Things Your Surgeon Should Tell You

Sometimes you've chosen your surgeon very carefully.

Yeah.

And you show up at the surgery center or hospital and you quite literally have no idea who your anesthesiologist is going to be, which is kind of like, mind blowing when you really think about that being the truth. You have no idea.

Well, a lot of people are blissfully unaware of what you've just described and just assume anesthesia is anesthesia.

Right.

Hey, everybody. Today's podcast is with my friend, brilliant cosmetic surgeon with a deep understanding of all things beauty, hair, anesthesia, flow states, and more. Enjoy this discussion with Dr. Cameron Chestnut of Clinic 5C in Spokane, Washington. And the URL for the show notes is BenGreenfieldLife.com CAM2025 CAM 2025. Hopefully this doesn't get too off the hook. I just put in the first nicotine pouch I've put in my mouth for like two months. Oh, yeah, I was filling up the truck.

How's that doing?

So far so good. It's only 3 mil kilograms.

Oh, man.

I had to put 25 gallons of diesel in the truck and was bored at the gas station and wandered in there it was. So my head explodes during this show. I've got water.

Highly beneficial, slash highly addictive.

I mean, yeah, nicotine, highly beneficial, highly addictive. The. There's a new variant kind of going around called cytocholine. I think it's called cytocholine or. No, not cytocholine. Conitine. Some company called Set, they had sent me a bunch of pouches of that. It's non FDA approved, apparently, like a less addictive form of nicotine. But, like, my. My philosophy is I don't like to be beholden right to anything. And I got to the point where I was probably like throwing in like 4, 4 milligram patches in a day.

Interesting.

And for me, it's just like, you know, you're addicted, which I think you've gotten above like 10 milligrams. So.

Yeah. Anyways, off of that difficult then? No, no, just willpower, basically.

I think part of it is your mentality. Like, you do a lot of like. I mean, we'll talk about this. Like, you do cold thermo and you do hard workouts and you do jits and you swing kettlebells. I think if you understand blood, sweat and tears, biologically, it's pretty easy to just like stop anything and shut up the inner in the same way that you do when you walk into a gym, sleep deprived and know that you just got to hit it anyways.

Yeah. I've been thinking about incorporating it post surgically for anesthesia recovery because there are certainly benefits to those sort of receptors. But I'm concerned with well, the way it makes people feel when they first take it, myself included, and how to dose it. And then of course the.

What would be the benefits like post surgically?

Well, so this is, this is very new to me. This is like as we talk and things I'm excited about is all the post anesthesia when we talk about post operative cognitive dysfunction or things like that, it really gets into neuroinflammation microemboli. And so there's some evidence that nicotine can have some neuro anti. Inflammation inflammatory.

Okay.

Benefits and activates some inflammasome or like inhibit some inflammasomes that are important to neuroinflammation. So it could potentially, potentially decrease postoperative cognitive dysfunction beyond just the stimulant effect of.

Yeah, yeah, yeah. Have you messed around at all with like any of the neural anti inflammatory peptides that kind of cross over into the neural piece like KPV or PBA or even bpc to a certain extent.

Exactly. Right. So my. I do have a peptide stack that I cocktail or alter a little bit and pre and post operative. And the post op edition is a kpv.

Yeah.

For that reason.

Yeah, yeah. I mean leaky gut, leaky brain crosses blood brain barrier.

Exactly.

That's in. I don't want this to turn into like a commercial, but there's level up health has like a neural anti inflammatory peptide mix that's got all of the things that help the quell neural inflammation and they've got all those peptides in it like that. Which is great if you're sleep deprived or I don't know about post surgical. Post surgically.

Well that's like the. It's even more pertinent in that period for sure.

Yeah. I want to talk about the postoperative co. What do you call post operative cognitive dysfunction. Okay, I want to talk about that. But back to shutting up the inner. Okay, you convinced me that when I come up here today that you want to do a pool workout. We haven't done it yet, so I guess that's for dessert after the podcast. So is this like a new thing for you? The whole like Laird Hamilton, Gabby Reese.

Cool thing came full shout out to Laird and Gabby. You know, they're the, the father, the king and queen, let's say of this for sure. And I definitely got into it through them and we just Built the new home and moved into it, you know, this summer, a few months ago.

And the pool, the home you've been building for the past 12 years?

Yeah, something like that. Yeah. Not barely exaggerating, but the pool is purpose built for these sort of unhappy houses. Oh, yeah.

You mean, like, purpose built, like the.

Depth or depth, the shape, the structure, how the bottom is shaped, how the outside is, where the workout space is. It's. It was purpose built for us.

What about. Because when I've done the workout at Laird and Gabby's, and people who might not be familiar with this, you're like hoisting dumbbells at the bottom of the pool and you're up and down and there's some breath hold components and proceed at your own risk and have a partner around while we're saying this, we should probably get that. That out of the way. The. The bottom of the pool, though, can be slippery. Did you.

Oh, yeah.

It's very, like some kind of attraction.

Or, like, treat the concrete sandy.

Okay. Yep.

Like a sandy finish to it to be really grippy but comfortable on bare feet.

Yeah. So for people who haven't done a workout like that and who haven't had the pleasure of just, like, going to Laird and Gabby's on a particular weekday morning. Yeah. What's. What's it look like when you hop in there?

Well, there's a. I would say there's. Depending on what you're doing, there's a few main components to it. The real one is, like, forced breathwork. I would say that's the most unique part of it is, like, we all try to control our breathing when we're lifting or doing yoga or something anyway. But I would say, personally, I wasn't very good at that or I'd lose focus on my breath. And you can't do that when you're in the water because your breaths only come at very specific timeframes in the workout. And then there's just the going to your dark place a little bit and kind of suffering through knowing, like, okay, I'm going to get a breath, but it's going to be four seconds from now, whatever that may be, which builds a whole bunch of metabolic flexibility, specifically, like a hypercavnic tolerance. We think of hypoxia, low oxygen, and interestingly, much more of it is about building up CO2, not getting low on oxygen.

Building up CO2 tolerance would be an effect of the pool workout.

Exactly. That's like, probably for me, the main effect of what I'm after. So I'm not blowing off CO2 and then trying to hold my breath as long as I can. That's where you get shallow water blackouts and things get dangerous. And that's also not applicable to real.

Life generally, because carbon dioxide, the presence of carbon dioxide would be a signal for your body to take a breath. And when you breathe it off, you're able to do the whole Wim hof hold your breath for a long period of time thing. But that's also dangerous if you're submerged in 12ft of water.

If you're underwater. Yeah. And, you know, with even going back to Laird specifically, like, the birthplace of this was to improve his, I guess, making him harder to kill in the ocean.

