Radical Regeneration Neurosurgery Meets Energy Medicine – Marcella Madera #582

Foreign.

A state of high performance.

You're listening to Bulletproof Radio with Dave Asprey. Today's cool fact of the day is that signs of new nerve cells have been spotted in adult brains. I like to say brains like that because it's like pinky in the brain. You know what I'm talking about. Now, a tweaked laboratory protocol revealed signs of thousands of newborn NER cells in the brains of adults, including someone who was 100. And those immature neurons mark the latest data points in this debate that's lasted for decades over whether people's brains develop new nerve cells as adults. And that process is called neurogenesis, happens in the brains of some animals. And scientists have been a bit divided over whether human brains as adults are capable of this thing. And what these researchers did, that must have been great fun, was they sliced or they viewed slices of post mortem brains of 13, 14 formerly healthy people aged 43 to 87 under a microscope and saw these newborn nerve cells. And they were part of the hippocampus called the dentate gyrus, a suspected hotspot for these new neurons. And that's kind of cool because they used some new procedures where they did really fresh brains and they soaked them only for a little while in chemicals that preserve the tissues so they're able to see more than they normally do. And that's really cool because, well, it looks like we really can make new cells in our brains. And what's really cool is they also looked at Alzheimer brains and they had far fewer of those cells, which means maybe one of the things that's going on with Alzheimer's is that you don't have enough stem cells in your brain. Just saying. Now, you guys know I've been really working on my foreshadowing skills and I think I nailed this one because we might just be talking about stem cells and brains today if you didn't figure that one out. But before we get into that, now back to brains and stem cells. Today's guest is a board certified integrative neurosurgeon named Dr. Marcella Madera. And the reason I'm having her on the show is, well, there are very few integrative neurosurgeons out there. But she's actually done work on me, which is particularly cool if you've seen my videos on YouTube or you heard the interview with Dr. Harry Adelson and Amy Killen from Dcerre Clinic. You've heard about my six hands whole body stem cell procedure where I had stem cells Pretty much everywhere you can stick them in the body. Well, two of the six hands sticking stem cells over my body belong to Dr. Marcella, or Dr. Madera, as we can call. I'll just call her Marcella for the interview. Marcela, welcome to the show.

Thank you for having me.

It's actually really cool to be able to chat with you when I'm not post anesthesia with all sorts of weird goopy things on my head, which I think happened last time. I'd like to start out by saying, what made you an integrative neurosurgeon? Because those words sort of feel oppositional to me. Most of the time, surgeons are the ones who are like, I don't know, hit it with antibiotics and I can stop a human heart, and I'm so tough. And here you are not only doing intergrowth stuff, you do Dr. Barry Morgolan's energy exercises before you operate. You're kind of out there. How do you exist in both worlds? What made you this way?

So I had many years of taking care of patients where I had this rigorous surgical training at Hopkins for my fellowship. And I really had the feeling over and over and over that I wanted to treat patients holistically. And I felt like there was so much more that I could offer to patients in terms of their whole life and their whole health, as opposed to just finding a place to cut. So that's how I started my journey.

How have your colleagues responded when you sit there and do some sort of deep breathing exercises, unusual stretches, and then talk about being integrative, Are you shunned? Do you sit by yourself at the cafeteria where all the surgeons eat? How does that work?

Actually, my partners have been really supportive of this adventure that I've been on of creating this integrative practice in the or. For example, I do physical energy exercises before every case and my whole team in the room, including anesthesia scrub tech, C arm tech, nurses monitoring tech, every single person in the room does the exercises. And now people start coming to the room ahead of time, like, hey, have you guys exercised yet? People that aren't in my room. So really, the whole team getting involved has been really supportive for both me and for the patient creating that positive environment in the room for the procedure. And then my partners, I have done exercises with them when we've scrubbed together, and they smile and they let me do it.

All right, describe the exercises that you're doing with people, by the way. Just people listening. If you've watched the video with Dr. Barry or listened to any of the interviews with Dr. Barry, he goes pretty deep. He's like the guy who. Doctor Strange, the movie. They interviewed him before they made the movie because he's that surgeon who went off to China and all that. All right. So, Marcela, what do patients see you do before you start cutting on their brains?

