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[00:00:28] Speaker B: That's who we are. Beatty the patriot is WWTC Minneapolis St. Paul FM 107.5 K298CO Minneapolis Intelligent Radio with SRN News. I'm Bob Agnew in Washington over Democrat opposition Senate Republicans on Friday muscle through a crucial next step that's central to President Trump's agenda. On a mostly party line vote of 51 to 48, the Republicans pass the plan that paves the way for the party to in the coming months push tax cut billed through both chambers of Congress. By doing so, Republicans say they're preventing a tax increase for most American families. That is correspondent Ken Lorman reporting. Israeli journalist Haviv Rettegur says that Israel has largely won its wars now against Hamas and even Hezbollah. He told the Salem Radio Network the Biden administration offered a lot of bad advice to Israel about that war in Gaza. He believes that President Biden's desire to assist Israel was always counterbalanced by a need to placate the Democrat Party's anti Israel wing. This is SRN News.
Eric Metaxas believes there's a reason it's been sealed by now the JFK files, 80,000 pages have been released. If they didn't want this to come out for 60 something years.
[00:01:53] Speaker C: Why?
[00:01:54] Speaker B: There's a reason and it seems that if it comes out today, we're going to find out the reason and it's not going to be pretty folks. The Eric Matthew Texas show overnights at 3 on AM 1280. The Patriot Intelligent Radio.
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[00:03:39] Speaker A: Greatest red carpet you'll ever walk is through your front door.
[00:03:43] Speaker B: We're Dr. Josh and Kristi Straub, marriage and leadership coaches and hosts of the.
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[00:04:04] Speaker B: Search famous At Home on your favorite podcast platform. Join Me to rally to read 100 books Reading is Fundamental invites you to visit rallytoread.org today to learn about our reading campaign. Join the pledge to read 100 books, hear your child's favorite authors, read their books, and find activities to keep young readers motivated. Teachers can also enter the Rally to Read Sweepstakes for a chance to win 100 books for their own school subject to rules, visit rallytoread.org today.
Chances are she's listening to you right now, but Alexa has a lot of competition. Google Nest or Amazon Echo are two of the best.
[00:04:45] Speaker C: All you have to do is turn.
[00:04:47] Speaker B: It on and tell it to listen to what you want this radio station, of course. When she hears our name, we start playing. Remember, it's as simple as this. Alexa Play the Patriot Minneapolis that's Play the Patriot Minneapolis. Intelligent radio we are am 1280 the patriot.
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[00:05:38] Speaker C: The following program was pre recorded and the views expressed do not necessarily represent those of this station or its management.
[00:05:47] Speaker E: Good morning, I'm Dr. Kerry Gehope and welcome to Wellness Footage Radio on Open your Eyes Radio. Please listen as I discuss the newest information in the world of health, nutrition and sports. Every Saturday morning, 6am Central Time on AM 1280 the Patriot. Also, please share your thoughts by emailing me at Dr.carrie
[email protected] that's D R K E R R Y-G-E-L-B gmail.com and visit my new website, wellness1280.com where we have all guest links, wellness 1280 info and previous shows. Wellness is taking over the Patriot Airways for the next hour, so sit back and enjoy with my interview, optometrist Dr. Mike Johnson. And in the first segment, we were talking about amniotic membranes, how it can help different parts of the body that have trouble with healing. Now, a lot of people out there have been unfortunately been burn victims or they have an eye problem where it just can't heal and they're in a lot of pain. And we get these membranes from amniotic tissue from mothers who are donating their amniotic tissue for these membranes to help with healing. And Dr. Mike Johnson is an expert and we were talking about a lot of it in the first in the first segment. And the first segment was a little technical, this one, we're going to make it a little bit more practical for people to understand how it could help them. So Mike, thank you for joining me today.
[00:07:18] Speaker B: Thank you. I appreciate you having me on.
[00:07:20] Speaker E: So let's talk about dry eyes. I know you're very passionate about dry eyes. General. Tell us about what dry eyes is, why it's become a big problem in the United States and what are some things that we could do for it. And then the severe kind when we have to actually use these amniotic membranes that we talked about in part one. Open your eyes with Dr. Kerry Gill.
[00:07:46] Speaker B: Sure. So dry eye is kind of a play on words where when I have my patients in my office most of the time they'll say, you know, Mr. Jones, you have dry eye? Well, I make tears. I don't understand what you're saying. And so from a From a clinician standpoint, it's okay. The tears are not. They're either not good enough from a liquidy quality or the volume of how much tears you're making. And then the other side is maybe they're making tears.