Right. Like, if you're at the bottom of the ocean with a surfboard, like, tangled around your feet or whatever, and you.

Don'T get to hyperventilate before that, you go down and then you're struggling. And I love. My favorite question that I've ever seen Laird get asked was, you know, how long can you hold your breath? And very classic Laird answer was like, I don't know. Long enough so far.

Yeah.

It's like, oh, beautiful.

Yeah, yeah, yeah. The. The interesting thing about the CO2 tolerance, I interviewed this guy named Anders Olson. He's. He's one of the guys out there who's written a book, breathwork Book, and he's one of the breathwork physiology guys who has a lot to say about it. And we talked about CO2 tolerance, and he talked about how the ability to withstand CO2 can be correlated positively to stress resilience. Right. Your ability to be able to just not freak out when a problematic email winds up in your inbox. And he developed, like, a machine that attaches to a carbon dioxide tank with a mask that allows you to breathe in anywhere from 3 to 7% CO2 just while you're at your desk to build up CO2 tolerance passively while you're in your office.

Yeah. That's interesting. That's an extreme way of doing it. I mean, with my kids even, we talk about how to breathe properly through their nose, whether they're sleeping or exercising. But that's one of the benefits of. And I try to get my patients to do this too, is in their weeks leading up to surgery. They don't need to be murdering themselves, but I want them to build up their hypercapnic tolerance. It makes their anesthesia better, makes their recovery better, makes their brain more protected. Sometimes it's simply just like light zone one, zone two, Walking, but breathing through your nose while you're doing it instead of breathing in.

You have a mouth tape. Have your kids mouth tape, your patient's mouth tape. Do you do that? You mouth tape?

I do, yeah. Yeah, I do. I've also gotten to a point where I don't really need to as much anymore. It changed. Broke that habit loop for me a little bit. But I'll still find myself sometimes, like, oh, I definitely was mouth breathing and then switch over.

Yeah, well, what happened to me was I did. So I've done podcasts on mouth taping before, so inevitably, you know, the hostage tape and Inhale and Respire and all these companies just like sent boxes of nasal strips and. And so I felt like I had to use them because they were around the house. So now every night, like right after Jess and I finish our evening prayers, I. I already have the nasal strip on, which actually I was surprised because I did mouth taping for a while, added the nasal strip, and you feel more oxygenated during the night. And when you wake up just with the presence of the nasal strip and there's a new one that's like.

It's like a couple of magnets that you apply to either side. And then there's a plastic piece that expands the nostrils. It's the most effective. Yeah, it's the clunkiest to put on.

But I found one that I really like too, that's different. I use this when I sleep. But I think the most unique place I use it is I put it under my surgical mask because I'm tuned into surgery and I'm hyper focused, flowing for eight, 10 hours. And I have glasses, my loupes, they're called sitting on my nose. I've got a mask sitting on my nose. I'm covered up and I find myself, mouth breathing, doing that sometimes because everything's compressing on my nose. And so there's an intranasal stent which actually comes from the. This is something I don't do, but the rhinoplasty world to kind of hold the nose open after surgery. And there's an ear, nose and throat doctor. I'm completely unaffiliated. I have nothing to do with this. It's called Hale H A L E, I believe. And they're these like little intranasal stents that you put in there. Rubber, plastic, kind of hold your nose open. They're very simple, very straightforward. They have three different sizes. And I now have them sitting next to my bed. I have them in the operating room. It's sort of like, I kind of hide. It's the last thing I do before surgery.

Outsides on the inside. This is like the turbine that Chris as a Chris Flume, the Tour de France cyclists. He used those during the Tour de France one year. And it's like a little yellow plastic piece that goes inside the nostrils and shoves them apart from the inside.

Yeah. Because when we think anatomically, again, this is not my world as much, but when we think about nasal, we have what we call the external valve at the very bottom where the air comes in. And then there's an internal valve that's a little bit higher up. We can define the anatomic walls of that.

The traditional nasal strips are focusing more on that internal valve, and this one's kind of more focused on the external valve.

So you're saying all of the overachieving biohackers out there could do both?

I hadn't thought of that, but I guess you should get it all open.

Somebody's gonna do it. Cameron Chestnut has been a guest on this podcast three times. This is fourth time with me. I'll link to all of our previous shows where we take a deep dive into his history and cosmetic surgery. How to grow your hair and keep it from graying and get the face more beautiful. He's done extensive work with my wife, Jessa, so I will link to all that if you go to BenGreenfieldLife.com CAM2025 like C A M 2025. So you guys don't get a deep dive into Cameron's whole backstory on today's show. You just got to go listen to those other shows. But back to the pool workout Cam, you. You use that as a way to build up CO2 tolerance. But what's it look like? Like boots on the streets when you jump in.

Yeah. So a little light warm up. First thing we'll usually do is go into something light where we're really getting into the rhythmic breathing part of things just to get facile and used to that, because there's a. Certainly a bit of even a technique to exhaling on the way up to the surface so that you, every second or millisecond, your mouse above the water is inhaling. You're not exhaling and inhaling at the same time. That's very much like basic, you know?

Yeah. Similar to, like, free diving or spearfishing you surface with empty lungs.

Exactly. Same idea. Exactly. Yep. And so that can be hard to wrap your head around at first for people to, like, purposefully let Their out underwater before they're getting a breath. And so that's usually like first things first kind of going over some basics about not hyperventilating and things like that. So little rhythmic warmup like that. Then the way that I said, my pool is purpose designed. There's different depths that are all about 18 inches different. Descending from 10ft all the way up to 4 and, and using, I like to like kind of use those different stations for different amounts of weight. Like, let's say today we might do a hip hinging workout, right. So in the deepest sections, you're using a little bit lighter weights, but you have more distance to cover. And by the top, you know, where it's seven feet over our head or whatever, we're, you know, maybe holding 50 pound dumbbells and doing like single leg pistol squats or squat lunges or something, but trying to get those breaths each time. Yeah, yeah. Then there's the component of. And those are like very, those could be very traditional types of workouts. But then there's just the very unique underwater components of just like taking weights distance underwater without breathing. That's the hypoxic part or the building up CO2 hypercapnic part.

It's really old school. Like I'm gonna carry a rock on.

The bottom of the ocean on some level. This is where all that comes from. Surfers have been doing this. Those are the coolest images, right. They're holding a rock between their arms, running on the sandy bottom. It's all, you know, that's the grandfather of it all. Flared's the father for sure.

Yeah, there's like this link between, between.

