Dr. Cook Roundtable Q&A Series: Latest Strategies for Using NAD+ to Treat a Range of Conditions

 The testing for entities is not, uh, not prime time yet. And so because of that, we're, uh, we're evaluating, uh, clinically to get a sense of, um, uh, how people are doing. 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. Cook, where he hosts weekly calls with doctors. Okay, so today's gonna be a great day. We're gonna talk about, uh, we'll go through like a nice little conversation on any d um, the, um, I got a question. This is, it is interesting.

I got a question like, uh, have you had any experience of a favor bowel outcome with any D I V treating a ls? Um, I LS as is I think catastrophically difficult, uh, to, to deal with. And interestingly, like all of these neurocognitive neurodegenerative problems, there's a spectrum of ALS patients. And so there are some that get als that, uh, uh, basically, uh, it has a very aggressive, uh, course and, uh, those patients can decompensate fairly quickly.

Um, and other people will come on more slowly and there's a whole host of different, uh, manifestations of of, of how it presents. Uh, and I, I've had, uh, I've been working with a patients with a l s for, for many years. I haven't found anything that I feel like is dramatically helpful. Um, I think that there's a, a logic for, for, for doing N A D and I've, uh, done n A D and I know patients that have a l s that have done some infusions of N N A D and gotten, uh, what they felt like was some benefit.

I know people who've done the PK protocol. I know, uh, people who have done regenerative medicine, um, and. My, my sense of ALS is that it's managing a very difficult time course. And, and all, all of the experiments that, uh, are in the category, the treat als, I think are experimental. And then unfortunately, I don't know anyone who is, who's really cracked the code and is making profound and, and, um, meaningful changes in aals.

That being said, I, I still think that it's a, uh, it's, we, we still have to do everything we can to take care of those patients, but there's not a, um, there's no, there's no great answer for that. And I think that, um, I think that ultimately the solution to that is gonna be like the solution to many of these things we were talking about, Ms.

Uh, last week. And I think it's that, uh, there's gonna be a case to be made for peptides, for regenerative medicine, for, uh, a functional medicine approach that is underlying it to try to assess what, once again, are any of the obvious things that we've talked about, mold, infection, Lyme disease, or any of those things present or not present.

If they're not, then great, we don't have to worry about that. If they are, then we have to start our way through kind of a, a logical process of dealing with that. And so, you know, with that in mind, I think that there are, are, uh, many, many modalities that may be helpful, but I think it's also, uh, important, uh, to, to not.

Meet somebody with a new diagnosis of als and then, uh, to give them the impression that, oh, uh, this, this is probably gonna be really helpful for you and, uh, cure things. Because a lot of times I find that people are, um, uh, have been maybe too, uh, maybe had more hope for therapy to be transformative than, than it had to be.

And, and I think that a l s is the most difficult, uh, condition to treat that I'm aware of. So with, with that in mind, that's, um, that's kinda my thought on that. And if you wanted me to talk more about als, I'd be, I'd be, um, happy to do that. Uh, just put a question in your chat box. Dr. Cook, it was just submitted.

I, I have not. So do you wanna read the question? Have you used n e d to treat mal requirement syndrome? I have not treated that condition. Um, so then, uh, so then it's, it's interesting. So n e d is this interesting, um, molecule. It's a, it's a, I think of it as a, as a signaling molecule. And it's a signaling molecule that relates to our, uh, Energy stores in our body.

And so, as long as our n e D levels are high a signal that energy stores are good, I, I kind of like to say that economic indicators are good. Uh, and if energy is good, then that means we can do things. And so if N E D is high, we tend to drive D N a repair. We tend to drive detox pathways. And, uh, it's a driver, uh, for oxidative phosphorylation in the mitochondria.

Uh, and then it drives, uh, physiological processes in the cell. And there are, um, we, when we went to medical school, we haven't had a good test and we still don't have a good test for N E D levels. Um, partly because it's, it's quite unstable. And so if you want to, uh, if you want to test n e d uh, levels in plasma, What happens is, is the, in, in the current algorithm, what people do is they, uh, stick a needle, draw blood, uh, put that blood in a cooled centrifuge.

And so the cooled centrifuge, and I actually have one of these just because I have been wanting to get into doing this, um, and I'm still not doing it, and I'll tell you why I'm not doing it. But basically, you put it into the cooled centrifuge, spin it, get the plasma, and then freeze it. And then the logic is that, uh, they take that, uh, uh, frozen plasma and then, uh, take a whole bunch of samples and then they run them together to to, to test.

Um, my understanding from talking to the PhDs that I work with is, is that, um, the, uh, they have very good. Within a test, uh, validation, but then test to test level. They've been having challenges in validation. And the, the testing thing for N A D levels is, has been done by research labs, but, uh, there have been challenges because of the low stability, uh, of it in, in reproducing levels.

And so that, uh, we're, we're, we're clinically assessing, uh, how people are. And then, uh, BA based upon that, uh, when to use any D So the testing is basically, the moral of the story is the testing for entities is not, uh, not prime time yet. And so because of that, we're, uh, we're evaluating, uh, clinically, uh, To get a sense of, um, uh, how people are doing.

And so then it's great because, uh, uh, this week, uh, is a, uh, a great week because this is kind of an addiction week for us. And so, uh, I've got, uh, a number of people, uh, who have had addiction, uh, issues for quite some time who are here, and were running them through our protocol. Uh, so remember I said, and any d is this signaling molecule.

Uh, as long as the levels are high, the concept is, is that we can do all the things we need to do. We can run our detox pathways and, uh, uh, make energy and, and, and repair our d n A and do what we have to do. Um, what, uh, what happens is, is if someone has been drinking very large amounts of alcohol, Then, uh, there's, the, the theory is, is that two molecules of n e d are lost for every molecule of alcohol that's broken down by alcohol dehydrogenase.

So alcohol dehydrogenase, uh, breaking down alcohol is an, is a metabolically expensive project in the body. And so since it's a metabolically expensive project, uh, we need to donate energy to facilitate that reaction. And N a D donates that energy. But then what, what happens is, is as, as, uh, then, uh, some of that n a d that is in the n A D stores that was gonna be used to make more energy ends up being utilized to break down alcohol and, um, That's also the case with opioids.

And uh, and so then what we will do is we will, uh, do a 10 day protocol where we, uh, do an infusion every day for 10 days, take the weekend off. So we do a Monday to Friday, take a couple days off, and then do a Monday to Friday rotation again, where we're giving any d every day. Now, um, the experience is quite interesting with, with, um, alcohol I think is potentially one of the better experiences with N E D that there, that exists on the planet, I think, and that's because as, as you start to give people the n e d typically somewhat, somewhere between day one and day three or four, all of a sudden people kind of like.

