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Weekly Live event replay- 20200701

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Weekly Live event replay- 20200701
Trying to thrive in a world of heightened uncertainty by focusing on:
-Small wins.
-Falling forward.

Chicago Arthritis and Regenerative Medicine- Weekly Live
Check us out live on Instagram and Facebook every wednesday at 12:15pm cst.
Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis


Hello everyone, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly Live event. It’s July 1st, 2020. I hope everyone’s doing well. This feels like the beginning of summer, even though that started a couple of weeks ago. Here in Chicago, we’ve started to enter phase four of the coronavirus response, which generally means that certain retail establishments, including restaurants, I believe bars, are now allowed to allow something like 25% of their normal volume of patrons. That’s a nice small win for us here in Chicago, since we had so really clamped down pretty hard for a couple of months, we’ve been able to start slowly easing into, you know, this new normal. At the same time we have other parts of the country that weren’t quite as… I don’t know if I want to say diligent or aggressive when it came to precautions when they were reopening. And now they’re in a position where they have to start kind of pulling back as well. My sense is that this sort of cautiousness and variability that we’re seeing throughout the country is something we’re going to be dealing with for at least the next several months. Meaning as some places are able to reemerge a little bit, more steady, other places may need to retract, and there’s going to be a bit of give and take, and pull and push as we, you know, as we grow into what this new world is.

And in that kind of world where you have so much uncertainty and volatility, I want to touch base on how can, how can we as individuals, still thrive in a world with heightened concerns? So it goes without saying that for folks that have active medical issues that require treatment or are being delayed because of COVID-19, those are really harsh things that obviously need to be addressed in a hardcore medical way. A lot of the things I’m talking about are more about, you know, how should we be approaching, how should we be approaching things from a mental and emotional standpoint with some of the heightened concerns that we have, and volatility that we have in this world. And so there’s two things that I think of, number one is being able to focus on small wins. And number two is really a concept that I believe in which is falling forward.

So in terms of small wins, I think it’s critical that we really appreciate when we do take those baby steps, when we are, when we are actually moving forward and when we have wins. So as an example, phase four in Chicago, that’s a big deal. I mean, we really were pretty clamped down and shut down from a business standpoint throughout, you know, our, the Metro Chicago economy for the last, for the last few months. And so to see restaurants starting to open up a little bit is a big deal. This past weekend, my family, we were able to go to the Chicago Zoo. And then the next day we were able to go on a picnic with some friends and we maintained appropriate precautions in terms of mask, as well as social distancing. But you know, that, those are small wins, and that’s important to recognize.

So in a professional component, when I think of how do we get small wins for our patients who have arthritis, tendinitis, injuries and back pain, there’s a few things that I think of. The first is, small wins help out in a couple of ways. For example, they help out with maintaining forward momentum or forward progress. In addition, small changes sometimes can equal bigger, bigger wins longterm as well. So as an example, maintaining forward progress, I think physical therapy is a great example of where small wins on a day-by-day basis go a long way. In particular, small gains in strength, small improvements in range of motion, go a long way in terms of improving a person’s function, a person’s pain relief, and a person’s quality of life on a daily basis. So key because small changes in strength, small changes in stability make a huge difference in quality of life. Regenerative medicine sometimes has a similar effect, for example, improving stability, which is a lot of what we’re doing when we’re treating ligaments, soft tissue structures, tendons, muscles, labrum, meniscus, that even just a small amount of improvement in stability and strength in those tissues goes a long way in terms of improving function as well. So that classic sort of example would be a patient who says, “Look Doc, I’m doing okay when it comes to my knee, when it comes to rest, and I can do some basic activities okay. But now when I’m walking about four blocks is when my knee is causing problems. I start to feel fatigue and pain and it starts to feel a bit loose.” Well, improving some of that stability with physical therapy, but also with the regenerative medicine techniques, whether it’s injecting your own platelets, dextrose, bone marrow stem cells, that that goes a long way in terms of taking somebody from walking four blocks to walking eight blocks. Quality life improvement there is pretty big. The original prolotherapy, dextrose prolotherapy, where you’re injecting sugar water, which has been going on for decades as a treatment modality for arthritis and tendinitis, that worked by improving that tissue integrity of ligaments. And by improving that function just a little bit, made a huge difference in terms of functional improvement, and quality of life, and pain relief as well. So small changes, small wins, when it comes to things like physical therapy and regenerative medicine, help to maintain forward progress, and help to push forward a person’s abilities.

The other thing is sometimes small changes can actually be equivalent to humongous gains. So two examples of that. Number one is a patient I saw recently who was having a lot of hand and wrist pains, who I think has probably early rheumatoid arthritis. You know, the next step in her evaluation is actually to check a diagnostic ultrasound of her hands and her wrists. And the reason why is I’m expecting to see some subtle changes of fluid. But really what I want to see is does this person have what’s called power Doppler uptake or active inflammation in those small joints, because if they do, that makes a big difference in terms of what our next steps would be. In particular, because if they have that small vascular change on ultrasound, it’s a sign of very significant inflammation, and it’s a very significant sign of progression or risk for progression of their condition, including actual damage in the joint as well. So identifying that small change is huge because we can actually make a difference with treatment there. If you start a person on the right kind of medication treatment who has that condition, you can reverse or actually get that inflammation signal to resolve, and that will then predict a reduction in chance of progression of their condition, and a reduction in chance of actual damage from their condition as well. So that’s humongous, making small changes, small win for that one small change can go a long way to improving that person’s condition, pain, inflammation, and longterm outcomes as well.