Always tend to use food as an analogy. So my favorite thing to always tell patients is it's kind of like a sandwich, right? Your tears are made of two layers of oils. Bottom layer, that's going to be the oil that kind of adheres and sticks the tears to your eyes. And then the top layer of oils come from your eyelids every time you blink. Those are called the meibomian oils. And then all of the stuff in the middle of your turkey sandwich, right? Your lettuce, tomato and meat, that is the liquid part of the tears. And so I tell my patients, you could have a problem with the oil layer on the bottom, or you could have a problem with the oil layer on the top where you could put the sandwich together. But if the top layer of oils is not working, sandwich falls apart, right? Or you can have a problem where you're not producing enough in the middle, which is the actual volume of your tears, and you could just have a very thin layer. So dry eyes is. It's a huge umbrella of the topic where the patient could have just one of those particular parts of the tear problem, or you could have one, two or three of the problems, especially these. These individuals that have already present inflammatory issues. I live in the south and the part of the world I live in, the humidity is terrible. So your weather plays a factor in dry eye. People that have inflammatory issues, as far as, you know, rheumatoid factor, or in our world, we call it Sjogren's, where they have dry eye, dry skin, dry mouth.
You know, individuals that have gone through medications, especially patients that are fighting the battle with these chemo medications, these radiation meds, they're going to zap all of those oil productions and tear productions. So there's a whole world of different types of dry eyes just kind of thrown into this compartment terminology called dry eye syndrome. So you have some mild cases where they can use these artificial tears that are over the counter that are just palliative, and they help kind of seal up and cause the volume or the tear to be more viscous and jelly so it feels more comfortable. There are some medications, I tend to tell my patients that medication.
[00:10:22] Speaker E: Let me ask you about the artificial people go to the drugstore, they see all these different brands of artificial tears. How do they know which one to get.
[00:10:31] Speaker B: Well, it all depends on kind of what you're looking for. I mean, I would say that there are different types, right? So if you look at the little boxes over the counter, if they have a little moon and stars on the corner, usually those are thicker. And those are for nighttime formulas. Those are for your individuals that may sleep with their eyes not completely closing. We call that lag ophthalmos. Some people sleep with fans in their faces or, you know, they, they have CPAP machine where they have a constant like a seepage or airflow. And so you want a thicker, almost like a viscous, oily tear drop to use. It's going to make their vision blurry. So that's why they put that little nighttime thing. You may have individuals that are sensitive to a lot of chemicals. Same reference with ladies that maybe have reactions to makeups that have different chemicals in them. So particular people would be looking for the artificial tears over the counter that say preservative free. And they usually come in these little individual vials. And then some people may want one that's a little bit more of a thinner tier, right. So you would say just an everyday run of the mill. I mean, you can use brand examples because they're all over the counter. But you're, you're, you're pound for pound, you're looking for that, that teardrop that's going to allow your comfort stay on your eye longer. So you've got the preservative free, the nighttime, and then you've got the gel version that lasts a little bit longer. And then some people, there's some of them over the counter that they tend to look for. They'll see the visines or the Opcon A's and the Luma Phi. Just keep in mind those aren't really artificial tears. Those are more vasoconstrictors. Those are, those are just going to make your little, the redness, the blood vessels, they're just going to make those blood vessels constrict. So when you're over the counter, I mean, ask the pharmacist, they would have the knowledge to tell you which one you're looking for. And most of the time you can Google the brand and they can tell you which types they have. Another little tidbit is most of the time you can open those little boxes and they have coupons, there's a coupon down inside the little teardrops over the counter to save you a little bit of money too.
[00:12:32] Speaker E: I know with us, especially with dry eye especially, we spend A lot of time on diet. We try to get people on an anti inflammatory diet, get them off the processed foods, use some supplements like Omega 3s and they fairly well. I was wondering if you do any.
[00:12:48] Speaker B: Of that 100%, you know, if you follow the dry eye workshop, which is like the holy grail for eye doctors in the very initial setting, we tend to have to educate the patient on their findings. We educate them on the omega threes and the secondaries, you know, the flaxseed oils, the omega oils. One of my favorites is krill oil. You're getting the omega threes but you're also getting the mesos of things from the krill feeding off the algae as well. So you're getting the lutein or the mesosantins for those are the vitamins for the back of your eye that helps with your vision. But no, as far as educating my patients and there's a whole world of research on omegas, you can go to omegah research.com and it's everything from brain function to skin function to eye function. So I would say flaxseed oil, omega 3s, omega 5s. You know, you can have a good fish diet where you're, you know, one or two dosages or meals with a fish, salmon is, is your, you know, Atlantic cod, salmon, all of your healthy nutrients for that matter.
[00:13:58] Speaker E: And then we have our cyclosporins, we have our steroids, we have some prescription medication and some anti inflammatory zydrus. What do you, what do you, what do you fall with the medications? What do you like?
[00:14:13] Speaker B: Sure. So it depends on which type of dry they have. Right? So like you said, if it's in the inflammatory side, and I know this patient's already on some type of treatment for an inflammatory issue, you know, I tend to always go to my first, which would be the FDA approved steroid. People tend to hear steroids, especially patients and they get nervous, right? They think, I don't want to get, I don't want my face to get swollen and I don't want to be a, you know, moon face. Lot of prednol, 0.25%. The trade name for that drug is Isubis. It is FDA approved for dry eye treatment and it's shown to not cause any pressure spikes. A lot of patients have been told for years, you know, get your eye doctor to check your eye pressure, make sure there's no response there. But I would say that in the, in the same category of getting the inflammation calm down, Zydra, cequa, restasis there's about three or four of those. I I like those. But they tend to take about a month or so to show up in the system. Right.