Wake up and then start to interact more and people are like, oh my God, I feel like I'm alive again. It's really, it's really super interesting and what people will tell me is the cravings start to go down. Uh, and so it's been a, uh, a super great experience for us. Uh, remember I said that you can do n a d subq, you can do it iv, uh, you can do creams that you can rub on, uh, you can do patches.

Um, and so then there's a, uh, and then you can do the nasal spray. The, the issue is, is for, for the addiction space, and there's been more of a history and more of a long-term use with n a D in addiction than in any other space in medicine. Uh, and so, uh, so we, we do the IV form in addiction. And the reason is, is because we're pushing to get to a dose that is high enough.

And so then what dose am I talking about? I'm on, on addiction. I'm gonna try to get to 750 to a thousand milligrams a day. Uh, if, if somebody has an a, an extensive and long-term history of addiction. So then you say, uh, how long does that take? And it's interesting, it takes somewhere between, um, Somewhere between three and, and, uh, three and six or eight to 10 hours.

I, I still remember the, and, and what happens when you give any div people get a flushing and a histamine reaction. And interestingly, I think that it, that there's a, an a component of the flushing that relates to your methyl status. And I'm gonna explain that in a second. Uh, but there's a component that also relates to your detox status.

And, uh, and so then in my, in my old life, which was super interesting, I was an anesthesiologist and so I was breathing inhalational anesthetics like every day for quite a bit because. Every time you take a patient to the recovery room, you're breath, they're breathing sibo, florine on you the whole time is super interesting.

But, um, so I, I remember I, and I was kind of worried about the money myself cuz I didn't have any money. And so I, uh, I said, well, let's do this. Let's do N A d and I, I still remember it to this day because I, I put an IV in and I gave it to myself and I put a thousand milligrams in the bag and I said, let's do this.

And it was, um, it was like three o'clock in the afternoon and I finished that IV at about two 30 in the morning. Um, and so then it, what, what that shows you is that I was fairly, I think I was fairly toxic and my methyl status was probably not that good because it was, that was a long time ago and I hadn't done a lot of this stuff.

And so if I sped it up, I got. Overwhelmingly intense histamine, uh, type of reaction and that histamine reaction. Sometimes people feel it in the heart, sometimes they feel it in the diaphragm, sometimes they feel it in the abdomen, and then sometimes they feel it in the pelvis. I, if they're walking around, you'll feel it in their muscles.

And then sometimes people can feel it in their head. And then almost every time when somebody does the id, um, uh, you'll feel it in your sinus. And when you feel out your sinus, you'll often sneeze a couple times, and then that will go away after about 15 minutes. But some people will have sinus, uh, sinus congestion and symptoms for maybe like the whole length of the IV that day.

Any of those feelings. Almost immediately, within five minutes go away once you stop the iv. Uh, I, the reason I say all of this is because it's useful to memorize and know all of those, uh, symptoms if you're, uh, treating someone just so that you can talk your way through, uh, and, and help talk, talk people through those symptoms.

Uh, the, I, I, um, did this podcast with Joe Mercola and as part of doing the podcast, it was awesome. He sent me a podcast that he had done like the day before, cuz he was doing this mitochondrial thing with, uh, Dr. Sinclair from Harvard, who's a total genius. And I super respect him. And I don't know him, but I do wanna talk to him as soon as I can.

Um, But I was listening to him and he was talking about the methyl cycle, and he was talking about the fact that he takes fairly significant doses of his supplements. But then when he looked at the methyl cycle, he realized that, um, uh, as you shuttle through the methyl cycle and, and through the, the n a d salvage pathway, having methyl donors is helpful.

And so then I looked at all of that, and then I realized, I wonder what would happen if you gave someone methyl support when they did the N A D I V. And so then I started giving people trimethylglycine. And that was just kind of a, a wild shot in the dark just because it's the, the, it's a methyl donor that I think is the easiest, the most easily tolerated methyl donor.

That doesn't seem to have much in the way of side effects. And so I. I, uh, started giving people trimethylglycine before any divs. And what I found is, is that the, the severity of the flushing reactions that people get when they do an N A D I V went down by more than 50%. For some people it totally went away and other people still had some flushing.

And so then that's an interesting data point. Uh, what's happened is I've done just, you know, whatever field you're in, you're gonna do a lot of, so if you're a plastic surgeon, they all have like, way too much plastic surgery. So I've probably given myself too much N a D, but, and I, I, I'm gonna, I joke, but then I'm gonna tell you my thoughts about that as well.

But, um, interestingly, as time went on and I did it more, What happens is that, that that flushing reaction seems to kind of fade. And so on a scale from one to 10 of getting flushing with n e d now, it, to me it's like a one, like I, I kind of barely feel it. And I've generally noticed that over time, that, uh, people, uh, have less symptoms.

And I've also noticed over time that a lot of the people that I have seen for some time do better and better and better, and they don't need as much of it. And I'll kind of talk you through, through that part. The, and, and interestingly, I, I feel that that flushing has a vascular component cuz when you feel it in your chest, it's almost like you feel it, uh, in your, in your heart.

Um, and then whatever, whatever, uh, the. Issue that people present with when they come to see you often gets exacerbated while you're doing an iv. So for example, we had been having this conversation about like, just what I just said. And then, um, I started to get, uh, some people with endometriosis and then they would feel the n a D flushing in the area where they, they would feel endometriosis pain.

And so then that's, that's uh, just an interesting sort of idea to, to, um, to be aware of. Um, there, somebody texted in, uh, Ken texted in, would, would an antihistamine help? That's a great idea. We, we should test that. I haven't tested that, but we've just done this methyl support. Um, that's a really, really very good idea.

So good job. Um, I'll test that tomorrow. Um,

so then, uh, other things, it's interesting if you do an IV ozone treatment, it turns out, um, it turns out that the flushing that you get, uh, with N A D is also about half. And so a lot of people, if you'll, if you give them IV ozone and you give them the mental support, they get the N A D and they like barely feel anything.

Someone asked the question of what can you combine, uh, with IV in terms of IVs? And so since we're on the topic of ozone, I often will combine n a D and ozone together because I, I think that they're quite synergistic. And the, one of the major philosophies that Dr. Shellenberger has forth is that, uh, N A D facilitates these oxidation reduction reactions and N a d, uh, and ozone will donate an electron and convert N A D H back into n a D plus.

And so the idea is that ozone increases your n a D levels, intracellularly. And that's because that electron gets shuttled into the cell, either by a lipid peroxide that was created when O three combined with a lipid or the O three dissolves into the cell and then converts any DH into any d plus. And so his idea is that increases the n d plus to any DH ratio, which intracellular intracellularly, the goal is for that ratio to be 700 to one.

Now, this is a hypothetical number that's based on some of the basic science, but, um, uh, I, I think that that's, that's the best, the best information going that, that we have right now. What, what I can tell you is I've had 40 or 50 people. Who I did IBO Ozone for, and I gave them n a d and they felt like they'd had like 10 cups of coffee.