The second concept that I think that’s important is something that I think a lot about is this idea of falling forward. So, you know, I got this idea originally, I am a big football fan, and every once in a while, you’ll find a running back who’s in the league who is not the fastest, not the quickest, not very elusive in his movements, but he’s someone who based on his size, his agility and the way he plays, that anytime you hit him, he still falls forward. He still somehow gains yardage. So if you hit him after a three-yard gain, he gets five yards total. If you hit them behind the line of scrimmage, instead of a one-yard loss, he still somehow ekes out two yards. Falling forward. I think that’s important mainly because, in my own personal and professional life, I find that when you have to make tons of decisions, it’s hard to make all those decisions perfectly and correctly. And sometimes you just have to make a good decision that makes sense on paper. And hopefully if it’s enough of an improvement, that even if the result is not ideal, you still fall forward, meaning you’re still getting some forward momentum. You’re still inching forward, so that you’re not as concerned about, “Did I make the exact perfect decision?” You’re more thinking about, “Did I at least move things forward? Did I at least move my life forward, my business forward, the effect on this individual forward?” So that we’re still moving forward in a positive way. I think that’s key because it’s important that when you make decisions that you are learning, you’re adapting, and you’re moving forward.

This is, this is important, not only from a life standpoint, a business standpoint, I think it’s so key from a musculoskeletal standpoint as well, namely for the following two reasons, two examples. I had a patient ask me recently about what to expect after his regenerative medicine treatments. And the key for him to understand is that, that first couple of weeks are going to be a little bit up and down, that he may feel like he is, his progress is a little bit up, a little bit down, but the key is to understand that as long as you’re inching forward, falling forward, you’re making progress. And that long term, that sort of slow progress of falling forward will eventually equal big gains longterm. I think physical therapy and exercise is the same thing. There’ll be moments where you feel like you’re doing well. And there may be the moments where you feel like you have a little bit of retraction. That little bit of retraction, that can occur. And that’s okay because that’s part of the process of healing and improving, meaning that it’s not a linear straight line. A lot of times it is actually just getting small improvements and there may be a small setback, which you learn from that, you adapt from that, and then you kind of get back on that upward trajectory. Falling forward is key because I think in a world of uncertainty, we’re not going to have full visibility of what’s coming next. We’re not going to have full visibility of, are we making always good progress? But as long as we’re making micro progress falling forward, I think that’s, that’s a way to gauge that. Are we actually in the right direction?

So in this world of heightened uncertainty and concern, I think whether it comes to your own personal life, whether it comes to your own professional life, and certainly when it comes to your own musculoskeletal health, those are the key things. Are you making small wins again and again. And are you falling forward. I think if you are, then you’re heading in the right direction. You’re still growth-oriented. You’re still moving positively. I think that goes a long way.

Thank you for your time. Until we connect again next week, I hope everyone stays healthy and is safe. As a reminder again, I’m publishing two things right now. The first is obviously this Weekly Live kind of interaction. The other one is a Weekly Educational meeting that I have with my own team every week. We’re publishing that as well. Good way to kind of learn from both of them in a slightly different way, but until next week, I hope everyone stays healthy and live well. Bye, bye.


***For more educational content:
Sign up for our email newsletter:

Subscribe to our Newsletter

See our blog:

Chicago Arthritis Blog

Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:

Candidate Form

Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses how to thrive in a volatile world- 1) Small wins. 2) Falling forward.

#chicago
#chicagoarthritis
#chicagoarthritisregenerativemedicine
#westloop
#westloopisthebestloop
#regenerativemedicine
#prp
#stemcells
#arthritis
#osteoarthritis
#tendinitis
#rheumatology
#rheumatologist
#rheumatoidarthritis
#psoriaticarthritis
#anklyosingspondylitis
#autoimmune

 

Weekly Education- 20200629

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Weekly Education- 20200629
-Expectations post regenerative procedure for arthritis, tendinitis, injuries, and back pain.
-Can prp or bmac help after a prior surgery?

Hello, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. It’s June 29th, 2020, and welcome to our weekly educational meeting. So this meeting is typically me discussing with my team typical issues that come up in the scope of our practice clinically, and discussing how we generally approach those issues, either questions that specific team members have, patients have, or things that I’m seeing, to give a bigger picture perspective in terms of how we handle clinical issues and problems to not only add value to individual patients, but based on how we’re handling them, to also give a sense for how we try to approach medical issues so that the general public gets a sense for what are best practices and how we evaluate things. So today’s going to be a little bit different, namely because I actually have a couple of folks who are on vacation today. So this is going to be more me just discussing directly, questions that have come up in the last week from patients that I think can help to clarify some things and offer some value.

So the first one is from a recently treated patient who had his knee and lower back treated, who had described some discomfort roughly one week after treatment, and discussion I had with him regarding expectations regarding post-treatment care, post-treatment progression and discomfort, and progressive improvement that will occur over time. So in his case, treated about a week ago, and he had sent me a text message over the weekend saying, “Hey, still having some stiffness, what are some expectations?” And so reviewing that with him again to make sure we’re on the same page. So after any sort of regenerative treatment, there is an expectation of inflammation up front. That’s normal. So inflammation for the first two, three days after treatment is expected. That can go out to roughly about a week and that inflammation can get presented as swelling in a joint that’s been treated or a tendon that’s been treated, and more discomfort or even pain for the first few days after treatment. We normally treat that with things that are not going to impair or impact the actual treatment that we’re using. So what I recommend is avoiding anti-inflammatory medications, ice, things of that nature that are meant to reduce inflammation on a more profound level. On the other hand, utilizing things like Tylenol, possibly a short term narcotic, heat, some compression, bracing, manual therapy, all those things are okay, cause they’re not going to limit the effectiveness of what we’re trying to achieve.