Being in an anaerobic, acidic or glycolytic state and that being unfavorable to long breath hold times and being in a state of fat oxidation, ketone utilization, maybe a little bit more alkalinity being conducive to burning through less oxygen or having higher CO2 tolerance. So diet is kind of a component of this. I mean, when I went down and did a freediving course in Fort Lauderdale, I tested this with a bottle of those like exogenous ketones. And my static breath hold time, absence of ketones was about 20 seconds lower than when I kind of like artificially induced a state of ketosis by, by drinking my blood ketone levels up. Do you mess around? I mean, either for your surgical focus like you're talking about, or these pool workouts like, what's the, what's the dietary.

Component component for you? Yeah, those all tie together. I first became Aware of this via, I think a mutual acquaintance of ours, Justin Lee, who lives in Hawaii and is like a free diver. He's incredible. Have to check out his bow Hunter too. Great everything hunter. Epic. Right. He swam with the University of Washington, so he was like a Division 1 athlete in a very traditional sense, but is now, you know, remarkable. Knows, you know, Peter Attia very well now. They were looking at ketones and his breath hold time, that was like a really cool interlink of theirs. But so I became aware of it then. And the root of this for me is all. When it really boils down to is all peak performance for me in the operating room, that's where everything boils down to. That's why I'm getting in the pool to be at my best. That's why I go to jiu jitsu on some. I just want to be a good human and a good father and hard to kill. But it all boils down to how I can be at my best in the or. And ketosis as part of that is it's a noticeable difference in a workout, especially underwater or an endurance workout or something like that. But in the operating room, that's the state that I want to be in when I'm in ketosis going into surgery. It's that sense of like, this is how I'm supposed to be, you know, clear, crisp, making good decisions, which obviously you want your surgeon doing. It's just really hard to get into or stay in ketosis without a lot of exogenous use, you know?

Yeah. Yeah. Why did I see a video of you on Facebook or Instagram or something couple weeks ago eating sardines?

Oh, yeah.

In your scrubs.

Yeah, very much so. I'll usually going into a surgical state like I have a big routine that I do from getting in a flow state the day of surgery, but in the days leading in. So, like, I know my surgery schedule next week. I'm already preparing for it with when I'm timing workouts, how I'm doing everything. But I'll use a fasting protocol, you know, something simple like a 48 hour fast leading into surgery. And then when I refeed, I'm doing, doing things to stay in ketosis at that point. And, you know, Dominic d', Agostino, the, you know, the king of ketones, I would say, you know, he, when I spent some time with him, really got into this like idea of, you know, sardines and olive oil, which are actually pretty delicious. Yeah. And, you know, 22 grams of protein.

Once you're sitting next to on the airplane.

Well, yeah, maybe they're a great airplane snack though. But that's a great way to like, get the protein that I need, needs day in ketosis and kind of be in that performance.

Yeah. Do you mess around with, like, the exogenous ketones? Yeah, obviously Dom has his variety. There's a lot of them out there.

Yep, yep. So I do I use one called keto start. That's the one that I'll take preoperatively. Even if it's the time where I'm not in ketosis. I'll take those leading in. I like those for my patients as well.

Yeah. Do you know what that is? Like what?

It's a ketone table. It's a salt. It's a beta hydroxybuty.

Okay.

Yeah.

Yeah.

And salt versus an ester. Right. That's a whole other thing. But I like my patients on those going in as well, even if they're ketone naive. And that gets into a little bit. We keep like, hinting at this, but.

Ketone naive, meaning they could be having Cheerios for breakfast and a sandwich for lunch and sweet potatoes for dinner. But if they have those ketones, they're still able to maintain some semblance of ketosis.

Yeah, yeah. And I'm encouraging metabolic flexibility before they come in so that they can use ketones if they're unfair.

Yeah. You have an egg with your Cheerios, right?

Yeah. If your body's unfamiliar with those. I think I have a sampling error. Where most of my patients are not, I would say ketone naive or they're very metabolically flexible. Just because the world that I live in is very, like, high performance. And a lot of them are. And so they've figured out that you can't eat, you know, Cheerios and cereal.

And then have typical patients swing by Taco Bell on their way in.

No.

Yeah.

Absolutely not. And so having them with ketones on board pre surgery helps them recover from their anesthesia via some of those same mechanisms. Mechanisms we'll talk about with neuroinflammation, which is what Dominic kind of built the whole world around, is understanding how much ketones can stabilize us neurologically.

Yeah. When you're looking at the effects of anesthesia, just because I feel like, at least from my perception and the few discussions I've had with surgeons, even that alone, the diet and the post surgical interventions aside, does the type of anesthesia you use, like, kind of fit into the equation at all? And this is like how good someone feels or how Bad someone feels after the surgery.

It's the biggest factor is 100% the anesthetics used. And you know, I am a surgeon, not an anesthesiologist, but I'm a surgeon in a setting where I'm operating in my operating room, my space. I purpose built it. You know, I'm hiring the team. I'm not just like at a hospital or something and get assigned who I'm working on with. And so I get to choose very carefully who I'm having administer my anesthesia. People of a similar like mindset. Right. Okay. And so I kind of have approached this the same way that I would with Jessa or with my wife, which is like this. If I were having surgery with a family and it was something like elective or non essential, but important to me, this is what I would want it to be. And so it's been an evolution, honestly, over time. The first steps were getting rid of narcotics or ben. Or opioids, you know, better said opioids and benzodiazepines, which are generally for small procedures, the staple anesthetics use.

Benzodiazepines are like valium. Fit into that category.

Yep, exactly. So the diazepam, lorazepam, these are like the, you know, the generic names of those types of drugs. But you know, in the anesthesia world, people wonder, oh, fentanyl and Versed. These are like the opioid and the benzodiazepine mixed together. You give them IV and you get your colonoscopy or whatever. It's going to be like very standard, but also habit forming, not great for your respiration, cause significant amount of neuroinflammation and cause a lot of what everybody knows. We call it postoperative cognitive dysfunction. That fogginess afterwards, difficulty finding words, not feeling like yourself, super disrupted sleep, which is completely under talked about. That's a whole nother part of it. But those are like very big culprits in that thing. And it's supposed to be a very simple gentle anesthesia. You're getting a colonoscopy, it's easy. It's twilight sedation type of thing, right?

Yeah.

On the other end of that spectrum we have these inhaled gases and these would be like the general anesthetics. The very classically used things still use very much now which cause same thing, like a ton of neuro inflammation and little microemboli post operatively.

Is that like laughing gas? Like same.