Sure. Well, so I do with my integrative practice. I always teach all of my patients one exercise that they do leading up to the surgery, and then they do after a physical exercise, and that's a neck exercise, a very simple one where you turn your head all the way to one side, hold in your abdomen your core really strong, and you say, each day I go farther, and. And you do that to both sides really slowly. Each day I go farther. So I teach that one to patients again. It helps align their mind and body getting ready for surgery, and then helps them recover after in terms of again aligning their body to heal. And then in surgery, while the patient's asleep. With the team, I choose one of the hundreds of exercises that Dr. Morguelin has given us. So today, for example, we did this exercise where you put your hands together and you touch your chest, you hold in, and you say out loud, if it's going to be. It's going to be me. That's a fun one. We also did a push pull today, which is pushing one hand out and bringing the other to the chest, and then alternating that and taking big, deep breaths.

That's like a Tai Chi. It's a relatively common Tai Chi one, but with Dr. Berger's spin on it. Okay, but all the Tai Chi stuff comes from that lineage anyway. But just for people who aren't going to see this on video. Yeah, these are. These are unusual things. And I gotta tell you guys, I listen to Dr. Barry's audio stuff, and I do some of his movement exercises. Not as often as I probably could, but there's weird stuff that happens, and it's reliable and repeatable. So I just find it particularly ballsy when a licensed medical doctor is willing to go out there and be like, yes, I do this. It's almost like if you got out a rattle and shook it three times and spun around and lit a candle before, there might be value in that. The shamans I know are very serious about that, Stu. And they have. Some of them have very unusual abilities. So I'm not discounting it. It's just like, it's a bit risky because people could say, she made me do this and I didn't like it, or whatever. Do you Worry about that?

Never. And the thing is the results speak for themselves. When I started doing these exercises in the OR with my team, this was years ago, before I had my integrative practice. I was doing this, you know, for myself and for the patient. But people love doing them and they love the way they feel. Everybody in the OR loves to take a deep breath and start the case. You know, we always do a timeout before surgery. So the timeout, we say the name of the patient, what procedure we're doing, do we have all the equipment. So there's, there's a space in the OR that's reserved for getting everybody on the same team together. Eye contact, let's do this. And this just adds a piece to that that allows each individual person to take a deep breath, clear their mind and go for it. And people love it. I haven't had one person in the room say I don't want to do that anymore. If they're not telling me they are.

There are a bunch of studies out there. One was just published. I shared it on social media about it. Turns out we really can learn when we're asleep at least a little bit. And they looked at EEG and they did all this stuff. So something happens. There's also various people, surgeons as well as I believe a few studies I've come across where they talk about what people say when you're unconscious during surgery actually affects outcome. Right. So do you pay extra attention to the language when you have a patient who's out? Do you think when you're saying if it's going to be, it's going to be me or whatever it is, I mean do you think that that's moving the needle and have you ever measured it or is it one of those things where, you know, it feels good and it can't be harmful? So let's do it.

I think it's a little of both. So I have a great example of this. I have a patient who was a, is a PhD psychologist who has an expertise in hypnotism. Asked me very specifically to read him script while he was going to sleep and while he was emerging and he wrote the script and it had to do with no pain, just pressure. It was like a three paragraph script that had to do with his recovery and mainly minimizing pain. This guy had a multi level lumbar fusion, very big and a revision. He'd had surgery before, so four plus hour operation hardware. The guy did not take one narcotic pill in the hospital. Now that's an N of one dang.

Spine surgery with no anesthetics, Would you just cut the spinal cord all the way? There you go. You won't feel that.

That's next. Oh, my gosh, Tony, don't say that. That hurts my feelings.

No, no, no. I'm just saying, like, how could you not feel it? But unless there was no nerve there. But clearly. Clearly something was happening.

Right?

But n equals 1.