There's a whole new world of newer drugs out that are helping fight the that top layer. If you go back to that sandwich analogy, if you will, the top layer of bread, that was the oils that come from your eyelids. Those are called the Meibomian oils. There's a new drug right there.
[00:15:26] Speaker E: We're up against the break. This is Dr. Sure to open your eyes radio on Amazon 1280 the Patriot I'm speaking with Dr. Mike Johnson. He's helping us with dry eye and other eye problems.
[00:15:38] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyourizedradio.com to find an eye doctor that specializes in this treatment program. Learn
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[00:17:39] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming near. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySite. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn
[email protected] we're back with Dr. Mike Johnson.
[00:18:45] Speaker E: We're talking about dry eye and we're talking about some of the medications. So tell us about. You were talking about steroids, Isobus eye steroids. These are drops. These are not taken by mouth. So people understand that and that always check with your doctor. We're not giving you medical advice. We're having a discussion. So we want you to check with your eye doctor about some of the things that we're talking about. But tell me about Isobus, something you like a lot. It doesn't raise the eye pressure. Is there any other drops that are new that you're very interested that do well with dry eye?
[00:19:18] Speaker B: Yes, very much so. So I would say yes. Isuvis tends to be my entry level as far as getting the patients to to not only start treatment but usually it shows a pretty quick rapid response on as far as their complaints. But there is a new new drug that's been out for about a year or so. It's called Mibo. The drug vehicle is perfluorohexetane and it came from Europe so we knew it had worked and it's allowing it's a very viscous oily type drop and the patient uses it four times a day. These individuals that don't have a good tear oil layer on the very top. So in the before the break, I use analogy with my patients. This is a visual for food is easy, right? So the, the sandwich where you've got a two layers of bread that are oils that kind of keep your tears from evaporating. If you don't have that top layer of tears, doesn't matter how much fluid you're producing, it's going to evaporate. So it's evaporative dry. And Maibo helps replenish and regenerate the oils that are in those eyelid tissues. So it, it has, it has its qualities. It's definitely showing, it's an effect.
Most of the time the company actually works with the patients and helps get their first sampling in place. And then you have to go through this online prescribing system because it's so new. But yes, I am very much a fan of that. My go to of course is the Isuvis or some type of topical there. But then the other ones that have more of a long term effect, you got your Zydra, your restasis. I mean if you've been around since the 90s with the northern Exposure actress with her commercials, all that. So Restasis has been around forever. I would say that as a patient, if you've been on those, if you're on restasis for six months to a year and you're not seeing the improvements, then I would start having the question, the conversations with your eye care provider of hey, are there any new drugs out there? You know what, what else is there out there? Are we going to keep, keep staying on this dropout and seeing the same result or are we going to try and get, get it better, get it more, more comfort, more improved because there's more out there.
[00:21:24] Speaker E: Let's move forward a little bit. How about ipl?
Where does that fit in with Dry Eye?
[00:21:31] Speaker B: So if you're following the Dry eye workshop, we have to follow that standard of, you know, if you go through steps one, two, which is your education, your Omega threes, your artificial tears, step two is adding that drug, whether it's Isobus or Zydra. Step three would be after you've had your failed attempts, there's no improvements, you're still seeing the surface issues or you're still seeing the evaporative issues where there's no oil production, the IPL and amniotic membranes and radiofrequency, they all fall in that step. Stage three, where okay, what am I going to do? Now, am I going to keep my patient on these medications? Am I going to discuss the ipl, which is, stands for intense pulsated light. Why is that a big deal? We know the Magic Temperature is 120 degrees. To get those oils that are in your eyelids melted or become liquefied, if you will, to be able to come out easier onto the surface. Because every time your eyes blink, that's what you're doing is you're causing a negative vacuum effect where it's pulling the oils from those vertical meibomian glands that are inside your lids and they come out right at the base of your lashes. So IPL helps kind of rejuvenate and revamp those, those dysfunctional or damaged meibomian glands.
I would say that the, the radio frequency is one of those where there are devices out there that you can couple them together so you can massage and stimulate the meibomian glands from the outer tissue area and cause a rejuvenated effect and use it with the ipl.
And that way you're getting the maximum amount of, of response from those my mobile glands and helps release the oils onto the surface of your eyelid and give you more comfort, reduce the inflammation and allow the medications you've been on to either maybe stop them potentially or give you a break to where you're not having to use them as often and definitely give you more comfort in between your dosages of drops.
[00:23:35] Speaker E: And what would you use amniotic membrane for? Dry ice.
[00:23:39] Speaker B: So that would be in the same phase where if you have that dry eye patient, they're not responding to your medications. You follow the Dry Eye Workshop handbook and you still have a corneal epithelial defect. Right. So the company Ophthalogics has a built in card that has all of the diagnosis codes where if it's a surface keratitis or a neurotrophic keratitis, I tend to tell all the doctors that we typically live in what we call the H16s to H18s, which is what the diagnosis codes start with. So if you have that surface keratitis, slash breaks on the surface, if you will, that's where the membrane would come into play to allow the healing, allow a better surface, allow for more comfort while you're either doing the IPL or using it alone while you're doing your treatments that you've gotten to step three.