No, not, not nitrous. These would be like more volatile types of Inhaled gases, which are, you know, they work beautifully for what they do, you know. And so you have these two ends of the spectrum with like this very global general anesthesia that, you know, metaphorically sort of like just pushes you to the bottom of the ocean. You are out, you're unconscious, you're not breathing. You got things breathing for you, like it's a whole. You're just completely shut off. And then you've got the ones that are supposed to just kind of like sedate you or make you unaware so that you can have your procedure done. But both of those have cognitive issues or at least take some little tax on our brain. We all have a cognitive reserve that, you know, if you and I get anesthesia, we're going to get it and we're going to recover and we're going to be fine afterwards. But there's a period in there where we will have this, you know, essentially metabolic insult to our brain that we have to recover from. And we know that that is not transient and temporary. It's. There is some long term price tag to that. And if we are 85 years old and we get it done, that price tag can push us out of budget. We're over. And we all hear stories of people getting anesthesia never recovering. They were never the same afterwards. You and I get it and we recover. But that doesn't mean that we didn't take this metabolic insult along the way. That essentially could have cost us some neurons along the way.

Right. Almost the same type of mentality you've had. You'd have about, I don't know, like the radiation from a CT angiography. It's like, how many of these do I want to do over the course of a lifetime? Can I space them out and would like, maybe I want to get a carotid intima, media thickness score, ultrasound instead. For the majority of procedures I get, you've got a similar approach to anesthesia. It's like, well, yeah, a certain variety or flavor will allow you to get the procedure done pain free. But there's still a biological cost that you should be thinking about if you're going to be on this planet for like 70, 80, 90 years.

100% very, very, very well said. And a good way to think about it because I don't mean to also make people fearful of anesthesia because it's incredible. Like you need a hip replacement or an appendectomy or these are incredible drugs. And it's an incredible process that we can get those types of procedures done.

Yeah.

Where I Cross into it a little bit is that I'm doing elective cosmetic based things. And, and it's not worth kind of tapping into that reserve for something that's so elective, especially when there's other options that exist in the sort of area between the opioid and benzodiazepine and the inhaled gas, general anesthetic. There's this whole world in between that I live in and play in. And I have some freedom to do that because of all the things I mentioned before about controlling it. But also I'm not functioning in an insurance based environment.

Yeah, you're not amputating legs, you're doing like earlobe lifts.

Thanks.

But yeah, I'm functioning in a world where I, it's, it's facial based. And yeah, I can be really great with local anesthesia and do nerve blocks and then I can control consciousness and comfort in a way that I don't have to have this big neurologic insult. And there's some very specific drugs in there that are more difficult to work with, maybe more expensive, whatever it may be. And that's why I kind of mentioned this insurance aspect is like, it's really to do the way I do it is very intensive and challenging and focused. And in the world of reimbursement for anesthesia, for regular procedures, it's just not reimbursed. It's like, why would you do that? You know, human nature, why would you do the hard thing? You can do the easy thing. Right. But where I'm living is, you know, kind of like this is what I would want. And so I'm gonna, you know, do it and further it and talk about it.

You pay more money to come see you.

Right? Exactly. Well, and again, it's like there's more to it. But you know, getting back to it's the agents that are the real thing. And, and it's really complex and interesting and complicated. And you can get a bunch into the neuroanatomy and the neurotransmitters involved, but there's a few key players, some of which are familiar to people that they've heard about, like ketamine and propofol. But then some are very unfamiliar.

Ketamine and propofol would fit into the category or something you think is less damaging from day.

For sure, less damaging. But interestingly, there's a dose paradox to both of those ones. And then something that not a lot of people, or at least lay people have heard about, called dexmedetomidine, which calls precedex is the brand name which is very fascinating from you know, in our world. I would say because it's a very central acting alpha 2 agonist. Very specific for a Alpha being a sympathetic mimicker but central nervous system and Alpha 2, not Alpha 1.

Anybody who's ever had like a muscle cramp is felt in alpha motor neuron reflex.

Exactly. Yep. And in our central nervous system when it's hitting that, it's basically telling our brain to kind of chill like and it puts a, it causes a sleep like state, like non rem delta wave type of sleep. So it's super relaxing and you're out. But it doesn't affect your peripheral blood pressure or your breathing or anything like that. It's, it's mimicking and it, and if we look at what it does from a restoration standpoint, it sense makes mimics this non REM type of sleep. Right. So if we can focus on that as our main anesthetic, we are not having those neuroinflammatory issues. In fact it downregulates some very important inflammasomes in our brain and the inflammatory cascade that follows, which is what causes a lot of that post operative cognitive dysfunction is neuroinflammation and like I said, some microemboli. And so it's a great sort of like that's the base if you will of your cocktail that you're choosing this. And it's more challenging to work with like a little bit of a slower onset. And so you have to be really comfortable and diligent working with it and then sprinkling in ketamine and Ketamine being dose dependent and low dose ketamine is very neuroprotective. It works on a completely different system. We talked about alpha here. When we get into ketamine we're getting into more like nmda, like the glutamate receptors, which is an excitatory neurotransmitter. Right, right. And so low doses, and this is really important in low doses, Ketamine is very neuroprotective. It's a little bit of a dissociative, helps with pain and awareness and consciousness types of things. So it's beautiful in that sense. Doesn't really mess with your respirations, actually kind of helps your lungs dilate but in high dose flips over and becomes very pro inflammatory. So you gotta be careful about that. And this probably carries over into the other parts of the therapeutic and recreational world.

Yeah, especially when you take into consideration like the pharmacogenetics of ketamine and the fact that like some people are toast from a neuroinflammatory standpoint on like 20mgs.

Exactly.

And then others will not feel anything on it.

Right, Yep. And that would be, you know, again yearsly dosing per kilogram, but that would be like pushing that like you know, more of more upper limit. When I'm using it, it's like a drip or a sprinkle kind of along the way or certain aspects of the procedure. And then propofol, which you know, everybody is propylene, a lot of people have heard of as famous Michael Jackson, all kinds of things like that. Interestingly, the reason that Michael Jackson was using it was for sleep because in some low doses propofol has been shown to improve some sleep architecture. In high doses it can be more like a general anesthetic, have that neural inflammation. But when I'm using propofol I'm sort of using it to kind of turn us into almost like a low power mode to decrease the oxygen needs or capacity of the brain a little bit because then we're protecting a little bit in our needs. So there again that's probably the order of which they're prioritized in my operating room because I get, I talk about this and often get asked, well, how do you do it? What agents do you use? Especially for my colleagues and in a short social media type of form, it's difficult to talk about those things. But in a long form like we're out here, that would be a very general recipe as to how I like to use them.

So if somebody was going to get a procedure done and they're listening, they're not going to get a procedure done by you. Is there something they can say to their doctor or like some kind of advocacy they can take to ensure they're not risking as high a level of post operative cognitive dysfunction?