All right, for sure. And then also, I do believe that all of our brains are wired to focus on the negative or our culture, our upbringing, our protective mechanisms in our brain, and we want to protect ourselves. So anything that's negative, we focus on that because we're protecting ourselves. But the more you speak in a way that is in reality but also encouraging of the future. So this is going to go great. Your nerves are going to heal. You're going to feel better. Whether it's during the surgery or in preoperative discussion with the surgery or after the patient. I do feel like the intention that we have for healing can affect the results for sure.

Do you think intention matters more when you're using stem cells?

I think it matters all the time, but I'm somebody that uses it in my regular practice and my integrative practice, so I think it doesn't hurt anywhere.

Yeah. And that's something that I would love for everyone listening to just hear. That mindset is exceptionally unusual in hardcore Western medicine, where you're saying, okay, if it doesn't hurt and it might have benefit, even if we don't know why, it's okay to do it. But we have almost this fear of, like, well, if I don't know that it works, we just can't do it because we might look silly. But here's the deal. If it feels good and it might work and it isn't expensive and it doesn't introduce more risk, it's okay to do it without knowing for sure. And that mindset just requires courage, especially when you're dealing with, you know, a licensed thing like that. So I love it. You're pragmatic, and what you're saying makes so much logical, scientifically true sense that it's. It's super cool.

But I would say too, you know, in my integrative practice, every patient has gotten better. So I know it works. And. And in those, you know, But I've used that intention. I write my own goals. I hand write goals for every single patient, that I want that patient's procedure to go perfectly, that I want them to have perfect recovery and the, like I said, the results speak for themselves. So I'm using the intention and it is working.

There you go. Part of the reason I'm asking that is that, all right, guys, I'm just going to go out and do a little bit of crazy land here. You all know from the people I've interviewed, Alberto Viodo, Dr. Barry, Joy, Martina recently. So I'm totally happy to talk to people who just know stuff and they can't say why or how, but they're just people I'll call highly intuitive. My experience with the world as a biohacker and a skeptical computer scientist guy is that sometimes there's stuff I can't explain yet, and I'm going to find a way to explain it. But in the meantime, I'm not going to ignore this stuff and I'm going to actually look for it. So I know people like that. One of those people, after I had my whole body stem cell makeover with Harry and Amy and Marcella, they actually were like, oh, what's going on here? And I didn't really give them much details, but like, wow, like there's these, these little golden thingies floating around in your body. And yes, there are people who at least believe they can see inside you with Superman X ray vision. I don't know if they can, but they, they knew something was going on. They're like, oh, wow, those little things, they move around like when I tell them where to go. And actually two different people who have that kind of weird skill set independently, didn't know each other, both said the same thing. So there's probably something cool about stem cells might listen, because something has to guide in your body when you're in the womb. How does a stem cell know whether it becomes like your liver or becomes your tooth? Right. Do we know what's telling them to do that?

We think part of it is the. So the paracrine signaling or the signaling from the environment that they're in contributes to that. The chemical signaling, Correct? Yeah, chemical signaling or microscopic chemicals that tell the cells what to do. And that's how we think that the regenerative treatments is that we inject, whether it's your own cells or an external substance like exosome or umbilical cells, something we inject that then tells your cells to wake up and heal. So it has to do with the chemical signaling.

So there's definitely some chemical signaling, but there's also some evidence that there's electrical or magnetic signaling that also is helping to guide what's Going on. If you run a current over a developing embryo in an animal, very strange things happen that aren't, that don't happen otherwise. So at least my understanding of that system is that it's probably some chemical and some other field based stuff. And when I say field, I mean measurable fields, not, you know, fields of intention. But hey, we just talked about maybe those matter too. Who knows?

I will say too, my patients who have done the energy work into my integrative practice, some sign up and do more intensive practices and listen to the audios and the patients that have done more of that have done better than those who didn't.

