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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.


***For more educational content:
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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 why regenerative medicine is a necessary step in musculoskeletal care.

 

Inflammation, Pain, and Musculoskeletal Health

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Inflammation, Pain, and Musculoskeletal Health
Inflammation is complicated. But it definitely has a role in musculoskeletal health, pathology, and pain.
Hello, this is Siddharth Tambar from Chicago arthritis and regenerative medicine. On this video today I am talking about a fundamental issue when it comes to your musculoskeletal health and that is inflammation. First and foremost it’s important to understand the difference between acute and chronic inflammation. Acute inflammation would be when you’ve sprained an ankle, acutely injured your shoulder or knee, and it feels very inflamed, hot, warm, maybe a little bit swollen as well. That is generally the body’s normal way of trying to recover from an injury. Meaning you have an acute injury, trauma, your body brings in platelets, red blood cells, growth factors to help try to heal that kind of injury. In most circumstances that’s a good process. Occasionally too much acute inflammation can be problematic, but normally that is the normal process of trying to recover from an acute trauma. On the other hand, there’s chronic inflammation.
Chronic inflammation is a problem. And the reason why is because it’s your body’s way of trying to function and recover but is not doing so appropriately, and will actually prevent a normal healing process and normal function. So when it comes to chronic inflammation, it’s important to understand the difference between systemic or total body inflammation, versus local chronic inflammation. So systemic inflammation or total body inflammation is a problem because it can cause a number of issues including inflammation in the joints, damage in the joints, and sort of permanent damage and persistent functional problems. It can also make you more prone to metabolic syndrome as well as cardiovascular disease. Chronic inflammation is on a systemic level is a big problem and leads to a lot of pathology and pain and dysfunction long term. There’s then chronic inflammation at a local level meaning at a one joint, one tendon level. You could see that as persistent inflammation within a knee that is chronically swollen, or a tendon that is chronically strained or inflamed as well. That leads to not only persistent pain, instability, dysfunction, but also damaged in some cases as well. You can have that chronic inflammation if you have a joint or tendon that is chronically unstable or if you have some other process systemically that is causing that inflammation in that joint.
So chronic inflammation is a problem. Ways that you can control that include trying to be as clean and healthy when it comes to an anti-inflammatory diet. That can mean different things to different people, but as a general rule it, to me, at least it means more of a plant-based diet, reduced refined sugars. Each person probably has some degree of susceptibility to inflammation based on their diet and that can vary from person to person. Working with an expert, proper nutritionist can help you in that regard.
There are certain supplements that can also help with chronic inflammation- omega-3 and turmeric have benefit as well that’s been shown to help not only osteoarthritis, and rheumatoid arthritis in some cases. And can be as useful as chronic Anti-inflammatory medications as well. In some cases if there’s significant chronic inflammation, medications are necessary to help control those kind of conditions. Those medications work by modulating your immune system to prevent that chronic inflammation. And then lastly in some cases regenerative medicine treatments, orthobiologic treatments, can be helpful as well either because the actual treatment itself has an anti-inflammatory effect or because if you have an instability issue by improving instability, you can reduce the chronic inflammation with that joint as well.
Inflammation has some good parts if it’s acute but is a problem if it’s chronic. It’s something that can be treated and evaluated. It’s important to recognize, it’s important to treat it. And if it’s a component of your pain and inflammation and dysfunction, it’s something that should be checked out. Have a good day. Be well, and bye-bye.
***For more educational content:
Sign up for our email newsletter:
https://www.chicagoarthritis.com/newsletter/
See our blog:
https://www.chicagoarthritis.com/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:
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 inflammation, pain, arthritis, tendinitis, and injuries.

Corona- Managing Pain while Social Distancing

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People are delaying evaluation and treatments for many conditions given the Covid19 conditions. So what can you do right now to help manage your pain while you are appropriately social distancing?
***For more educational content:
Sign up for our email newsletter:
https://www.chicagoarthritis.com/newsletter/
See our blog:
https://www.chicagoarthritis.com/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:
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 how you can manage pain from arthritis, tendinitis, injuries, and back pain during Covid19 social distancing.

Facebook Live- 20200327- Chit Chat with Shounuck Patel DO

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Great conversation with Shounuck Patel DO this afternoon.
Topics discussed include:
-A lot about:
1.Telemedicine evaluations for stem cell and prp treatment for arthritis, tendinitis, injuries, and back pain.
2. What we can learn from current challenges.
3. Leading as a physician during difficult times.
4. How physicians are adapting to the current environment to continue to offer value, guidance, and treatment for patients.
5. Continued evolution of regenerative medicine as a field.
-A little bit about Covid19/Corona virus

***For more educational content:Sign up for our email newsletter: 
https://www.chicagoarthritis.com/newsletter/
See our blog:https://www.chicagoarthritis.com/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: 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 regenerative medicine, corona virus, covid19, arthritis, tendinitis, telemedicine.

Telemedicine- Our New Normal

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Telemedicine- Our New normalTelemedicine is here in full force. The Covid19 outbreak has forced us to start working remotely, and that includes in medicine as well.  It has also forced us to work more efficiently with the rapid introduction of telemedicine. This change is unlikely to go back to business as usual. This video discusses this New Normal.

***For more educational content:Sign up for our email newsletter: https://www.chicagoarthritis.com/newsletter/
See our blog:https://www.chicagoarthritis.com/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: 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 telemedicine, telehealth, corona virus, Covid19.