Neuroplasticity Care

Welcome to Disability Matters with your host, Joyce Bender. All comments, views, and opinions expressed on the show are solely those of the host, guests, and callers. Now the host of Disability Matters, here's Joyce Bender.

And hello everyone, hope you're having a great day. To all of my great friends and listeners, Throughout the Americas and to all my listeners around the world. So yes, it has continued. Number 2, right after the United States, with the largest amount of listeners is Singapore. As I said, I don't know what's going on there, but you just keep getting more and more listeners. I mean, you rock, Singapore. I'm telling you. I am so impressed with how this keeps building up. And after that, Brazil and Spain. You know, we have over 143 countries with listeners, and I always shout out one that I have not talked about before. So it's Zimbabwe. To that one person in Zimbabwe, you know what I'm going to say? Because they say it all the time: one person can make a difference. One, just one, one person. So thank you to that one person in Zimbabwe. So you know, through World Vision, I sponsor a child there. So that's why I was so thrilled to see the country. So thank you. What you do is making a difference. This is a special shout out to you. And also to Yoshiko Dart, my good friend Yoshiko. Yoshiko, you know I love you, and I will always have a shout out to you on every show. I know you're listening, Yoshiko. I know it. Lead on. Keep on going, Yoshiko. And to Highmark. Highmark is the lead sponsor of this show. Highmark, Blue Cross Blue Shield Highmark, a great, great company. Oh my goodness, they're the 3rd largest insurer now and just a huge supporter of everything that they can do to help Americans with disabilities gain competitive employment and through their work impact the rest of the world to do the same. So we have such a great show today. We have Dr. Kelsey Harris, the CEO and founder of Neuro Access Rehabilitation Services, and Dr. Eugene Lipoff, the pain medicine expert witness, medical legal consultant, SGB and autonomic nervous systems expert, digital toxicity researcher, author. And boy, is he smart. Can't you tell with that introduction? He is really, really smart. And we are just thrilled to have both of them with us today. As you know, we're on YouTube Live, but We're also on demand on Spotify, Amazon, Apple, almost every social media platform. So, you know, if you want someone else to hear the show, you can send them that way and they can hear it. So, Dr. Lipov and Dr. Harris, welcome to the show. You know, as the fact that I live with epilepsy, that everything that you're doing is so important to me, but I thought we would start with you. Dr. Lipov, and it is a pleasure to meet you in person, uh, and such an honor to have you as a guest with us today. Uh, but I'd like our listeners around the world to know about you, your journey, you know, how you got to what you're doing today, because obviously you are a great man with how you've spent your life giving back, trying to help others. So Let's hear about you.