Such a good question, and I should have said this at the beginning, but these are applicable to every single type of surgery. There is nothing along the spectrum where these at least principles. Principles wouldn't be worth asking about. Right. If you are having a brain surgery or a huge orthopedics like, okay, you're probably going to be into the general anesthetic part of things, but you can certainly let your. This is the challenging part to navigate. Your doctor and your anesthesiologist know that you're interested in these types of things and that you're aware and that you're, you know, wanting to minimize these afterwards. Can I have A regional nerve block instead of a general anesthetic or something along those lines. Regional nerve block being local anesthesia, which is the dream. Because then there's no pain signal ever since. Right. Because I should mention this with my area, too, is a lot of what I'm doing is really good local anesthesia. You just can't feel anything in the first place, which really helps. This is a whole nother conversation with postoperative pain, because if there's never a signal sent from the periphery to the central nervous system to start with, those pathways never get primed. And then post operative, when the anesthesia is worn off and sort of the pain stimulus is gone, there's not as open a pathway as for postoperative pain. So it's better. And we know this even with general.

Unless you're that crazy athlete who gets a regional nerve block and decides you're going to go out and do heavy squats the next day because you can't feel anything. Have you heard of people do it? Be careful. I have also been guilty of messing around too much with a regional nerve block and thinking how far you can push it.

Yeah, yeah. That's a different story. But yeah, you push yourself into rabdo that way.

Yeah, exactly.

Yeah. But with any, you know, going into any procedure, sort of navigating who to talk to. Because sometimes you've chosen your surgeon very carefully.

Yeah.

And you show up at the surgery center or hospital and you quite literally have no idea who your anesthesiologist is going to be, which is kind of, like, mind blowing when you really think about that being the truth. You have no idea.

Well, a lot of people are blissfully unaware of what you've just described and just assume anesthesia is anesthesia. Anesthesia.

Right, right. So if you can find somebody's a little bit more progressive. I find that if you have somebody who's curious enough and you talk to them about this, they're kind of willing to like, let's play. Let's figure out the best way to do this.

But there's not like some website collective of anesthesiologists that you can look up who are trained in your ways or preach what you preach.

Exactly.

Just send your doctor this podcast, basically.

Yeah, Well, I mean, it's not what. The way I do it is not common. Yeah. And it is, you know, like I said, it's just a little bit more involved, more challenging to do it that way. But it's definitely worth asking if it is a situation where your surgeon's getting Involved with your anesthesia, it's much more likely to happen versus just who you get assigned to that day type of thing. And this is the other crazy thing. And like, I don't know, some hospital settings, the person administering your anesthesia will likely rotate out throughout your procedure, like who's on shift kind of going on. So it's difficult. But these are. They're best had preemptively before your day of surgery.

I've always been asleep when that handoff occurs.

Right.

Yeah, it's a little concerning. So this. I'm gonna save myself a lot of syllables. Pocd, Right. That's the cognitive dysfunction thing.

Correct.

Maybe a loaded question. I don't know. But what else do you do besides the pre. Metabolic dietary suggested modifications, the anesthetic modifications.

To mitigate that?

Yeah. So just to summarize, those pre things coming in are everything from peptides to something like creatine, which is an interesting and fun discussion, to ketones. I've been using creatine preoperatively for years, for a decade. And you were ahead of the curve on that then. Well, this is the crazy thing. I would say over the. And at first it would be like 10% of my patients came in on creatine predominantly working with women.

Right.

You know, there's 15, 20% of my patients are men. Most are women. So I found that, you know, 10% were on creatine coming in now, I would say over the last 18 to 24 months. I probably. The ratio's flipped. It's 80% plus.

Rhonda Patrick and Andrew Huberman, the public science educators. And are you modifying the dosage or suggesting that based on the idea that, like, once you exceed 10 grams or so, you see a little bit more of the cognitive enhancement? Exactly.

Yep. So I'm usually trending towards 15.

Okay.

Coming in again, I find most people now are sort of on that.

And just like 15 grams creatine powder spread throughout the day.

Exactly.

Yeah.

Yep. And, you know, even, like, which brands we're recommending here, you know, kind of spaced into it. But the. I think that one's fascinating because when we think back to our youth of creatine, it was athletic performance, muscle gain.

You know, and it was 5 grams.

Right. If I.

Unless you're doing a loading.

Unless you were loading and you have a little glucose with it, or whatever we used to do. Then the more recent discussion of the cognitive benefits. Right. Which sort of makes sense. It's not isolated in our muscle. We know it's in our neural tissue. Central nervous system. And this is I think part of the future is now I see it benefiting like skin changes. So this is going to turn into a beauty supplement as well because our fibroblasts, the cells that are creating and healing our skin are energetically demanding. Especially after what I'm doing like let's say something like a laser resurfacing. So if I can help those cells metabolically be more efficient.

I'm going to get better results. There are studies right now looking at creatine and skin and no stimulus and showing improvements in skin structure. So that's going to be a really, really fun evolution over time. We're just going to find out more.

As opposed to what is the opposite of no stimulus.

Well, I'm stimulating, I'm using like a laser resurfacing or like a laser part of what I'm doing.

So. So you would load someone with, with creatine collagen and then aggravate with.

Exactly. I'm making, I'm creating even more supplement.

Line like the CCCC Cameron Chestnut creatine collagen cocktail.

You're not going to catch me getting too into selling supplements and or skincare. Not my areas as much but I.

Do appreciate what I can do. So creatine ketones. What was the other thing you said?

Peptides, Dietary things.

The peptides would be like the PEA.

KPV, BPC, Common Anti Inflammatory Peptides, TB4 and GHK Copper. And. And the post op is often where I'm adding more of the KPD and types of things into the preoperative stack. This preoperative stack might be two to four weeks before I get this question. A lot depends a little bit on the procedure of the patient. If we're doing ideally if we're doing an injectable form versus a sublingual form because if we get to sublingual of the peptide. Yeah then we lose bioavailability. But it's also someone's not poking themselves. So this is all consumption.

Unless you're looking like the gastric neural anti inflammatory effect.

Exactly. And that's going to be different with different peptides as to what ones have benefit there. So then afterwards, and I'm talking about neuroinflammation a little bit with something like KPV mixed in there. And then this is I think the coolest part. I have a very regimented post operative, I call it my optimized recovery protocol that I have my patients do after their surgeries or procedures, whatever it may be. All of my Patients are traveling to see me. So we're sitting just down the street. We have three homes on the water, beautiful views.

Coeur d', Alene, Idaho, by the way.

Coeur d', Alene, Idaho. Yeah.

And Spokane, Washington. Yep.

