Dr. Cook Roundtable Q&A Series: All About Peptides

 And I've treated random people that happened to be in the clinic and they were like, oh, I have a headache. And I was like, oh, I have a bag of 5% dextrose. And I took somebody back and had 'em lie down and did that, and the headache was coming. It's shockingly more effective than I would've ever thought.

You're listening to a Bio Reset medical podcast with Dr. Cook. If you have questions, we're gonna talk more about your symptoms and issues. You can always reach us at 6 5 0 8 8 8 7 9 5 0. The following is a q and a hosted by Dr. Koch, where he hosts weekly calls with doctors. Oh, does any, if anybody has any questions, they can step up.

Oh, I wanna know if you can nebulize. N A d. Oh, you asked me that on text. I've never heard of anybody. Nebulizing it have you? Or did you hear of somebody nebulizing it? No, but I'd like to do it cuz I have some, I wouldn't do that because I don't know how it acts and would like to, um, talk to somebody who's done that before.

You know, you can, in, in the vasculature you get this reaction. That's like a histamine type of reaction and it can be. Um, and obviously if you've done any d you know what I'm talking about. Um, yes. My, my thought of that is that I feel like it is related to the mechanism of the niacin flush. I think that they're similar and when you give people large doses of niacin right away, people will have these methylated.

Niacin metabolites that sort of show up in the urine. And when I heard about that and I heard, um, Dr. Sinclair was actually doing high dose TMG Trimethylglycine as a methyl donor, uh, when he takes his product, then I started realizing I wonder if a methyl donor will help. And so then we started giving people methyl donors and they have a lot less symptoms.

Now, the concentration of that methyl methyl donor is fairly easy to get into the bloodstream. Okay. Versus if, if you got it pulmonary wise and you started nebulizing, and then because of that nebulizing you started to get a histamine. Like spasm response. I am anticipating that you, someone could get bronchospasm and could have a hard time breathing and then that could become an emergency.

And so, uh, that's number one. Number two, I don't, um, the, the dosing ease of subq and, uh, IV and topical and nasal and those, the, the sublingual. And I like that sub. You can do sublingual, n a d, the real n a d, um, uh, that is made, um, by the same people that own archway. Mm-hmm. And, uh, the company, uh, that they have is called avr, A V I O R.

I like that. N e d. Um, and then there's uh, uh, n e d gold, uh, from Quicksilver, which is, uh, and a man, which is salvage cycle. So I just haven't done that and I wouldn't, I, I wouldn't particularly in anyone fragile start that without some experience. If you told me, oh, I talked to 10 people that did it, I'd, I, I would pay a little bit more attention in terms of being engaged.

But my number one thing on that is to do no harm. However, we do know that it work. The topical part works pretty good. Um, and so then, and then one other dosing thing that I figured out, I probably never told this one before, is that, um, do you guys know, uh, do you guys know how to do, uh, a topical spinola ganglion block?

Okay, this one's, this is actually a total 100% home run. And, uh, and so the, the sphenopalatine ganglion is like a parasympathetic ganglion that's kind of like the cell ganglion is a, a fight or flight ganglion for autonomic nervous system. And so it's kind of like the st eight ganglion. It's a, it's a, a, a parasympathetic ganglion that's basically right back here.

Uh, and it's, it basically is a ganglion for the sphenoid bone, which is straight back here. And the palette, the nasal nasopharyngeal. Uh, and, and interestingly I'll do the injection for that. The injection for that is actually one of the most difficult injections there is because you have to come in and the maxillary artery there as big.

And so you have to avoid that artery. And then people will do it under either ultrasound or fluoroscopy. So, uh, this comes a little bit from the liftoff world, is where I learned this John Liftoff, uh, aka perineural injection technique, a k a neuro prolo. And it, he's in the 5% dextrose world. And so then what they will do is they'll take someone and then have them lie in a bed, and then you put the bed into Trendelenburg.

And so the bed's in Trendelenburg, once that bed's in, um, Trendelenburg. So the person's lying there and their head's down here. So if, if the, the head is down at some point your nose is pointing straight up cuz you're kinda like almost hanging upside down. So then if your nose is like, Like that. Then what happens is your terminate bones are gonna be almost ho horizontal.