So this individual’s gotten over that initial post-treatment discomfort and he’s still having some stiffness and milder discomfort. And what I generally expect is some degree of that sort of stiffness for the first week up to even three weeks. The most I’ve seen is up to four weeks, but normally it’s in that first week to two weeks that people will have that. Again, that’s a normal process of what’s going on here. And that’s because the inflammation component of what we’re trying to trigger with treatment is going to lead to these kind of symptoms. So when you have that initial acute inflammation, that swelling of the structure that’s been treated, you’ll see for that first week or so, there’s still then that lower level inflammatory process that’s bringing in other cells and growth factors that you should expect for the next couple of weeks afterwards. So stiffness immediately afterwards and for the first couple of weeks is normal. If that goes beyond that sort of normal course, then reevaluation may be needed.

So to me, a more significant or concerning aspect would be if someone’s developed fevers. That shouldn’t happen. Some low grade warmth can happen immediately after treating a joint. But it shouldn’t be outright fevers that someone’s having systemically. you would want to make sure that gets checked out to make sure that an individual doesn’t have an infection. In addition, if somebody has something like gout, pseudogout, rheumatoid arthritis, psoriatic arthritis, or any other kind of autoimmune condition, getting a more significant inflammatory component for that first week in a treated joint is certainly common and expected. And I’ve seen that quite often. And that generally comes down after about a week, and then there’s that progressive sort of improvement that will develop. Other things that would have me concerned would be if somebody said after a week, “Hey, knee’s feeling or the joint’s feeling more unstable.” I’d probably want to check that out then at that point. But for the most part, swelling will slowly, progressively improve, and improvement in pain and function I’d want to be hearing at roughly the four to six week mark with a slow, progressive improvement, then going on for the next, roughly three months up to six months. There’s some data showing that with some of these treatments improvement, even up to the first year or so. But my general approach is inflammation, stiffness up front and then slow progressive improvement for the next few months.

Second question that I got was from someone who was interested in learning more about our treatments, who is asking that, she had had surgery for her joint, could this treatment still be helpful? So there’s layers to this question. The first question is obviously what kind of surgery did they have, and then in addition, what’s actually their pain? So I gave an example, I believe last week, on this same broadcast, about how someone who’d had hip replacement surgery had persistent hip pain, and it turned out that his hip pain was actually coming from his SI joint. So in that kind of case where someone’s had surgery, if they still have pain, the exact same pain, perhaps their pain is coming from a different structure. In which case, yes, they can still benefit from treatment because the area that’s already been treated was not actually their pain generating structure.

Number two, let’s say someone’s actually had treatment. Let’s say arthroscopic surgery for the knee or some kind of surgery for the back, and they’re still having pain. Why would they still be having pain, or is the pain different than what they’ve had before, and can they benefit from treatment? So, number one, let’s say someone who’s had arthroscopic surgery, they’ve had some benefit from treatment initially, but they’re still having some discomfort or progressive pain. So that can happen for a number of reasons. Number one, again, their pain is not coming from just that one area that’s been treated. They may have pain that’s coming from chronic instability in the joint. And in which case that’s not something that’s going to get naturally better with routine arthroscopic washout kind of surgery, but can still get better from the regenerative treatments that we offer, whether that’s platelets or bone marrow or even prolotherapy, where if you can improve some of the instability in a soft tissue structure, that that person’s pain and functional impairment may actually get better.

Number two is if you’ve treated an area with surgery, let’s say a lumbar fusion, they can still get what’s called adjacent segment disease, where the areas above and below what’s been treated can still get stressed. And that’s expected in the sense that if you have a surgical procedure that fuses a segment, you still will have the same normal forces and weight that’s going through that area. And instead of now being taken up by that area that’s been fused, it’s now offloaded to the area above or below. And so people can then develop that same degenerative process in that area above and below. Or in some of the soft tissue components over that same segment that had already been fused. And so in that kind of person, now they can still benefit from treatment because now you’re treating those other segments that are now being stressed. Not to mention those same ligaments that were previously in that segment that’s already been fused, those ligaments may be taking on more stress. Just because you’ve taken it off one structure, the other structures around it are now still having to take on the load. So in someone that’s had surgery, if they’re still having pain, yes they can still respond to treatment if their pain is coming from a different structure or if their pain is coming because now the stress has been offloaded to other structures.

So the short answer is yes it’s possible to get benefit from treatment, but the more nuanced answer is, why do you still have pain, what structures are involved, and what else can be helped? Now, without a doubt, if you have, let’s say, something like a knee replacement, and if you still have pain, not only consider is the pain coming from another structure, but you would also want to make sure with your surgeon that there isn’t anything wrong with the hardware that’s in place. That should always be step one. But then also consider whether other structures are problematic. So the more nuanced answer is, get to more of the details and the why, but the short answer is yes you may be able to still benefit from treatment.

Well, this was a shortened version of this week’s educational meeting. I hope those two issues are ones that, if people have been thinking about them or having questions, I hope that gives some additional explanation and answers. And until next week I hope everyone is doing well. Be safe, be healthy, have a good day and live well. Bye bye.


Content- Weekly Education
Weekly educational meeting for the team at Chicago Arthritis and Regenerative Medicine where we discuss the basics of what we do for arthritis, tendinitis, injuries, and back pain.