Well, first of all, thank you so much. That's, you know, you probably can't tell, but I'm blushing. So, so my journey was kind of unique in certain ways. So I was born in Ukraine, and then I had interesting trauma there, shall we say. And then I came to the United States when I was 72. And then I went to medical school. I went to Northwestern. Then I got hit by a propeller blade in my last year of medical school. So I almost died there. I had an out-of-body experience, which is kind of interesting. And then next year my mother took her life and when I was surgical resident, so I was doing trauma surgery, ER, normal, you know, surgical stuff. Then I left surgery, went to anesthesia. I did not really, was not a huge fan of anesthesia. Got into pain medicine. And where it becomes relevant to our discussion today. So I was doing the usual pain procedures. So one of the procedures, I had a patient that had severe hot flashes. She came in to see me for neck pain. I took care of that. So I sent her my brother, who is a very smart guy. And then he tried to take care of hot flashes, couldn't do it. And then I did, he said, why don't you do an injection called stellate ganglion block? It's something that's been done since 1925. For CRPS, which is complex regional pain syndrome. One of the symptoms is sweating. So he said, eh, sweating hands, sweating whole body, do the injection, see if it works. So I did that and it worked, which was shocking. She came back and we did another one like a year later. She did great. Then Chicago Tribune came in and they basically tried to annihilate me, which was really lovely. They said it's working, but you don't know how it works. It's garbage. So the first line in Tribune, a big newspaper in Chicago, said Bianca Cannon, this beautiful breast cancer survivor, was so desperate to get rid of hot flashes, she let Dr. Lipov plunge a 3-inch needle into her neck. First of all, the needle was not that long. And, you know, since then my friends call me needle plunger, which is lovely. So they gave me a lot of impetus to understand why it worked. So I read through about 3,000 papers. One of them was from Finland where they did T2 clipping, which is basically go inside the chest and clip the fight and flight nervous system to take away hand sweats. And they found PTSD stopped. So I read that and I was like, wow, that's weird. Why would that actually do that? Which is very strange to me. So what happened was that turns out there is fight and flight nervous system connects in the neck in a ganglion called stellate ganglion, and then goes up to the brain. So I called up my brother, I said, send me a patient that had PTSD and see if you can fix them. I did that procedure in 2006. The patient didn't have to be admitted to psychiatric ward. He did great. And then from there, I start to publish. Then Walter Reed Hospital, which is a big military hospital, followed my work, and so on. The only rest relevant thing that's relevant to our discussion today I had absolute honor taking care of a lot of Special Forces guys, SOF. And then I did an SOF training as an old man, and we were breaching things, so blowing down doors, and my head was woozy. And he said, ah, it's called eating the charge, my instructor. So basically, by the time you're done with your training, not even being deployed, everybody has BTBI, blast traumatic brain injury. So I wrote a paper about SOF method, which is stellate plus ketamine seems to be synergistic. And that's where, that's why I was able to meet our NeuroAccess PhD because she's very interested in neuroscience. I was actually amazing at it. So basically what I found through a bunch of research and I published this, that stellate seemed to do 2 things. It reduces fight and flight nervous system and reduces autoimmune response. Interleukin-6 and stuff affecting the brain. So that's basically in a nutshell. Hopefully that's what, what we're talking about today.

Wow. What a story that is. Oh, convoluted, right? You have overcome a lot of things. You're very resilient. That is for sure.

That I am. And persistent.

Well, those are both good traits. Yes. How about you, Dr. Harris? Let's hear your story.

So I'm a physical therapist by background, and I spent the majority of my career specialized in working with individuals with strokes, brain injuries, spinal cord injuries, any type of neuromuscular neurodegenerative condition. And through our healthcare system, I had a lot of frustrations as a therapist because I knew I could help my patients get better. Our system just wasn't set up to allow that to happen. Neuroplasticity has been around for decades. We know how it works. We know what we need to do to optimize neuroplasticity. But unfortunately, our healthcare system, from an insurance reimbursement and just structural standpoint, isn't set up to allow that to happen. So individuals aren't allowed— aren't having the opportunity to be able to fully recover, and our healthcare system's limiting that recovery for them. So 5 years ago, I got very frustrated and disgusted with our healthcare system and started my own company NeuroAccess Rehab, where we provide therapy based around the principles of neuroplasticity. And we've continued to grow in-home, in our recovery center, in different avenues. And I'm always looking for new ways to offer services to our community to allow them to continue the recovery journey, because it does not end, you know, 3 months, 5 months, 6 months after an injury occurs. And that's where Dr. Lipov and I got connected, and I got very interested in, in what he was doing from the neurologic standpoint of things. So we're working to bring Dr. Lipov and his wonderful knowledge to the Pittsburgh area to be able to combine his, um, massive amount of knowledge on this with the, um, injections paired with our therapy to really optimize people's recovery potential for them.

Well, we're lucky and thrilled to have you here with us, Dr. Harris. And I got to meet Dr. Harris when I spoke at a brain trauma conference. And you are also a smart person. I have 2 very smart people on here with me today. And we're going to be talking about this neuroplasticity, But first, we're going to go to break. If you just joined us, we are talking to Dr. Kelsey Harris, NeuroAccess Rehabilitation Services, and Dr. Eugene Lipoff, and he just is fantastic. We'll be right back. Don't go away. After break, we'll be back with both of them.

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You're listening to Disability Matters. Now please welcome back the host of Disability Matters. Here's Joyce Bender.

Hi everyone, welcome back to the show. If you just joined us, we're talking to Dr. Harris and Dr. Litkov, and we are going to be talking about neuroplasticity care So that all of us will understand it more. Dr. Harris, I'm going to start with you. You're very passionate about this. Could you tell us why, why this is so important to you?