[00:24:34] Speaker E: How long does it usually take for an amniotic membrane to work? For a patient to start feeling better, how often do they have to use more than one?
[00:24:43] Speaker B: I Would I always tell my patients that we're looking for a good absorption and for us to see the effect around day three, which is why I see them back in three to four days to remove the bandage, contact lens, ideally, depending, you know, it's all case dependent. So you may have that severe dry eye keratitis patient that has Sjogren's. I might for the first couple of sessions. I might have to do another application in a month or it might have to be in three months. But usually one application is usually indicated in most of my patients one time, about every six months I have some cases. Literally the other day I was seeing patients and I had not applied a membrane for a year and a half. So it's all case dependent. I know that's not the best answer in the world, but that's the truth is you may be a severe case where I have to do one or two cases within a couple months. But ideally in most of the time, if I can get it to where we can sustain comfort with minimal amounts of eye drops, some type of just topical, whether it's teardrops or, or isuvis and I only have to do a membrane once a year, that that's what I'm shooting for.
[00:25:52] Speaker E: I could turn our attention to something new that's fascinating to me is plasma pen fibroblastic therapy. And is that the same thing as plasma electrophoresis?
[00:26:06] Speaker B: So it's the same pen, it's the same energy. Both of them are going to be using radio frequency energy. The, the pin that you're referring to, I believe is the Nuvisa plasma pin. And so that, that energy is 1.6, 1.7 MHz. So it's a very low radio frequency energy.
The difference between the two is the type of tip.
[00:26:27] Speaker E: Right.
[00:26:27] Speaker B: So if it's got a needle tip to it, like a copper needle tip, that allows that energy to be emitted almost like a lightning rod, that is the plasma Nuvisa plasma. Whereas if it's a rounded tip that has a larger base and the device can switch out and interchange the tips when you have a larger base and you can emit the energy in a more widespread manner, that would be plasma electrophoresis. So it's the same device but just, just all depends on which tip you're using.
[00:26:56] Speaker E: And do they do different things?
[00:26:58] Speaker B: 100 yes.
[00:27:00] Speaker E: So they do. And then I want to concentrate on the plasma pen for a second. But tell us the difference between the, the electrophoresis and the plasma pen and what, what indications Are they used for what differences?
[00:27:14] Speaker B: So the electrophoresis would be one that when you're wanting to use in conjunction with stimulating those meibomian glands that we were just talking about, and you're using it with IPL and you want to massage in a larger area, it penetrates that same 3,4 millimeter depth. So it's going to get into your tissue, your eyelid tissue, your facial tissue, and it's going to stimulate right there at that epithelial dermal junctions where the fibroblasts live. And so you're getting almost like a flexion or a contraction to where it's stimulating those meibomian glands to squeeze and help promote the meibomian oils to come out and to produce themselves. Those would be when you're coupling it with an IPL device.
You can also use it from facial rejuvenation if you wanted to get a more firming effect. But electrophoresis is definitely more advantageous if you, you're in the esthetics world and you have a darker skin type, right? So for the listener, if you've heard of the IPL devices and you're looking at electrophoresis, most of the time, IPL machines, they're not really indicated for skin types that are darker skin tones that are in those four, five, and six skin types. So a fair, pale, complected individual is usually a skin type. One olive skin type is more of a three. Then of course, you, like, your Latin American lighter brown skin types are going to be fours. And then of course, darker skin types are like a 6. You don't want to use an IPL and cause a risk of a hyperpigmentation or cause a spotting formation. The electrophoresis penetrates the tissue and does not cause the melanocytes to overproduce. So you have doctors that might say, oh, Mr. Jones or Mrs. Smith, you're, you know, you're at risk for some issues because of your skin type. They can use the electrophoresis as another option to help stimulate the meibomian oils, the eyelid, the lower lid, upper lid tissues, and help manipulate and squeeze those. Those oils out.
[00:29:18] Speaker E: So does that, is that come with the IPL or come as part of the radio frequency, or is that a separate something? Separate that the doctors buy.
[00:29:28] Speaker B: Some of your IPL devices have a combo where you can have radio. They'll have one IPL head that has a filter, and then on the other side of the device, they have a radio frequency that is. That is the same thing that's a combo unit. The plasma pin that you can switch and interchange the tips delivers the energy in a little bit less of a manner. So you don't you have one setting. You don't have to worry about turning down the actual frequency of radio frequency emitted. So you can do options. Some people can look at having a combo IPL radio frequency device. Those are out there. And then you can have a handheld device that's easily portable like in the plasma pen to where you just switch the tip and you've got a lower energy.
[00:30:13] Speaker E: I'm very interested in this plasma pen because it could do some really interesting things. Skin tags, warts grow, eyebrows, people that have little wrinkles like I do exanthal asthma people have these patches that may be in the indicative of diabetes. We're up against the break. This is Dr. Kerry Gelb. You're listening to Wellness 1280. Open your eyes radio. We'll be back with Dr. Ken I.