***For more educational content:
Sign up for our email newsletter:

Subscribe to our Newsletter

See our blog:

Chicago Arthritis Blog

Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:

Candidate Form

Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses expectations post regenerative procedure for arthritis, tendinitis, injuries, and back pain. And also whether prp or bmac treatment can help after a prior surgery?


#chicago
#chicagoarthritis
#chicagoarthritisregenerativemedicine
#westloop
#westloopisthebestloop
#regenerativemedicine
#prp
#stemcells
#arthritis
#osteoarthritis
#tendinitis
#knee pain
#hip pain
#back pain
#ankle pain
#feet pain
#shoulder pain
#elbow pain
#wrist pain
#hand pain
#neck pain
#rheumatology
#rheumatologist
#rheumatoidarthritis
#psoriaticarthritis
#anklyosingspondylitis
#autoimmune
#covid19
#telemedicine

Weekly Education- 20200615

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Weekly Education- 20200615
-Why regenerative medicine.
-Improving upon the standard of musculoskeletal care.

Weekly educational meeting for the team at Chicago Arthritis and Regenerative Medicine where we discuss the basics of what we do for arthritis, tendinitis, injuries, and back pain.


Okay, all right, so welcome to our first weekly educational meeting. This is Siddarth Tambar from Chicago Arthritis and Regenerative Medicine. In this weekly format, I’m here to talk about a lot of the basics of what we’re doing in clinic to help treat arthritis, tendonitis injuries, and back pain. This is really situated for my team, all of you guys, in terms of getting us on the same page. And whether that is discussing concepts related to the rheumatology side with inflammation or the regenerative side regarding procedures and sort of philosophical bend with how we approach things, the idea is that we’re all sort of on the same page, understanding, messaging, all that kinda stuff.

And this works best if it’s kinda back and forth. Meaning if it’s not just me talking, I can do that if needed, but I think it works best if you guys have questions as well. In particular, Jackie, you’re talking to patients more and more. They’re probably asking you a lot of questions. I think as you have questions, kinda asking me, that’s how we learn. Right? Lilia, you’ll learn just kind of the basics of what we’re doing as you start conversing with patients more, it’ll be the same kinda thing. This is really meant to help fill in the details regarding the frequently asked questions sheet that we’re building out for what we do around here. And of course, Devi, this is good for you to at least get the basics. Then also to help coach me. Am I messaging things appropriately on a non-medical level? And then also kinda integrating and synthesizing everything that we’re doing.

We are definitely going to be videotaping this. It is videotaping. Good. Mainly because if there’s anything that is work-related, content-related, information-related, that is HIPAA compliant, we want to videotape, tape, and sorta distribute. I just think that going to be smart going forward.

So I thought a good topic to start our first one is why we even are involved in regenerative medicine? Like what’s the reason, what’s the purpose, what’s the why. And it’s really a couple-fold. The big picture to me is we can do better. Right? Something I’ve been talking about more and more is, as we come out of corona, we’re starting to realize there’re people talking about going to back to normal. And I would say, forget about normal. Why don’t we do better? Why don’t we take this is an opportunity to say, why don’t we do better? So regenerative medicine is one of those things. How do we do better?

So, as an example, when you take individuals who are at the level where their musculoskeletal condition is so severe, where surgery’s being discussed, the British Medical Journal has documented that only 20% of orthopedic surgeries meet Level I evidence for evidence and purpose of treatment. And what that means is, Level I evidence means that you have double blind, placebo-control. It’s like your highest level of evidence in medicine. So that means 80% of those surgeries do not meet that criteria. What that really means is that there’s opportunity to do better. Whether that’s on the non-surgical side. Whether it’s on the minimally invasive side. Things that we do. Or whether that’s even on the surgical side. You know, how can medicine do better knowing that only 20% of them meet that highest level of evidence? So first and foremost is how do we do better? And regenerative medicine, while it’s a relatively new field, the concepts, which we’ll talk progressively over the next few weeks, are built on sound medical concepts and in a low-risk fashion.

We’re thinking about risk so much more aggressively now. In large part because we’re all obsessively thinking about corona. But the reality is that when it comes to medicine, we should be thinking about risk in everything. We should be thinking about the risk involved in a blood draw. We should be thinking about the risk of actually coming to the clinic rather than doing this in a telehealth setting. Let alone we should be thinking about risk when it comes to medications, when it comes to surgeries, when it comes to procedures. The general public doesn’t always think about this proactively. They sometimes rely on us, on the physician end. And I think where we can add a lot of value to people is that when it comes to their musculoskeletal health, how do we help them re-understand or begin to understand risk and reward when it comes to their musculoskeletal health.

Okay, good. So that’s kind of one big picture. The other big picture is when it comes to musculoskeletal health, most people take the following approach. They wait until something is so severely bad that they cannot do anything before they actually pursue treatment. That’s crazy. Meaning if somebody’s got back pain, they don’t address that when they’ve got back pain initially. They wait until it’s so severe that they can’t work, till they can’t lift up their kids, till they can’t do anything. And they’re missing a chance to do something at an earlier stage to make things better. So whether that is addressing an injury at an early stage with something like physical therapy or exercises. Whether that’s emphasizing things like weight loss, more of an anti-inflammatory approach, the diet supplements functional medicine. Or, if somebody has something that is early on not responding to treatment, rather than just doing things like ice, rest and anti-inflammatory medications, can we help to improve stability at that functional unit that’s been damaged so that we can prevent this from getting worse. That is really where regenerative medicine can shine at that early stage. Because traditional medicine, the way that it’s approached, is if someone’s got persistent pain, you’re basically masking that with pain medication, steroid injections, ice. And you’re just waiting until it gets worse. The reality is if you’re 16, 18, 20 years old you’re probably going to get better on your own. For the rest of us, that’s just not how life works. Right? That progression and accumulation of injuries and mild soft tissue problems eventually leads to instability, which then leads to arthritis, tendonitis, and more problems. If we can catch some of those issues earlier on, regenerative medicine can help to improve stability and actually put somebody on a better trajectory course.