Horizontal like this. So then what you can do is you can take a catheter and thread it along the top of the nose. And so I get these one and a half inch or two inch catheters, and then I'll slowly, carefully thread that up past the middle turbinate. Okay? And so then what I'll do is then I'll, then I'll have a syringe connected to it, and then I'll slowly inject the solution.

And so then 5% dextrose is a fairly good analgesic. And the reason that, uh, people got into the idea of 5% dextrose is liftoff has a b uh, a theory. And I think that this is ultimately gonna be borne out that 5% dextrose. Is analgesic and it blocks what are called Trip B one receptors. So these are the, the, uh, the pain receptors of unmyelinated C fibers.

And what all of those pain fibers do is they manage and modulate blood flow in a tissue bed. And so then what happens is if they get stimulated and they can get stimulated by cold, they can get stimulated by light, they can get stimulated by, uh, capsaicin. And so that was why, uh, or block capsaicin was studied a lot for the trippi one receptors.

And it was thought that that was gonna be a, a pain home. Ron. Back when I did my residency and that didn't really ever play out, but there was a lot of talk about that. But 5% dextrose is really great and that's, and those receptors are spread out in all tissue beds. And so the, what LiftOp and those people will do is just do subcutaneous 5% dextrose injections over an area that hurts.

And the concept is, is that, uh, if you can treat that area subcutaneously, it'll reset the nerve there, and that may actually reset the nerve to the joint that's underneath where that topical injection was. And I can tell you, I've talked to hundreds of people that have had incredibly good results with that.

The downside is they're, they do all of their work by palpation. And so then when they do injections, they're always palpating for nerves, but then they often will hit nerves, or at least sometimes we'll hit nerves. And I've actually treated several cases of complex regional pain syndrome where someone actually injected into a nerve and then created worse pain, which is why my strong recommendation is to do all of those with ultrasound.

But, and actually, Dr. Loff came and spent a couple days with me, and I had had a great experience, and he's a genius and has lifted and driven the field in many amazing and positive ways. So I'm, I'm a fan. But, so then what happens is, is they started doing, uh, instead of using like ropivacaine. Or lidocaine or something like that.

They started positioning people head down, threading this catheter. And then when you thread that catheter up there, then slowly, um, injecting 5% dextrose. And basically since they're upside down, you end up filling up the top of the nose from the cribriform plate all the way up through the metal turbinate with, uh, with fluid.

And if you have 'em at a steep enough angle and you have them open their mouth and breathe, what will happen is you can fill that up and you fill it up with 5% dextrose. And when you do that, that dextrose is enough. Um, uh, to start to have a block of the unmyelinated C fibers, the trippy one fibers, which are controlling flow into that tissue bed.

And those go to the spinal palatine ganglion. Okay. That, that's, that's the, that's the ganglion that they go to. So it's actually kind of an amazing, um, treatment. And so as a, and, and interestingly as a headache treatment, that's the risk of that is like a zero. And I've probably treated like. Three or four or 500 headaches, just of like random people that happened to be in the clinic.

And they were like, oh, I have a headache. And I was like, oh, I have a bag of 5% dextrose. And I took somebody back and had 'em lie down and did that, and the headache was gone. It's shockingly more effective than I would've ever thought. Um, and uh, I, there's a guy who has done some research on it and has taught it and, and really has been a champion and a promoter of it, um, who may be one of the nicest guys in the entire world.

And his name is Greg Reer. Um, and I'll ask, uh, Chris, and if we we're gonna send a text to him and ask if we can give his email aloud, because he's got a lot of thoughts about it. What There's a, um, there's a catheter that's called the Sino cath. There's a re this all relates to N A D by the way. It's like a, this is a, a, a digression, but there's a catheter called the s pheno cath, and it basically has an outer part and then a soft, flexible inner part that bends.

And so then what you can do is you thread the sphen cal up and then thread the smaller, soft kind of rubber thing through it. And then you, it's threads up, um, right. Very close and a little bit posterior from the top of the nose so that you can aim, get your fluid by the vena palatine ganglion. The issue with this is that that's like 70 bucks.

And then so for, for me, I was doing this and I still do it, but I do it as, um, Just as like a favor for people because I feel like I don't wanna charge for it because it's just 5% dextrose and I'm just happen to be doing it for somebody in clinic. So I've probably, I mean, I've, I do it all the time and I almost never charge for it.