[00:30:40] Speaker A: Went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the us it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays four. I recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn more at openyourizeradio.com Join Stock and.
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[email protected] that's twincitiestuitions.com I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySite. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureysradio.com to find an eye doctor that specializes in this treatment program. Learn
[email protected] Come.
[00:33:43] Speaker E: We'Re back with Dr. Mike Johnson where he's a managing partner and national provider trainer for Nuisa ocular devices. And we're talking about one of their devices which is the plasma pen which I'm finding interesting because it may be able to help with to something we call ptosis where the lid drops and droops wrinkles and fine lines around the eye because it could stimulate collagen production. Dark circles and bags. Example asthma, which are these little yellow spots, like yellow lipid spots around the eye that people hate. Skin tags, little skin tag removal. Let's start with that. Dr. Johnson, can we. Does it work for these things?
[00:34:29] Speaker B: Yes, yes. I've, I've actually when I do my training I actually have a whole before and after session and all of them are clinical cases that I've actually done in my chair. So everything you said as far as I would say skin tags, baruchas which are like little warts that I would say the ones that obviously have a smaller base are more advantageous. You know, if your listener has some kind of little lesion or papilloma or, or something that it's a large base. Just understand that your, your doctors have an obligation to where if they feel like it's suspicious of something bad of a cancerous nature, then they're going to do their job and do their due diligence and give you, you know, send it out for some type of biopsy whatnot. But as far as your, your lesions where somebody might have a, what we call a cherry hemangioma, it seals those up. Someone that has a small skin tag or what we call an acrochord on with a small base, it can definitely just. You apply the little needle tip and you'll have your tweezers and you're talking less than a couple minutes topical little numbing anesthesia. You don't have to do any injections for that. I don't, I don't really see the reason for having to do that. Because you can get absorption, most of your doctors can prescribe a combo anesthetic ointment cream called blt, which is kind of a combo of three different numbing agents but, and it numbs it up just fine. As far as your, your aesthetics that you were mentioning, most of my patients actually they're, they're preferred is this glabella region that the ladies refer to it as the 11 lines seem, seems to be the most, the most requested as far as getting this area right here is their, their, their brow wrinkles or their, their frown lines and then like you said, the crow's feet getting that rejuvenated effect.
From a ptosis lid standpoint, please, you know, keep in mind this is not replacing a full on lid surgical blepharoplasty. So if your listener is wanting to get their lids lifted, you know, three, four millimeter lift, that's a surgical case. This would be for that listener that is maybe looking into Botox and they're looking into I might be ready for some, some kind of facial procedure in the next few years. And they want to see a nice firming slash youthful appearance. From an aesthetic standpoint. This is for you. This would be to talk to your provider, your eye care provider or your, your estheticians, if you will. You can use this in conjunction with Botox. You can do this with your fillers, but you just want to wait about 14 days just to kind of allow the nerve sensitivities to heal properly. From an eye care standpoint, some of the neater things that we've been working on with the team of us Doctors is like you said, you can do the skin tags, the lumps, the bumps, all that. On the eye, we have a condition that leads to some dryness issues where the conjunctiva, which is the two or three layers of clear tissue, one will be interfacing with the eye, but the two layers that are on top, it tends to lose its kind of structural integrity from the back of the eye. And it causes all these folds and wrinkles. And patients will come in and their tears are running out of their lids, or they'll say, I'm just tearing all the time. And you see all these loose folds. That's called conjunctival chalices. And we can use this plasma device to topically numb the eye and actually go in and tighten up those folds directly onto the eye. Takes about a five minutes as far as prep time. Procedurally, we call that conjunctival chalice plastic or CCH repair. The other thing is you may have these individuals that get these recurring cysts on their eyes if they rub their eyes a lot or have inflammation. So this is an easy way. Instead of having to go in and lance it or get it with a needle and drain it, you can use this plasma pen to help seal up those little conjunctival cysts. I think the last time that we kind of noted on our website, I think there's around 16, 17 ocular clinical indications that you could use this for. It's just. And it's like the size of a pen. It's literally like holding a pen.
One doctor down in Jacksonville, Florida, she just carries around in her pocket just in case cases arise from it. But it's got the aesthetics indications and it's got the, the ocular clinical indications as well.
[00:38:50] Speaker E: So it's like you do you make, you do like these little burns in a, in a certain pattern. How close together? So what is it, like 82 to 85 degrees.
[00:39:01] Speaker B: So the actual temperature of the device, if it's touching your eyelid or touching your surface, it's only 82 degrees Fahrenheit. Right. So if you go back to our previous conversation in the last hour, last hour, I believe when we mentioned that for your oil glands to get melted in optimal temperature, it's 120 degrees. So you can tell that this is nowhere near that, that type of heat temperature.