So why regenerative medicine? Because we need a higher standard. Because we need to be thinking about risk more proactively. Because there’s a huge scope of area that we can do better for people that have more advanced conditions. And because, can we treat people at an early stage to prevent this from getting worse? So, you’re starting to hear about more and more formal organizations starting to recognize these kind of treatment modalities. Whether it’s platelet-rich plasma from knees or other conditions, but this only going to be growing. And, you know, I’m pretty excited to be in this at a ground level. Questions? Jackie.

– [Jackie] I have to think of some. I will have some. Trust me.

– Okay, good. Yeah, I think going forward as much back and forth is helpful because number one, it, I think the best way to learn is if you’re asking questions. Right? And we’re going back and forth with that. Number two, I think as you start to talk to patients and hear their questions, like the way you respond to them, is how you’re actively learning at the same time. And then the reality is that helps me learn as well. That helps me to refine thoughts and philosophical approach to treatment as well. Good.

– [Student] At what point do you decide they are no longer benefiting from weight loss or PT and it’s time to intervene?

– Such a great question. Right. So when do we decide someone is failing conservative treatment like weight loss or strengthening? You know, the nice thing about medicine is that you can really just ask are you making progress? Right? So if you take somebody that has, let’s say, back pain, right? Well, start some physical therapy, some weight loss. If at the two month mark, six week mark, they’re telling you, hey look, I’m like 40% better, great. Give it more time. Right? But if at some point they say, look I’m doing my part appropriately, I’m still not making progress, that’s the time to jump in and intervene. So, medicine offers us this great concept that we can get feedback from a patient immediately. And we can figure out when they’re kind of plateauing, and that’s the best time to intervene. Reality is, a lot of our patients don’t quite do that. They kind of wait for us to initiate. But it works better if they’re initiating on their own, pushing proactively, and then we’re getting feedback from them in terms of when we realize we need to push harder. What else? Yes?

– [Lilia] When….

– You don’t need to raise your hand, Lilia. Yeah.

– [Lily] When do you know when there isn’t…. Is there a time where you cannot help these….

– Yeah. Great question. So when do we know when we can’t help them?

– [Lily] Yes.

– The reality is that there is data on some of these things. Right, so we know someone that has advanced knee arthritis can still benefit from treatment. But someone that has advanced hip arthritis, less likely to benefit from this treatment. So it’s going to vary from area to area. A lot of that is still relatively early understanding. But we know that different areas will respond differently. We know that certain types of tendon tears, right, if someone has a partial tendon tear or even if it’s a full tendon tear but it’s still pretty closely approximated, that can still respond well. But we know one that’s more pulled apart really just needs surgery. Now the thing, the interesting thing is that even in those kind of cases, the kind of treatment that we offer can actually help to augment a surgical process long-term as well.

A lot of it is defintely understanding certain things really would be better off with surgery. But in the same way that, let’s say, cardiac surgery went from being the dominant way of treating advanced coronary artery disease to now it’s a very small subset of that. Where the vast majority is handled with minimally invasive procedures. That’ll be the same thing with what we’re doing.

What else? Jackie? No questions from you. Putting you on the spot.
– I can’t think.
– Okay. All right, good. I know. I know.
– [Jackie] No, but I am doing a spreadsheet of what the main….
– The FAQ. Good. Good, good, good. Okay good. If there’s nothing else, thank you, guys. This is a good start. The back and forth is helpful for me. Thank you very much. Yeah, bye.


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MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses why regenerative medicine is a necessary step in musculoskeletal care.

 

Weekly Live- 20200610

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Weekly Live- 20200610
-Getting back to normal vs creating a higher standard.
-Covid19 updates.
-Risk awareness.
-Things worth living for.


-Hello everyone, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly live event. It’s Wednesday, June 10th. I hope everyone is doing well. Last few months have been something, really pretty intense. Here in Chicago, we entered phase three of our COVID recovery, which generally means that people are starting to be able to do more, some more regular activities. Restaurants are allowed to have patrons eat at the restaurant if they’re sitting outdoors and appropriately spaced. And people are progressively starting to go back to work and we’re seeing a lot more people outside and doing activities.

We’re starting to go back to some version of normal life. And it makes me think of a couple of things; you know, what is normal? Should we be better than normal? Where do we go from here? I’ve heard a lot of people say that we’re moving into a new normal, or we have to think about what is a new normal. It was suggested to me that instead of new normal, why don’t we think of a elevated or higher standard of where we want to be?

So I think COVID-19 has made us all think very differently about; the things that we value, how we’re living, a lot of things. And the recent social protest connected with the George Floyd murder, I think make us think about maybe normal isn’t good enough. Maybe our goal should not be to get back to just regular life, Maybe this is a moment where we start asking, how do we elevate and actually live better in terms of our expectations from our interactions with other people in, terms of what we want out of life? And maybe normal is not good enough. Maybe an elevated standard and a new normal is what we should be aiming for.