Yeah, absolutely. So neuroplasticity, like I was mentioning, is something that's been around and known and researched for decades. We know there are 10 principles that came out in 2008 that We know with years of evidence and research that if we implement all 10 principles, it's going to give our neurologic patients the best chance for recovery. Those things are salient. So activities— salient activities— activities people love to do every day. When you're doing what you love, not only is there better biome, but it also allows for neuromodulators to be released in the brain to improve synaptic connections so we can make quicker, newer connections in the brain when people are doing the things that are important and meaningful to them. A perfect example in my therapy world of this is if someone loved working, let's say they loved gardening and they love working out in their shop every day, working with nuts and bolts, having them pick up marbles or move cones in a therapy session is not going to have buy-in for them. If we get mulch out, we get dirt out, we have nuts and bolts in the session, we're building things that actually is engaging to them, we have better buy-in, and we also are going to increase our ability for neuroplasticity and synaptic connections to occur. That typically doesn't happen in healthcare settings in the therapy world, just from an environmental limitation, which is why I built the company that we can go out into the home and communities. So we work with people out in their gardens, in their shops, in their kitchens, in their homes to help make those good connections happen. Another principle is high repetitions. It's crucial to get a lot of high repetitions. I'm talking 400 to 600 repetitions in a session where research right now is showing in therapy that we're getting 20 to 35. Nowhere near. We're underdosing our patients, and then we are asking, well, why aren't they getting better? Well, because we're not making them work hard enough. We're not giving them as much repetitions, as many repetitions as we need to. And that comes back to an insurance regulatory standpoint of what they're going to pay for is only a shorter visit, shorter limit of time that it doesn't allow for the therapist to hit those repetitions. So we see our patients every session is 60 to 90 minutes long so that we can hit those high repetitions for things. So, you know, there's 10 principles overall of this, of neuroplasticity. I think those are the 2 main ones that get missed the most in therapy. Also, intensity of things. Again, we don't work our individuals with neurologic conditions hard enough, I think, as a healthcare system overall. we kind of come at people with like a white glove, you know, I'm worried about hurting them, I don't wanna overstrain them. Our individuals are strong and, you know, they need to be pushed, they need to get their heart rates up for not just the neuro standpoint, but also to work on cardiovascular endurance as well. And just the overall logistics of standard therapy settings don't allow for this type of environment to occur for people and limits their overall ability for recovery because they can't maximize those neuroplasticity principles.

Yeah.

What—

explain to me what you mean by those repetitions. What do you mean by that?

So if I want to have someone— if we think about someone with, um, a brain injury that has one arm that's maybe weaker than the other, If we want the arm to start learning, the best way I can describe neuroplasticity, and this is what I use to describe to my families all the time, is I think we all going to, let's say going to work every day. When you go to work every day, you take that same drive every single day and you're in autopilot. And by the time you get to work, sometimes you're probably like, whoa, how did I get here? Because your brain just goes on and it does the driving. You don't even have to think about it. But if your main road to work is shut down and they're doing construction for the next 6 months, you can still get to work. It's just gonna take a little bit longer. You're gonna have to think about it. You're gonna have to figure out a new route. But if you start taking that drive every day for the next 6 months, you're doing those multiple repetitions, your brain's gonna begin to make new connections that is gonna become the new normal for you. That's the same thing with our neuro patients when they're working on making new connections connections and making a new muscle or making, you know, being able to grab a cup again. The first time after a brain injury or stroke, that might be hard for them to do. They might not be able to do it because that road now is blocked from the injury. But if they do that 100, 200, 300 times, and we want to alter it, we don't want them doing the exact same thing 300 times, that would get boring for them. But working on that same movement pattern, it's going to allow the brain to make a synaptic connection, which is just a new pathway for them, a new detour in the road to allow that movement to become automatic again.

Wow, that is amazing. But I always have thought it's amazing the things the brain can do.

It sure is.

That we don't even have any comprehension of. Yeah. Well, Dr. Liphoff, I was thrilled to have you on the show, and I'm very excited about the work you've done with PTSD, which we were calling PTSI. Is that you that came up with wanting to make that change?

No, I followed the great man. His name is Frank Akberg. So Frank, now 87. So he came up— so he was Number 2 man, NIMH, National Institute of Mental Health. So he was part of the committee that started the term PTSD in 1980. So, you know, he's been at this for a bit. And so he came up with the term Stockholm syndrome. Most people have heard that. That's his term.