Uh, in general, people just feel really good and feel like they have a sense of energy, but some people, basically the N A D is driving energy and then the ozones driving energy, and then together they're, they're, they have this very synergistic effect. What, what, uh, what then, uh, what, how do you manage that?

And then how I manage that basically is, uh, sort of this similar conversation to what we do all the time, which is start low, go slow, this Barry Shallenberger, uh, ask, take your time and then do, um, do one thing at a one or two things at a time and not, not give everything at the same time. Um, and so the question somebody wrote is, It doesn't make sense as O three is an oxidant.

So O three is an oxidant. Uh, what happens is in the body, it donates an electron when it donates an electron. So it, it has an oxidant effect on the body. Uh, the body responds by having an antioxidant response to the O three, but when it donates, its, its electron that electron does something. And the, the theory is that when it donates that electron, it converts n d hvac to n d plus.

So that's the, that's the, the concept. Um, so then, and so then our worldview on N E D, uh, was informed and comes from the experience of, of the addiction world. And so then within, within that space, uh, People would do a 10 day protocol. And Dr. Meier, uh, who, who's down, kind down kind of near New Orleans, um, uh, has has been doing, uh, any divs for people for I think 15 years or so.

And, uh, is, I'm super grateful to him and to the work that he has done. And, and, and, uh, I have spoken to many people that he has treated. And, and he is, he has really helped to inform and shape the educational experience for people, um, who in, in this space. And it's, I I think it's been, it's been really, really, uh, wonderful.

His. His contribution to, to science in this regard. The, um, the experience that they had there, and I got this from talking to him and his wife, uh, who's also great. And the, the experience was that they would do, uh, the N A D I V and a lot of times what would happen is, is they in the addiction side and they would do the 10 day period and they said people would do great, but then all of a sudden it was like they went off a cliff and two months later, or three months later or six months later, it would be like, it, it never, they never happened.

And then they would come back into their clinic and they would do an N A D iv and then generally in one or two days they would get back to where they had been at 10 days. And so what, uh, when I first learned about n e D, the idea was well just do the 10 day protocol for addiction and then see how they do.

And then whenever things start to get a little sketchy, then just have 'em come in for booster. And the idea would be, uh, if they came in for a booster in three months, then uh, what you would do is then have 'em come back another three months for their booster. What we evolved into doing is we evolved into doing a 10 day protocol and then doing boosters sooner to try to prevent people from having problems.

And what I immediately started doing is, uh, doing subcutaneous n a d where you take a vial. And so the n a D that comes in the subcutaneous form is 200 milligrams per mil. And so, Remember on the IV side, on the addiction side, we're trying to get to 750 milligrams. And so 200 milligrams is a lot less than 750 milligrams.

And so, uh, but still you don't have to have an iv and it's super easy and it takes about 10 seconds to do. So that's, I think, positive and, uh, uh, a good experience. And so we, we started doing this and I've, I've got about four or five different algorithms that I use for the, for the subcutaneous, a e d, and addiction.

And, uh, for a lot of people when they leave here after the 10 day protocol, I'll have them do one, um, one. Subcu a month, a a week. And so then they're just doing a, a treatment once a week. Uh, I'll have some people who will do it, um, uh, a couple times a week. And then for people who've had fairly sustained addiction, things that have been going on, I'll, I'll will have them do it three or four or five days a week for the first month to just kind of get them, get them through that moment.

The, it's, it's a lot of n e d on the one hand. Uh, but on the other hand, what I found is if I am willing to escalate up my frequency of dosing, uh, in that first month, I, I feel that I keep symptoms and cravings low. And when I do that, uh, it's like I talked to one guy, this really nice conversation with him and he was like, you know, I'm, I'm doing great.

I'm. Talking to my sober living person. But he goes, if I'm honest with you, I'm still trying to figure out every single day how I can sneak up and get a drink. And, uh, and, and I think that the biochemistry of resetting with the n e d is, is super helpful. Uh, on that front. When people come in for that. I will often do some ozone, uh, combined with it.

Uh, and outta that 10 days, I might do that, uh, two, two or three times. But I won't do that every day because I don't want to do too much ozone. And, uh, but I do find that, uh, that's very helpful. Uh, in, in the addiction space, I will generally give vitamin C, uh, B complex B12 and magnesium every single day that they do their addiction IVs.

And I find that, I find that. Uh, when I do that, um, people do better. So I'm giving an antioxidant, I'm giving magnesium mag. Everybody generally feels magnes better with magnesium. It relaxes the blood vessels. A lot of these people have headaches and a lot of times the magnesium will help with that and, uh, it relaxes the blood vessels.

Uh, and I've noticed that when I do that, that also makes NA d go better than if I don't give the vitamin C and all that stuff together. And so a hundred percent of the time I bundle in all of those IVs with the N A D and I don't charge anymore for it. Um, the next thing is, is that, uh, glutathione is a great antioxidant, uh, for patients with liver issues.

Glu glutathione's an important antioxidant in the liver. And I, uh, have, have noticed that it can be extremely helpful for many patients. I've also noticed that, that some patients can have quite a bit of trouble with glutathione and uh, and sometimes I think that's a, because they can't, uh, deal with, uh, sulfur compounds.

And when that happens, uh, uh, that can be a challenge. Sometimes people are low in molybdenum, and so we have molybdenum and if, if, uh, we give glutathione, a lot of times people will, uh, uh, people will, uh, will give them, uh, some sublingual molybdenum and they'll absorb that, and then those symptoms will go away.

And so then obviously I evolved to, every time we give people IV glutathione, then I, I give them the sublingual binum before we give it to 'em. Now, then the next thing on detox, you know, and it is interesting. Glutathione, any d can trigger detox. And then the, the other thing that can trigger detox reactions is, um, glutathione.

And so I re, I, I had, um, one person who just about, I felt like it was gonna code on me, uh, when I, when I gave them glutathione. And it's interesting because the, uh, the traditional conversation, and I think it was be before people basically knew how to use anterior cast, is that they would put a butterfly needle in and then do a myers cocktail push and then they would do a push of glutathione.

And I super strongly recommend that nobody does that. Uh, primarily because I have. Like 20 or 30 people who I just super love as patients that got IVs where they got that genre of IV and it, it, it, it led to a bunch of, uh, basically like thickening and ca and clotting of their veins. And so that their va, all of their veins are totally scarred up.

Uh, if you make isotonic solutions of vitamin C and these things, and I can coach you in how to do that, but uh, that never happens. And so I think that that's like a crucial, crucial thing to be aware of. Uh, the next thing is, is that glutathione is interesting. It can cause a hell of a detox reaction. And if I go back to myself, I remember the next thing I learned about glutathione.