I know here at work, we’ve been thinking about that. And for the last year, we’ve made a big commitment in terms of communicating better with patients. And I think the last three months, we’ve taken that even higher to the point where we’re committing more resources, even bringing on an additional employee to help out with client service related issues. Because normal was not good enough, because I think our patients deserve a higher standard and hopefully we can deliver upon that higher standard.

So one of the things that I think is interesting, how do we balance risk and benefit? How do we think about getting back into some of the usual things that we do in life, but take into consideration what are the risks that we have to deal with in this kind of newer COVID world? And you know, what things are worth the risk, what things are not worth the risk?

A couple of examples. During the social protests, these last week and a half, there were a lot of people out and people had concern about; is there risk that you’re going to suddenly spread COVID-19 to a lot of people? And that’s interesting because in large groups of people, where you have less social distancing, that potential risk is there, but are there certain risks that are worthwhile taking?

Now, I wouldn’t be thrilled if a 85 year old individual that has multiple medical problems, was out there without mask. But the flip side is; if you’re a young person, a middle aged person, you’re still healthy, you’re wearing a mask, you’re being sensible, you’re protesting non-violently. Maybe that risk is worth it because the benefit is you’re trying to create a better society. It’s an example of where I think thinking about risk and benefit is not a static thing, it’s a much more dynamic thing.

On that same level, the World Health Organization this past week or last couple of days, came out saying that they’re not exactly sure about the risk of asymptomatic spreaders of COVID-19. That’s a little bit disappointing. It’s good news that if the risk is not as bad of asymptomatic spreaders, but the flip side is; we literally just stopped the whole world because of concern about asymptomatic spreaders. I think this is one of those things that’s still up in the air and we still don’t fully understand. And so, I think still maintaining the usual precautions is important, but I think it emphasizes that if you’re in a position of authority, like the World Health Organization, that you need to be careful with your words and how you’re guiding people. Because, if you say one thing one week, and then you say another thing a couple of weeks or couple of months later, that’s a little bit of a problem. Like, we literally stopped all of the world’s economic activity almost to account for asymptomatic spreaders.

But the flip side is; I think for those folks who are considered low risk, getting back into some version of their usual life, maybe they can slowly start creeping back into that. Which is what people are doing and I think that’s smart. I still think it would be sensible that if you do have any medical issues, that you still talk to your trusted physician to get guidance in that regard, that what are your own personal risks? What are things that are worthwhile getting into? And kind of balancing that,
An example of that is; I was speaking with a patient of mine, an 85 year old woman. She’s 85, she’s got things like diabetes, blood pressure but she’s relatively healthy. She’s got a lot of osteoarthritic issues that I help care for. In her words; she hasn’t been this stressed as COVID-19 has put her under stress. And the last time she was under this amount of stress was when she was a little kid living in Northern Italy during World War II bombings. That’s pretty profound to hear somebody say that and it’s affected her life in a lot of ways. For example, it’s because she’s had less social interaction with friends and family, because she’s had less physical activity that she would normally do with those social outings her back has started to ache. She’s a little bit less strong, a little bit weaker and that’s causing her back to be a problem. We’ve been able to maintain her back issue for the last three, four years with some treatment but really just a lot of physical activity. And trying to figure that out for her and realizing that that is a significant issue for her because it’s not only that she has back pain but in turn, that means that it’s hard for her to cook, it’s hard for her to do other things that she enjoys, gardening. And so, trying to figure out a sensible solution for her that’s still is cautious and risk conscious, has taken some effort. And a lot of it has been some small things, things like, well, what about if we try to get you some regular physical activity every hour or two? What if you work with a physical trainer remotely? Little things to try to get her back into that.
But the reality is that this is one of those costs of COVID-19 that I think, that really won’t register in terms of problems officially but it’s one of those things that is really meaningful because it affects her life, it affects her children’s life, it affects her quality of life, it also affects her husband as well. And so, it’s a big deal. So the other thing there is, she’s thinking about; what are the other things that she can get back into? I think it’s her and her husband’s like 60th wedding anniversary, something remarkable like that. And so, they’ve made some plans with their family where they’re going to cautiously try to have some kind of get together in that regard. Where they’re still maintaining some safety measures, social distancing and all that, but realizing that maybe the risk of that is low enough but the benefit is so high that she should absolutely do something like that. And so, I think the next several months are really going to be a lot of balancing benefit and risk and trying to figure that out.

I think one of the other challenges that a lot of us are going to have is how do we get back into our normal physical activity routine? I know the last few months I’ve had to change a lot of things, in terms of maintaining my shoulder health, my back health. Things that I was normally doing, I’ve had to sort of adopt other ideas with home related exercise rather than going to the gym. And I think it’s going to be interesting that as some of these facilities reopen, how do we get back into that? And I think, again, it’s a matter of being smart and targeted and risk aware that likely I’ll probably go back to playing tennis once where I play tennis opens up, because you’ve maintained kind of a natural amount of distance. I’d probably be a little bit more cautious upfront for those first few weeks or even month when they reopen the actual sort of gym facilities. But I think it’s one of those on a case-by-case basis where you recognize the benefit of doing certain activities and you have to balance that with other things.