I have zero doubt that that would be the case having experienced Dr. Berry's work in person and just done his stuff. In fact, my 11 year old, after one week of listening to Dr. Barry's meditation stuff, before she goes to bed, she's like, I go to bed a lot easier. I like this. And she said, I told myself I'm doing it for three months and she did it and she said, no, I'm going to do it for a year. So every night for a year, my 11 year old, of her own volition, without any encouragement decided that she would listen to, you know, one of probably 50 different Dr. B meditation things. I, I know that they do something and I've felt some really cool stuff that I don't normally get from meditation without really advanced work. So I don't know, there's, there's stuff going on with that. So I could see why patients get better because if you can increase that thing we call qi, you'll heal faster. And there's tons of studies of that with acupuncture and that sort of thing. So like we know there's something going on there and I love it that you're just like, yeah, I'm going to do it because it's not going to hurt anyone. And my patients seem to like it. Like how, like what a great healer perspective that is.

Thanks.

I want to get more into though, the fact that you're one of the only spine surgeons to selectively and occasionally offer stem cell treatments using a patient's own harvested cells for things like Ms. Or Parkinson's or things like that. Can you talk about what you think is happening in the future of that field?

Absolutely. The neurodegenerative diseases have been linked more and more to inflammation and we know that the regenerative substances, whether it's patient's own cells or again, these other regenerative substances we can use do modulate the inflammatory response. It is very promising. What's going on in other countries with studies with these severe cases of neurodegenerative diseases and treating them with regenerative medicine. So I do think this is the future for those diseases for sure.

If you put on your 20 year from now, hat someone walks in, they've got spinal cord injuries or they've got Alzheimer's or their brains all jacked up, what are you going to be doing?

So I think spinal cord injury, that's what gets me really, really excited, because I think we're closer to that one because I feel like we're getting to where we know where to do the injections and how to do them, and especially for incomplete injuries. So, meaning someone is not completely paralyzed, but partially because they have further or less far to go in terms of healing. But I think we're going to be doing intrathecal injections, and then we're going to be doing injections in multiple other areas of the body to help the nerve healing.

I definitely haven't been paralyzed or anything, but I did the full on, give me a young person's spinal cord and brain stem cells everywhere in the body kind of thing. The most extensive procedure I think, that's ever been done on one person at one time, at least according to anyone I can find. And we did masses of exosomes and my own stem cells. And can you walk people through what are exosomes and why would you use them anywhere in the nervous system or in the body?

Sure. So the simplest explanation is that they are little nanoparticles full of awesome regenerative juice. What's in that regenerative juice are rna, which is, again, a very microchemical signaling molecule. And then also growth factors and hundreds of different growth factors. The exosomes come from immature stem cells, and those stem cells secrete these vesicles. So they actually don't have any DNA in them. So they're not cell. They're powerful.

So I had 11 vials of exosomes pretty much everywhere, everywhere in the body. And guys, if you didn't hear the original interview about this, I had stem cells in every joint in my body, basically from the ankles on up every vertebra, and then all the cosmetic and reproductive organ stuff. And then, Marcel, can you describe what we did with the stem cells along my spine and brain and things like that?

Yeah. So for your spine, at every joint from your cervical spine, so the neck and also the base of the skulls, from the base of the skull, all of the neck spine, all the thoracic spine, which is the part that's connected to the ribs, all of the lumbar spine, which is the low back si joints, which are the joints that connect your pelvis to your spine. And then iliolumbar ligaments, which are ligaments that connect the pelvis to the spine. And then also. So that's all of the joints from top to bottom, plus epidural injections, which help the nerves. So epidural injections in the lumbar, thoracic and cervical, and then intrathecal, which is into the spinal fluid in the neck, and then those cells get into the spinal fluid and get to the brain as well.

