1 00:00:00,100 --> 00:00:03,880 Surgery should always be the last tool in the toolbox that you use, especially 2 00:00:03,940 --> 00:00:08,260 nowadays. There are so many other options before you get to surgery, 3 00:00:08,760 --> 00:00:11,420 even though, although surgery sometimes is the right option. 4 00:00:11,622 --> 00:00:16,082 Once you've had that excruciating nerve pain coming down your leg and 5 00:00:16,182 --> 00:00:20,622 incapacitating you and you have to have major surgery, you feel differently 6 00:00:20,662 --> 00:00:21,862 when you take care of patients. 7 00:00:22,330 --> 00:00:25,130 So, since we're talking about technology, I want to show something that we developed 8 00:00:25,190 --> 00:00:27,910 over the last couple of days that is pretty exciting. 9 00:00:28,163 --> 00:00:31,063 So I said, let me try to see if I could actually use the 10 00:00:33,603 --> 00:00:37,443 GPS capabilities of the watch to track 11 00:00:38,383 --> 00:00:41,882 a padel, you know, a padel activity. 12 00:00:42,043 --> 00:00:43,503 I think I haven't verified all this. 13 00:00:43,543 --> 00:00:45,083 This is first version of this. 14 00:00:45,703 --> 00:00:49,703 And I got to actually, you know, see how 15 00:00:50,963 --> 00:00:52,563 I moved through the court. 16 00:00:53,460 --> 00:00:55,160 Welcome to Augmented Wellness. 17 00:00:55,580 --> 00:00:57,980 Where we meet the people in pursuit of Better. 18 00:00:58,540 --> 00:01:02,940 Today, we speak with Doctor Cesar Ceballos orthopedic surgeon and sports 19 00:01:03,020 --> 00:01:04,160 medicine specialist. 20 00:01:08,009 --> 00:01:11,529 Hello. Welcome to another episode of Augmented Wellness. 21 00:01:11,909 --> 00:01:15,209 I'm here joined today by Dr. Ceballos. 22 00:01:15,549 --> 00:01:22,349 He is an orthopedic surgeon and sport medicine specialist who has spent 25 23 00:01:22,349 --> 00:01:24,429 years treating injuries right here in South Florida. 24 00:01:25,549 --> 00:01:28,329 And yeah, we're going to have a talk today, a little bit about your life, 25 00:01:28,529 --> 00:01:33,909 about your upbringing in Miami, what brought you into this world, 26 00:01:33,909 --> 00:01:39,549 and learn what are the latest innovations in this space. 27 00:01:39,569 --> 00:01:42,969 I'm excited because I know you treat a lot of athletes, 28 00:01:42,969 --> 00:01:48,509 and I'm excited to see what you're seeing in the cutting edge of this field. 29 00:01:48,709 --> 00:01:50,189 So welcome, Dr. Ceballos. 30 00:01:50,189 --> 00:01:53,029 Thank you, Demian. Thank you very much for having me here, 31 00:01:53,129 --> 00:01:56,549 and it's always a pleasure to see you and collaborate. 32 00:01:58,129 --> 00:02:01,529 Awesome. So yeah, so let's start at the beginning. 33 00:02:01,649 --> 00:02:06,109 I'd like to go way back. I mean, you're a native of South Florida. 34 00:02:08,329 --> 00:02:14,269 I know that, you know, like many people here, you're passionate about baseball, 35 00:02:14,269 --> 00:02:20,929 and you started your journey as an athlete there, but then you had an injury. 36 00:02:21,429 --> 00:02:25,369 So take me back, sort of back in those initial years, 37 00:02:25,389 --> 00:02:30,409 and how was it to grow up in Miami, and what was life back then? 38 00:02:30,409 --> 00:02:34,029 Yeah, Miami was a small town. I mean, I'm a little, 39 00:02:34,209 --> 00:02:39,789 I got a few years on me, so Miami was a small town, nothing like it is now. 40 00:02:40,309 --> 00:02:44,549 I went, I've been here since I was two years old. My family immigrated from Cuba. 41 00:02:46,229 --> 00:02:53,769 I was gifted with athletic talents. I actually got hurt playing football. 42 00:02:54,029 --> 00:02:54,809 Oh, football, okay. 43 00:02:55,109 --> 00:02:59,489 But, which, I had scholarships to most of the big schools in the 44 00:02:59,489 --> 00:03:04,489 country for football, but where I can take it to the professional level was baseball. 45 00:03:04,689 --> 00:03:05,749 I was better at baseball. 46 00:03:05,949 --> 00:03:06,309 Okay. 47 00:03:07,949 --> 00:03:10,049 And from, at the age of 17, 48 00:03:10,089 --> 00:03:14,489 I had a really bad football injury, and then switched to baseball in college. 49 00:03:14,669 --> 00:03:18,769 And then that injury kept flaring up throughout my career in baseball. 50 00:03:20,989 --> 00:03:22,409 And after that, 51 00:03:22,429 --> 00:03:27,489 I had a child fairly young, and had to work to support my family, 52 00:03:28,809 --> 00:03:35,889 and never thought medicine was going to be part of my livelihood in the future. 53 00:03:37,569 --> 00:03:40,589 As I was getting up in age a little bit in my mid, 54 00:03:40,669 --> 00:03:46,069 late 20s, I met my wife, who is a fourth-generation Miamian. 55 00:03:47,009 --> 00:03:47,429 Her 56 00:03:47,429 --> 00:03:50,969 great-grandfather is actually one of the guys that incorporated the city of Miami. 57 00:03:51,189 --> 00:03:51,469 Wow. 58 00:03:51,469 --> 00:03:53,029 So they have deep roots here. 59 00:03:53,209 --> 00:03:57,729 Actually, my grandkids are sixth-generation Miamians through my wife. 60 00:03:58,189 --> 00:04:00,649 So with her help and support, 61 00:04:01,109 --> 00:04:06,329 went back to medical school, went to the University of Miami. 62 00:04:06,569 --> 00:04:11,249 Then I did a five-year orthopedic residency there, 63 00:04:11,269 --> 00:04:16,629 and then I did an extra year in California at Stanford University of Sports Medicine. 64 00:04:16,629 --> 00:04:20,609 And came back, I got offered the job to be the 49ers physician. 65 00:04:21,369 --> 00:04:21,969 Declined it. 66 00:04:22,589 --> 00:04:24,529 There's no way I was getting my wife out of Miami. 67 00:04:24,729 --> 00:04:25,129 Yeah. 68 00:04:25,409 --> 00:04:31,249 So I had to come back here, which it's nice to take care of a professional team, 69 00:04:31,249 --> 00:04:35,089 but you lose a lot of interaction with your family and your kids. 70 00:04:35,249 --> 00:04:36,229 And I have five daughters, 71 00:04:36,229 --> 00:04:42,429 and I value that a lot more than just work, even though I'm a workaholic. 72 00:04:42,429 --> 00:04:44,969 But I always put family first. 73 00:04:45,549 --> 00:04:50,689 And eventually, with her help, we noticed Miami. 74 00:04:50,849 --> 00:04:53,609 As Miami grew into the metropolis that is now, 75 00:04:53,849 --> 00:04:58,809 we noticed it doesn't have a multi-specialty orthopedic group 76 00:04:58,809 --> 00:05:02,449 that can provide care for different body injuries, 77 00:05:02,789 --> 00:05:08,869 different subspecialties within the realm of orthopedics. 78 00:05:08,869 --> 00:05:11,409 So we founded OrthoMiami, 79 00:05:11,729 --> 00:05:18,169 and not too long afterwards, I joined forces with Dr. Hommen, Pieter Hommen, 80 00:05:18,589 --> 00:05:23,329 who's been instrumental in building the group we have now, soon. 81 00:05:23,689 --> 00:05:24,269 And my doctor. 82 00:05:24,989 --> 00:05:26,489 Your doctor also, yes. 83 00:05:26,629 --> 00:05:29,149 I actually broke my clavicle. 84 00:05:29,829 --> 00:05:32,529 He took care of it, cycling. 85 00:05:32,769 --> 00:05:35,549 So Pieter, Dr. Hommen, actually, he's not from here. 86 00:05:35,549 --> 00:05:36,729 He's Dutch. 87 00:05:37,109 --> 00:05:40,089 I think he came down to the States when he was 11, Pittsburgh. 88 00:05:40,909 --> 00:05:44,869 But eventually, when he finished orthopedics, came down to Miami, 89 00:05:45,529 --> 00:05:52,149 although his wife is a large Miami family, and they also care about – 90 00:05:52,149 --> 00:05:55,289 we had the same philosophy. 91 00:05:55,289 --> 00:05:56,869 Let's build this group together. 92 00:05:57,009 --> 00:05:58,289 There's nothing like this in Miami. 93 00:05:58,769 --> 00:06:02,029 You either have to go to a big hospital system or the university 94 00:06:02,029 --> 00:06:06,909 systems where you lose that personal care that we can provide in the private sector. 95 00:06:07,269 --> 00:06:09,249 So we joined forces, and 96 00:06:09,249 --> 00:06:13,909 I think in September we'll get the last – one of the last pieces of the puzzle. 97 00:06:14,029 --> 00:06:15,689 We're having a spine surgeon join us, 98 00:06:15,709 --> 00:06:20,229 and we'll have most of the major subspecialties in orthopedics. 99 00:06:20,229 --> 00:06:21,889 So which are they? 100 00:06:22,369 --> 00:06:24,749 We have sports medicine, 101 00:06:25,269 --> 00:06:32,449 orthopedic hand, foot and ankle, joint reconstruction, spine surgery. 