Yep. Where my patients stay after their procedures. It's a retreat. They're, you know, it's just a beautiful, wonderful setting for them. But then they're doing things like hyperbaric oxygen every day, targeted IV nutrition. And some of that's targeted towards the healing from surgery, and some of it's targeted towards the anesthesia, like glutathione afterwards or, you know, Coq 10 or whatever we're doing very specifically.

You mean almost like detoxification from the anesthesia. Even though what you've described is less damaging, you still want that, right?

Yeah, I want any neuroinflammation taken away and taken care of. Even the hyperbaric oxygen, which has a wild benefit to just soft tissue recovery. Fat pads, skin, muscle after an injury. It also helps with the neuroinflammation, which is why it's used in traumatic brain injuries, or people are exploring it with autism spectrum types of things. And so we, you know, it's this wild, beautiful double benefit. And I kind of love to talk about this, just is that everything meets in the mitochondria at that point. Like, we just really, whether you're healing from surgery, whether you're recovering from anesthesia, all of these things become really beneficial. And again, this is not unique to the types of surgeries that I'm doing. If you have any type of procedure, you have soft tissue and sometimes bone healing, that needs to happen afterwards. And you have to. Your brain needs to recover from that anesthesia.

Yeah. What about red light therapy using that?

I like red light therapy and different benefits to it. One of the things I'm targeting often is skin or skin of the face. And so again, I've created more metabolic demand in that particular tissue. Let's go to that word. And I love red light for that particular purpose, because.

The more efficient that tissue is metabolically, just like what I talked about with creatine. We know that red light's enhancing that in the mitochondria. It's going to get better healing. And we can read better healing in this case as a better collagen structure, not necessarily more. We want collagen, but what we really want is elastin. Elastin is the other fibril in our skin that gives our skin its elasticity. We talk about collagen, collagen collagen, which is great, but that's the structural strength of our skin. And that's often not what's failing as much as a skin losing its ability to recoil after it's stretch, which is hanging skin, basically.

Yeah. Yeah. I would be remiss then, not to ask you what you think about the overpriced Asian imported red light face masks that are all the rage nowadays.

It's hard. Well, this is like, how do you separate the pearl from the poo there? A little bit. Right. There's so many out there. And what's doing what. And, you know, it's. It's a big challenge to know, like, to really get into the science of the wavelengths and the irradiance and the. And, you know, the spectrum, you know, because you'll see all these, like, individual wavelengths listed, which is cool. But these aren't lasers. They're not individual wavelengths. These are just peaks in the spectrums. Right. And so you dang near have to have a physics degree to, you know, to understand the photons, to know what's best and that, you know, honestly, it's like kind of look for the reputable brands and. Yeah, you're not shopping for a deal as much with your.

Yeah, I have one. I use it well. Jessa has one too. And I haven't taken a deep dive into these brands in terms of putting on the physics hat, but when I look at the radiance, at the wavelengths and at the power, they seem like they should work. She has one, she uses like the face and the neck one by. What's it called? Mito Red.

Yeah, I think.

And then I have one called Irestore and it does like a purple wavelength, the blue wavelength, red wavelength.

And that Iristore has a lot of hair data behind.

Yeah, their helmet too. Yeah.

Yep. And you know, I like, again, no affiliation with any of these brands, but I like. You know, there's one called Bon Charge. Therabody makes one.

Actually, you know what? No, I take it back. Bon Charge is the one Jesse uses.

Charge. Yeah. They have that neck attachment to theirs. Yeah, that's a great one.

Okay.

Therabody or Thera Face has therabody, obviously a brand that I think there A.

Light I think is the same company as Therabody.

I think their latest line is called theraface. So then a Canadian company called Kala K a L A Kala therapy, makes a really great red light. And I like them because in my sauna, which you'll see today, those are the red lights that I put in my sauna, very. I dove deep, deep into, like, what are the best sauna red lights. And.

Oh, for people who aren't going to be in your sauna later today, what'd you do?

So I put eight big panels in my sauna.

So this is a dry sauna.

So it's a. I have a big, beautiful whom hive. Like dry sonic heater.

Yeah.

I have the whom heater that's, like, beautiful. Wonderful. It's like, maybe the best balance of aesthetics and function of anything. You know, they're so pretty. And then I have infrared panels as well against sort of one of the walls. And then I have the red light sort of, like domed around it. So you can have the infrared, you can have the red.

You have the heat of a dry sauna, but then you have put red light and infrared light in the sauna as standalone lights.

Exactly. And you can work out in there. Yeah, it's built to work out in.

Yeah.

Yep.

Oh, I can't wait to see it.

Yes. Cool. Okay.

All right, cool. Is there not to belabor this point too much, but for the home engineers, do you have to look into, like, heat resistance of the bulbs and choose specific brands? This is where you've written about this, or can you just, like, tell people.

Well, this is where Kala came in, is looking at. Because with any red light device, there's really great ones out there. The. The issue is dissipating heat. They get hot. Right. So how do you function in a sauna that's 200 degrees and have the light function enough to be beneficial for safety?

Goggles, just in case they chatter.

Right. Yeah. And not turn off.

Right.

Because if they can't dump heat, they'll just shut themselves off. That's where the Kala ones came in. Kala, like K A L, A.

Okay.

KALA therapy. And they're really great in the heat, and they put out enough irradiate to be, like, you know, wildly beneficial. And it's honestly just where they came from. I have no. No affiliation other than they're really great.

And they do red and infrared.

They do red near infrared. Yep.

Okay.

And, you know, they have a peak at about 660 for their red. 660. 670 is usually ideal for what I'm looking at, my purposes of surgical recovery.

Yeah.

And then, you know, lots of them will have multiple. Multiple kind of peaks in their spectrums.

Yeah. Is there anything else that is high up on the priority list from a recovery standpoint?

Yeah. Yep. So I really, you know, in addition to those basics of like very targeted IV nutrition, which I kind of just mentioned some of the ingredients of. But most of the time when my patients are coming in, I have a relatively robust laboratory and often genetic profile for them as well that they're coming in with. And so I can see how they methylate and look at. Okay, what are we putting in their IVs, do they have any micronutrient deficiencies, things like that? So their IV nutrition is very targeted to them. We have hyperbarics, we have red light. I love pemf. I think PEMF is underutilized in all types of surgical recovery. It's one of the things from a data standpoint that has FDA indications for healing from non and malunion of bones. So in an orthopedic setting, like your bone doesn't heal after it breaks. The PEMF helps it heal, which is incredible. But it's not unique to bony healing. It happens in our soft tissues as well because the way that the electromagnetic fields work is by stimulating the extracellular matrix outside of the cells to heal better. So it does great with soft tissue healing, helps with swelling and things like that. And then I have a few other little things I'll use like a biocharger and a nanov and those, you know, kind of down the line of like getting a little bit more esoteric into the.