But the way the plasma works is it's, it's not really touching your body. It's creating an arc of energy. So it's actually causing a little jolt of energy to come from the tip of that needle or from the tip of the probe. So it's non invasive. It's not going to cut into you. It's not, not going to cause anything that requires a suture or any kind of sealant. But you are correct. It's, it's penetrating and causing a little bit of a puckering effect. So when you get finished with it, you're going to have like a little burn look to it. You will. And that, that's probably the most common.
[00:39:59] Speaker E: How long does that last, that little burn look of those dots?
[00:40:02] Speaker B: Yeah. So we don't want you to have any makeup or anything like that. So we do a post, post care treatment for about 72 hours.
And most of the time it is stimulating those fibroblasts. So there's going to be an itching effect. Most of your patients are going to say, I want to itch it. So I tend to tell my patients to take their, you know, over the counter allergy medications and then I, if I'm doing a large area of, of facial wrinkles or rejuvenation, I tend to call in a Medrol steroid pack just to help with that. But most of the time I'll do, you know, my cases on a Thursday or Friday, no makeup, take their medications. As far as their, their mend roll pack, their Claritins. By Monday, they're wearing makeup and they're, they're back to work. And the spots are 90, healed up.
[00:40:50] Speaker E: So the spots last two or three days. That's it.
[00:40:53] Speaker B: That's it.
[00:40:54] Speaker E: And it causes it to form new connective tissue and causes secretion of collagen fibers.
[00:41:00] Speaker B: That is, that is 100. What you're, what you're doing is you're wanting to cause the area to stimulate at that dermal junction where the fibroblasts live. And it's not going to cause a scar formation. But what's going to happen is you're going to have newer, tighter, firmer collagen tissue that's in that dermal junction. So you have a firmer, tighter look. That is exactly what you're trying to do.
[00:41:24] Speaker E: And what are the side effects that we're worried about? Are we worried about changing skin color? Are we worried about delayed healing or redness, scarring?
[00:41:34] Speaker B: Well, so if you're a keloid former, you want to avoid it because you're already a scar former. Those will be the people that have pierced ears and have those big, large, you know, keloids forming. You know, if you're an individual that has A scar formation or if you've had shingles within six months, this is not for you. Right. But if you have a darker skin type and you're trying to do that skin dermal rejuvenation. If you have a darker skin type, you will have the risk of hyperpigmentation. So you don't want to do the needle tip. That would be a risk. That will be where you go to have your consultation with your provider, make sure you're the right person. I would definitely say that if you're an individual that has a pacemaker or some type of device, this is radio frequency energy, so you definitely want to avoid that as well.
[00:42:20] Speaker E: How about the dark circles around the eye and bags? How does it work for that? And does it work good enough for that?
[00:42:27] Speaker B: So it does work for that. It does take multiple rounds to where you're going to use the needle tip and then you're going to come back with the, and switch the tip out to do the electrophoresis. So you're going to do both procedures where you massage and get the electrophoresis effect more broader and deeper. And then you're going to come in and do that whole ocular orbital region and allow that plasma tip. So you're going to have the scar spots plus the massaging in. I tell my patients, usually with that one, we're looking, especially for the gentleman, we're looking around three rounds for us to get the effect.
[00:43:01] Speaker E: We're looking for three rounds. How far apart?
[00:43:05] Speaker B: About two weeks apart.
[00:43:08] Speaker E: And then the bags and the dark circle should be gone.
[00:43:11] Speaker B: I'm not gonna say gone. I mean, you know, I think from, in the society we live in, it's, it's, you know, the. Only to get a completely flat structure, you might have to have some type of surgical removal of some of those little fatty pockets. But yes, as far as getting that youthful, tighter look, you know, I just, I'd be remiss if I said it's completely flat and gone, but I think realistically, yes, you're, you're looking after round three for that effect. You're looking for.
[00:43:36] Speaker E: How about skin tags? A lot of people have those little skin tags. They're insulin resistant. Insulin causes, you know, is, is anabolic. So it causes tissue to multiply and people get these skin tags. They'll get them on their neck, they'll get them or sometimes around their eye in the corner. And how does it work for that? How long does it take to get rid of those?
[00:43:57] Speaker B: I would say it takes literally two or three Minutes for, for us to take them off. I mean you're long enough for us to use a topical numbing agent and use your forceps to actually pull so you can get that pedunculated base. You go in with a needle tip and you put it, we put it in constant mode so you're just literally holding it in place and then you'll just see it go right across. So two to three minutes for, for you to get the whole procedure. And the beauty is that the, the itself cauterizes itself if you will by causing that arc of plasma energy. So there's not going to be a bleed. It's literally going to just zap and then seal it up.
[00:44:34] Speaker E: And how about for wrinkles and fine lines like I have over here? How about that? How long does that take? How many treatments that usually I tend.
[00:44:42] Speaker B: To tell my patients that I like. You know, when I do my package, it includes two rounds. Space them two weeks apart and I'll do a third round if we want to. But most of the time for this zygomatic, crow's feet and plus this glabella region, usually it's the two rounds. That procedure, it just, I like for it to be numbed up and anesthetized just a little bit longer. So usually prep time, you're looking around, being there around 30 minutes. The majority of that time is to be in the chair, sign the consent forms, take the before and after pictures and then you know, being able to prep them with the BLT and numbing cream. So 30 minutes is usually this whole region right here. Upper, lower lids, zygomatic and glabella region. And then afterward, I'm Sorry.