102 00:06:33,409 --> 00:06:34,369 What else? 103 00:06:34,549 --> 00:06:36,589 We have interventional pain management. 104 00:06:36,909 --> 00:06:37,509 The only 105 00:06:37,509 --> 00:06:41,729 ones we basically don't have is pediatric orthopedics and oncology orthopedics, 106 00:06:41,829 --> 00:06:44,989 which those – especially oncology orthopedics, 107 00:06:45,149 --> 00:06:49,149 that usually is best served by a big university program. 108 00:06:49,149 --> 00:06:49,529 Yeah. 109 00:06:50,449 --> 00:06:51,289 Very interesting. 110 00:06:51,649 --> 00:06:57,249 So obviously your injury as a young athlete also 111 00:06:57,249 --> 00:07:06,969 gave you a passion for how life-changing these orthopedic challenges could be, 112 00:07:07,149 --> 00:07:09,069 especially for an aspiring athlete. 113 00:07:09,769 --> 00:07:14,649 And you've been on the other side of the table a couple of times yourself, right? 114 00:07:15,189 --> 00:07:16,069 More than a couple. 115 00:07:16,289 --> 00:07:17,049 More than a couple. 116 00:07:17,049 --> 00:07:19,449 So, yeah, walk us a little bit. 117 00:07:19,529 --> 00:07:23,369 What did you learn, you know, as a patient that you applied, 118 00:07:23,369 --> 00:07:29,449 you know, in your practice or in your way of, you know, 119 00:07:29,569 --> 00:07:33,209 helping your patients go through this journey? 120 00:07:33,289 --> 00:07:34,789 Because sometimes it's pretty difficult. 121 00:07:35,069 --> 00:07:40,849 I mean, that's a huge part of how I practice medicine. 122 00:07:40,849 --> 00:07:44,689 And my original injury, I wasn't treated properly. 123 00:07:45,089 --> 00:07:48,809 In retrospect, going back and knowing medicine now, I wasn't treated properly. 124 00:07:48,809 --> 00:07:53,309 So that's always been ingrained in me, like you have to do the right thing. 125 00:07:53,309 --> 00:07:55,269 And I am a surgeon. 126 00:07:57,429 --> 00:08:02,189 And many surgeons see a patient while you came to the office because I'm a surgeon. 127 00:08:02,389 --> 00:08:05,349 So, you know, most surgery is one of the first tools you use. 128 00:08:05,349 --> 00:08:06,909 I look at it the other way. 129 00:08:07,029 --> 00:08:10,209 Surgery should always be the last tool in the toolbox that you use, 130 00:08:10,249 --> 00:08:11,109 especially nowadays. 131 00:08:11,589 --> 00:08:15,129 There are so many other options before you get to surgery, 132 00:08:15,629 --> 00:08:18,249 even though, although surgery sometimes is the right option. 133 00:08:19,089 --> 00:08:21,549 But losing, being a patient, 134 00:08:21,749 --> 00:08:29,769 losing mobility and losing the capacity to do what you like to do is, if you haven't 135 00:08:29,769 --> 00:08:34,009 experienced it and you just read it in the books as a physician, it's not the same. 136 00:08:34,229 --> 00:08:36,889 Once you've had that excruciating nerve pain 137 00:08:36,889 --> 00:08:41,369 coming down your leg and incapacitating you and you have to have major surgery, 138 00:08:41,709 --> 00:08:44,369 you feel differently when you take care of patients. 139 00:08:44,369 --> 00:08:51,049 So I always use that and be very compassionate and thoughtful. 140 00:08:51,349 --> 00:08:54,389 And that's really instrumental in how I practice. 141 00:08:55,149 --> 00:08:58,849 Yeah, look, you know, my father, obviously, you know, 142 00:08:58,909 --> 00:09:02,329 he's been in the office taking empanadas to you guys quite a year of time. 143 00:09:02,449 --> 00:09:06,789 But, I mean, I'm right now struggling personally with him. 144 00:09:07,889 --> 00:09:12,029 You know, he's had a couple back surgeries and, 145 00:09:12,189 --> 00:09:18,309 you know, he's a fragment of what he was even a year ago. 146 00:09:18,489 --> 00:09:18,789 Right. 147 00:09:19,629 --> 00:09:20,989 And it's hard. 148 00:09:21,329 --> 00:09:22,629 And, you know, he goes to therapy. 149 00:09:22,909 --> 00:09:26,169 I think, yeah, I think he goes with you guys a couple of times a week. 150 00:09:26,369 --> 00:09:28,549 He's trying everything, but it's so hard. 151 00:09:29,709 --> 00:09:31,229 And he sees different surgeons. 152 00:09:33,129 --> 00:09:37,269 And, yeah, most of the time I can't go with him to the appointments. 153 00:09:37,989 --> 00:09:39,349 But, you know, I hope 154 00:09:39,349 --> 00:09:43,469 that the doctors have the compassion to see how he's suffering because I see him. 155 00:09:44,229 --> 00:09:45,309 My parents live with me. 156 00:09:45,709 --> 00:09:48,869 I see him 24-7, this struggle from the moment he wakes up in the morning. 157 00:09:49,229 --> 00:09:51,929 You know, he didn't have a good night because of the pain. 158 00:09:52,409 --> 00:09:55,729 Then, you know, now he's falling asleep regularly because of that pain. 159 00:09:55,969 --> 00:09:56,729 Sleep is huge. 160 00:09:56,729 --> 00:09:58,769 Yeah, and, you know, 161 00:09:58,829 --> 00:10:04,149 you see a deterioration that happens, and you feel a little bit hopeless or helpless 162 00:10:04,149 --> 00:10:07,909 on what I could do myself because he's seeing the best doctors. 163 00:10:09,269 --> 00:10:10,529 So, yeah, 164 00:10:10,609 --> 00:10:17,929 it's definitely good to obviously see someone that sees it from the other side. 165 00:10:18,149 --> 00:10:20,809 Yeah, and, you know, a lot of the younger 166 00:10:20,809 --> 00:10:25,389 doctors in my office haven't had the surgeries I've had, but I always try to. 167 00:10:25,949 --> 00:10:27,569 So, yeah, tell us a little bit because, 168 00:10:27,669 --> 00:10:32,449 you know, in your research I saw, you know, spine, knee, hip, you know. 169 00:10:32,809 --> 00:10:36,629 Yeah, I've had multiple knee surgeries. 170 00:10:36,889 --> 00:10:40,749 That was the original injury that threw off. 171 00:10:41,689 --> 00:10:42,129 Actually, 172 00:10:42,129 --> 00:10:47,769 good and bad because I ended up becoming a physician instead of a baseball player. 173 00:10:48,349 --> 00:10:49,749 Now I can help others. 174 00:10:49,969 --> 00:10:53,089 As a baseball player, I can just entertain them and not really help them. 175 00:10:54,289 --> 00:10:56,089 But I have a knee replacement. 176 00:10:56,109 --> 00:10:57,289 I have both hips replaced. 177 00:10:57,489 --> 00:10:58,829 I've had five back surgeries. 178 00:10:59,709 --> 00:11:01,989 And this is because you continue doing sports or? 179 00:11:02,389 --> 00:11:04,449 Yeah, you know, some of the things are genetics. 180 00:11:04,689 --> 00:11:06,589 You have some genetic issues with your spine, 181 00:11:06,589 --> 00:11:09,369 and then you do sports or dumb stuff when you're young. 182 00:11:09,989 --> 00:11:12,129 And then you pay the price when you get a little bit older. 183 00:11:12,129 --> 00:11:12,489 Yeah. 184 00:11:13,289 --> 00:11:16,949 And, but, yeah, that losing mobility and the capacity 185 00:11:16,949 --> 00:11:21,769 to do what you like to do is it affects you not only physically but mentally. 186 00:11:21,769 --> 00:11:22,569 So I always 187 00:11:22,569 --> 00:11:25,889 keep that in the back of my mind when I practice medicine and see a patient. 188 00:11:26,329 --> 00:11:26,509 Yeah. 189 00:11:27,109 --> 00:11:27,469 Yeah. 190 00:11:27,969 --> 00:11:30,989 Again, going back to my father, I mean, mentally is really, 191 00:11:31,409 --> 00:11:36,169 you know, where I see him not being who he was, as I said, like a year ago. 192 00:11:36,169 --> 00:11:42,969 So, and in that sense, I mean, is there any, I mean, there's so many things going 193 00:11:42,969 --> 00:11:50,149 on in health care now, and especially, you know, practices that before didn't, 194 00:11:50,609 --> 00:11:54,569 you know, weren't collaborative in a way, but mental health. 195 00:11:54,749 --> 00:11:58,989 Is mental health now a factor or still 196 00:11:58,989 --> 00:12:02,429 very separated from the way that you treat patients? 197 00:12:02,949 --> 00:12:06,149 I mean, we tried to pick it up, but it's still fragmented. 198 00:12:06,369 --> 00:12:07,989 It's still separated, to be honest. 199 00:12:08,549 --> 00:12:10,129 Like medicine is separated. 200 00:12:10,409 --> 00:12:13,069 Everybody's so specialized and especially. 201 00:12:13,069 --> 00:12:14,069 Especially pain, right? 202 00:12:14,189 --> 00:12:15,269 Pain, pain management. 203 00:12:15,669 --> 00:12:16,549 I mean, and mental health. 204 00:12:16,689 --> 00:12:19,009 I mean, I was in the mental health space on that, 205 00:12:19,169 --> 00:12:25,349 and, you know, just, you know, chronic pain is one of. 206 00:12:25,509 --> 00:12:26,049 It's horrible. 