I was like, let's do this. And I gave it to myself and I thought I was gonna die. It was like, it was crazy. And so then I had to back way off and start to give myself super low doses of glutathione. And so I would give like, uh, and so glutathione is also 200 milligrams per mil. And so if, if I, if somebody walks in and it seems like they don't have any problems, then I'll, what I do is I give one three ccs of glutathione, which is 600 milligrams, which is kind of a standard dose.

And then I will ask the nurses to hang that and drip it really slow for like 15 minutes. And so what I'm getting out of that, and Virginia Osborne is one of my mentors who I found who be very influential and she teaches IV therapy courses. And I think her and Dr. Anderson are, are probably two of the smartest, um, smartest IV therapy educators in, in the world today.

And I, I have, I give them by far my highest recommendation. And it is interesting cuz even they talked about, I, I was, I went just to see what was happening to one of their courses and right away they said, oh yeah, we used to always do IV glutathione as pushes, but now we always put it in a hundred cc bag.

And we've noticed we people do a lot better with that. So that, that's, these, these are little, like little pearls that I don't know if they're helpful, but I found, I, I wish that somebody would've told me a bunch of this stuff five years ago. Um, so then, uh, so then to answer the question on N E D. A hundred percent of the time when I give N A D I will do combinations of vitamin C and magnesium and B complex as, as one thing, and then follow that up with n a d.

The you can combine and, and they seem to combine very well, uh, B vitamins and magnesium and vitamin C. Glutathione doesn't like to be combined with those. So I never do glutathione in the same bag as those other things. And I always do glutathione last, and then n e d uh, is unstable. And so we never do glutathione with all of those things either.

Um, that being said, I, you know, I've talked to Virginia and I've talked to some of these people well, um, and they'll say, oh, if somebody's, sometimes we'll just put maybe half a CC or one cc i e. Let's say 50 or a hundred or 200 milligrams in like a Myers cocktail bag. There are some people who do that. Um, the teaching from Dr.

Mattea is strongly to not do that. And so I have not done that, but I know that there are some people who will combine the, combine, the n a d with other vitamins. But my, my experience has been to keep it separate and I've done very well. And, uh, that's been my, my practice is to, to keep them separated and then sort of to thematically work our way through that.

The, um, the one. One knock on n a d is that it? It may drive senescence, uh, cellular senescence, which, which is, uh, cells that are taking up space in our body, uh, but um, have become dysfunctional, are not doing something. My analogy is they're taking up a room in the office, but they're not, they're, they're not part participating.

Um, and so then there is an idea of if you're gonna do ad then to combine something that is, uh, a lytic with that. And so then, uh, my favorite thing in that category is, is quent. And so we'll always combine quercetin, uh, uh, with n e d. And if you're doing that orally, I think you can probably go up to, um, go up to, you know, uh, Very easily a gram, but even potentially you can go to high dose, particularly if you're not doing any d that frequently.

Um, maybe one or two grams. And, um, and, and we, we've had a good experience with that and our experiences is that when you, when you combine, uh, quercetin with a a d people, I, people generally will feel better. And I think it's just a more harmonious way to do it. And then we will, uh, we've, we've got a bunch of different algorithm things that we do.

Uh, I, if I do it, if, uh, I, I have it around, which I usually do, we have Sammy, and if you take Sammy with n e d, it makes this either the Sam. Works better or the n a d works better. I think they're both working better. SAM e is part of that methyl cycle you're driving and if you take the TMG and Sam E and N a D, that's probably the most energy that I've ever felt in my life.

Um, so that was, I mean, I felt like an incredible amount of energy when I did that. Um, now that being said, people who are fragile, whose energy pathways are not, uh, fully dialed in, you don't want to give them that charge because they probably can handle, and a lot of times they'll feel a little shaky and fragile with that, whereas if you've kind of worked everything out, probably is gonna be fine.

Uh, another thing is interestingly, When you inject the N A D subq, uh, it can burn and then some patients, 10%, 5% will, will have a fairly significant detox reaction when they inject N A D subq. And, but they'll be totally fine when you give N A D iv. And I have a theory that those patients are somehow inflammatory in their fat and their fat's a little toxic.

And I haven't really noticed it to be related to actually how big they are. And so I've seen some people who are pretty skinny and then I'll do, or, or normal, and we'll do the, uh, will do the N A D. Subq, and then they'll have this real detox reaction, or they'll have a lot of pain at the injection site.

Um, it turns out, I think I was one of those people when I did N e d subq at the beginning, I thought, I have made it to the Promised Land. This is gonna be the greatest, um, N a D subq, and I did it, and it, it, it, I was like really uncomfortable for like four or five hours every time I did it. And then I think I, I did it about 20 or 30 times, and then next thing you know, um, it, uh, it went away.

And so now it doesn't feel like anything now, as I was saying now. But what I've noticed also is, is that, When you start to do the N A D subq, it seems to reset these energy pathways. And then once you've done it a while, I notice you don't really need to do it anymore. And so the only time I do it is if we have like expired BS, and then I just will use, kind of use 'em up.

Um, and then it's kind of interesting for me to ex experiment around with that. What my, what my idea is, is that if you're gonna do it, I'd like to use N A D to drive some physiological processes. And I'm thinking, I'm, I'm trying to think, uh, who am I dealing with and what am I dealing with? I'm d am I dealing, I'm on an infection pat, uh, a detox, a wellness, an addiction.

So I'm kind of looking in into what's happening with those people and I'm trying to drive that. And then step back and then try something else. And so then one, one thing that we've played around with on the peptide side is doing, uh, doing N E D and then taking a break from that and doing five amino one mq.

Uh, and then taking a break from that and then doing, going back to N A D, so cycling through that pathway. Um, the, you know, I talked to Dr. Seeds in some detail who I think is the smartest person on peptides that's on the, on the planet right now. Like, kind of like by far, which is, which is awesome to talk to him.

Um, and so then he is a little bit against n d because he's trying, he, and, and, uh, and I think what I'm gonna have him on the podcast and we're gonna go through that conversation back and forth, which I think is gonna be really good. Um, uh, but, and, and so he's using more of the peptides, but even when he's driving the mi the mitochondria with peptides, he's doing that and then stopping.

And so I think that this is a crucial fact to consider, and we're putting this up and so I'm, I'm rehashing some concepts that I may have mentioned to you before, but they, they're probably worth hearing again, but that means I'm, I'm not suggesting that any d is the, this energy panacea that you might do for five years in a row.

To me, it's an, it's an idea that I'm using to kind of try to restart a detox pathway, for example, and then I'll, or an energy pathway, and then I'll do that and then step back and stop, or then I'll stop it and then try to do something else and then try to, Try to get things going and then see how they do.

Basically what I almost always find is, is that the frequency that people need to do, it starts to go down because people start to get more energy and feel better. And, and so then that's, uh, I think a quite positive, um, experience. The question, um, the question about the subq also is, uh, you have to think about if I was doing an iv, then what's happening is it's dripping in and I can see the drip rate.