But, um, and so because I don't charge for it, I don't like paying $70 for that catheter, which is why I started using the, the two inch catheters. The one inch catheters also work, and when you use a one inch catheter, what I'll do is I'll put it up and then I'll slowly advance and I'll get the, the, the tip of the angiocath all the way into the nose.

And if you go easily and slowly, this works fine. Uh, sometimes I'll put a little bit of lidocaine jelly in the front of the nose if they have an issue. Now, uh, you can try this. Uh, this is on a scale from one to 10 of intensity, like a 10, but it is kind of amazing and that is that you can have someone lie down, thread that catheter up, and then you can put in actual n a d up there and you get a flushing that if the, a regular N A D I D was like a five, you get a flushing up here, that's like a 10, but that's palatine.

Ganglion is right. In front of where your pituitary gland, it's like a it's, and so I've done it. I used, I used to do it and I kind of forgot about it. Um, and then I just remembered it just now. But that's another way to do N A D and that's a way to do n a d nasally. That's like 10 times more than just doing a couple sprays like this.

Cuz when you do a couple sprays, it'll just go up and then it kind of comes, a little bit of it comes out. So it's not super efficient. So that's another way to do any d just, and, and I think the reason that I just remembered this, um, it was interesting. There's a, there's a great, um, There's a great, um, album.

There's a great song, you can look it up, uh, called Whiskey in the Jar and The Grateful Dead did it. And they were in studio, and then Jerry just remembered and they go, how did you remember the words and everything? He goes, I don't know, I just remembered. But what happened was, uh, last week, uh, and I, what happened is last week somebody accidentally pulled some exosomes from the freezer.

And so then they were just out and, um, and so I said, well, don't use 'em. And so then I actually did that technique on myself where I, and so then it was like the end of the day. So I said, I just put 'em in their refrigerator. So then I, I went in there and then I did it, and it's pretty easy to do. You just thread it up.

And the tips if so, you can put exosomes there. You can put peptides there. You can put, um, A d there, it's a great delivery mechanism. And when you do it, the key is you have them lie there. It's, it's a awesome headache thing. The other thing that you can do is even if you don't have an angiocath, if you're using 5% dextrose, and I've done this for a lot of patients at home that have headaches, and this is a total home run, which is that, uh, I just gave them a whole bunch of bags of 5% dextro.

And so then what happens is, is that I just had them fill up 10 ccs and then I had them get in that position upside down, open their mouth, and slowly inject and kind of fill up the nasal cavity. So now you're upside down. The key to remember with this stuff is you're up, you're breathing through your mouth and stuff like that.

Now then the key to remember is turn your head to the side. And start swallowing and then slowly come out of tr ellenberg and keep swallowing the whole time. Because the only thing that's ever gone bad for me, uh, I, I did to myself cuz I, I did it and I was like, I'm a genius. This is amazing. Uh, and then I promptly sat up and then all of that fluid just starts to go right down your throat because there's a whole bunch of fluid in there.

But as long as you very carefully roll to the side, then that's a, a, a way to do it. Um, and so I've had, I've used, there's a, there's a lot that you can do with intranasal techniques, but that is a cool one and that's a cool way to do N A D, but it's way more intense of a rush. Um, of course, back when I was doing that with N A d I wasn't using T M G.

So if I did that with t with n a d now I would do a rel, I think I'm gonna try it now just since I've talked about it. But, and report back. And report back. But when, if I did that, I would, I would take like a good amount of TMG and stuff like that beforehand. Is that helpful? That's great. Okay, good. I didn't, I answered everything but your question, but, but it was very interesting.

So you would take a 10 cc syringe and fill it with whatever solution, like N a D, what kind of concentration? So N A D what? When I did it before, I used the regular concentration because I think I was just maybe financially stressed and I was just trying to just get the most of it. And so I used straight N A D, which was like 50 milligrams per milliliter.

And, uh, which is what it comes in from, almost all the com compounding pharmacies. If I was to do that now, uh, I would probably do five to 10 rather than that. And so then I think it would be more dilute and then it would be an easier thing to go through. Uh, the, um, since we're talking about nasal delivery, I found a new compounding pharmacy that does nasal, um, thymosin alpha one.

Uh, and so I'm ordering that and I think that's gonna be an interesting, uh, alternative of, uh, dosing strategy for, uh, covid people, and especially people who can't do injections is 200 milligrams per ml and you do one spray in each nostril. I'm gonna be extremely interested in. How the responses of that compared to a patient told me that this morning.