Wow.

So he's been very involved in this. So in 2012, he, after observing and treating many, many patients, he believed the term is stigmatizing and it creates a lot of problems. So he connected with Peter Chiarelli, Pete Chiarelli, a 4-star general who was in charge of suicide prevention for the US Army. So both of them went to American Psychiatric Association, APA, and basically said, we need to change the name. People are killing themselves. And what we're hearing from the soldiers that it'll help them not kill themselves by changing the name. And they said no. Which was interesting. So Frank and I have a very cordial, amazing relationship. He's an amazing man. So I did this study, but interestingly enough, nobody's ever studied it. So to me, when you say something, I'd like to be able to back it up with data. So I did a study of 3,000 people in 2023. It came out, and we found that three things happen if you change the name PTSD to PTSI, post-traumatic stress injury. Because it's a biological thing. So when I did my TEDx this year, we talked about disorder is what's wrong with you. Injury is what happened to you, right? Meaning it's biologic. You should be able to diagnose it. You should be able to treat it biologically. We hope anyway. So I did the study, and we found that majority of people said the name should be changed, and we would have more hope and get more treatment. I went to the APA in 2024, and they said no thank you very much, not enough data. So if you listeners would like to help make that change happen, if you go to itsptsi.com, I'm trying to do a survey of 50,000 to 100,000 people. So there is a very quick survey. If you could do it, that'd be amazing. So that's the complete answer in PTSD. But to me, I say most psychology is biology. You can diagnose it and you can treat it. So when people say PTSD is an invisible wound, I take exception to that because it's invisible from 1980s scanners. 2026, we have fMRI, functional MRI. You can actually see activation of amygdala is associated with PTSD symptoms. So it's a visible wound. You just need the right scanner.

Oh, that is amazing. I never knew that. Well, I learned this from Dr. Harris so that when I speak, I always say PTSD.

Now I'll send you a pin. I have a special pin.

Okay, I want it. You got to get me that pin. I want that pin.

No problem.

But, but I have to say that, you know, when you say disorder, Like, what does that mean? I mean, that, that can mean so many—

It means it's a lifestyle. Yeah, you're stuck, you're done, you're going to be with it. And it's, you know, the great thing about the way— you know, I'm not critiquing all psychiatrists, but the perspective of it should be very little changes, 2% per year, is not good enough. So if you look at Dr. Hoag, is my favorite guy in PTSD outcomes. He was a colonel in Walter Reed, psychiatrist. So he knows a little bit about PTSD in military, at least. And what he said is that if you take all gold therapeutics, gold therapy approach, which is psychotherapy and pharmaceuticals, efficacy of all of that together is 40%. So if you think about that, placebo is about 35%. So it's not my— and the main problem is lack of compliance. So if it's too long and see much, don't see much effect, that's a problem. Also, pharmaceuticals currently used for PTSD efficacy is like 30, 40%, which is very low. So at least that's my perspective. Not everybody would agree with that, but the pendulum is starting to swing and outside the normal gold standard therapeutics.

That's good. Well, I'm happy to hear that. Um, and you know, this month is Suicide Awareness and Prevention Month, World Suicide Prevention Month. And I spoke this morning. I have to give a shout out to Eaton Industries, Eaton Corporation, multi-billion dollar company. They had today a webinar with panelists of which I was one. Talking about what can we do to help with prevention, you know, of suicide and education and training. And I told them I was going to give them a shout out because I think it's so great that corporation did that. But you know, there is stigma with both things. There's a terrible stigma. of course, with suicide. There's also a stigma with PTSD. And, you know, do you think there is any connection there? In other words, there are people that have had something terrible, a trauma, something terrible happened to them. Do you think there's a connection at all with suicide to that?

Your question is, Is suicide connected to PTSD? Is that the question?

Mm-hmm.