If I get too much of a histamine reaction, then um, I just turn the IV off and that his, that reaction, whatever it is, will start to go away. Um, In, in like 30 to 60 seconds. If you do, uh, I'm not sure who's unmuted.

Thanks. If you do the subq, you're committed to whatever you've put in. And so I, uh, I kind of quickly try to get a sense of where people are and I will have people start with 50 milligrams and almost nobody flares with that. Then I'll have 'em work their way up to a hundred to 150 to 200, and the sweet spot where most people feel the best is somewhere between a hundred and 150 milligrams.

For people who are on the addiction side that find that any d is really helpful for them, I have people where I will, that will do 200 milligrams and wait two or three hours and then do another 200 milligrams on the other side of their abdomen. And so then they've gotten 400 milligrams. And what that does is that just keeps them at a dose where they, they they're, it's, they've got enough, they're getting some number that's close to what they would've gotten if they gotten an iv.

And so this, this has been a good experience for me because obviously, uh, like I have some people that I just saw who, uh, basically, um, it was, it's hard to come in every day for the detox protocol, yet they're dealing with addiction, but they're also trying to go to work. And so then we're, we're using this as a 10 day protocol, but then, uh, if they can't come in, we'll give them sub Q N A D and have them do that on the days when they can't come in.

Uh, the. For, for the addiction protocol. I think the, the update that's kind of interesting is to then think about peptides because I think the, we've had a really positive experience working with and supporting patients with peptides, uh, in this experience. And the, in, in broad terms, what I'll say is I try to get a sense of is there a major immune infection problem or not?

If, if there is, then a lot of times we will get people taking thymosin alpha one, uh, and I'll find that that really starts to modulate and calm down the immune system. And then we'll use that to support people while they're, they're going through the, the protocol. Uh, if they're more in a, uh, pain. Pain just kind of difficult situation.

Often we'll use, uh, thymosin beta four and BPC 1 57 and, and we'll also, uh, depending on what's going on GI wise, often give, uh, them oral BPC 1 57 through, um, uh, through that. So then I got a, from Billy, uh, in my soft experimentation of n equals one, I found the histamines did not help me. And I've talked to a whole bunch of people who told me that the hi histamines didn't really help 'em, but at the antihistamine medications, but that the methyl donors did.

And so I, and so that's why I, I, I talked to so many people that told me that the, that you didn't get any benefit from taking antihistamines. That I, I, I've just never tried it. What I can tell you is that, uh, There are some people who take Sammy and it's the greatest thing that ever happened to him. And then there's another group of people that take Sammy and they do not feel good.

And it sort of is, is too much and it's, it is too much of a driver. And so, uh, and, and then like I told you, I've never done cocaine, but I, when I did N A D and Sam, E and T M G, I felt like I, I must have done something. It was crazy. Um, and so that being said, uh, be super careful with the C M E as you support people.

Uh, going through that. Uh, we've mentioned this, but just since this is kind of a good little mini D thing, remember that people with, um, LY and chronic infections and mold. Often n a d will try drive detox pathways and, and I think this may be especially true with mold. Some of those people can get really sick and start to decompensate.

Um, if, if you give them too much n a d and 200 milligrams of N A D is often too much in that population. So then you begin to see there's this bimodal. This is a trimodal response, which is the addiction people, the Lyme and complex illness and well people and then the wellness, people in the middle, wellness people in the middle.

Generally, you can kind of do whatever you want. Addiction people, you can almost do whatever you want unless they're addiction and super sick. Usually they're not super sick if they were recently drinking much unless they hit the end of the road. And it was kind of a, a crash landing. Um, uh, for the wellness front, a lot of times we'll have people do two or three days.

A lot of times I'll have people do one or two days of IVs before a big injection, and I've had a a great experience with that. A lot of times I'll have, a lot of times I'll have people who will say, oh, I've been in this chronic viral mold, kind of just dysfunctional episode in my life and with, with brain fog and difficulty concentration and difficulty getting stuff like that.

Done Work, work done. Uh, the, my, um, a friend of mine, uh, Martin from Upgrade Labs, I think it was him came up with the idea for a name of, uh, the subq injection and he called it the Best Day ever. That was what they called, uh, that IV at Upgrade Labs. And uh, and so it kind of is the best day ever and I have had a ton of people who were, whose lives were just not happening and it wasn't working.

And we got them to do a little bit of a sub Q and A D and it really boosted things and kind of brought things back online. And then that success was enough to begin to let everything else work. And that is, I think, a good way to, to think about it. It is a, it is a, it is a rebooting kind of strategy, but it's not a, um, it's not a permanent and super long term.

And then I'm actively and continuously looking for other things to cycle in, uh, as modules and alternatives to it so that you build this robust, uh, approach to helping people, uh, cycle through with energy. The question I got a question about, can you do any D with vitamin C? So the answer yes. Now what um, we will do is give people a fairly significant dose of vitamin C, five or 10 grams, and then we, after we do that, then, then they'll, they'll move through the, the n d experience.

And I've done that. Thousands and thousands of times with with good results. Uh, with, with good results. So then that's been, uh, positive.

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Or at our website, www biore reset medical dotcom. It's going to be amazing. So then there's a question medi, apparently somebody said, the Meier said, uh, 250 milligrams each day in two days is better than 500 milligrams in one day. Um,

and then he says to mix a 500 milligram, 500 cc bag and refrigerate half of it for the next day. So I would never do that. So I never, I, this, I don't know. I just, here's the thing. We had all of these rules that just came from, like the experience in the hospital. And so then, and so any time anything was spiked, It, it, it, the sun couldn't rise and set on that product.

And so it's kind of like, you know, you can't let the sun rise and set on a bowel obstruction. And so if I, if I spike, if there's, if there's anything in my office right now that's open, there's a 100% chance that that's gonna be thrown away. At the end of the day, I don't care what it's, and so then that is just my approach.

Um, if you have a, a vial from Archway, I'm fine with just taking half of it up, uh, and then putting it in a bag and then taking the other half the next day. I think that that's, that's reasonable, but I never will make a bag and let that bag sit overnight. Um, and then that, that's just comes from the sort of sterility rules that come from a hospital.

And I guess I just still follow those rules and it may be. That if you told me that there are an organization that said that would be okay, that would be fine. But I still probably wouldn't do it. And I just kind of obsessed, I obsess about sterility more than kind of anybody that I've met up until now in this space, just because I came from a world of a lot of stability, sterility.

And so I try to bring that here because I think that the more that we do to promote, uh, sterility and, and lack of complications, I think the better. Um, the, the, the question is N M N or nr, uh, does that, uh, is that helpful? Uh, uh, before or after? Uh, So Chris Shade talk and Chris Shade of all of the geniuses about n e D in the world may be is the top.