207 00:12:26,209 --> 00:12:26,709 I've been there. 208 00:12:26,829 --> 00:12:26,969 Yeah. 209 00:12:27,249 --> 00:12:27,449 Yeah. 210 00:12:27,629 --> 00:12:28,149 It's horrible. 211 00:12:28,149 --> 00:12:28,189 It's horrible. 212 00:12:31,389 --> 00:12:35,449 So, you know, to move on a little bit here on, you know, 213 00:12:35,469 --> 00:12:40,489 actually the next slide, it says, when someone comes to you in pain, how 214 00:12:40,489 --> 00:12:44,189 do you decide whether the answer is time, rehabilitation, a procedure, or surgery? 215 00:12:45,369 --> 00:12:48,529 So it ties a little bit into how. 216 00:12:48,909 --> 00:12:49,869 The whole package. 217 00:12:49,889 --> 00:12:52,309 There's not one just thing. 218 00:12:52,449 --> 00:12:55,849 You've got to look at the, first of all, you've got to get the diagnosis right. 219 00:12:55,849 --> 00:12:55,869 Right. 220 00:12:56,609 --> 00:12:57,689 Now, why is that? 221 00:12:57,769 --> 00:12:58,829 Why are they having pain? 222 00:12:58,989 --> 00:12:59,849 That's number one. 223 00:13:00,029 --> 00:13:04,429 And then it can be from just adjusting the way they carry things at work, 224 00:13:04,549 --> 00:13:05,809 working on their mechanics, 225 00:13:05,949 --> 00:13:10,249 how they lift things, physical therapy, getting more flexibility back. 226 00:13:11,229 --> 00:13:13,589 And then it's like biologics now, especially now in Florida, 227 00:13:13,749 --> 00:13:19,289 that we can treat patients with stem cells. 228 00:13:19,929 --> 00:13:20,409 PRP 229 00:13:20,409 --> 00:13:25,729 is huge that we use a lot to try to avoid taking the patient to the next level, 230 00:13:25,849 --> 00:13:30,129 which the last level in our, the last tool in our toolbox is always surgery. 231 00:13:30,869 --> 00:13:33,269 And even surgery sometimes is the correct answer. 232 00:13:33,449 --> 00:13:35,569 But we look at the whole picture from, 233 00:13:35,569 --> 00:13:40,829 you know, from doing as least as possible to do the most invasive thing if needed. 234 00:13:43,009 --> 00:13:46,289 So, you know, now obviously a lot of people today have access to AI. 235 00:13:46,489 --> 00:13:48,649 We've been talking about AI for a while. 236 00:13:49,549 --> 00:13:50,849 How has that changed? 237 00:13:51,049 --> 00:13:51,929 What have you observed? 238 00:13:51,929 --> 00:13:53,209 I mean, you know, people come, 239 00:13:53,349 --> 00:14:00,789 you know, ready now with some, you know, self-assessment that they've done. 240 00:14:03,329 --> 00:14:04,129 Dr. Google. 241 00:14:04,309 --> 00:14:06,549 Dr. Google or Dr. GPT. 242 00:14:07,809 --> 00:14:08,909 You know, what are you seeing? 243 00:14:09,009 --> 00:14:09,909 What are the trends you're seeing? 244 00:14:09,989 --> 00:14:11,029 I mean, obviously the models 245 00:14:11,029 --> 00:14:14,289 are getting better and better and people now could upload a photo or a video. 246 00:14:16,289 --> 00:14:18,129 Dr. I personally think it's phenomenal. 247 00:14:18,369 --> 00:14:19,549 Education is huge. 248 00:14:19,969 --> 00:14:22,269 Now, it does have its downside. 249 00:14:23,869 --> 00:14:29,069 It's not a, you got to get the whole evaluation right. 250 00:14:29,649 --> 00:14:31,489 AI is good for data collection. 251 00:14:31,889 --> 00:14:34,429 You got to put the data together, you know, 252 00:14:34,529 --> 00:14:38,809 and humanize it and get the diagnosis right and then provide the treatment. 253 00:14:38,809 --> 00:14:45,449 I think where AI will really be huge in our practice is not, 254 00:14:45,689 --> 00:14:50,789 is the diagnosis they can get, AI can get it, can get it down to the T. 255 00:14:51,029 --> 00:14:55,849 But it's the minutes between getting the diagnosis, 256 00:14:56,169 --> 00:14:58,769 evaluating the MRI, and then tell the patient, 257 00:14:58,909 --> 00:15:02,149 okay, go to physical therapy, do this, see me back in six weeks. 258 00:15:02,149 --> 00:15:06,529 During that six weeks, the data collection with AI and then what we do with that, 259 00:15:06,749 --> 00:15:10,669 I think that's where it's going to really take medicine to the next level. 260 00:15:10,829 --> 00:15:11,449 Yeah, yeah, yeah. 261 00:15:11,549 --> 00:15:17,669 Because even last episode we talked about, you know, 262 00:15:17,809 --> 00:15:21,249 one of our partners that we're doing a lot of personalized training. 263 00:15:22,429 --> 00:15:27,069 You know, when they go to the gym, it's less than 2% of the time. 264 00:15:27,069 --> 00:15:30,109 I mean, what happens the rest of the time, and, you know, in therapy, 265 00:15:30,589 --> 00:15:34,729 when physical rehabilitation is, yeah, the person doesn't do the homework, 266 00:15:35,049 --> 00:15:37,609 doesn't, you know, do the stretch and all that. 267 00:15:38,609 --> 00:15:40,009 You know, it's great that they come and, 268 00:15:40,149 --> 00:15:44,449 you know, they do it for an hour with your therapist, but if they don't continue it, 269 00:15:44,589 --> 00:15:48,469 you know, it's not going to have the same effect, right? 270 00:15:48,829 --> 00:15:49,309 Yeah, correct. 271 00:15:49,309 --> 00:15:53,089 And we, you know, we'll spend 20, 30, 40 minutes with a patient in the room, 272 00:15:53,209 --> 00:15:57,629 but what do they do the next hours between visits? 273 00:15:57,749 --> 00:15:58,249 Yeah, yeah. 274 00:15:58,249 --> 00:15:58,549 It's huge. 275 00:16:01,889 --> 00:16:07,409 And so let me see here, you know, I have a couple of things that we already covered. 276 00:16:08,289 --> 00:16:12,169 So let's go into, obviously, a very exciting part, right? 277 00:16:12,629 --> 00:16:16,069 You know, you sort of hinted at it, regenerative medicine. 278 00:16:17,089 --> 00:16:18,869 There's a lot of hype, right? 279 00:16:18,949 --> 00:16:20,169 There's a lot of promise. 280 00:16:23,689 --> 00:16:29,089 How, you know, explain to us a little bit about PRP, stem cells, exosomes. 281 00:16:29,769 --> 00:16:31,709 You know, what is the difference? 282 00:16:31,789 --> 00:16:32,549 I mean, what do they mean? 283 00:16:32,649 --> 00:16:33,309 What is the difference? 284 00:16:34,109 --> 00:16:36,209 What are you guys excited about? 285 00:16:37,049 --> 00:16:37,889 Well, we're 286 00:16:37,889 --> 00:16:41,689 excited now that some of those weren't legal before in the state of Florida. 287 00:16:42,549 --> 00:16:42,869 Patients, 288 00:16:43,029 --> 00:16:50,129 famous people, athletes will have to leave the country to get stem cell treatment. 289 00:16:50,469 --> 00:16:52,609 Now they can do it in Florida. 290 00:16:54,489 --> 00:17:00,209 Not, you know, not everybody, but it was July 1st, 2025. 291 00:17:01,049 --> 00:17:04,249 There was a law passed in Florida where we can 292 00:17:04,249 --> 00:17:09,529 use stem cell treatments for orthopedics, pain management, and wound care. 293 00:17:09,809 --> 00:17:11,169 So, and these are, 294 00:17:11,329 --> 00:17:18,149 so just to go into the technical aspects of it, is stem cells from someone's own? 295 00:17:19,129 --> 00:17:21,949 Someone's own, you could use it before as long as you didn't modify it. 296 00:17:22,049 --> 00:17:23,649 Like, you can do bone marrow aspirate. 297 00:17:23,749 --> 00:17:25,989 You can take some blood from the patient's bones, 298 00:17:26,169 --> 00:17:28,749 concentrate it a little bit, spin it in the centrifuge, 299 00:17:28,749 --> 00:17:30,309 and reintroduce it to the patients, 300 00:17:30,329 --> 00:17:33,209 but you don't know how many stem cells you're actually getting from there. 301 00:17:33,569 --> 00:17:36,009 That's called autologous. 302 00:17:36,189 --> 00:17:36,569 Okay. 303 00:17:36,789 --> 00:17:39,989 Allogenic stem cells you can get from a donor. 304 00:17:40,189 --> 00:17:40,509 Okay. 305 00:17:40,709 --> 00:17:43,389 Those are the ones that have become legal now, 306 00:17:43,829 --> 00:17:46,669 although they're not FDA approved, of course. 307 00:17:46,789 --> 00:17:46,909 Right. 308 00:17:47,569 --> 00:17:51,249 So you have to be careful how you use them, how you explain it to the patient, 309 00:17:51,369 --> 00:17:56,329 get appropriate consent, educate the patient, give them alternative treatments. 310 00:17:57,769 --> 00:18:01,209 That's stem cells, and it's not a cure. 311 00:18:01,509 --> 00:18:02,189 It's not magic. 312 00:18:02,569 --> 00:18:04,069 It's part of a... 313 00:18:04,069 --> 00:18:04,989 Of a treatment plan. 314 00:18:05,129 --> 00:18:06,209 Part of a treatment plan. 315 00:18:06,449 --> 00:18:06,969 It's just like PRP. 316 00:18:06,969 --> 00:18:09,169 I know this happens in the office. 