The reason I wanted to do all this is, well, okay, I'm planning to live to at least 180, and I have a pretty crappy history in terms of people who are likely to either be in men's health with my shirt off, which did happen, given that I used to weigh. I mean, I used to weigh 300 pounds. And if you look closely, you can see my stretch marks in the photo. And I didn't know I was taking my shirt off. They're like, could you do that? I'm like, over my dead body. Are you kidding? And they coaxed me into doing it. And the pictures are like, I guess I have abs, whatever. But that was unlikely. But in terms of living to 180, given that I had high risk of stroke and heart attack, arthritis in my knees since I was 14, runaway inflammation, chemical damage to my brain from toxic mold, and then over the last couple years, actually had two substantial traumatic brain injuries. So I'm like, you know what? I think I need a reset on all this. I'm just going to go in and do all that. And that was what motivated me to do it, even though I don't have Parkinson's or any of that. But I know I've had inflammation throughout a lot of my life because of autoimmunity and toxic mold, all that stuff. And so that's the context. But also, if I hadn't had all those things, would I have done this? Probably because I still lift 180. And, you know, this is kind of a reset for me. What I noticed that was probably most profound after the treatment was it took about maybe two weeks, but my sleep score went through the roof. I. I've gotten really good at hacking my sleep. I have 10 years of sleep data that I've been gathering most nights going back all the way to the days of the Zeo, which they don't even make anymore. And pretty good sleep data most of the time. The difference I found is that the amount of deep sleep that I get went through the roof. And I do it in conjunction with the TrueDark glasses. I take sleep mode. I do all the other sleep hacks that I originally wrote that have been kind of copied all over the Internet. Collagen or honey or brain octane before bed, all that stuff. But the amount of REM and the amount of deep sleep, I oftentimes get two hours plus of each one per night in six hours of sleep. So I'm getting as much of those things as a 20 year old gets in 8 hours in 6 hours and I'm 46.

Amazing.

I think it was the cells. I mean can we prove that that's what didn't know. But wow. Have you seen other patients improve their sleep when they get this kind of stuff done?

I haven't. But also I think that, you know, every chemistry is different and your chemistry clearly needed that if that was the source of the improvement. Like you said, the chronic inflammation that you've had has caused a long standing disruption or could have caused a long standing disruption in your sleep and that setting it with this inflammatory modulating exosomes could have gotten you that effect for sure.

Something else really irritating and kind of disruptive happened. Since I was maybe 11. My preferred bedtime is 2am and if you look at my sleep data, I go to bed at 2:05am I get tired at 1:55. I write my books until 1:55. Between 11:00pm and 2:00am almost. That's my quiet time. I'm in the zone. I just nail it. Go to sleep, wake up fully refreshed. Six hours, you're ready to go. But I started getting tired at like 10 o' clock and wanting to wake up at 5:30. It's horrible. Like it's, it's dark at 5:30. It's the middle of the freaking night. Okay, so. And I've since managed to push that back a little bit. But I still I waking up like you know, 6:30 or 7. I don't want to wake up that early. I need my writing time. And so I do think that it shifted my circadian rhythm to be more normal. But I don't want to be normal. I want to be above normal. So I blame you.

Morning.

No, I have kids. Are you kidding? I wake up in the morning, the energy's all wrong. A lot of writers actually there's something magic that happens after 11 for writing. There's I don't know. The. The moon energy comes out and I put on crystals. I'm kidding. I have no idea. But there's something special that happens there. So I do think there's a circadian thing. Can you talk more about nervous systems surgery? Circadian stuff. What have you learned, especially as an integrative practitioner, that might be applicable to everyone listening if they're going to get any kind of surgery?

Well, for surgery, optimizing sleep before surgery is really important. And that's something from an integrative perspective. I never talked about that before. I was doing integrative work. But certainly surgery is extremely traumatic to your system. And so my entire process leading up to surgery, or even if it's just a small procedure, not a surgery, is optimizing the stress response, inflammation response, and trying to keep people as calm and cool, rested and well, even better than their normal state of health leading up to surgery. So sleep is incredibly important before and then afterwards, depending on how big the surgery is and how long people are in the hospital. Most of the things that I do in my integrative practice are actually pretty small surgeries, because one of my goals with my integrative practice is to minimize the size of surgery that I do. So I'm actually doing small, minimally invasive things. But if you're in the hospital for a few days or with medications that you're taking, all of that can disrupt sleep. And the more sleep you get, the better you're going to feel, the better you're going to heal. That's very, very, very well known.