[00:45:28] Speaker E: Speaking with Dr. Mike Johnson. We're up against the break. This is Dr. Kerry Gelb. You're listening to Wellness 1280 on Open youn Eye radio on AM 1280 in the Patriot. We'll be right back.
[00:45:40] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less, less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called My Sight. This specific one day contact lens is already worn by thousands of children in the US it is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyourizeradio.com to find an eye doctor that specializes in this treatment program. Learn
[email protected] when you hear the term.
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[00:47:39] Speaker A: I went to the eye doctor the other day with my daughter Maggie. I was shocked when the doctor told me that my daughter was already becoming nearsighted. It turns out that this problem affects more than 40% of Americans. My eye doctor thinks this disease is getting worse. Perhaps it's getting worse because of kids prolonged time spent playing with smartphones or maybe because kids now spend less time outside. My genetics probably aren't helping her a whole lot being nearsighted myself. But the good news is that the doctor told me about a new FDA approved product called MySite. This specific one day contact lens is already worn by thousands of children in the us. It is proven to slow down the progression of nearsightedness. And best of all, Maggie loves these contact lenses. The doctor taught her how to use them. Now it is so exciting to see her have even more success in the classroom and when she plays sports. I Recommend you visit openyoureyesradio.com to find an eye doctor that specializes in this treatment program. Learn More at ownership. Open your eyes radio.com we're back with Dr. Mike Johnson.
[00:48:43] Speaker E: He's telling us some really interesting things about getting rid of some crow's feet and some skin tags and getting rid of some puffiness below the eye and dark circles. People want to get rid of that. So we talked a lot about that. How much should someone expect to pay at a doctor's office for this type of treatment?
[00:49:03] Speaker B: Sure. So from an aesthetic standpoint, that's usually an out of pocket expense. I would say that's regional. I mean, I would say here in the southeast you range anywhere from 8, $900 to $1600 for upper lowers and then most of them will have additional fees. So I would say around 8, $900 basic upper lowers. That includes two sessions and then you're looking around 2, $300 for each additional region.
[00:49:33] Speaker E: And you ask your patients how satisfied with the results are they.
[00:49:38] Speaker B: We do, we do. So the majority of the time it's all about internal referrals and how satisfied are you? You know, are you, you know, would you recommend to your friends? And most of the time it is built that way because they'll go to church or they'll go to work and their friends will see these little spots and they'll be like, what is, what is that? What's going on? And usually this one right here gets the most result because that's, you know, ladies are in the mirrors looking and doing their brows and their makeup all day.
So the satisfaction, I would say upwards of 80, 90% of them are like, no, this is exactly what I wanted. But it's also because you have to give them the mindset of we're looking for that youthful. This is almost like a bridge procedure where they're not quite ready for a full on facelift or a bleph lift. Right.
But if they're looking for that rejuvenated 12 millimeter lift and that tighter look. And then the next question is, well, how long will I expect this to last?
We're telling our patients around three years.
[00:50:32] Speaker E: So this is the plasma pen. This is fibroblast therapy where we're, we're increasing connective tissue, secreting collagen. But tell me about when you would use electropheresis. You could do all this with the plasma pen when what you can't do with plasma pen that you have to do with electrophoresis for sure.
[00:50:56] Speaker B: So if you're going into a procedure where you're wanting to stimulate the meibomian glands and you have a Darker skin type, or you're wanting to couple this with ipl, intense pulsated light therapy. Then you would switch the tip to a rounder bead and you would massage in the electrophoresis technique. So you would use elect for electrophoresis. If you're wanting to do that dry eye component and couple it with your ipl, Some doctors may have an IPL device and a lot of practices don't have IPL devices. Right. So there may be some states that have some laws about which radio frequency you can have. So this particular device has a low enough frequency where they don't need to have the ipl. You could do the electrophoresis alone and get that effect as far as stimulating the bivaline glands and let your eye doctor go right into using the forceps to squeeze the meibomian oils out. I would say the synergistic effect of having the IPL plus the electrophoresis together. Those are the studies we are doing where we're, we're comboing it. I prefer to do, if I've got that patient that's got that severe dry eye and I'm already done one or two steps of IPL and I want to have that synergistic, I want to get that push over the hurdle for that patient. Then I'll add this right after ipl, I'll do the electrophoresis massaging one minute upper and lower each eye for two passes. And then I will express and squeeze those meibomian glands to get that better effect.
[00:52:26] Speaker E: The plasma pen, does it have the attachment of the electrophoresis where you don't need the ipl?
[00:52:32] Speaker B: You are correct. So when you buy the, when you buy the device, it actually comes with multiple types of heads. So there's different beads depending on how close you're wanting to get up on or what the shape of the person's eye is. There's an L bar that you can massage the whole large area. So when you get the device, you get the copper tip needles to do the conjunctival chalices repaired directly on the conjunctiva or the aesthetics treatments. But you also get the rounded beads and the flatter beads so that you can actually do the electrophoresis. All that's built in and then the tips just are just like a, like a thread. You can just change it like your changing the tip on a. On almost like a drill.