Um, uh, and then remember, you know, we're doing a lot, we're seeing a lot of people with nasal biofilms who are mold patients. Mm-hmm. And their MARCoNS positive o obviously. And so then as you begin to think along these lines, then I think that may, some of these things we may be able to add in that will help make our, uh, uh, nasal reset stuff a little bit better.

And so what I've been having a lot of people do is we're getting, uh, glutathione. Glutathione that's preservative free for nebulizing. Um, yeah. It doesn't have to be glu, um, preservative free. Cause it's way more expensive. So it's insanely more expensive. And it's, and it's really, um, Much more difficult because it's way harder to get, and I've been getting it from Koshland and kind of like everything that I do, I, I started telling everybody about it and now I can't get it from Koshland anymore.

Like, cuz I think they got like 50 people sign up and so you can't get it from them. I've tested it. I had, I've had probably 30 or 40 people just do regular glutathione nebulizing and remember I've talked to Jan about it a bunch of times and I know we, we know some people who have had preservative free and some people who haven't.

Mm-hmm. I've personally just took the, the, the glutathione that we have here and took that home and nebulized it non preservative free myself and I had, I didn't have any problem. I felt great. So I think it's a reasonable. To, to do. If, if I had covid, I probably would nebulize it, um, and, and take my chances.

Um, but uh, and I think the probability that somebody would have a problem with that is really low, but, but it's not, uh, optimal. We're doing the hypertonic Quinton Minerals and what I'm having people do is they'll nebulize glutathione and then when that's empty, I'll have them pour in some of the hypertonic tinton minerals and nebulize that.

And then, uh, if they're really sick, I'll have them nebulize silver cell from Designs for Health. But there's other ones also. And so I have a lot of people doing silver cell and glutathione and hypertonic minerals all in one day. And I've had a lot of people that did really great and made strides with that.

I think adding in something like Thymosin Alpha One Nasal, you can do Nasal clan, um, uh, which is, has probably has some antimicrobial. Uh, antiviral effects you can do nasal exosomes. Um, and so then, uh, uh, and then you, and then the other thing that you can do is you can do the same strategy that I just said, where you take 10 ccs of Quinton hypertonic minerals mm-hmm.

And then you could do the same thing where you lie upside down and put that in your nose. And I've had a home run with that. I, I definitely have done good with that when I break those. Glass ampules, and I always had this in anesthesia because all of our, like fentanyl and stuff like that came in glass ampules.

And so I always have, if, if I'm doing an injection, I draw that up with a filter needle so there's no glass. I, somebody said there's no glass fragments. And so then I was like breaking 'em at home the other day and then a tiny little glass fragment came off. And so then what that, what I did, you're gonna love this, I guess this is a home run.

I have a little, it's like the size of half of a mask and it looks like a little bowl. And it's one of those things that you put tea in and then you pour hot water over. It's like it has a little mesh. And so what I do is I set that here and then I break my cantons and I pour it through that, and so that I don't get any glass, and then I drink like three of those a day because that's just a great source of minerals and use a hypertonic.

Yeah, I, so, so the, um, the, the theory and this comes from, um, Kenton and I think probably Robert Slovak, maybe one of the top two most intelligent, if not the most intelligent water person that I've ever met in my life. Um, I totally love him. He's super, super good and super smart. Um, and he argues that there's a logic for doing, um, uh, Isotonic.

And then there's logic for doing hypertonic. And then he says, uh, and I'm 99% sure that I've got this right, that hypertonic kind of stimulates the, uh, sympathetic nervous system and isotonic stimulates the parasympathetic nervous system. And the I, and I don't know where they got that, but this, this has been like, to some extent, a little bit of like a, uh, a fable that has gone down in Kenton was like a hero in France.

Um, and, uh, an early, uh, health pioneer, I would say. And so then the, the concept is, is that they would have people do hypertonic in the morning for sympathetic and then isotonic in the evening for Paris. Parasympathetic the idea, get going in the morning and then relax in the evening. Um, and so I, uh, I, and then we're just gonna send an email to him and then we're gonna ask him if we can send out his email to everybody and we'll confirm that.

And then I'll be super embarrassed if I'm wrong, but I don't think I am. But if I'm wrong, then we know exactly that I'm 50% exactly. A hundred percent wrong.