He may be like, I super love, there's almost nothing, there's almost nobody I would rather listen to than him like 24 hours a day. He's just totally the greatest. And, uh, I, and, and so I, and, and I have considered him a mentor for many, many years. Uh, he, he makes a product that has nmn that is, that is driving the methyl cycle.

And he put TMG in it, I think intelligently. And I love that product. And what I can tell you is, is that, uh, it's a sublingual pump and I have, um, I have, uh, it in my office, and then I have it at my house. And this is just me whenever I remember to do it, I do it. Which, and which means that I do it about three days a week, but when I do it, I feel totally, I, I feel like it does something like I, I feel more energy and I'll feel, I feel really good with no side effects whatsoever.

And so I think that, that, I think that his product, and I think that that product is by far the best n e d energy product that there is. And I feel it now. I like the concept of nr. Like I, like, I definitely like the concept of it. Um, and if, if you gave it to me for free, I would definitely take it. Um, I've probably talked to like 800 people who told me that they take it.

And, but they always say, I take it, but I don't feel anything. And, and, and so what I would like to do is to try to dig into physiologically how much of a benefit do you get from that? And then how, how is that affecting things? Um, that is a terrible answer. I'm gonna judge myself, but, uh, what, what I can tell you is, is I feel like the n a d gold, the n m n, you feel and you feel good and you tend to feel more energy.

And I haven't had that experience with the nr. Uh, but I, I do, I do still feel like scientifically it makes a lot of sense. I think it makes a ton of sense. And so we just have to. And I, what I wanna do is interestingly then start to dig into people who ha have low any d and see how helpful that was. Let, let's, let me give you an example.

What about addiction? I bet you that if you do nr, n m n and things in that, uh, in that category, you're gonna drive the salvage cycle, drive more optimal use of N E D and that, that may help prevent recidivism, uh, with addiction, which would be totally fantastic. And so, uh, what am I doing now? Everybody that comes in that's on the addiction side, I am starting them on.

Uh, n m n during the treatment, and then I'm keeping that going and they're just kind of staying on that permanently for a year. You know, I talked to somebody, I was like, how many times have you, have you, I talked to somebody recently, uh, and I said, oh, how many times have you relapsed in the last, um, six months?

And it was like three times. And apparently the data is that, it's, the average is seven times, which is fairly intense concept when you think about how, um, what an overwhelmingly stressful thing it is to fall off the wagon and all of the social and, and life consequences of that. Um, uh, now to go down the addiction road a little bit more then.

Interestingly, what else can you do to support people? And so, um, we're everybody, just about everybody that comes in on the addiction side, we're doing, uh, uh, ketamine treatment because it, uh, helps to reset your neurotransmitters and it drives, uh, turning off, uh, an m d a pathways which may be associated with depression.

People tell me, oh, I feel way less depressed when I'm doing ketamine. And so we will do a little bit of ketamine during the, during the, the, that two week period. And then 90, 90, 90 5% of the time, I'm also doing a Ella Ganglion block and resetting the experience of fight or flight. And stress. And, and you know, it's interesting when you think about addiction is I talked to somebody, I did, uh, a stellate ganglion block for yesterday, and the question was what, um, what caused everything and what caused everything was mom and dad were horrible alcoholics.

And so then there's no boundaries and there's sort of emotional chaos in the house. And so there's no ability to kind of just get a sense of a, um, a way to get your grounding in terms of just building relationships and having kind of a normal life. Um,

So then that's, so then that's, uh, super helpful. We've done a lot of work with neurofeedback and I think that's a, a great tool to use in, in that space. Uh, now real quick, before I go on, is there any, any, any questions about any de did, would, did I leave anything untouched about that?

Um, trying to think if I missed anything. Dr. Cook, you might wanna mention that we're hoping to, um, open up our NA group, our n a d certification class this summer, at the end of the summer in August. Oh yeah. So we're doing the certification course for, um, Archway, um, And I did a course, which was super fun, and then we did IVs on each other and we did subq injections and kind of got an opportunity to kind of learn all of this stuff.

And, um, I even, I think I even had some, a couple non practitioner patients who showed up to that class. And, um, so we're hopefully, and, and, you know, every, the whole world went to hell, um, with Covid obviously. And so, uh, so that was, um, a challenge. And so we're, we're getting back to the idea of starting to open up for our clinic's fully open, but we're getting back to the idea of, um, uh, running some, some courses.

And I think we are gonna try to do something in August. And so if we do, uh, Kristen will. Post it and we'll try to do a any de course soon. Um, now, now then, so then this is an interesting one. This is a super interesting one. Uh, Dr. Meier told me, and I v I vividly and viscerally remembered him telling me this.

And I think it maybe is because I grew, my father's a psychologist and so I grew up in a psychologist family. And what he told me is, and he's a psych, Dr. Meier is a psychiatrist who does N A D. And so he does all of these IVs. And he told me that there's no, there's no, uh, psychiatric condition that he has seen that didn't get benefit from n a d.

That's, that's a, uh, that's a big statement now. What I have to say is that's what I've seen. So I have, I have treated, uh, very peripherally, but like I had, uh, someone had a psychotic break and their family brought them in and I gave them an D and they got like, way better. I've treated, um, lots and lots and lots of people with anxiety and depression, and I think that n e d is not, um, a, a panacea or a be all, end all.

But I've, I've found it to be very helpful in those groups. Um, I have found, remember we were talking about the addiction experience and that we're doing ketamine. We see a lot of people with PTSD and. If you just kind of like dive into the N A D community, a lot of people who are in the N A D community will take care of patients with P T S D.

And my experience in talking to them is that they have a very, very good experience. And, uh, the reason I think that is, is that if you're driving, uh, improved mitochondrial function and then you're driving, uh, improved detoxification, then there's gonna be improved conscious clarity of consciousness and thinking and, and, uh, cognitive processing as a result.

And, and as that happens, people tend to feel better. And this is, this is kind of my theory on that, but, uh, we've had a, a very good experience helping people with the, the. Psychiatric psychological space. And I, I think that I would rather like walk a thousand miles. I would rather walk like 10,000 miles than take an antidepressant.

I've gotta say like, uh, and interesting. And, and this one is an interesting one. There's a, you know, a lot of interesting pharmacogenomics around how people respond to antidepressants. And I remember learning in medical school about antidepressants and it just seemed like it was not that big of a deal.

And, you know, you put people on all these medications and, um, what I can tell you is, is that I've got,

30 or 40 people that I have seen who came in on antidepressants, especially nortriptyline, um, sometimes on the serotonin drugs. And they've had a harder time getting off that than the worst opioid addict that I've ever seen in my life. And so, uh, I am, just because I don't see 'em very often, uh, I haven't totally perfected an approach and, and figured out exactly what to do.