317 00:18:09,429 --> 00:18:09,809 Yes. 318 00:18:10,009 --> 00:18:11,789 And what is the... 319 00:18:12,869 --> 00:18:14,189 It happens in one visit? 320 00:18:14,509 --> 00:18:16,409 I mean, what is the period of that treatment? 321 00:18:16,649 --> 00:18:20,329 It can, like for PRP, you mentioned platelet-rich plasma. 322 00:18:20,529 --> 00:18:21,889 That's been around for a while. 323 00:18:21,889 --> 00:18:24,849 That's longer than stem cells down here in Florida. 324 00:18:25,209 --> 00:18:27,489 We use it for many things in orthopedics. 325 00:18:27,609 --> 00:18:30,189 We use it sometimes to delay or avoid surgical intervention. 326 00:18:31,129 --> 00:18:33,709 We use it to enhance healing after surgery. 327 00:18:34,569 --> 00:18:36,409 That's taking the patient's own blood. 328 00:18:36,549 --> 00:18:40,209 We centrifuge it, and we separate the red cells from the growth factors. 329 00:18:40,209 --> 00:18:45,749 And nowadays, the good PRP is high-concentrated platelet PRP. 330 00:18:46,009 --> 00:18:46,929 That's done, 331 00:18:47,429 --> 00:18:52,209 takes about usually 10, 15 minutes to spin it in the centrifuge after the blood draw, 332 00:18:52,429 --> 00:18:55,829 and that can be reintroduced right then and there to the patient. 333 00:18:57,469 --> 00:18:58,649 Autologous stem cells, 334 00:18:58,809 --> 00:19:02,429 you can get it from the patient's pelvic bone towards the back. 335 00:19:02,589 --> 00:19:06,549 You can do that in the office, spin it in the centrifuge and reintroduce it. 336 00:19:07,329 --> 00:19:07,849 Allogenic. 337 00:19:07,849 --> 00:19:10,489 And that takes also 15, 20 minutes? 338 00:19:10,729 --> 00:19:13,029 Yeah, that takes – the spinning does. 339 00:19:13,229 --> 00:19:16,009 The spinning in the centrifuge takes 10, 15 minutes. 340 00:19:16,229 --> 00:19:20,269 The procedure takes probably 20 minutes to do it and then reintroduce it. 341 00:19:20,329 --> 00:19:22,349 You're there for about an hour in the office. 342 00:19:22,549 --> 00:19:23,329 And then the other one, 343 00:19:23,369 --> 00:19:30,169 the allogenic, it comes – you have to have it at a certain temperature, very low, 344 00:19:30,729 --> 00:19:33,949 and it comes usually overnight FedEx in a little vial. 345 00:19:33,949 --> 00:19:38,909 And all these are out-of-pocket or insurance covers some of them? 346 00:19:39,129 --> 00:19:39,749 What is the – 347 00:19:39,749 --> 00:19:43,069 Insurance basically, they don't cover these. 348 00:19:43,129 --> 00:19:43,569 Okay. 349 00:19:43,809 --> 00:19:44,609 These are – 350 00:19:44,609 --> 00:19:50,249 Some workers' compensation insurance will cover platelet-rich plasma, PRP, 351 00:19:50,249 --> 00:19:54,309 and maybe one or two of these insurance programs may cover it, 352 00:19:54,329 --> 00:19:56,509 but it's usually out-of-pocket, yeah, unfortunately. 353 00:19:58,669 --> 00:20:02,609 And what makes a good candidate for these type of treatments? 354 00:20:05,329 --> 00:20:07,069 It depends on the diagnosis. 355 00:20:08,149 --> 00:20:10,329 And maybe we can get into this later. 356 00:20:10,589 --> 00:20:15,009 A good candidate, I believe, is somebody who wants to do preventive stuff. 357 00:20:15,249 --> 00:20:16,949 You know, and orthopedics, 358 00:20:17,069 --> 00:20:21,229 to me, is the most reactive – medicine is reactive in the United States. 359 00:20:21,229 --> 00:20:21,469 Yeah. 360 00:20:21,469 --> 00:20:22,849 You wait until you get sick, you see the doctor. 361 00:20:22,849 --> 00:20:25,269 You don't come see me if you're feeling well. 362 00:20:25,489 --> 00:20:26,229 You break a bone, 363 00:20:26,369 --> 00:20:31,209 you have an ACL injury, you take your rotator cuff, then you come in. 364 00:20:32,169 --> 00:20:34,649 With all these new biologics available, 365 00:20:35,449 --> 00:20:38,889 eating healthy, you mentioned earlier, you mentioned proper sleep. 366 00:20:39,329 --> 00:20:40,129 There's so much 367 00:20:40,129 --> 00:20:45,369 we can do to prevent injuries and prevent disease that we're not taking advantage. 368 00:20:45,369 --> 00:20:48,489 And I'm actually in the middle of developing 369 00:20:48,489 --> 00:20:53,589 a preventive orthopedic branch of our office to try to prevent these injuries 370 00:20:53,589 --> 00:20:57,489 and provide patients with a healthier and longer health span. 371 00:20:57,549 --> 00:20:58,749 So how would that look like? 372 00:20:59,409 --> 00:21:02,909 What would be a typical preventive – 373 00:21:02,909 --> 00:21:03,929 For example, 374 00:21:04,009 --> 00:21:09,229 something really cool that I've developed, we can get into later, needle arthroscopy. 375 00:21:09,709 --> 00:21:12,149 When you have an arthroscopic surgery in the joint, 376 00:21:12,369 --> 00:21:15,329 you typically use a big camera, it goes in your knee. 377 00:21:15,429 --> 00:21:17,949 I use something that's called needle arthroscopy. 378 00:21:18,249 --> 00:21:21,689 It's the size of a needle, basically with a camera chip on the tip. 379 00:21:23,029 --> 00:21:29,409 Let's say you're a marathon runner or you like to run a lot of miles a week. 380 00:21:29,569 --> 00:21:32,209 Why don't you come in once or twice a year? 381 00:21:32,469 --> 00:21:34,329 I can stick a needle in your knee, 382 00:21:34,609 --> 00:21:37,769 evaluate the cartilage in the office, take a look. 383 00:21:37,769 --> 00:21:39,489 Listen, your cartilage looks super healthy. 384 00:21:40,089 --> 00:21:40,829 Right then and there, 385 00:21:40,889 --> 00:21:45,769 I can put some PRP in your knee, which can protect the cartilage. 386 00:21:46,449 --> 00:21:50,029 And you can – you know, okay, listen, I can continue to increase my mileage. 387 00:21:51,349 --> 00:21:54,229 Different example, your cartilage is taking a beating. 388 00:21:54,449 --> 00:21:55,609 How many miles are you running? 389 00:21:55,709 --> 00:21:58,409 Why don't you cut back on a certain amount of miles, 390 00:21:58,629 --> 00:22:03,209 cycle a little bit more, swim a little bit more, inject PRP preventively? 391 00:22:03,549 --> 00:22:06,749 There's things like that that you can do that we couldn't do five years ago. 392 00:22:06,749 --> 00:22:07,149 Yeah. 393 00:22:07,369 --> 00:22:10,089 And many more preventive things we can do. 394 00:22:10,109 --> 00:22:12,289 Well, actually, so this ties a little bit to what we were talking about, you know, 395 00:22:12,369 --> 00:22:14,329 the collaboration opportunities that we have. 396 00:22:14,389 --> 00:22:18,029 And when I show a little bit of the demo I'm going to show today, 397 00:22:18,189 --> 00:22:19,049 it's exactly that. 398 00:22:19,209 --> 00:22:24,009 How, you know, how can we partner so you can monitor people's, 399 00:22:24,229 --> 00:22:26,269 you know, are you doing too many miles, right? 400 00:22:26,689 --> 00:22:29,149 Should you cut back a little bit, you know, 401 00:22:29,269 --> 00:22:34,109 given X, Y, Z, and then, you know, alternate it with other type of sports? 402 00:22:35,029 --> 00:22:35,389 Right. 403 00:22:36,529 --> 00:22:36,889 Yeah. 404 00:22:37,029 --> 00:22:37,449 Yeah, so it's... 405 00:22:37,449 --> 00:22:39,849 Yeah, I'm excited to hopefully get that done. 406 00:22:40,069 --> 00:22:40,689 That's going to be phenomenal. 407 00:22:40,689 --> 00:22:47,229 Yeah, yeah, because, I mean, I mean, as not an expert in running, 408 00:22:47,349 --> 00:22:50,389 but running is, for me, it's a really hard sport. 409 00:22:50,829 --> 00:22:54,949 I'm, how do you say, my biomechanics are not for running. 410 00:22:54,989 --> 00:22:55,449 You weren't built for running. 411 00:22:55,609 --> 00:22:56,429 You weren't built for running. 412 00:22:56,429 --> 00:22:58,009 I mean, I just ran one time, 413 00:22:58,089 --> 00:23:00,049 I did a half marathon, and I thought I was going to die. 414 00:23:00,249 --> 00:23:03,929 Well, in cycling, I never thought I was a cyclist, 415 00:23:03,929 --> 00:23:06,889 and a couple years ago I picked it up, and it feels amazing. 416 00:23:07,009 --> 00:23:07,269 Right. 417 00:23:07,689 --> 00:23:10,229 For me, and I react very well to it, 418 00:23:11,109 --> 00:23:17,209 obviously it doesn't have the same, you know, what do you say? 419 00:23:17,729 --> 00:23:18,729 Load on your body. 420 00:23:18,729 --> 00:23:19,209 Impact, impact. 421 00:23:19,389 --> 00:23:26,469 I actually went with Dr. Nimer, who was here from Sylvester a couple episodes ago. 422 00:23:26,709 --> 00:23:29,349 He invited me to a longevity talk, and 423 00:23:29,349 --> 00:23:36,869 there was this lady that she's the medical director, I think, for Boston Marathon. 