So when is the PEMF face mask gonna come out? Right.

Yeah, so the. The.

Seems like that should be a thing.

The PEMF I'm using now has a large focus on the face when we're doing it. There's like kind of different, you know, paddles you can use with it.

Okay. Are you. Do you have the pulse centers one.

Okay.

Yeah, that's I think the most powerful.

Well, yeah, the first time I ever experienced that.

So you can take like the paddles from that and kind of like put them pretty close to the. Exactly.

Yep.

Yeah.

Y.

But you still need like, kind of like an apparatus to hold them up there. So that was going to hold them. Them up to their face.

Exactly. And we got that invention idea. Yeah, we have like a little bracket.

That we just like license whatever, whatever it is you've made.

We just, you know.

Yeah, yeah. And then from a dietary standpoint, are you just maintaining the whole like ketone, creatine, collagen rich foods, anti inflammatory type of approach?

Exactly. I try the anti. I try to get the anti inflammatory set before people come in if they're not doing it already. But again, see, sampling error. Like that's one that people are pretty dialed with already postoperatively. I usually just kind of base this. I love nutrition. Right. I was a nutrition undergraduate. I love that aspect.

I forgot about that.

Yeah. And my, I just kind of will go with what do you do before, you know, I'm not, I'm not changing people's diets per se to, you know, if they're, if they're a vegan. I'm not trying to convince them to be a carnivore and vice versa. I believe just looking at my teeth that we're meant to eat a lot of different types of foods. And so whatever you're sort of used to, we're going to optimize that in the post operative period, which is predominantly making sure that we have enough protein. Right. And when we get into the micronutrients and things like that, we're testing for that beforehand. We want our vitamins D status, very basic things to be good. That's maybe the most basic supplement before anybody having any surgery. If your vitamin D optimized going into your surgery surgery, your risks of all the bad things of surgery are so much lower afterwards. Like post operative infection. The way you heal things really.

And you're not just saying that like.

There'S actual research that's like the most. It's like so basic, overlooked. Like every, you know, people who are maybe not in the same space that I am who like love this to the degree that I do. Every surgeon knows or should know that you know, vitamin D like the most, you know, rural general surgeon doing everything in the world. Every procedure like vitamin D, vitamin D.

And assuming pre testing doesn't indicate levels are already elevated or even excessive, you know, most of the time the recommendation is anywhere from 2000 to 4000 IU. Are you increasing that going into a surgery?

Yeah, so I'm looking. I usually have those numbers before. Again, this is one of the luxuries of my practice. And so I'll do 5 to 10,000 IU's with K2 people going into it just depending on where their baseline levels are. And I honestly find that I don't really need to do that that much anymore. This is one of those fun, more than a decade of evolution of looking at those things. And it's one of the things that I noticed people's vitamin D levels in my world are getting better. I'm not saying globally that's reflective, but as people have become more aware and again in the selective high performer group, people are doing better with their vitamin D supplementation.

Yeah. You said that the sleep is going to have some. Is going to be impacted sleep architecture to a certain extent. With the traditional anesthetic methods, I'm assuming there's still an impact on sleep from something like ketamine and propofol.

Yeah.

Are you doing anything as far as sleep goes like melatonin or anything else?

Yeah, thanks for bringing it back to. That's a really good point. Because.

Of those agents, those unique, unique things I talked about, really only the dexmedetomy and the presidex is the one that's really helping sleep architecture. Ketamine and propofol are neutrals to negatives. More on the negative end still. They're not, you know, depending on the dose. But precedex is the one that's really protecting. Right. But no matter what in that cocktail, we're still disrupting sleep to some point. We just want to disrupt it as little as possible so that we can get back on a normal sleep architecture. If we 30,000 foot view zoom out, we know for any stress, metabolic, emotional, whatever it is, that sleep's wildly important to that healing. And so to ignore that as part of a huge lever to pull in the surgical recovery period is just missing it. Right. So anything we can do to start thinking about it from the anesthetics, we're choosing to something very simple like melatonin beforehand at 10 milligram dose of melatonin or 5 milligram dose, you also get an antioxidant benefit to it as well. So it's kind of this like double benefit to it. I don't love relying on sleep aids afterwards. I have patients coming from different time zones all over. So we're taking that into consideration. Even like when we're doing their surgery and planning their follow up, because we want their sleep so optimized afterwards. And some people are good sleepers coming in and some aren't. And we're trying to make that a really strong part of our recovery.

Yeah. So when you're talking about the times zones thing, do you mean like you wouldn't do like a later afternoon, early evening surgery for someone who's coming like three or four hours from back east?

Yeah, exactly. Yep. And again, it's all the same thing. Like, you know, we'd love to start Everybody's recovery at 8 o' clock in the morning? Because the day that they come, the days that they come in, basically every day after surgery, they're with us for maybe five or six hours to get through this whole sort of regimen and process every day. It's very passive from a physicality standpoint, but it's very committed. Right?

Yeah.

And so, you know, but if 8 o' clock is, you know, midnight your time or 2:00am, someone's coming from, you know, Europe or something like that, we're trying to like be thoughtful about when we're planning that on their circadian rhythms.

Yeah, yeah. We've talked a lot in other episodes about some of the different protocols that you do. You know, probably the, the, what you call it, the laser resurfacing is the correct terminology being the one that I think people are the most curious about. Maybe it's because my wife's been very vocal on social media that she did it and that seems to be the one that, that turns the most heads like a month or two later once the effects have kind of kicked in for sure. But as far as like future advances in cosmetic surgery, I know you go to a lot of the conferences and events, have your finger on the pulse of this, what's coming down the pipeline that you think is cool.

So I would say it's interesting because when I think about this from what I see coming in the cosmetic world as a whole, right? And I think of then where I'm at and where, you know, kind of maybe thinking a step ahead of that in the cosmetic world right now. I just went to our big national or American Academy of Facial Plastic and Reconstructive Surgery conference and I gave a standing room lecture only on peptides and regenerative medicine, which for your audience is going to be very like, ho hum, like, yeah, of course, Peptides and regenerative medicine. We got to remember, we're talking about an entire academy, me, an entire world catching up with it. And we're talking about a dynamic, cash based, free flowing, not reliant on insurance type of academy, catching up with it. Facial plastic surgery, that's not happening in a lot of other surgical specialties yet. You might find a few orthopedists or general surgeons who have hopped onto that, but they're so far away from that.

Happening.

In a world tipping scale. That's what's starting to happen. Regenerative medicine is beyond a buzzword. And we're starting to get into what, why, how, how do we use it best, what's it, doing things like that, right? And then in my world, you know, I start getting into, you know, if I start subdividing that out. For me, a lot of my regenerative medicine is using somebody's own stem cells for their surgical healing and Recovery. Because I'm already accessing their fat to do facial fat.