I know in that same respect, one thing that we’re trying to do at work we’ve had, I mean, my office team has been incredibly busy and really hustling to try to make sure that patients and client service has been maintained the last few months, even when we’ve had COVID-19 going on. And so, we’re trying to set up some sort of outing where we can kind of meet outside of work in a safe space that sort of is able to let the rest of the team kind of cool off, enjoy themselves and sort of recognize some of their hard work. And I think, it’s a low-risk activity that we’ll figure out how to do but the benefit is; it’s a matter of connecting with the people who are working so hard and doing the right thing, that there’s some benefit to that.
I think there’s a version of that, that we have for everyone. Some sort of regular recommendations I would have for folks who are older, that are dealing with some of the challenges of being confined in social distancing is; keep in mind that there are certain things that are still worthwhile doing. You can still take a walk outside. I think when it comes to important life events, birthdays, do we totally avoid them now? I don’t necessarily think so, I think you can do some of these things in a risk-conscious, low-risk way. I think if you’re asymptomatic and you know that the number of people that are going to be at the event is going to be relatively small and limited, you can still partake in some of those activities.

Part of getting out of COVID-19 is recognizing what things are still important and are worth living for. And I think if we take nothing else from the last three and a half months, it’s resetting what is worthwhile for life. I think in the normal groove of life, there’s a lot of just distractions and things that don’t really have a lot of importance that we all get stuck in. And I’d like to think that in this new normal, this elevated standard, that hopefully we start to think about that. Maybe we really allocate our time and efforts on things that are more meaningful to us, because realizing that some things are still worth the risk and there’s a lot of things that really aren’t.

Lastly, the last recommendation for some of my autoimmune patients who are taking medications, good news is; we’re still on track. Meaning that if you’re on meds, understand that the evidence and data out there is that it’s still okay to stay on those medications. I still think you utilize the same precautions that we’ve all been taking in terms of social distancing, as well as wearing masks but understand that there’s no evidence that folks who are on these medications are at higher risk for complications. And as long as you’re asymptomatic and you’re doing well, you’re staying in touch with your physician, you’re making risk-conscious decisions, it’s okay.

I think this, it’s such an interesting time right now that we’re all so risk-conscious and thinking about things in ways that are different. Whether it’s, how do we want to live in a more equitable and just society? Or whether we’re thinking about what things are really worth the risk of living? I think we can come to some decisions individually and hopefully as a society to make smarter, better decisions that make life worthwhile living and make it better. So that we’re not just getting back to the usual normal but that we’re actually trying to live and get to a higher standard.

I appreciate your time. I hope everyone is doing well. Leave me your thoughts, and until next week, have a good day and live well! Thank you, bye-bye.


***For more educational content:
Sign up for our email newsletter:

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Listen to the Regenerative Medicine Report podcast:
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***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:

Candidate Form

Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses doing better than normal.

 

Weekly Live- 20200603

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Weekly Live- 20200603
Topics discussed:
-George Floyd
-Peaceful protests
-Riots
-Doing better
-Health disparities
-Covid19

-Okay, hello everyone. This is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. This is our Weekly Live event. It’s June 3rd 2020. My mother just sent me a message saying you’re drinking water while live. Yes, I know. It’s okay. These are some fairly extreme times whether you’re talking COVID whether you’re talking about protests, whether you’re talking about rioting, an extra sip of water on a live stream I think is okay right now. I think we all get some leeway.

So, I’m going to keep it relatively focused and straightforward today. I normally am focused on obviously talking about medical related issues because am a physician obviously will have something to talk about. But you know the last couple months everything has been so focused on COVID. COVID, COVID COVID! And that’s like everything is affected by that you know, are we talking about you know condition x, what’s going on with COVID. People are on treatment, why? But has COVID affected that, COVID COVID COVID. And at some point, you start to get kind of drained from just talking about everything connected with COVID. But that’s obviously what’s on people’s minds.

And so as you try to stretch out to talk about other things, I think there’s always value in that kind of diversity of thought and thinking and what else is going on. This last week however, you know we have to be honest and the only thing that’s on the mind for a lot of us in the United States is really what’s been going on socially in the world or rather in our country. And it’s relevant from not only the standpoint of that’s what on my mind and that’s what’s on the mind of everyone that works in my office, my colleagues, in the town I live in, my family, but I’m sure all of you as well. But also you know, how do we grow, adapt and how do we get better with what we’re doing? because some of the themes and topics of what’s going on right now affects us in healthcare as well for sure.

Obviously the big picture right now is all about George Floyd and protests related to that and now some of the violent activities related or surrounding that as well. And first and foremost you know, it’s made me think about some things very differently. And you know the video of George Floyd getting killed. I’ve never seen anything quite so dramatic and so vicious to see someone literally get choked out and killed on a video, that’s something. You know, with that said, I mean, we’re constantly nowadays seeing videos of Black Americans black people being shot by either security forces or civilians. And that’s some heavy stuff and so relevant because it affects not only our neighbors, our colleagues, co-workers, employees, team members, all that kind of stuff. But you know some of this even affects, you know my daughter who’s six years old. I’m obviously very disturbed to see some of these kind of things on TV because it is extreme and so dehumanizing. But, you know, on top of that, I’m obviously not thrilled that, you know my six year old daughter is seeing some of these things. And while she hasn’t necessarily seen a video of that of George Floyd being killed, you know, she knows what’s happened. She knows that this happened to somebody by a police officer who is supposed to be there to help. And fortunately, my wife has a level of sophistication and emotional intelligence to have that kind of conversation with her to give some perspective and thought and understanding to it. But you know, what a world that we live in that our kids that young have to be thinking and aware of this. Obviously, incredible. Not a good thing.