I have a question. Okay. Awesome. Um, since we're talking about sinuses, um, doing that, uh, gumline canine ozone injection for the ma maxillary sinus, is that a effective treatment for someone that has bacteria buildup in their, in their nasal? Oh, okay. So that's a great one. Uh, how did, tell me how you, how do you do it?

I don't do it. I'm just asking. I'm, I wanna learn how to do it. I haven't, I, I heard you go through the canine, through the gumline, right up to the maxillary sinus. Right. So, um, that, that I think is probably an incredibly good injection. Um, it's a little bit of an advanced injection. Uh, we teach it at Dr.

Shallenberger's course in the advance course. Um, and I've had some incredibly good experiences with that, especially with people with chronic sinus infections and stuff like that. Um, uh, the, there's a couple techniques that I've seen for doing that. Um, and the, so just to give you guys an idea, what's happening with that injection is, is that's an, uh, a, a field injection.

So it's a, it's, it's gonna come here, it's gonna come at the go line, and it's gonna point up. And, uh, there's a couple ways to do it, and I'll tell you how I do it and I'll tell you my thought process for this. Um, but, uh, what, uh, the way Dr. Shallenberger teaches that is, is that, um, uh, you'll have a syringe, hook that up to the ozone generator, build that syringe up, and so, uh, with 20 gamma ozone, so now I have a syringe, a five cc syringe with 20 gamma ozone.

I flip that. And so it's the, it's open on the top. Then, uh, what he'll do is have a syringe that has propane or lidocaine in it. Um, sometimes propane's hard to get. He strongly feels, and I would say the entire naturopathic community of the world strongly feels that propane's probably better because it breaks down into natural, uh, products.

And it was interesting, I did a consult with a friend of mine this afternoon, just like who I, I hadn't seen and or even heard from in like years. And then I was like, oh, they're on my schedule. What's going on? And then she was like, oh, hey, I got a propane injection. It worked perfect. So it was kind of interesting.

But, so then when you inject that either, whether you inject propane or lidocaine into that, it will turn yellow. So then it, it'll be surprising cuz you'll inject it in, it turns yellow. That is a reaction that happens between the ozone and either lidocaine or propane. And so that's a good sign. So don't worry about that.

So now you've got, you displaced one cc of ozone with your one cc of propane. Uh, you can also use half a cc of propane or lidocaine. So now you pop a, uh, one inch 30 gauge needle on. Then kind of same thing, you have the person lie down, put them in trendelenberg a little bit. I take, um, a, uh, I've got a lot of props today.

Um, I take a gauze, grab a hold of the gum and lift up then what you do. And I kind of basically go over the canine and then I go in and I make a skin wheel at the, basically the apex of the gum. So when, when you do that, uh, and then here's a great tip.

I put my needle real close and then I start to inject before I hit the skin. And back to LiftOp, who does all the subq injections, he does that and he taught me this. And I have to tell you, it is a total home run because what happens is as you start to inject, before you hit something, it immediately pushes everything out of the way.

So you're less likely to have some kind of nerve damage. And, and as far as even injuries from like left off technique, they have done like probably a hundred thousand injections, but an extremely low complication rate. And people can still have complications from ultrasound. And ultrasound is super long to learn and that's like a super easy technique to learn.

And so I don't wanna be disparaging in any way of that, but I still am promoting ultrasound. So then what happens is you, you hit that and by hitting that wheel that's, uh, making a little wheel there that just makes us it not hurt. And then you go in and continue to inject all the way up until you touch the bone.

And so you're gonna come up and if you put your finger up and press here and you're aiming towards like the eye, and so you're gonna feel your maxillary sinus is right here. And so if you have a one inch needle and you aim towards your eye, you're gonna go up and you're gonna hit the underside of the maxillary sinus.

So then as you, you're slowly injecting on your way up, but then once you hit it, then you deposit your fluid. When you're depositing your fluid, you're pressurizing the syringe cuz there's gas in the syringe. And so you're pressurizing the syringe syringe and you're gonna watch, and then all of a sudden the fluid is gonna come out.

That fluid is hitting the maxillary sinus. It's, it's your, your periosteal. There's two techniques. There's one technique where you go and touch the bone. There's another technique where you're in the subcutaneous tissue. The reason I don't do the one in the subcutaneous tissue you could, is that there's a lot of blood flow and hypothetically, that needle could be in a blood vessel and then you don't know where it is.