424 00:23:37,529 --> 00:23:45,389 And she was actually sharing some data of the amount of inflammation that, 425 00:23:45,389 --> 00:23:48,809 you know, like marathon runners have. 426 00:23:49,029 --> 00:23:49,969 It's just incredible. 427 00:23:49,969 --> 00:23:50,209 Yeah. 428 00:23:50,209 --> 00:23:52,769 I mean, the impact, and then, 429 00:23:52,849 --> 00:23:56,609 you know, how that leads to sort of generalized inflammation of the body. 430 00:23:57,389 --> 00:24:00,329 And you don't have to wait for that to become an issue nowadays. 431 00:24:00,329 --> 00:24:01,989 There's things you can do preventively. 432 00:24:02,069 --> 00:24:02,349 Exactly. 433 00:24:02,509 --> 00:24:03,649 Now that we know that. 434 00:24:03,649 --> 00:24:04,889 From, you know, obviously. 435 00:24:05,249 --> 00:24:05,289 That's data. 436 00:24:05,549 --> 00:24:05,929 That's data. 437 00:24:05,929 --> 00:24:05,949 That's data. 438 00:24:06,209 --> 00:24:06,749 We have the data, 439 00:24:06,809 --> 00:24:10,529 and now we can do preventive medicine to prevent the final problem. 440 00:24:10,809 --> 00:24:10,949 Yeah. 441 00:24:14,229 --> 00:24:16,989 So, yeah, let's talk a little bit about Florida. 442 00:24:17,229 --> 00:24:22,609 So, how unique is it that Florida allows this? 443 00:24:22,789 --> 00:24:23,909 How many other states? 444 00:24:24,089 --> 00:24:29,149 I mean, because obviously, talking to professionals down here, 445 00:24:29,249 --> 00:24:30,849 they're pretty excited that Florida allows this. 446 00:24:30,849 --> 00:24:34,309 But is it something so innovative versus other states? 447 00:24:34,629 --> 00:24:35,749 What is the situation? 448 00:24:35,989 --> 00:24:37,069 It's very innovative. 449 00:24:37,489 --> 00:24:39,049 Again, it's not FDA approved. 450 00:24:39,169 --> 00:24:40,749 The feds don't recognize it. 451 00:24:42,029 --> 00:24:44,189 It's kind of like medical marijuana in Florida. 452 00:24:44,489 --> 00:24:45,209 It's done. 453 00:24:45,209 --> 00:24:48,269 It's done, and it helps a lot of people, but it's not FDA approved. 454 00:24:48,329 --> 00:24:49,389 The feds don't recognize it. 455 00:24:51,409 --> 00:24:54,089 It's, I think we have about six or seven states. 456 00:24:54,189 --> 00:24:55,409 I think Tennessee's on board now. 457 00:24:55,509 --> 00:24:57,149 I think it's about six or seven other states. 458 00:24:57,349 --> 00:24:58,249 Six or seven. 459 00:24:58,689 --> 00:25:00,489 Don't hold me to it, but I think there's six or seven 460 00:25:00,489 --> 00:25:04,329 other states that have similar laws that have been passed over the last few years. 461 00:25:04,329 --> 00:25:06,749 A couple just were implemented not too long ago. 462 00:25:07,489 --> 00:25:08,229 But it's huge. 463 00:25:08,289 --> 00:25:10,089 You don't have to travel out of the country. 464 00:25:11,089 --> 00:25:14,449 You go to some of these places out of the country, 465 00:25:14,549 --> 00:25:15,489 you don't know what you're getting. 466 00:25:16,589 --> 00:25:19,129 If you get it from a reputable company down here, 467 00:25:19,309 --> 00:25:20,629 you know exactly what you're getting. 468 00:25:20,789 --> 00:25:25,249 And I have labs that have tested the products where we receive it, 469 00:25:25,309 --> 00:25:26,169 and it's right on point. 470 00:25:26,309 --> 00:25:27,689 You're getting what they tell you you're getting. 471 00:25:28,389 --> 00:25:30,169 This is exciting, 472 00:25:30,169 --> 00:25:34,709 and obviously it's great that we have this available in our backyards. 473 00:25:37,269 --> 00:25:42,869 To that point, I mean, what are, you know, some of the things to watch for? 474 00:25:43,069 --> 00:25:45,209 You said, you know, reputable. 475 00:25:46,189 --> 00:25:48,369 Is it that they do third-party testing? 476 00:25:48,629 --> 00:25:50,629 I mean, what are some of the general suggestions? 477 00:25:50,629 --> 00:25:51,789 Yeah, third-party testing. 478 00:25:51,929 --> 00:25:52,669 You have to be careful. 479 00:25:52,789 --> 00:25:54,469 A lot of companies want to move into Florida. 480 00:25:54,469 --> 00:25:56,069 Hey, let's make a quick buck and leave. 481 00:25:56,489 --> 00:25:59,629 One of the companies that I use, they've been around here for 13 years. 482 00:26:00,009 --> 00:26:02,109 They're not just here because of that law has passed. 483 00:26:02,109 --> 00:26:04,709 They want to advance medicine. 484 00:26:04,889 --> 00:26:07,789 They want to make medicine better, and they care about it. 485 00:26:07,849 --> 00:26:08,509 They do research. 486 00:26:08,689 --> 00:26:08,729 They're 487 00:26:08,729 --> 00:26:12,869 doing some research with the NFL and with high school players about certain things 488 00:26:12,869 --> 00:26:16,869 to reduce inflammation with some other products right after an acute injury, 489 00:26:17,129 --> 00:26:19,509 even TBI injuries. 490 00:26:20,249 --> 00:26:22,109 But you have, like anything, 491 00:26:22,249 --> 00:26:25,269 you have to be careful where you're getting it from and do your research. 492 00:26:25,709 --> 00:26:26,949 A question on inflammation. 493 00:26:27,109 --> 00:26:30,209 What markers do you use to measure inflammation? 494 00:26:30,209 --> 00:26:33,809 Do you use, like, also blood panels, like hs-CRP and those type of? 495 00:26:33,809 --> 00:26:35,469 I leave that more for the medical guys. 496 00:26:35,589 --> 00:26:35,789 Okay. 497 00:26:35,889 --> 00:26:36,929 I'm an orthopedic guy. 498 00:26:36,929 --> 00:26:38,629 I'm more like a mechanic. 499 00:26:38,629 --> 00:26:39,009 Mechanic. 500 00:26:39,169 --> 00:26:39,329 Okay. 501 00:26:39,349 --> 00:26:42,989 But I leave it for the guys that are smarter than I am, such as yourself, 502 00:26:43,129 --> 00:26:44,009 building all this. 503 00:26:44,049 --> 00:26:48,709 Well, I, you know, I self, I'm a, I guess, a biohacker. 504 00:26:50,829 --> 00:26:52,889 But I leave it to the smarter physicians. 505 00:26:53,289 --> 00:26:57,549 You know, and then I take their advice and I implement that advice into our program. 506 00:26:58,549 --> 00:26:59,109 Great. 507 00:27:03,469 --> 00:27:05,129 So, interesting question here. 508 00:27:05,389 --> 00:27:09,649 I coordinate with some other primary physicians that will do that. 509 00:27:09,769 --> 00:27:10,509 They'll give me the data. 510 00:27:10,689 --> 00:27:13,189 Then our physical therapy guys take that into consideration. 511 00:27:13,189 --> 00:27:17,209 Yeah, I know the full coordination between all the experts. 512 00:27:17,609 --> 00:27:19,529 So, you talked about the little camera needle. 513 00:27:23,629 --> 00:27:26,389 So, it says here that, you know, 514 00:27:26,449 --> 00:27:28,469 you could look inside the joints now, right, with a needle. 515 00:27:28,769 --> 00:27:30,529 You know, arthroscopy. 516 00:27:30,709 --> 00:27:32,369 That's, you know, I haven't said that word in a while. 517 00:27:34,389 --> 00:27:40,529 So, what, I mean, is this like a new technology that, you know. 518 00:27:40,569 --> 00:27:41,709 It's fairly new. 519 00:27:42,169 --> 00:27:45,089 It's revolutionizing the way we practice orthopedics. 520 00:27:45,229 --> 00:27:48,169 In the future, whoever doesn't use that 521 00:27:48,169 --> 00:27:52,749 camera to perform an arthroscopic surgery is doing a disservice to the patient. 522 00:27:52,909 --> 00:27:55,609 And once you use the camera, there's no impact. 523 00:27:55,809 --> 00:27:57,349 I mean, you could go about your day. 524 00:27:57,349 --> 00:27:58,789 It's just like injecting a knee. 525 00:27:59,029 --> 00:28:01,149 But I do my surgeries with that camera. 526 00:28:01,449 --> 00:28:01,589 Wow. 527 00:28:01,709 --> 00:28:03,969 Anytime I need an arthroscopic, I use that camera. 528 00:28:04,109 --> 00:28:07,569 For example, the data that I've been collecting, 529 00:28:07,889 --> 00:28:11,989 most people know what a meniscectomy is, meniscus. 530 00:28:12,049 --> 00:28:12,889 A little cushion between 531 00:28:12,889 --> 00:28:15,569 the thigh bone and the leg bone and the knee that tears very frequently. 532 00:28:16,269 --> 00:28:17,049 Typically, a 533 00:28:17,049 --> 00:28:22,309 20-year-old college football player has a meniscus tear that doesn't require fixing. 534 00:28:22,309 --> 00:28:25,849 It just requires a little cleaning up so it doesn't rub between both bones. 535 00:28:25,849 --> 00:28:27,809 Sometimes you go in there with a regular camera. 