Oh, yeah, you're doing like the whole liposuction. Put the fat in the face. So you've got. You've already got access to. To the stem cells.

Exactly. Right, yeah. Yep. And so autologous.

Like somebody's own stem cells.

Their own stem cells. The liposuct. Just to clarify, the liposuction is very gentle, very small. It's not like what people think of with liposuction. This is very like focal, you know, minimal, leave no trace type of thing.

Right. But you don't have like a lightsaber and a chainsaw. Yeah.

Which I think is what people think about because they're thinking about this person doing this and sucking out like, massive amounts of fat. I'm using some very low quantity, high quality types of things. But now for me, it's like, okay, I have these stem cells. Who are they from? Where are they from? How are they performing? How can I make them work best? Where can I use them? It's beyond just rejuvenating fat pads with fat, which is cosmetically incredible. Right. That we can replace, like, for, like, and make your fat pads stronger, more structural, age better. But then it's also, well, how can I use this to help from the surgical healing process? How you can. Can I use them to help from the laser process, make the skin better? All these paracrine mediated communication effects, you know, that's like one thing, and I'm always working to improve that. And then, you know, in this, in the world as well, like, this is an example, recently went down this, like, microplastics rabbit hole in the operating room, realizing, like, we are using a lot of plastic in the operating room.

Well, did you see, it was like, last year, there was several news reports and research coming out showing that like, just intravenous administration alone from the tubes.

Right.

Was such an issue that they were encouraging physicians to like, run the first, I think, like 30 milliliters or so before they actually. Right. Like, put it into the patient just to get rid of some of the plastics in the tubing.

Exactly. All of that was the original impetus to be. Be like, oh, yeah, yeah. Think of, think of all the plastic wording. This goes back even to me to like, my first surgeries in medical school when I was like a kid, basically. And you're just like, shut your mouth. You know, don't touch anything. Just like, be in the operating room. But I remember at the end of these surgeries being like, there's Four garbage cans full.

Like the Barbie theme songs.

Fantastic. Yes. Life and plastic. And you're just like, I can't believe all this waste and all this plastic. And then, you know, in my operating is a little more efficient than that. But same story is like, you know, getting into like, okay, hearing this, thinking about most of the plasticizers we're worried about are softening, making things like plastic softer, more pliable, like an IV bag or IV tubing and going, okay, what am I, what am I using?

Like the worst kind, right?

Yeah, like, what am I using? What's in them? How can I get around them? Which. This was a deep dive. I always thank my operating room staff for this because with most places, if I was at a hospital, this, everybody would have quit. Yeah. Like, you're just making our job so difficult. We're out of here. Right? But this is again, sharing a mindset in my own private space. Everybody's like, yeah, all right. Oh yeah, this is good, let's do this. And diving into where are the microplastics? Where are our main sources? How do we get rid of them? Throwing away tens of thousands of dollars worth of like pre purchased supplies, being like, okay, now that I can't use these, now that I know what's in them. Finding ways around it and, and then also learning that some of the, you know, specific plasticizers we're using in the United States aren't even legal in, in Europe. Right. Or that the US knows that like high doses of these things in kids, like exposure with kids with, you know, to these via IV for a long time is detrimental. But for you and I getting our procedures, it's like, ah, you'll be fine. You know, so you're an adult. Yeah. Right. So I wiped all those things out, which was really huge in learning how to do where, where I was finding them. Because to be in full disclosure, I found some in my OR that I'm like, I wouldn't want, I wouldn't want this.

And then they're difficult via standard detoxification methods. Whether it's, you know, the bowels, the sweat, you know, when you're looking at the, the Dalton size, you know, being like up to a thousand, like you're going to pass that through a sweat gland, right? Yeah.

And then you, there's. It's just such a world that once you learn, well, what's it really doing anyway? And you know, you're like, no matter what it's doing, it's inhibiting the cellular efficiency. The cellular optimization organization that I want for healing no matter what. So they've got to go, you know.

Yeah.

And even if it's a 1% better result for me in the long term, totally worth it in my world. And so these are all these little things, and this kind of. It's, you know, funny that I'm talking about plastic surgery and microplastics. It's in every type of surgery, but it just takes a. I think we're. I think we're so far away from that becoming, like, adopted.

I think remediation of microplastics is going to be a hot topic in the health industry for the next decade. I mean, one of the things I do, as I said on calls with companies who are looking for money, and I had a very interesting one a couple days ago, and they're doing bacterial remediation, like looking into bacterial engineering of bacterial strains that in the gut could cause remediation of plastics via the postbiotic compounds that the bacteria make. And I think that's just the gut.

Right.

There's a lot of other places that they accumulate because you get lung exposure, you get transdermal exposure exposure. But the gut is a significant source.

Yeah.

So I think. I think we'll see a lot more people and companies looking into how do we just, like, engineer this stuff out of the body.

Yeah, that's super. Because that's where my head goes next is like, okay, well, now what can we do? Even I'm thinking in this more acute setting of weather healing to eliminate them because it's, you know, you mentioned traditional detoxification. It's hard. I'm not putting somebody in a sauna day one post surgery, you know, so it's like, okay, what can we do? So that's really.

Yeah, that's true. You can't do that because of the. The surgical.

Yeah.

Wounds or whatever you call them, everything. Wounds probably is the word you use.

Yeah, I don't use the word wounds, but I mean in the sense of like, you know, it's a hormetic stress that. We don't need a hormetic stress right now. We got enough other stresses going on.

Yeah, yeah, yeah. Super interesting. Well, I'm ready to go. Try this pool workout sauna, folks. BenGreenfieldLife.com CAM2025 Listen to Cameron's other episod episodes. Because I get asked all the time, like, my hair's turning gray or my hair's falling out or my skins were good like 75% of the time, like, go, listen to my episodes with Cameron Chestnut because that's. I'm being lazy and just sending people to listen to you because I know you're on top of this stuff. So thanks for being a 4P guest.

Yeah. Do you remember when we had your, like, hair. Jesus. Looking for a while there you were getting long. You're growing everything out. I was during your hair growth phase when you did a little experiment and we went kind of nuts on your hair.

Yeah. And I kind of had to clean up a little bit, but. That's right.

That was years ago and it worked. Yeah.

Yeah. Still, again, we should do that.

And we did it. We did some laser on your skin. Your skin looks great.

Yeah.

Yeah, yeah.

Awesome.

Love it.

Down.

Yeah.

All right, folks, again. BenGreenfieldLife.com CAM 2025 Check out the great Dr. Cameron Chestnut.

Thanks for watching.

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