once a year as well, so that's usually a place where we've found each other and compare things and talk about studies. It's hard to do studies in this field because of the myths, because no one wants to be on the placebo end and then someone's got to fund the study and because the FDA hasn't yet approved marketing claims, federal government's not funding very much in this realm, so we are held back. We have the shackles on in regenerative medicine. We have the shackles on in regenerative medicine. But the other thing is I'll mention Google and Facebook will not allow you to advertise regenerative medicine, biohacking, stem cells, anything like that. It's a disqualified ad. I've met people from various places. You can find it in your area. You can still find a website by Googling stem cell or knee pain or your city name. What have you?

Speaker 1:

It's available um, let's speculate wildly. Uh, look into the future, put on your, your, your magic hat and your crystal ball and, um, where do you see this going? Well, if, if things continue in the direction they're going, what do we have to look forward to? And I think I'm specifically thinking in terms of anti-aging?

Speaker 3:

Well, I was going to take you another direction first.

Speaker 1:

Oh, okay.

Speaker 3:

But I think anti-aging will be the natural consequence of this approach. And you know I mentioned earlier to answer your question, jack that when you're an embryo you have these more powerful stem cells and they're called omnipotent and pluripotent stem cells. And the ones we use clinically, that adult bodies maintain, are called multipotent, which sounds great, they're fantastic, they can do almost a lot of things, but they're not as powerful as some of those earlier along the lineage of cells. So a Nobel Prize winning doctor named Yamanaka discovered some small growth factors which turn out to be epigenetic transcription factors, and that's fancy term, for it calls upon certain genes to become active and those, if you apply those to a multipotent stem cell, they get moved back into a more youthful state, they get what's called induced and they can go from multipotent back to pluripotent. So these pluripotent cells are where the newer magic is going to be happening, you know, with our imagination glasses on, and there are a lot of big pharma companies looking at using these induced pluripotent stem cells to, you know, fight disease and regrow islet cells for the pancreas, for diabetics, to help people with Parkinson's disorder who need, you know, improvement in certain cells in the brain stem. We see that also they've got. They've got using those cells to produce antibodies against cancer to our body, to our, to cancers we could have or would develop.

Speaker 3:

And and the real holy grail, you know, if we, if we move even further forward in the future, we're looking at spinal cord injury repair and regrowing a limb right, because there are species that'll regrow a tail and a limb, and you may not know this, this is a nice little trivial pursuit thing, but a child under the age of five or six, if you cut the fingertip just beyond the last joint, that child can still regrow the missing part of the finger. So what that tells us is, as we develop from a fetus into a child, we lose, we turn off those genes that could allow us to regrow a limb, that same gene that some of the you know, the axolotls and the starfish have when they regrow a limb right. So if we could tap back into that, you know, imagine what we could do.

Speaker 1:

You know, imagine what we could do Any implications in terms of anti-aging I mean?

Speaker 3:

literally anti-aging.

Speaker 3:

Yeah, I mean you know broadly.

Speaker 3:

You know slowing and then reversing the cellular metabolism, meaning the cellular functions, the proteins being made into a more antioxidant, anti-inflammatory state, puts the body in a less aged state.

Speaker 3:

And we know this because we have done studies and we can look at with our patients these biological age tests where we look at markers of age, not the calendar age. Then we give them stem cells, then three months later we repeat the test and we see this. So we already know that is happening. I think what we'll see is we're going to learn the individual molecules more involved and we can accelerate the process by enhancing that type of thing. And some of this is going to be through gene therapy, which overlaps with stem cell medicine. But it would be taking advantage of what we're learning from stem cell medicine and employing it. On the gene therapy side and we're seeing this already, there's a company that has the phallostatin gene in a, in a small plasmid which is a little bit of DNA, and they can actually inject that into you and for a couple of years it has an anti-aging benefit. So we're.

Speaker 1:

We're not smart. I just want a cream I can put on my head That'll grow my hair back. That's it's really my. The bar is low for me. That's all I'm looking for. That's all you want.

Speaker 3:

There's great work in hair regrowth. It works much better if you have follicles, but I will tell you that through this induced pluripotent stem cell business, when those become available clinically, I imagine we'll be seeing a hair regrowth in in in those who are who are hair challenged.

Speaker 1:

There's hope for us. Yet, speaking as speaking as the hair challenge, the majority on this call that that can't get here soon enough. This is a fascinating subject, um, and I'll confess I don't feel like I I understand or know enough to even ask particularly intelligent questions. So I'm going to ask one more question what else should I have asked you?

Speaker 3:

Um, you actually did a great job. Um, you know, um, there are a couple other things we do. You could ask about that. We have some injections for sexual health for men and women O-shots and P-shots. By the way, anything we're doing is probably something you could obtain now using platelet-rich plasma, which is the lower end of regenerative medicine, which also, ironically, is not approved for marketing claims by the FDA, but some health insurance companies have started to pay for because they finally the bean counters, figured out oh, we do save money when you use the PRP, we're we're not spending as much on surgery, so so I think we drop the mic moment right there for this, for this uh conversation.

Speaker 1:

Holy smokes, there's an insurance company will actually pay for something that saves money. Wow.

Speaker 3:

Right. So so we have that, we, we, we have some cosmetic things uh, you know we do for enhancing uh, skin and and things like that, but but you know, my, my, my true love is the musculoskeletal and helping people that just are looking for a new and natural option to recover from a stroke or a heart attack or some kidney failure, don't want to have dialysis. We've helped a number of people stay away from Whoa, whoa, whoa.

Speaker 1:

Reverse kidney failure Is that what?

Speaker 3:

I'm hearing Well again. I can't make any claims, but I have anecdotally had patients with an elevated creatinine that was creeping in the wrong direction and their nephrologist was saying hey, we got to talk about dialysis, where we've done some IV approaches using the stem cell derived exosomes and we've brought their creatinine down with no other intervention kept them away from dialysis.

Speaker 2:

Wow, I think the future is quite bright in this area and a lot more to be uh discovered and explored. Um. So, uh, let people know you know how they can uh learn more, uh, how they can maybe connect with you in particular, um and um you know, if they're interested in working with you, how to do that you know if they're interested in working with you, how to do that.

Speaker 3:

Absolutely, thank you so much. So I changed my practice name to ReCelebrate, because we are celebrating the renewal of yourselves, and that's spelled R-E-C-E-L-L-E-B-R-A-T-E, and if you search that, you'll find our website, our LinkedIn, our everything. That's the best way to get us.

Speaker 1:

Very good. Thank you, Dr Jeffrey Gross. Reselebratecom. I am just fascinated with this. I'm really glad we finally had somebody on who could talk about it, because I've been hearing about it. You know athletes paying for this kind of stuff for a long time and it I guess I wouldn't interested enough to really dig into it. This has been cool, this is really cool. My mother has a messed up shoulder. I think she'd be a prime candidate for.

Speaker 3:

I'd love to meet her. We will do a case study right here.

Speaker 1:

We will make sure that the connection gets made All right. Well, for Dr Jeffrey Gross and Dr Philip Ovedia, this has been the Stay Off my Operating Table podcast. Thanks for joining us. We appreciate you being here and we will talk to you next time.

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Dr. Philip Ovadia

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Jack Heald

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