And if you're injecting gas, you could get. Embolism. So then what I do is I go, periosteal, I'll touch the bone, I'll inject my lidocaine there, and then I'll very slowly inject the gas. They will feel very full, and then their, uh, mouth from midline all the way back goes totally numb. And then like your, this lip is 100% numb from that.

And we use like 2% proto propane or 2% lidocaine. Um, so then, um, but then that ozone gas is spread in the connective tissues all the way through there. And, and those on gas spreads, and especially if you're periosteal, it's gonna spread all the way back through there. Um, as a, I'm kind of embarrassed by the question that I haven't been doing it more often because it's like one of the greatest things that I've ever learned.

And back when I didn't have a lot of techniques, I helped a lot of people with sinus stuff. And so then now thinking about covid and everything like that, that is kind of an amazing idea to just, to keep in the back of your mind as a as, as a thing to do. And I think that if you touch periosteal and you do it that way, I think it's very safe and I think it's a super home run.

And then by getting, interestingly, like I had a guy who was here today who had, uh, who said, uh, first of all, he, first of all, uh, he went to get p r P and then they, um, the, this is crazy, but they screwed up and they gave him somebody else's P r p. Which goes to show you I just totally o c d and about sterility all the time.

But it was like, and we label everything and we triple check and, but it was interesting cuz that it basically turned into affection and his entire body just left it out and they debrided it and he had to close by intention. So it's, it's, uh, it's catastrophically important to pay attention to sterility and stuff like that.

But interestingly, the, he had these areas where basically he kept chronically getting in infections in there and herpes outbreaks. And I have had a whole and pilonidal abscesses and stuff like that and I've had a whole bunch of people where I start injecting subcutaneous ozone in an area where they'll have like pilonidal abscesses and stuff like that.

And then eventually that ozone is forming lipid peroxides with the fat in that area. And then what will eventually happen is, They won't get abscesses anymore. And I have done this like a lot of times. Um, and I basically never had it not be like really helpful, which is kind of crazy cuz I always thought of that as like a problem that I had no, a ability to weigh in on.

And I used to do anesthesia all the time for people who would, um, uh, I used to do general anesthesia and we would do these huge surgeries with flaps and stuff like that. And now I just inject ozone in there. And most of the people that I see, almost everybody gets a lot better. Interestingly, derivative of that experience.

If you can inject ozone and get ozone into this connective tissue, then it might, it, it, it stands to reason that then, uh, they're less likely to be able to have an entrenched biofilm. You're not in the sinus, you're around the sinus because you're touching. The outside of the sinus, cuz the sinus is like, like this.

And you're on, you're touching here. Okay. But the, the ti the, there's an opening into that sinus and the ozone gas is gonna spread all the way around the tissues and around the tissue where that opening is. And so, I, I think that that's a, a fantastic question and a fantastic, uh, thing to learn. If you ever come here, I'll show you how to do it, or if you take the advanced course with Shellenberger and then you can learn how to do that as well.

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It's gonna be amazing. There was a question about methylene blue and um, the interstitial cystitis treatment, and it's interesting. Th that's like super off label, but we, we've, we got someone to count, compound some methylene blue for us, sterly, and then we were able to, to use that iv. I remember when I was.

In the working, in the operating room, we used to always do, uh, like a sentinel lymph node biopsy where they would, they would inject methylene blue and when they were doing like, uh, lymph node dissections and stuff like that for, uh, uh, breast cancer. So, um, I know that there are ways to get methylene blue.

Um, this pro I'm giving you this is just like grab bag, crazy sounding stuff. Um, and when somebody told me this, I did think that it was the craziest thing that I'd ever heard of. Um, but there's this protocol, um, uh, uh, that I learned at a meeting where basically you take methylene blue. Then you put it on an IV and it's, it's like a, if if, if you have a sterile version of it, it's okay.

You put the, you put it, and, and I'm gonna find the, the dose that we used and put it on here. But then what you do is you put an iv, it's gonna get filtered through your kidneys and go into your bladder. And then what you, we, we got this guy makes these lights and then the lights go over, um, the, um, the bladder.

And then you can also put it kind of a little bit like in between the legs. And, um, and, and so I figured this out and then I never do it because I always have my nurses do it because it's women. Um, and, and then interestingly, I had like, Three people in the and and then it is kinda like you'll get a little cycle.

So you'll get a, a group of people that come through. W