536 00:28:28,009 --> 00:28:31,849 They're playing in a game at the college level maybe six weeks, 537 00:28:32,229 --> 00:28:35,329 five weeks, maybe four weeks, depending on their pain tolerance. 538 00:28:35,809 --> 00:28:39,489 With the needle scope, you can get it back in 10, 12 days. 539 00:28:39,769 --> 00:28:40,049 Wow. 540 00:28:40,209 --> 00:28:40,609 For example, 541 00:28:40,789 --> 00:28:45,749 our Olympic hockey team, the U.S. hockey team that won the gold medal, that goalie 542 00:28:45,749 --> 00:28:52,129 had his knee scoped with a needle scope three weeks before the gold match game. 543 00:28:52,249 --> 00:28:54,289 If it would have been done with the other scope. 544 00:28:54,289 --> 00:28:55,789 Why exactly is it? 545 00:28:55,929 --> 00:28:57,529 Because it's more precise? 546 00:28:58,449 --> 00:28:59,329 It's precise. 547 00:28:59,749 --> 00:29:01,349 Just as precise is the size. 548 00:29:01,509 --> 00:29:04,469 It's smaller, less trauma in the joint. 549 00:29:04,609 --> 00:29:06,309 You're not sticking a big instrument in there. 550 00:29:06,309 --> 00:29:15,169 And I think the [unclear], what really separates it is with the big 551 00:29:15,169 --> 00:29:18,429 camera, you have to inflate the knee with a lot of pressure with fluid. 552 00:29:18,909 --> 00:29:20,949 With the needle scope, minimal fluid. 553 00:29:21,149 --> 00:29:22,989 And I think that's what causes it. 554 00:29:22,989 --> 00:29:27,129 So there's minimal trauma inside the joint, less swelling, quicker recovery. 555 00:29:27,129 --> 00:29:29,509 And I haven't 556 00:29:29,509 --> 00:29:33,429 prescribed a narcotic in I don't know how many years after a regular knee scope. 557 00:29:34,269 --> 00:29:36,289 With a regular camera, 558 00:29:36,769 --> 00:29:39,769 typically most doctors prescribe a narcotic after surgery. 559 00:29:39,869 --> 00:29:41,369 I haven't done that, I think, over three years. 560 00:29:41,369 --> 00:29:43,649 I haven't prescribed a narcotic for a regular knee scope. 561 00:29:44,889 --> 00:29:49,789 No, obviously that has all its benefits on their own, right? 562 00:29:51,289 --> 00:29:56,089 So just to compare, is this like a replacement for an MRI? 563 00:29:57,409 --> 00:29:59,489 It can be used as a diagnostic tool. 564 00:29:59,649 --> 00:30:03,689 I've used it in the office when patients can't get an MRI because 565 00:30:03,689 --> 00:30:07,969 they may have some type of metal near their heart, a pacemaker, defibrillator. 566 00:30:08,509 --> 00:30:10,049 Some patients are claustrophobic. 567 00:30:10,229 --> 00:30:11,209 They can't get an MRI. 568 00:30:11,409 --> 00:30:12,809 I've used it for that particular reason. 569 00:30:13,349 --> 00:30:15,769 When MRIs are inconclusive, you're not sure. 570 00:30:16,629 --> 00:30:18,449 It can be used for diagnosis also. 571 00:30:18,609 --> 00:30:20,409 And at the same time, you can identify the problem. 572 00:30:20,749 --> 00:30:22,629 In many cases, you can treat it right then and there. 573 00:30:23,269 --> 00:30:24,769 And it's actually better than an MRI. 574 00:30:24,889 --> 00:30:25,929 You're actually looking at the structure. 575 00:30:26,049 --> 00:30:28,169 Yeah, you're actually looking at the real thing, right? 576 00:30:28,369 --> 00:30:30,569 And I'm sure it's like 4D, you know. 577 00:30:30,749 --> 00:30:32,449 Yeah, and it's just getting better. 578 00:30:32,789 --> 00:30:35,089 The new one's coming out now, I think, in October. 579 00:30:35,089 --> 00:30:38,349 The next generation, which will be easier to use. 580 00:30:38,569 --> 00:30:41,969 So hopefully more doctors will start using it and better serve patients. 581 00:30:42,669 --> 00:30:44,769 Just ballpark, what is the cost of something like that? 582 00:30:46,229 --> 00:30:47,029 It depends. 583 00:30:47,649 --> 00:30:51,149 It depends what you're doing, what type of surgery you're doing with it. 584 00:30:51,229 --> 00:30:53,169 Just taking a look can be a few thousand dollars. 585 00:30:53,629 --> 00:30:56,629 But the camera itself, is it like a $20,000, $30,000, $50,000? 586 00:30:56,949 --> 00:30:58,689 No, no, no, no, no, no, no. 587 00:30:58,809 --> 00:30:59,329 No, it's not. 588 00:31:00,409 --> 00:31:03,529 It's actually disposable, and it connects to an iPad. 589 00:31:04,169 --> 00:31:04,509 Oh, yeah? 590 00:31:04,509 --> 00:31:05,529 Yeah, it's really cool. 591 00:31:06,989 --> 00:31:08,029 It's disposable, yeah. 592 00:31:08,269 --> 00:31:09,509 You use it one time, you throw it away. 593 00:31:09,749 --> 00:31:11,689 So it's like a fiber. 594 00:31:11,689 --> 00:31:11,869 That's it. 595 00:31:11,869 --> 00:31:13,249 I wish I should have brought it. 596 00:31:13,349 --> 00:31:15,909 I have it behind my desk, a little sample one. 597 00:31:16,069 --> 00:31:16,729 I should have brought it. 598 00:31:16,849 --> 00:31:19,649 So basically, it's a cable that connects to an iPad that has a camera. 599 00:31:19,689 --> 00:31:21,109 You use it and dispose it. 600 00:31:21,129 --> 00:31:22,549 You take pictures with it, and then you. 601 00:31:23,049 --> 00:31:23,389 Wow. 602 00:31:23,589 --> 00:31:23,709 Yeah. 603 00:31:23,909 --> 00:31:24,369 It's amazing. 604 00:31:24,629 --> 00:31:25,989 You learn something every day. 605 00:31:34,289 --> 00:31:35,049 So, yeah. 606 00:31:35,169 --> 00:31:41,129 So let's talk a little bit about OrthoMiami and your plans. 607 00:31:41,329 --> 00:31:43,009 I mean, I know you have big plans for it. 608 00:31:45,489 --> 00:31:48,469 And so right now you have how many offices? 609 00:31:48,649 --> 00:31:49,209 You have Doral? 610 00:31:49,989 --> 00:31:51,649 Right now we have two offices. 611 00:31:52,049 --> 00:31:58,049 South Miami Kendall on 87th Avenue between Sunset and Kendall, the original office. 612 00:31:58,049 --> 00:31:58,809 By the way, 613 00:31:59,009 --> 00:32:04,509 I just walked into the lobby of the original, and I love how you guys did it. 614 00:32:04,569 --> 00:32:05,109 Yeah, expanded. 615 00:32:05,349 --> 00:32:05,769 It's huge now. 616 00:32:05,909 --> 00:32:06,049 Yeah. 617 00:32:06,129 --> 00:32:07,929 We have physical therapy there also. 618 00:32:08,509 --> 00:32:10,909 The guys who run our physical therapy are phenomenal. 619 00:32:11,789 --> 00:32:12,769 One in Doral. 620 00:32:13,529 --> 00:32:13,649 Yep. 621 00:32:13,809 --> 00:32:15,669 And we'll be expanding pretty soon. 622 00:32:15,869 --> 00:32:17,749 We're looking for a centralized location, 623 00:32:17,749 --> 00:32:20,949 a little bit closer to the Brickell area, possibly, 624 00:32:22,709 --> 00:32:23,069 and 625 00:32:23,069 --> 00:32:29,149 tying that together with a new surgical center to better serve our population. 626 00:32:29,669 --> 00:32:32,829 And what, you know, talking about the population, 627 00:32:32,989 --> 00:32:35,429 what are the shifts that you've seen in Miami? 628 00:32:35,989 --> 00:32:37,249 Obviously, Miami has changed a lot. 629 00:32:37,369 --> 00:32:39,389 I mean, you said, obviously, from when you were young. 630 00:32:39,669 --> 00:32:41,589 So what are the shifts that you see? 631 00:32:41,889 --> 00:32:43,089 I mean, because everybody used to say all sorts. 632 00:32:43,089 --> 00:32:43,709 Besides traffic. 633 00:32:43,929 --> 00:32:44,369 Oh, yeah. 634 00:32:45,369 --> 00:32:45,729 Yeah. 635 00:32:45,849 --> 00:32:48,829 But, you know, everybody in Florida, you know, all their population, all that. 636 00:32:48,989 --> 00:32:50,049 I mean, that has changed dramatically. 637 00:32:50,049 --> 00:32:50,169 Dramatically. 638 00:32:50,589 --> 00:32:50,789 Yeah. 639 00:32:51,229 --> 00:32:53,909 The sports scene has changed dramatically, Miami. 640 00:32:54,389 --> 00:32:55,409 When I was younger, 641 00:32:55,409 --> 00:32:59,249 you go to California and you see everybody outdoors walking or jogging 642 00:32:59,249 --> 00:33:00,989 that wasn't like that down here. 643 00:33:01,169 --> 00:33:04,169 Now this is the place to do the outdoor stuff. 644 00:33:04,449 --> 00:33:06,109 And obviously now we have, 645 00:33:06,269 --> 00:33:09,909 I mean, there's also all these cultural shifts on people now, 646 00:33:11,089 --> 00:33:15,849 you know, changing nightlife for actually healthier stuff. 647 00:33:16,069 --> 00:33:16,629 They're running more. 648 00:33:16,629 --> 00:33:18,829 But I'm sure by running more and doing all that, 649 00:33:19,249 --> 00:33:22,029 you know, there's also an increase on injuries and things like that. 650 00:33:22,249 --> 00:33:25,729 It's no longer the 80s where nightlife was what you did for recreation. 