[00:53:12] Speaker E: The contratitil folds with the folds that you were talking about, the cch, the chalices Conjunctival chalasis, where we have the folds, a lot of times that's common after surgery, people get that, and usually over 50. But we'll see those folds in a lot of people. And they're constantly tearing. And they go. And they see many, many different doctors. I've seen those people. They've seen oculoplastic surgeons, and they're doing all kinds of stuff for the lacrimal gland, but they never get better. But they have these folds, and all you have to do is put this on the folds. For how long does it take this procedure on the folds to get rid of them and tighten them up, and then the patient feels better for sure.
[00:53:59] Speaker B: So, yes, I would say almost all of your patients that have some type of what we call epiphara, where there's. They're coming in complaining of tearing all the time, or they've had a surgery where they've had their eyelids stretched open with the retractors most of the time, people that are older in nature, your eye doctors can start identifying the folds. The procedure itself, instead of doing the original conjunctival chalasis plasti, where they go in behind the eye, they pull it back, they tighten it. That's an ins in hospital surgical, very invasive. And this one literally is chair time, maybe 10 minutes tops. The longer portion is going to be the doctor getting their tray, their surgical tray ready with the device loading the tip, numbing the patient, but putting the. Putting the little cotton swab down into the cul de sac, if you will, the lower portion down in the cul de sac of the eyelid where the eyeball is pushing that in, and then using that little copper tip and just tap, tap, tap, tap. As soon as you tap and cause that little arc, the doctor will literally see that loose fold tissue tighten and pucker. Real time. I would say start to finish, five minutes.
And that one, we're looking at it lasting, you know, that three to five years as well.
I would say from a billable standpoint, the providers would be able to bill for that procedure. It does have a diagnosis code, and it has a surgical billable code for.
[00:55:29] Speaker E: That procedure to be reimbursed for the patient. Their insurance could cover it.
[00:55:35] Speaker B: Yeah, I would say that they would just need to check their deductible because it is a surgical procedure. It's a six code, if you will. But if they have a coverage where there's no high deductible, that would be where them and their doctor's office will cover it, there's some groups, some doctors groups that we have, they just charge this as a cash pay option. You're looking at, you know, 8, $900 for this procedure to get it set up. The other way is when we do this procedure, I prefer, I want to have as optimal of a soothing healing as possible. So I actually, once I do my treatment where the spots have been heated up and tightened and pucker, if you will, I immediately apply an amniotic membrane on straight onto that tissue. That way I get those healing properties that are within that amniotic membrane. And then the patient will also have a more comfortable interface. When we let go of that lower lid and there's an face there, that way there's no rubbing sensation. So that's billable as well.
[00:56:36] Speaker E: We only have about two minutes left. So I want to ask you about amnion serum. Tell us what that is and when can we use that to help our patients.
[00:56:45] Speaker B: So when you're doing these particular procedures, and you could use it just for facial rejuvenation as well.
The company that we, that I like is Gymnovi or amnio renewal. When I'm doing my facial procedures, and I own an aftercare product that's going to allow healing, allow and promote that epithelial tissue to be tighter and firmer. So the amnion. Right. So a lot of times there were companies that would get the fluid, but the amnion that we're speaking of, that inner lining, we actually have gotten that to be produced into a serum formation to where they can apply it to that facial tissue that has been treated and absorb it. The other aspect that we've been using this with is the electrophoresis, where we're massaging those meibomian glands. We are penetrating that and pushing that amnion serum into that skin tissue to allow for it to get deeper and allow for a healthier meibomian tissue to be produced as well.
[00:57:46] Speaker E: What kind of results are you seeing?
[00:57:48] Speaker B: Huge results. The odd part is, when we did our initial studies, the electrophoresis is going to cause an immediate spike in the surface inflammatory response. When we're doing our tear check and our infrared meibomian imaging. So day one, we see a spike in the inflammatory response, but one week later, we're actually seeing a 10 to 20% improvement of the surface inflammatory problem. And then we're seeing about a 15 to 20% improvement of the damage to meibomian glands on the tear check mammography scans.
[00:58:24] Speaker E: Oh, that's great stuff. So if people want to find out more about you and find out about these procedures. How can they do it?
[00:58:32] Speaker B: So I'd say from a from a new Vista standpoint, you go to nuvistaocular.com amnion any kind of topics. We have all those preloaded on our website. That's opthalogics.com and how do you spell nuversa N U V I S S A and apologics O P T H A L O G I X well.
[00:58:56] Speaker E: I want to thank Dr. Mike Johnson for joining me today. He really is a wealth of information. The first part was a little technical but the second part was very practical and I hope that people listening got a lot out of it. This is Dr. Kerry gel for open your eyes radio on wellness 1280 and we'll see you next week with another great episode. Thanks for listening.
[00:59:18] Speaker B: Thank you.
[00:59:18] Speaker E: Thanks Mike.
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