On the other hand, you know also just seeing the video of George Floyd being killed, knowing some of the things that he said, not just that he can’t breathe, but even calling out to his mother knowing that his life is ending. I mean, just heartbreaking. Really just amazing. And in my office today, you know we have our weekly meeting. And you know we spent some time talking about this because it affects all of us and it weighs on us and I think talking about it, discussing it is vital to really not to make sense of it, but just sort of deal with it. And so that’s really what’s going on in my mind.
You know, it’s been impressive the nonviolent protests that have happened after that. It’s very encouraging to see the diverse group of people that are involved in that, whether it’s ages, whether it’s racial ethnic groups, all over the country that’s incredibly positive and productive and something that I’m proud of as an American for sure. On the flip side, you know the violence, the riots, the looting that have happened afterward, is devastating and very disappointing and so hurtful to people. And to see what’s happened certainly in the city I live in here in Chicago is shocking. And first and foremost, understand that here at work you know we’re very fortunate that even though we’re located downtown, we’re in an area that is still relatively protected and okay and safe. And so, in our office I mean, we’ve been fine. In fact, we’re starting this week we’ve been working in the office three days per week and starting next week we’re here five days per week. We’ve been fortunate that things have not been more extreme or problematic and so I’m very grateful for that.

But, you know this goes much beyond just you know what we’re doing at work. The reality is that here at work we’ll be okay, we’ll get through this security is fine. But, you know it’s made me think about other things as well. You know, at baseline there are security issues that a lot of our friends, colleagues have to deal with that maybe we don’t always think about. And I think decent people think about, you know what they’ve seen in the last week and say this is unacceptable and having that kind of animosity or dehumanization of another person is unacceptable, especially when it’s based on things like race, ethnicity and gender.

It’s occurred to me that, you know at baseline, obviously, black people have a level of stress and bias that they have to deal with that most of us don’t have to think about. And even if we have our own issues and our own biases that we have to confront on a regular basis you know our black brothers, sisters, colleagues, friends, neighbors, they deal with a level of stress on a daily level that is crazy. And it’s unacceptable.
Since I’ve had my daughter who’s six years old, you know I’ve thought about issues that women deal with in a much different way as well. And, you know at baseline it’s disturbing for me to think that at baseline women have concerns about security every single day. And that the greatest threat to women kind is mankind. That’s terrible. And so even if we don’t have explicit biases, and if we don’t have explicit badness in our heart or in our actions, the implicit biases that so many of us carry and walk around with are making the lives for a lot of our citizens worse, whether it’s for black folks or their ethnic or racial groups and certainly for women as well. That’s unacceptable and I think that’s something that you know as individuals we have to work on.

You know, locally, you know I didn’t grow up in Chicago, I grew up in Western New York, but I’ve been in Chicago for almost 20 years now. And I’ve been in practice since 2008. So for 12 years now. And the vast majority of people that have worked for me have generally grown up and have very deep roots in Metro Chicago, whether that’s North side, South side, West side or the suburbs. And to see their city and their area being burned down is very rough. And it made me realize that for a lot of the people that have spent the time and the effort to help me at work, to help patients and to help my professional career that a lot of them at baseline have security issues based on a neighborhood that they live in, or social issues that they have to deal with, if based on their racial or ethnic background, or security concerns just because they’re women. And the majority of people that work in my office are women. And it strikes me that for them to still be able to deal with that on a daily basis and to come to work, and to show such a high level of professionalism. I mean that takes a lot. And I’m impressed by that. And I’m extremely grateful for that. Because a lot of those things I don’t necessarily have to think about on a daily basis. And I’m impressed that those folks who support me and help me out, are able to push through those things in a way that goes above and beyond what is frequently required or expected. And so I’m extremely grateful for that.

So, you know it’s interesting here in Chicago, we are actually in the next phase of opening up like we’ve had this crazy week where protests are still ongoing, but on a nonviolent basis. Incredible amounts of violence though and yet we are actually opening up to the next phase to account for COVID and I think for businesses that have the wherewithal, the guts to kind of persevere and try to open up now, hats off to them. because that’s not easy. I can tell you here at Chicago Arthritis and Regenerative Medicine, we’ve been very fortunate that we’ve been able to continue at a significant level because my team’s been able to figure out telemedicine at such a high level. And we’re pretty much getting back to full capacity and doing what we need to do.
But this is, you know the new normal. It’s gotta be better than the old normal, because the old normal wasn’t that good. The old normal was a world that made it a lot harder for black folks, for women, and was kind of lousy to begin with. And I think this is an opportunity for us where we have such extreme challenges but we can do extremely well. And how we react to create a better world is how we are defined going forward. So you know, hopefully the new normal is dramatically better than what we’ve been dealing with. Anyway, I know this has been sort off my normal flow and sort of ideas. But this is important.

Reality is we need to do better for each other, but this affects not just things outside the office. The reality is that when you look at health outcomes for black folks, Latinos, even women when it comes to heart disease like their outcomes are worse than other populations. And is that because that there are intrinsic problems, metabolic problems, maybe. But are there differences in terms of how people are treated and dealt with how their health concerns are addressed long-term. If black folks have higher rates of have high blood pressure long-term because they’re not getting the same level of care that the rest of us do. Or if their rates of asthma are worse than other asthmatics then they do worse with coping. And that’s what we see, we see that COVID patients that are having much harder times tend to be blacks and Latinos. And I can’t fix, none of us can fix the macro the global problems, but on an individual basis on a micro basis, we can do better. And I think we all deserve that to live in a world that is better.
So thank you for your time. Have a good day and live well and look forward to talking again next week. Bye bye.


***For more educational content:

Sign up for our email newsletter:
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See our blog:
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Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://www.chicagoarthritis.com/regenexx-candidate-form/
Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.
***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses doing better.