Uh, and because it's such a, it's, I, it's, it's such an important. Physiological process. I think that what's gonna happen is you're gonna need to work in a whole bunch of categories to basically reset those people. And so you're gonna be doing peptides, peptides that have central nervous system effects, uh, combined with a lot of these other things.

But I've generally found to be n e d quite, uh, helpful and supportive to those patients. And then in general to broadly to the, the depression, anxiety, P T S D, uh, patients and so, and so that, um, and helping, I have had to say helping those people. Is honestly one of, totally one of the highlights of my life.

And, and we've, we've treated a lot of people, um, a lot of therapists, a lot of psychologists will come and find us and it's just like totally a pleasure to, uh, help them. Cuz I think of 'em as kind of like first responders in a way. Um, uh, helping people out in the field and especially at this moment with everything that's going on and culturally in our society is kind of, um, which I, I'm just gonna go on the record and say, I kind of think it's great because we needed change and so I, I am really standing for that.

Something amazing is gonna happen. That's gonna be good. Um, and that we are gonna have a more, a culture that's more supportive of everybody and that it's gonna be better. That's like, I'm going on record as saying that, that's my prayer. Um,

so then the, somebody made a comment about microdosing mushrooms. Um, interesting concept. I've heard a lot of people come and talk to me about this and I see a lot of people and with, uh, people have a, if people microdose and they do subcutaneous n a d in the same day, they tell me that they feel better and that the micro dose works better.

Also, what happens is you break down, uh, whatever, any substance you take, you will feel better when you take it, but it will also wear off quicker. Um, and then if you take any d the day after any, any substance, uh, hangover feelings are less and people feel better and just have less side effects. So that is a intriguing and interesting sort of area, and that's sort of, I guess you could say ridiculously and wildly off-label on the one hand.

And yet I think there's going to be a experience where all of that is coming to a theater near you soon. Because I think, you know, what I'm, I'm hearing is, is that, uh, that, uh, uh, SIL Sabin may be legal like in the next year. Uh, you, and there's these people in San Francisco that are doing, um, doing. Uh, M D M A, uh, also known as Ecstasy.

And I was at, uh, I was at this meeting, it was great, and I'll kind of finish on this, but this is a good one. Um, I was at this meeting and so they were, and obviously these are addiction people, and so, you know, it's hilarious to me. I, I am going to every meeting, or I'm, I'm at least going to every community cuz I wanna know what the hardcore addiction people think and I wanna know what the hardcore ed people think.

So then they were talking about, um, M D M A and apparently the people figured out right away when they started having people do M D M A, uh, that what it did is it gave you a fairly profound feeling of empathy. But then they were like, ah, that's, uh, That's a terrible name for a drug, so we gotta get a better name for this drug.

And so we're like, well, what are we gonna call it? And so they're like, oh, okay, we're gonna call it, um, ecstasy. And so it was a better name for a drug. And so then that was how, uh, M D M A got it's it's name. But, and as you kind of come into this, this space, it's, it's very useful. Uh, and I think informative to have an experience of, uh, talking to people because I learn, I can't tell you how much I learned from patients.

And I, I had a a, a patient last week that I did a Stella Gangland block for, and uh, he was like, yeah, I've been in fight or flight forever. And then I was like, well, what's been happening? Has anything, um, Helped. And he goes, I did a guided M D M A journey and it was the best thing that ever happened to me in my life.

And so I was like, wow. Um, and somebody says that to me essentially every week. Like one person will say that to me every single week. And so it's been a very interesting experience for me to kind of contextualize and think about that. And, and I am in, uh, some level of communication with the maps people, uh, who are doing a clinical trial, uh, and working with a lot of people in this space.

And, uh, how I, how I, uh, and then so since, since you brought this up, then I'm gonna try to put together my. Worldview of how I think to, to think about these things in a, in a, in a functional way. So when we're, and then I'll, I'll end with this, but I do think this is kind of sweet. So when we're kids, we, we have a, a fairly pure expression and sense of empathy.

And so I, I really, um, uh, get this from my nephews, like when you're, I'm around my nephews, they are just like, Pure, uh, the purest expression of love that I've seen up until now in the planet is amazing. And so, um, so then that, the empathy is amazing because it's like, oh, hi, how are you? We're gonna, and this, I remember how I felt when I, I met, uh, my first friend, Lee Beckner, and I said, Hey, do you wanna be friends?

And then we were like friends for 15 years. It was amazing. And, um, so then there's that, uh, the psilocybin and L s D are thought of in, in, in their communities as sort of consciousness openers. Uh, and, and so then what happens is, is people who are working with those substances are working kind of on opening consciousness with the idea of seeing potential and possibility in their life.

The. The often people who are using those substances will use, um, the M D M A, which is considered to be a hard opener to kind of open up. And then they will do, uh, then they will do, they'll, so they'll do that as a combination. And I'm not promoting or encouraging you in any way, shape or form to do this.

I'm just letting you know that this is out there and that people are doing that. And so then, uh, what will happen is many people will then do, uh, any d to start to improve, uh, metabolic functioning before they do those. And when they do that, typically they will have a lot less, uh, side effects and feel better, uh, afterwards.

Um, I, it's. It's fair. What what I think happens is, is in trauma often that there's a, that moment when you feel the pure acceptance and, and, and the, the, that naive childish, oh, we're gonna be friends forever. Kinda like that Beatles song. I'm in Love for the first time and Don't, you know It's gonna last.

And then all of a sudden it's like, oh, it may be that it was sarcastic that they said, don't you know it's gonna last cuz it's like, ah. And so then when it doesn't last, then it's like your heart's broken and then all of a sudden we swing from empathy to no empathy. Now obviously that happens to all of us.

And that's, that's a normal experience. But when that happens continuously from the time that you were one or two years old, because you're in a chaotically dysfunctional family, often those people were never taught or learned how to have any kind of normal relationship and then nor any normal patterning of boundaries.

And so, uh, we don't do anything like that here, and we're not going to be one of the clinics that does that. But, uh, there are a whole bunch of, uh, clinics that are gearing up to, uh, participate in the M D M A clinical trials, and then a lot of them will end up coming here, uh, both for, uh, cell ganglion blocks and, and ketamine.

What I always tell people is ketamine is a, a very good thing to do before, um, uh, because it is a self limited. Very low side effect, uh, 30 to 60 minute intervention that can be done at a micro dose. And so what happens is if you can start a process of journeying in, into, uh, uh, self-acceptance, that leads to emotional connection with other people.

And then you can begin to see that your relationship and your place in the world and that, oh, it's, everything is gonna be okay. What, what? My attitude is ketamine is legal and safe. And so that's just the best thing to do. And if at some point in the future these other things become legal, then. So be it.

But at this time, I try to encourage people, uh, that, that there are some great legal strategies when people take matters into their own hands. I tend to be very non-judgmental and just supportive and, uh, but I, I found it to be fairly useful to physiologically kind of understand, um, uh, the stuff because a lot of people are out there doing it.