Hospital environments suck. I do my best to stay out of the hospital. Okay? That's a statement all of us would say, unless we work in one. But I think the only time I've really spent any time in the hospital was maybe four years ago. I stepped on a rusty nail. And you're like, all right, fine, whatever. I had a tetanus shot a while back, I don't know. And I was feeling fine, and I thought I didn't go that deep. And I put some iodine on it. I'm like, I'm good to go. And three days later, I started getting a little infection in the spot of my foot. And I'm flying all over the place. And I come back and Lana, my wife's an ER doctor, and I'm starting to get pain in my jaw and weird muscle tension and things like this. So she's like, dave, you need to go to the hospital and go to the front of the line. I'm like, come on, what's up? She says, no, you actually have tetanus. Not anything. This isn't like, oh, you might have tetanus. You have the symptoms of this, and this can kill you in eight hours or something. So I'm like, I guess I'll go to the hospital. So I went there, and the Canadian system is really cool. They're like, oh, just hang out here. No problem. We'll have some. Some of the. Whatever the stuff is called. It's not the tetanus vaccine. It's the tetanus gamma globulins, I think, immunoglobulins, whatever they are. And so they fly the stuff in on a helicopter. And they didn't even charge me five bucks. It was amazing. But I spent eight hours in the hospital. I'm like, I couldn't sleep in this hospital to save my life. And if I was going to have surgery. Beeping and horrible lighting and constant eruptions. And how does anyone heal in a hospital?

Well, I will say, too. So the whole process of being in the hospital sets off a stress reaction, which sets off inflammation. And we do know that inflammation can affect the circadian rhythm, that there's. There are connections chemically between circadian rhythms and inflammation. So what do people do in the hospital? I mean, number one, we try to do the smallest surgery possible to get them out as quick as possible. For my patients who do my integrative program before and after, I actually have them listen to the breathing exercises while they're in the hospital after, really anytime, they could leave the breathing exercise on all night, and that helps with sleep. I also have another autogenic exercise that came from another. From a neurosurgeon who is a holistic pain doctor now that helps manage pain with cognitive exercises. So managing pain is a big part of it when you're in the hospital to get sleep and then keeping your nervous system calm as well. But the number one thing is quick surgery. Stay as short time as you can.

Do you envision a future where hospitals actually help you heal by designing their environments to be a little bit human friendly and a little bit less like being inside of a refrigerator? I have no idea. How do you even describe it?

I do. I think so. That's a great way to talk about a project that I'm working on with the medical school here in Austin. So Dell Medical School has supported me with this project of how do we reduce pain after lumbar fusion? And they're actually letting me add some integrative techniques to the pathway before and after surgery. So we're even getting anti inflammatory diet in the hospital.

Amazingly, what do you recommend? And so this is something, listening to this, you get to talk to a surgeon about, an integrative surgeon about, okay, what do you do before surgery? And this doesn't have to be before neurosurgery, before any kind of surgery. Right. So what kind of food changes do you make for people before they go in?

So I really design a food discussion based on how much I think the patient can manage. Some people come to see me and they already know where the meat sources that are important, what the good ones are.

Well, you're in Austin, so any barbecue is fine, right?

There are some places that are better sourced than others.

Okay, got it. So grass fed, you're basically saying, yeah, yeah, yeah.

But there are some patients that come and have a wide variety of knowledge and other people come and have ever heard that actually gluten and dairy can be inflammatory or have never believed it and have never heard a conventional doctor tell them that it is actually important. So the other thing is, you know, leading up to surgery is stressful. And so I don't want to give people 100 things to do leading up to surgery if, especially if their surgery, if they need to do something pretty quickly, if they've got severe nerve compression or something. So I really design it based on what the patient can feasibly manage without too much stress. So typically what that is, the simplest thing is, you know, very simple, low inflammatory diet, low dairy, low gluten cutting, both of those if they can. I do talk to them about fat sources, trying to get grass fed if they can. And the grass fed butter, we talk about butter and cheese, either European sources or grass fed sources. And in Austin, we're really lucky. We have great farmers markets and whole foods is from here. So people have access to really great stuff here. So I try to keep it as simple and compact as I can. If their surgery is coming up pretty quickly. For patients who want to dig really.

Deep, the ones who don't want to.