There is a very large connection. The other thing is to keep in mind— I mean, I could talk about that forever. Keep in mind, I lost my mother to suicide, so I would say I'm a professional. Unfortunately, I wish I didn't have that knowledge. Um, but there's a huge connection because think about it, what happens. And one of the big things in PTSD, one of the defining symptoms, is the lack of sleep. Right? I mean, most, most people agree with that. Sleep dysfunction, all of those. When people don't sleep right, their immune response goes up. That affects the brain. There is neuroinflammation. All of that occurs. And we know that that's been described. Lack of sleep can lead to suicides very clearly. In fact, you know, I'm writing a paper. I submitted the paper that it says PTSD and digital PTSD, which is doom scrolling, has the same underlying condition. The reason I bring it up is because that underlying condition is inflammation, most likely, or at least, at least large part of it. Behavior doom scrolling is associated with suicidal ideation, which is really interesting. Most people don't quite realize that. The other thing, the drugs we use to treat PTSD in the military, at least atypical antipsychotics, if they're not taken regularly, they The chance of suicide increased by a factor of 3, right? So not only does PTSD cause that, there is iatrogenic, or we as physicians are actually potentially increasing suicide rate. That's a big problem, right? So number one thing that needs to happen is get the sleep under control. So if you can reduce sleep dysfunction, if you can improve impulsivity, Those are two things highly associated with. I gave a speech at APA in 2015 about that. Two things associated with suicidal activity of all types: sleep dysfunction, impulsivity. Right? If you feel like, oh my God, I can never get some sleep. This is going to be like that forever. Jump off the building. That makes a lot of sense. Or eat a gun. All of that is connected. And those are two things are signs of. sympathetic overactivity. So when somebody has trauma, poof, right? It activates fight and flight nerves and gets stuck like that. And we can talk about what stuck means in detail. You know, we can really geek out on that. But as long as it's stuck like that, people cannot sleep. And 2 things happen. Inflammation goes up and they have nightmares. It's non-restorative sleep. And all of that leads more people to start suicidal thoughts. We've treated, we've taken care of a lot of patients and a lot of people have called us and say, hey, doc, you've saved me from suicide. And we're talking about people who were like, had a complete plan and all of that.

Wow. That is amazing. Never knew that. That is very, very interesting.

Yeah, we, we are big into it because of my mother's death. I'm very sensitive to suicidal ideation and we can talk about it and the stigma and everybody wants to hide it. It's another part we can talk about is genetics, epigenetic change. You can get suicidal tendencies from your grandparents. Isn't that bizarre?

Wow.

No, that is amazing. Well, we have a lot more to talk about, but we have the news. We have Mathis on the mic. This is our news break on the half hour. Jennifer, are you with us?

I am.

Hi, Jennifer. And we're talking about all of this suicidal ideation and PTSD. And here we have Jennifer, the Deputy Director of Bazelon Center for Mental Health Law, with us. So she is the other side, the advocacy side for all of that. But Jennifer, I bet you have a hard time thinking of news to talk about, huh?