651 00:33:26,129 --> 00:33:28,429 Now you take care of your body. 652 00:33:28,629 --> 00:33:29,169 You run. 653 00:33:29,369 --> 00:33:31,809 And unfortunately, with that comes injuries. 654 00:33:32,269 --> 00:33:32,569 Orthopedic. 655 00:33:32,569 --> 00:33:35,009 Well, that's where exactly also the preventive stuff, right? 656 00:33:35,169 --> 00:33:35,269 Correct. 657 00:33:35,269 --> 00:33:37,009 So if people, I mean, you know, because, 658 00:33:37,069 --> 00:33:42,789 I mean, running, you know, running, going back, I mean, if you run regularly, yeah. 659 00:33:42,989 --> 00:33:45,269 And if you're not watching your body. 660 00:33:46,869 --> 00:33:49,309 Not only just working out also, lifting weights, 661 00:33:49,469 --> 00:33:51,249 everything, everything takes a toll on your body. 662 00:33:51,389 --> 00:33:54,689 And you can do things for it not to get to where it's a disease. 663 00:33:54,929 --> 00:33:55,089 Yeah. 664 00:33:55,349 --> 00:33:57,329 You got a little ache, soreness, all that is good. 665 00:33:57,609 --> 00:33:58,309 And I expect it. 666 00:33:58,409 --> 00:34:01,009 But you can, there's so much you can do now to 667 00:34:01,009 --> 00:34:05,369 prevent all that getting to a disease and a problem that will limit your mobility. 668 00:34:06,309 --> 00:34:07,329 And we got it. 669 00:34:07,429 --> 00:34:08,809 We have to get, we have to be better 670 00:34:08,809 --> 00:34:12,469 as physicians to get the word out there and let the, or people know about it. 671 00:34:12,469 --> 00:34:14,649 Well, actually, when we did the event here, 672 00:34:14,769 --> 00:34:18,309 you guys, you know, share how much has changed as a physician, right? 673 00:34:18,409 --> 00:34:24,829 I mean, I think we were talking and you said, like, you know, five, ten years ago, 674 00:34:24,989 --> 00:34:28,309 you know, the role that we had as a physician was so different than today. 675 00:34:28,649 --> 00:34:30,889 Especially now with social media, you know, 676 00:34:31,169 --> 00:34:33,769 having to, you know, educate and be out there. 677 00:34:34,369 --> 00:34:36,629 What do you see, you know, how do you 678 00:34:36,629 --> 00:34:40,409 see the role of a physician now with AI changing in the next couple of years? 679 00:34:40,589 --> 00:34:42,189 I mean, especially in your particular area. 680 00:34:42,989 --> 00:34:45,949 I mean, I'm older than these young doctors that are getting out there now. 681 00:34:46,069 --> 00:34:47,389 But if you don't use it, 682 00:34:47,509 --> 00:34:50,789 you stay behind and you stay behind for your patients, which is important. 683 00:34:50,989 --> 00:34:57,109 You need to, but you have to integrate it in a way that it serves the right purpose. 684 00:34:57,109 --> 00:35:00,489 Like we were talking earlier about collecting the right data and, 685 00:35:00,609 --> 00:35:02,669 most importantly, making the right diagnosis. 686 00:35:02,949 --> 00:35:06,149 And then using AI to take that to a different level, 687 00:35:06,409 --> 00:35:08,289 expedite the patient's recovery. 688 00:35:09,389 --> 00:35:14,189 You can, before we, like, getting somebody back after an ACL injury, before 689 00:35:14,189 --> 00:35:18,249 we do a functional ACL analysis testing, that's making them jump on one leg. 690 00:35:19,229 --> 00:35:20,929 So, you know, measuring their strength now with AI, 691 00:35:21,129 --> 00:35:23,969 we can probably take that to the next level and do something that's... 692 00:35:23,969 --> 00:35:26,229 And do it on their own time, right? 693 00:35:26,289 --> 00:35:28,149 So, that way it also relieves it. 694 00:35:28,593 --> 00:35:30,773 So, since we're talking about technology, I want to show 695 00:35:30,773 --> 00:35:34,393 something that we developed over the last couple of days that is pretty exciting. 696 00:35:34,593 --> 00:35:38,753 And surprisingly, I developed it because I have a 697 00:35:38,753 --> 00:35:41,813 lot of friends that are playing padel and racquetball and other sports. 698 00:35:42,993 --> 00:35:46,753 And as we now develop the new version of the platform where we want to 699 00:35:46,753 --> 00:35:53,973 track as many sports as possible and track it with as much accuracy as possible. 700 00:35:54,913 --> 00:35:57,513 I don't know if you knew this, but, you know, Apple has, 701 00:35:57,673 --> 00:36:01,593 obviously, the Apple Watch has, you know, a bunch of activities you could track. 702 00:36:01,793 --> 00:36:02,773 But if you put something like tennis, 703 00:36:02,873 --> 00:36:04,693 well, first of all, it doesn't even have padel, right? 704 00:36:04,693 --> 00:36:04,773 Right. 705 00:36:04,893 --> 00:36:07,293 Which is a pretty big sport globally. 706 00:36:07,533 --> 00:36:09,433 And in Miami, it's a big thing. 707 00:36:10,113 --> 00:36:13,053 But if you track tennis, it only tracks your heart rate. 708 00:36:13,253 --> 00:36:13,553 Right. 709 00:36:13,693 --> 00:36:13,893 Right? 710 00:36:14,053 --> 00:36:16,293 And obviously, you're moving a lot in tennis, right? 711 00:36:16,593 --> 00:36:21,733 The only ones that you could track by the use of GPS that I've seen is walking, 712 00:36:21,893 --> 00:36:23,473 outdoor sports, running, cycling. 713 00:36:23,473 --> 00:36:26,913 So I said, let me try to see if I could actually 714 00:36:26,913 --> 00:36:38,113 use the GPS capabilities of the watch to track a padel, you know, a padel activity. 715 00:36:38,613 --> 00:36:40,613 And actually, this is pretty exciting. 716 00:36:42,033 --> 00:36:46,453 You know, this is, I'm here in our friend's Wynwood Padel here in Miami. 717 00:36:46,453 --> 00:36:52,253 I played, this is a half an hour play, and it, 718 00:36:52,253 --> 00:36:55,813 you know, it quantifies a little bit of some of the specific things for padel. 719 00:36:55,993 --> 00:36:58,253 Like, I ran, like, 0.2 miles. 720 00:36:58,393 --> 00:36:59,653 I think I haven't verified all this. 721 00:36:59,773 --> 00:37:01,273 This is first version of this. 722 00:37:01,593 --> 00:37:07,473 My top speed was 20 miles per hour, and 29% I was in play. 723 00:37:07,773 --> 00:37:09,433 And I added some zones. 724 00:37:09,693 --> 00:37:10,393 I actually 725 00:37:10,393 --> 00:37:15,213 had my AI help me figure out what are some of the things that are specific to padel. 726 00:37:15,213 --> 00:37:18,333 So these are my zone play times. 727 00:37:18,513 --> 00:37:23,753 What I wanted to do, I wanted to actually see it, you know, in a [unclear] overlay. 728 00:37:23,933 --> 00:37:27,453 So this is actually Wynwood Padel right here in Miami, right here in Wynwood. 729 00:37:27,833 --> 00:37:29,313 And I was playing in this court. 730 00:37:30,313 --> 00:37:37,473 And I got to actually, you know, see how I moved through the court. 731 00:37:38,193 --> 00:37:40,013 I did a perimeter first. 732 00:37:40,513 --> 00:37:45,413 That's my own invention to really make sure that I could lock it into the court. 733 00:37:45,613 --> 00:37:49,073 But this is how I moved, you know, in the 30 minutes throughout the court. 734 00:37:49,873 --> 00:37:51,713 And this is exciting because this is, 735 00:37:51,853 --> 00:37:57,133 you know, being able to, you know, put some data down to how I played. 736 00:37:58,853 --> 00:38:04,433 And, you know, obviously with the Apple Watch, I could also measure my heart rate. 737 00:38:04,613 --> 00:38:09,373 So this is my heart rate evolution during the play time that I had there. 738 00:38:10,093 --> 00:38:12,973 My elevation, obviously the court didn't have a lot of elevation. 739 00:38:13,253 --> 00:38:14,153 My pace. 740 00:38:14,453 --> 00:38:17,913 So here's some of the little bit of running that I did. 741 00:38:18,693 --> 00:38:19,993 I didn't run that much. 742 00:38:20,913 --> 00:38:22,313 And then my heart rate zones. 743 00:38:22,913 --> 00:38:25,053 So, you know, this is exciting because 744 00:38:25,053 --> 00:38:31,633 it could be applied to any sport where you could track via GPS. 745 00:38:31,953 --> 00:38:32,733 So tennis. 746 00:38:32,733 --> 00:38:33,473 That's phenomenal. 747 00:38:34,893 --> 00:38:37,453 And, you know, going back to some of the things that we discussed. 748 00:38:37,453 --> 00:38:44,033 I mean, if someone is tracking, you know, themselves through their daily life 749 00:38:44,033 --> 00:38:47,993 and you start adding up, okay, well, you know, your knee is hurting. 750 00:38:47,993 --> 00:38:49,753 But let's see what you've been doing. 