And, and part of that is I think that people have been somewhat abandoned in my mind in, in the, the space of P T S D just because it's been, we haven't had any good solutions and it's been, uh, difficult. Um, Uh, experience for patients. I remember people told me they never get better, so they don't do it.

And so now as we kind of get into this experience, I think that it's a, um, it's, uh, incredibly helpful. And so I'm, I'm, uh, uh, so I'm very, very positive, uh, about it. I'm looking at this note.

Um, so that's, that's just a private note. Sorry, that being said, the, I have, you have all of these ways to think about kind of P T S D. Part of it is seeing, part of that is the empathy part of that is your mitochondria working. What I feel like is you don't really, once you get really good at it, I kind of feel like, and if this is my interesting idea on a, on addiction and stuff like this, I just basically feel amazing now.

And so I don't feel like a desire to, uh, medicate. Whereas I remembered in the past I did, especially when like, anesthesia is extraordinarily stressful. And so what I feel like is, is once, and this is my idea, once you get, it's kind like the 99 monkeys idea. Once you get enough people feeling good and realizing that everything's gonna be okay, all of a sudden everybody feels okay.

And then if they wanna do a substance, they just do it because they feel good. But there's not the sense of self-medication and my sense in the drugs and alcohol world that I've. Perceived up until now is a lot of it is self-medication. And so, um, I feel that I just wanna stay in this area for a while because, and help people, because I feel like, uh, the, my feeling is, is that we're gonna, when you come, I think that if you took everything that I talked about today and deployed it into the addiction space, I think that we would at least cut recidivism in half.

But I think we would be more effective than that. And I, I think that'll be amazing. And so then the final thing that I wanna tell you, which is totally amazing, is, is that I did a, um, I had a, a, a interview. Somebody came to interview this week and, um, I said, what happened? What's happening? And she goes, oh, I listened to your podcast, or she listened to this talk.

I don't know how she listened to it. Maybe it was online. And she goes, and she goes, I really liked, uh, the part about we deserve to be here. And so we did this thing, this affirmation. So I want every, we'll do it again tonight. This will be kind of fun. And so everybody unmute your, your phone or your computer.

And so, uh, and interestingly, I've been doing this like, and I do this a lot, but, um, it's interesting, uh, to, to, to do this. So I'm gonna wait until people are unmuted. Awesome. Oh, good. Okay. Well, you're, so then, so everybody say, uh oh, now this is a good, this is always how I do this too. I'm not gonna come up with the affirmation.

Somebody says something that they, they feel like really good about, like that we should all say together.

Everything's perfect. Everything is perfect. Oh, this is gonna be fun. Oh, this, this is gonna be, this is, this is gonna be super fun. So this is gonna be super fun. And the reason it's gonna be super fun is cause everything is perfect. Everything is perfect, everything is perfect. And what happens is it takes a while to kind of figure it out and realize it.

But then what happens is once you realize that, you realize that whatever happened yesterday was difficult. But it helped us because it, uh, informs us and now we're wiser today. And so, as a result of learning from our experience, everything's perfect.

Um,

I'm super, I'm, I'm more in, I, I would say I'm like maybe 10 times more inspired than I was before Covid. And I think that what's happened with the, the difficult problems in society now, and what's happened with Covid is a lot of volatility. And what's gonna happen out of that volatility is that everything is gonna be perfect and then we're gonna, it is gonna be this very, very positive, um, thing.

And, uh, you know what? It's, it is not, um, This isn't like, I remember, oh my God, Marsala, this is so great. So, uh, I remember really clearly I, my first experience in surgery was with a neuro, a famous neurosurgeon who the, the e n t surgeon that I was with, um, said, this is gonna be really crazy. And he goes, I'm gonna do a skull based operation for someone and then it's gonna be really crazy.

And then he goes, and then so, but, and he goes, just pay attention and then don't say anything. So it was like, okay. And so then they didn't have the instruments and then all hell break loose and he started screaming and throwing instruments and it was like, I'd never seen anything like it. Then it was like a hundred times worse than anything you've ever seen.

It kinda, it gives me chills thinking about it. And so that was my first day in the operating room at medical school and it was like, oh my God. It was like, it, it was as crazy as anything you've ever seen and somebody's asleep leap And uh, so they said, don't, that was crazy, wasn't it? And I remember it was so crazy.

And then what happened was this was a very important person. And so then, What happened is, is they just, so they said, oh, you just have to deal with that.

And so then what happened is, is then the idea was just internalize that and accept that and, and it, it is interesting. So I was talking to these guys and I had a, um, one of my favorite people and my practice today came in, who's a very influential person. And so then we started talking about this and we were talking about the Black Lives Matter movement, which I'm in 100%, 1000000% supportive.

And I said, and my story is not, is kind of trivial, actually. That's a good one. My story is totally trivial by comparison, but it still makes me feel a little bit emotional and what I. What happened was, is is that the, the, the paradigm that we came to and the paradigm that we were in for my entire professional career was just manage bad behavior and internalize it and accept it, and then don't say anything to anyone or you'll be in big trouble.

And, um, and so then basically I, I was like very good at that. And so then I, but what happens, this is, that's catastrophically stressful and then it leads you to not be empathetic to anyone and to hide because it's like very difficult. Uh, what's happening is I feel like our society is waking up to, we all have to basically have.

Better behavior. And we have to, we have to be, we have to create safe workplaces and we have to, uh, create safe places for patients and all of this stuff. And it's, and so what I feel like is gonna happen from this movement and from everything that's happening is that medicine's gonna be better. That, uh, that we're gonna make changes.

And that, uh, on the other side of this, we're gonna look back and we're gonna say that was like a pivotal moment. And everything was kind of different afterwards. And what happens is, is, and so anyway, I'm so and so. Then ironically, I'm, I'm, I, I, I feel the change, I feel a palpable change talking to people, and I feel that, uh, That we are gonna be better and we're gonna do better.

And I'm, I'm very passionate and excited about that. And so I'm looking, I'm looking forward to what's to come. Anyone can say anything if they want otherwise, but it's, it's awesome. It's gonna be awesome. And I, so I, I just feel, and I'm excited for the kids going into medical school cause it's interesting to kind of watch them and, and hear those hear, hear, just hear them talk.

So anyways, uh, un unmute yourself and let's say one more time. Everything is perfect. Perfect. Everything is perfect. Everything is perfect. Everything. It's gonna be super fun. Everything is perfect. It's gonna be super fun. Super fun. It gonna be super fun. And by the way, it's not gonna be perfect. It's perfect right now.

Oh, it's perfect right now. It is perfect. It's kinda, it's kind of interesting. It's perfect. All right. I love you and thank you for being here. Thank you, man. Thank you. Thank you. Thank you, Matt. Thank you. Thank you everybody. Thank you. Have a good week.

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