Yes, I had to choose for today because lots of stuff going on as always. But what I wanted to highlight today is a notice in the Federal Register that HUD published a few days ago on September 11th, and this is related to A housing program, a very large housing subsidy program that HUD runs called Continuum of Care Program. Used to be Shelter Plus Care. It serves a lot of people with disabilities and enables them to live in their own homes in the community. We have talked about it before on prior news segments because HUD has tried to overhaul this program. in some pretty dramatic ways. It has abandoned its historic focus on what we call Housing First housing, which is where you don't condition the housing on somebody complying with the treatment regimen, because what happened there, we understood historically, is people got tossed out onto the street anytime they started to have a problem. And turned out all of the research, all of the evidence showed for years that Housing First as an approach where you made sure that people were first housed and then worried about engaging them with treatment because it worked better that way and housing retention rates were much, much higher that way. It was much more successful. HUD had begun to focus on Housing First. So now HUD was abandoning Housing First in— this program, and it was also moving away from permanent housing and focusing on transitional housing, where after a period of time, people would then lose the housing. These things were the subject of lawsuits, lawsuits brought by states and lawsuits brought by service providers, because it was a pretty dramatic change to the program and Hundreds of thousands of people were predicted to lose their housing if these changes went through. The courts thus far have said, you know, what HUD did, it wasn't able to do the way it did. It was unlawful. And so the courts had stopped the notices of funding opportunity that went out. And the last one The courts had stopped it and said, you did this improperly, HUD. You did it without taking public input, without doing what we call notice and comment, because the way the law is written, what you're trying to do, you had to do with notice and comment. You had to put it out to the public and take their input. So now HUD is doing that. And so what it published in the Federal Register on September 11th is a notice that it wants to change the Continuum of Care program in a variety of ways. And the 2 primary ones that I want to highlight are that they are trying to again move away from Housing First, to move back to an old approach that They had previously abandoned because it didn't work very well, called Treatment First, where it's all about kicking people out if they are not complying with treatment, not complying with all the rules. And people with significant mental health disabilities or substance use disorders tended to then become homeless again under this approach. But that is what they are promoting again, and they are promoting moving away from permanent housing and doing much more, doing set-asides to ensure that most of the program is now transitional housing instead of permanent, where people will basically lose their housing help after a couple of years. So this is people's opportunity to comment on that. I think it would be helpful if people have information about this to submit those comments. You have 30 days. You have until October 13th to do that. We will put some information on— I think we'll put it on our website. We'll definitely put something on social media letting people know about that. If you look for the Bazelon Center, It's B-A-Z-E-L-O-N Center on, I think, LinkedIn and Facebook will put out some information about how to comment. I think the disability groups will have some sample comments. I suspect there won't be a ton of time after those comments are ready because it's a very short comment period for something that's pretty complicated, but I think as soon as there's some draft comments, we'll let people know. I'll try to make sure to announce it again then on another news segment. But in the meantime, I just wanted to at least make people aware of it, and you can look for it if you just— if you do a search, if you just Google HUD and Continuum of Care, you will find this Federal Register notice and It has a link for how to submit comments. And I think people should submit comments making clear that permanent housing has worked far better than transitional housing for people. There's like a small amount of transitional housing that people usually need.

Right.

That's a little bit different than what they're talking about here, just like a place for people to be if they're coming out of the hospital. While they're looking for more permanent housing, but not moving people from place to place to place to place every time their service needs change. That's what the kind of transitional housing is that you're talking about here. Once you graduate, once you have kind of proven yourself in this housing, and you have to move on someplace else. And that is kind of old thinking. And so People can comment about that.

Well, what I would say about that is, once again, you heard it. Don't wait till it happens to someone close to you or you. Comment. bazelon.org. Bazelon, B-A-Z-E-L-O-N dot org. Jennifer, thank you so much, and we will look forward to hearing what happens next.

Thank you. I'll make sure to report again.

All right.

All right.

Bye-bye.

Take care. Bye.

She is so great. There is constantly something happening that impacts people with disabilities. Well, everyone for that matter, but we just have to do 2 things: move forward and communicate. You know, I always say to people, this is a time right now, all silos down. This is a time we should all be working together. Dr. Harris, the Neuro Access Rehabilitation Services, what is the recovery center? What is it you do? What do you do?

Yeah, so I started the company, like I mentioned, 5 years ago, and we were all mobile. So we went out into individuals' homes, communities, met them. We could do therapy in a grocery store, shopping mall. My favorite was we went to get a pedicure and practice getting in and out of the chair. But over the past 5 years, I've found, and we've had a lot of families driving in from outside states, from all over the state, staying in hotels to be able to work with us, staying with family, friends. And it was silly to me that families had to drive everywhere kind of to come and see us, but then also for our Pittsburgh community that they would have to leave the Pittsburgh area to go and get an intensive bout of therapy. So inpatient rehab hospitals all around Pittsburgh are fantastic and can offer intensive therapy, but our insurance regulations are in the guidelines for individuals to be readmitted back are changing, and it's making it challenging for our neuro community to get access to high-intensity therapy. And a lot of our patients were driving outside of the state to get access to this. So when I was looking at this, we had some people driving into the state just to get neuro-specific therapy to see us, and then we had our patients driving out of and we're referring them to different places. And I said, this is crazy. Pittsburgh needs to have something like this. So we opened the Neuro Recovery Center in June of this year, so 3 months ago. It's a 10,000-square-foot facility located in Canonsburg where we provide specialized therapy for physical therapy, occupational therapy, speech therapy, mental health counseling, medical massage therapy, group classes, caregiver support, really a one-stop shop for everyone, and also can provide therapy 3 hours a day, 5 days a week for 2-week periods. And we've partnered with the local hotel right next to us, it's a 2-minute drive away, to have fully accessible hotel rooms. We have it set up with all the equipment that anyone could need from an accessibility standpoint. point at an extremely reduced rate when they are working with us. So we have, over the past 3 months, we've had individuals come in from all around the country to stay with us for intense therapy, just as another option, and really an option for our Pittsburgh community so that they don't have to continue to travel out of state to gain access to this type of therapy and facility.