751 00:38:49,873 --> 00:38:50,773 Oh, you've been playing padel, 752 00:38:50,913 --> 00:38:56,633 which obviously is probably pretty abrupt in your knees or other type of sports. 753 00:38:56,893 --> 00:38:58,233 Plus, you've been running a lot. 754 00:38:58,353 --> 00:38:59,673 And we start adding those miles. 755 00:39:00,073 --> 00:39:05,073 You know, now we see that, yeah, you either need to take some 756 00:39:05,073 --> 00:39:11,713 preventive care or preventive treatments or slow down or change the mix of sports. 757 00:39:12,133 --> 00:39:14,913 So, again, this is a little bit exciting. 758 00:39:15,173 --> 00:39:16,073 That's super exciting. 759 00:39:16,213 --> 00:39:17,253 You can use it for any sport. 760 00:39:18,293 --> 00:39:19,053 Yeah, yeah. 761 00:39:19,133 --> 00:39:20,813 I mean, my daughter plays beach volleyball. 762 00:39:20,953 --> 00:39:22,073 We talked to her the other day. 763 00:39:22,293 --> 00:39:24,793 I said, hey, I'll build one of this for you. 764 00:39:24,973 --> 00:39:27,953 So, you know, how much are you moving around the court? 765 00:39:28,693 --> 00:39:30,773 And probably with these devices, 766 00:39:30,773 --> 00:39:33,293 you could even measure, like, you know, if they're jumping. 767 00:39:34,053 --> 00:39:34,793 It's exciting. 768 00:39:35,553 --> 00:39:39,913 But, you know, but when I told my friend that he's an expert in padel, 769 00:39:39,993 --> 00:39:42,713 he owns this, he's like, I only thought you could do this with, 770 00:39:42,713 --> 00:39:45,133 like, cameras that you put in the actual court. 771 00:39:45,513 --> 00:39:47,993 This is actually done with a device that anybody could get. 772 00:39:48,033 --> 00:39:48,593 That's what I thought. 773 00:39:48,653 --> 00:39:50,093 You can only do it with cameras on the court. 774 00:39:50,093 --> 00:39:52,513 So, yeah. 775 00:39:52,793 --> 00:39:53,093 So, yeah. 776 00:39:55,113 --> 00:39:56,173 That's going to be beneficial, 777 00:39:56,173 --> 00:39:59,333 even from all the way up to the professional level for many sports. 778 00:39:59,453 --> 00:40:01,433 And you could even see what your opponents are doing. 779 00:40:02,573 --> 00:40:04,033 The data is shared. 780 00:40:04,093 --> 00:40:06,013 I could actually make the two. 781 00:40:06,133 --> 00:40:07,853 And, you know, obviously, I make it fun and competitive. 782 00:40:07,853 --> 00:40:10,173 Like, oh, I ran, like, 20% more than you did. 783 00:40:11,373 --> 00:40:12,633 But this is just for me. 784 00:40:12,733 --> 00:40:13,933 I mean, obviously, I'm not a padel player. 785 00:40:14,013 --> 00:40:15,393 But just the fact that I stayed. 786 00:40:15,493 --> 00:40:16,793 I mean, you picked it up immediately. 787 00:40:17,093 --> 00:40:17,493 You're right-handed. 788 00:40:17,573 --> 00:40:18,633 You said you're right-handed. 789 00:40:18,633 --> 00:40:21,193 You picked it up immediately that I played on this side. 790 00:40:23,053 --> 00:40:25,373 But, yeah, it's interesting. 791 00:40:26,173 --> 00:40:27,513 I could use it for my pickleball. 792 00:40:27,773 --> 00:40:30,073 I've been relegated to pickleball because of my knee. 793 00:40:30,073 --> 00:40:32,633 Yeah, actually, let me see here. 794 00:40:34,153 --> 00:40:38,173 If you change the workout type to pickleball, 795 00:40:38,453 --> 00:40:47,593 look, it put it over a pickleball court and it changed the layout. 796 00:40:47,713 --> 00:40:48,373 You would have been on that. 797 00:40:48,493 --> 00:40:48,673 Yeah. 798 00:40:48,973 --> 00:40:49,553 That's amazing. 799 00:40:49,813 --> 00:40:49,913 Yeah. 800 00:40:50,213 --> 00:40:50,393 Yeah. 801 00:40:50,573 --> 00:40:51,973 And, obviously, maybe, yeah. 802 00:40:52,313 --> 00:40:53,033 So, again, 803 00:40:53,113 --> 00:40:58,973 this is all, you know, bleeding-edge development that we've been doing here. 804 00:41:00,033 --> 00:41:01,333 So, yeah, it's exciting. 805 00:41:01,513 --> 00:41:02,593 That's very innovative. 806 00:41:02,833 --> 00:41:03,813 All from the watch. 807 00:41:04,033 --> 00:41:05,793 All from the watch, yeah. 808 00:41:05,973 --> 00:41:08,153 So, I'm actually going to be – this is Apple Watch. 809 00:41:08,253 --> 00:41:10,753 I'm going to be trying it with Garmin watches. 810 00:41:10,753 --> 00:41:11,753 I haven't tried it yet. 811 00:41:12,013 --> 00:41:13,993 I think they have a little bit more precision. 812 00:41:13,993 --> 00:41:16,213 So, let's see how that looks. 813 00:41:16,393 --> 00:41:22,233 So, you know, to wrap things up, you know, so we look at the next 10 years. 814 00:41:22,313 --> 00:41:27,753 We talked a little bit about, you know, what do you see as exciting? 815 00:41:27,753 --> 00:41:28,453 I mean, obviously, 816 00:41:28,713 --> 00:41:33,153 all these innovations in new cameras are probably going to get even smaller. 817 00:41:34,653 --> 00:41:36,733 You know, what else? 818 00:41:37,573 --> 00:41:43,113 I see all that innovation tying the needle arthroscopies with the biologics, 819 00:41:43,233 --> 00:41:44,173 integrating them, 820 00:41:44,333 --> 00:41:50,013 not just using each one or the other separately, with the assistance of AI. 821 00:41:50,013 --> 00:41:56,433 I think AI, we're not even doing the tip of what we can do, 822 00:41:56,673 --> 00:41:59,933 not even a percent of what we can do in medicine with AI. 823 00:42:00,093 --> 00:42:03,113 I think AI, we have to figure out how to use it properly for medicine, 824 00:42:03,113 --> 00:42:05,833 you know, and for recovery. 825 00:42:05,833 --> 00:42:06,633 I think it's 826 00:42:06,633 --> 00:42:11,693 going to take it to the next level that we have no idea where we're going to be. 827 00:42:11,753 --> 00:42:14,753 It's going to – and it's going to blow up in the next three to five years. 828 00:42:15,433 --> 00:42:15,813 Yeah. 829 00:42:15,913 --> 00:42:16,193 You know. 830 00:42:16,333 --> 00:42:21,653 No, and it's – and it democratizes – well, 831 00:42:21,933 --> 00:42:26,333 it democratizes the access so you guys could help more people, right? 832 00:42:26,333 --> 00:42:32,753 Because, I mean, even just showing up to the office or visiting the office, 833 00:42:32,953 --> 00:42:35,713 you know, take time, people have to take time from work, all that. 834 00:42:35,933 --> 00:42:39,793 So people could, you know, do this at home and you could monitor and you could – 835 00:42:39,793 --> 00:42:42,513 you know, the data from home, they don't have to come in through the office. 836 00:42:42,953 --> 00:42:44,813 Patients are going to be better educated. 837 00:42:45,273 --> 00:42:46,853 Doctors will be better educated. 838 00:42:47,853 --> 00:42:50,373 That's what I noticed when I did my fellowship at Stanford, 839 00:42:50,373 --> 00:42:51,673 that the population there, 840 00:42:51,773 --> 00:42:55,453 that was during the Silicon Valley era, very educated patients. 841 00:42:55,593 --> 00:42:58,373 They used to ask me, well, what's that screw made out of? 842 00:42:58,593 --> 00:42:59,153 Yeah, exactly. 843 00:42:59,353 --> 00:43:00,973 I had to be on top of my game. 844 00:43:00,993 --> 00:43:04,073 Well, you add Elon Musk, he probably develops his own, you know. 845 00:43:04,613 --> 00:43:08,793 But, yeah, it's going to change the way medicine is practiced for sure. 846 00:43:08,793 --> 00:43:10,693 And it is changing it now for the better. 847 00:43:11,453 --> 00:43:13,913 Well, Dr. [unclear], it was an honor having you. 848 00:43:15,453 --> 00:43:22,073 It's obviously an area that we haven't covered, orthopedics and the innovation. 849 00:43:22,273 --> 00:43:24,973 And obviously, as a long-time patient of your practice, 850 00:43:24,993 --> 00:43:28,113 I'm excited to have been able to share this time with you. 851 00:43:28,333 --> 00:43:29,793 Hopefully, you won't need our services. 852 00:43:29,993 --> 00:43:33,153 But I appreciate you having me here, and it's been a pleasure, Demian. 853 00:43:33,533 --> 00:43:34,153 Thank you. 854 00:43:34,333 --> 00:43:35,053 Thank you so much. 855 00:43:35,153 --> 00:43:35,473 Thank you. 856 00:43:36,373 --> 00:43:38,433 Well, another episode of Augmented Wellness. 857 00:43:38,913 --> 00:43:40,493 Thank you so much for watching. 858 00:43:40,873 --> 00:43:44,953 And hopefully, some of this technology that I shared here, 859 00:43:44,973 --> 00:43:46,353 you're going to see it in the app soon. 860 00:43:47,053 --> 00:43:50,053 So I would love to hear your feedback in what you think about it. 861 00:43:50,353 --> 00:43:51,153 Thank you so much. 862 00:43:51,993 --> 00:43:52,373 Thank you.