Now, so do you do the therapy right at your location then?

We do. So we still provide the therapy in the homes. Well, we're still going out into the homes and community, but we also have the Neuro Recovery Center now where people— we see them for maybe 2, 3 times a week, but then we have families that we're seeing for 3 hours a day, 5 days a week. We have some people we're seeing for 4, 5 hours a day, 5 days a week, depending on what their services are, to really maximize their neuro recovery potential.

And then this is paid for how?

Great question. So we work with all different insurance payers, and we have private pay options for people if they've exhausted their therapy benefits. We also have a pro bono fund in-house that We are constantly fundraising for to help individuals who may not have the financial means to private pay after they've had, let's say they have like a hard visit limit. They have 20 visits a year, which is not enough to help a stroke survivor, brain injury survivor recover. So we have a pro bono fund to help with that. But we do always— Let's use insurance as much as we can for all the visits. And then we figure out a private pay rate once those visits are exhausted for them.

Yeah. Um, you know what, you saw a problem and you did something. So kudos to you for doing that.

Thanks.

Well, you obviously both have, um, done such wonderful things. And I know, uh, Dr. Lipov, with all the The work you're doing, the research, is that leading to new help in the area of PTSD?

Is it leading to new hope, new help? I'm sorry, tell me, rephrase the question, please.

The research you're doing, is that coming up with new methods and hope for people with PTSD?

Oh, very much so. Just, you know, if we— even if we stick to the basic stuff I've been doing. So the first time I did a procedure, stellate ganglion block, for PTSD was 2006. So it's been 20 years. So we've stayed— we and people who have followed my work have saved a lot of people from suicide, improved their lives, the loved ones. We have our first SGB child. So after the procedures, they got pregnant. All of that Has been a joy to see. And, you know, there's a lot of other things. It has other applications. I just published a paper in Military Medicine about a month ago about changing the neuroinflammation of the brain using stellate ganglion block. So all of those things will become more and more prevalent and how people are being taken care of. So I hope Kelsey's ability to improve people's lives will be significantly improved by stuff I do. We know we've, we've helped a lot of people with TBI, strokes, all of those kind of things. Because the brain, if it's inflamed, is a problem. So, for example, exercise, like Kelsey was talking about, it makes you feel better, produce endorphins, but it also reduces inflammation. It's all about inflammation, inflammation, inflammation. People talk about inflaming, that inflammation makes people age faster. So I think All of that is going to become more and more prevalent, and optimization of people's lives will happen. It's already happening, but we'd like to do more always.

What, what do you mean by inflammation? Brain inflammation? What is that? What do you mean by that?

So when, what do you, when fight and flight nervous system is overactive, let's assume that, which clearly happens in people with PTSD, it dysregulates the immune system. Immune system There is a direct connection. If you put a label, label the retrovirus virus into stellate, there is a connection to the thymus, the bone marrow, and the spleen. Thymus produces T cells, bone marrow produces B cells, spleen controls other things. So it turns out when you do an injection on stellate, interleukin-6 drops. Interleukin-6 leads to inflammation. Increasing interleukin-6 penetrates the brain, leads to depression. Depression leads to muscle loss, couple mechanisms. So if you lose the muscle, you get more depressed and you have more inflammation. Inflammation makes brain swell and it increases other receptors, transmitters which are not good for you, like glutamate, and actually leads to brain shrinkage. So I met number of soldiers who's had military action without TBI, and their brain actually shrinks due to PTSD. A lot of things are so secondary to inflammation. That's what I mean.

Wow.

And the cool thing, stellate reverses that process. That's why people can become more physically active. They can get sleep. And stellate has been shown to reduce interleukin-6 levels, which is really cool.

Mm-hmm. Well, this is all good to hear. Now, I'll bet the people listening right now, you're thinking, oh my gosh, I wish my family, someone in my family would hear this, or a friend or whomever. And they can, they can either go to benderconsult.com because all the shows from 22 years, that's how long we've been on, 22 years, you can hear all the shows. Or you go to YouTube and see the show. But the majority of people do go on demand just because of everyone's lifestyle and running around everywhere and doing what they're doing, which means that you could tell anyone, hey, go to Bender Consult, go to Voice America, or go to Spotify, Apple, Amazon, all of them. And you can hear this show, and that means you can get the show and send it to whomever you want. And this is a show that's worth sending to other people. I know I've learned so much just in this short time I have been on here, and I really am so glad I got to meet you, Dr. LePov. You were right, Dr. Kelsey Harris. She told me, oh, what do you mean? You're really gonna like him.

He is the best.

And I do.

Very sweet.

So, Dr. Lipov, tell me, who would you say is your role model? Who has impacted your life the way you— and now look at you today. Who is your role model?

Hmm. I think Salk. Dr. Salk created the vaccine, uh, and then, uh, can never pronounce his name, the man, uh, Schmettner. He was a man who got doctors to wash their hands. He, he went, he saved huge amount of women and their children. Unfortunately, he was driven mad. put him in a psych ward and he died a month after being admitted. But he stuck to his guns. He paid with his life. 20 years after his death, once doctors figured out germ theory, he was celebrated as savior of babies. So, I love that man. He saved huge amount of lives. Unfortunately, he didn't survive. But that's been my— my point is I'm still kicking. I have changed life a little bit, hopefully for the better. I'm extremely proud of being able to do that, and so many people having followed us.

Leo, wow, that's wonderful. How about you, Dr. Harris?

I was thinking about that after you asked Dr. Lipov. I think I've had a lot of people throughout my career. I mean, even just from my parents kind of teaching me when Do what's right, treat people the right way, professors along the way. But honestly, I think the patients that I work with every day and that we get to see in the recovery center and through the clinic, they've had the worst things in their lives happen, and they're still showing up every day and giving 100%. So for me, if if they had this awful thing happen to them, and they're still showing up and giving it 100%. It's just motivational and powerful for me to keep showing up and fighting for them.

Well, we're all thankful for both of you. We are thankful for both of you. Do you have any message you'd like to leave with our listeners, Dr. Lipov?

So a couple of things. One, stay alive. Don't die. Especially don't help yourself die. And there's all types of dying. There's slow dying, like drinking yourself to death and car accidents, all of those. There's hope. Hope is huge. So if something does not work, do not wait for 5 years to change the path. Whatever you're doing, 6 months later, change it. If it's not working, change it. And there's definitely hope. If this doesn't work, doesn't mean everything we do works, but there's hope. Stay as positive as you can. Move. And once you start moving, you'll feel a lot better, I think. But hope is huge. Have real hope, not crazy hope. But if it is not working, change it.

No, that's good. Yeah. How about you, Dr. Harris? What message would you like to leave with our listeners today?

I tell everyone that I meet that recovery is always happening. It happens at different phases and at different intensities throughout the recovery process, but recovery from a neurologic standpoint is always happening. And then same thing that Dr. Lipov mentioned, that continue to have hope. The way giving up on hope is the worst thing that people can do, and we're here to help in any way we can help provide continued hope and recovery for them.

Well, I love those messages of hope. And thank you so much for being with us today.

Thank you for having me.

Of course. And to all of our listeners, thank you. Oh, so awesome you all are. And Zimbabwe, that one person, and everyone else around the world, thank you for being a devout follower of the show. So we end every show with a quote. And today that quote fits what we're talking about with hope. And it is, there were times when it would have been easy to fall apart or to go in the opposite direction. But somehow, somehow I felt that if I took one more step, someone would come along to join me. Said the great Rosa Parks. This is Joyce Bender, America's Voice, where disability follows us and helps us every day realize we should be proud of who we are. Disability is just part of who we are. Talk to everyone next week. And in the words of Mary Brocker, When you get up tomorrow, remember, choose joy. You won't be disappointed.

Voice America would like to thank you for tuning in. Please join us next Tuesday at 11 AM Pacific Time and 2 PM Eastern Time for another installment of Disability Matters right here on the Voice America Variety Channel. We are the leader in live internet talk radio. VoiceAmerica.com.