Changing the Patient Experience with Therapeutic Plasma Exchange: A Florida Nurse’s Perspective

Today we're going to go behind the scenes with Mitch, a clinical apheresis nurse at MD Lifespan. So he's leading the charge out in Florida where he's delivering firsthand the cutting edge therapeutic plasma exchange treatments to a bunch of patients. So he's going to walk us through a real patient journey like as if we were going to walk into the office and he's going to step us through the process from the first session to the sessions that follow and share some of the life changing results he's also seeing every single day. So if you're curious, let's dive in.

All right, Mitch, we're doing this. It's so glad, I'm glad to have you here. As someone who is running the first clinic for TPE in, in Florida for MD Lifespan, I'm super curious to hear your perspectives and insights and all that. So thanks for joining me today.

No, definitely thank you for having me, Joe. I really appreciate it.

Yeah man. So what I guess I was like, I'm always curious like how did you get into this whole field? Like what was the, what was the turning point or maybe some aha moment that you might have experienced?

Yeah, I mean like most nurses started as a baby nurse, worked in the ER for a few years, tried everything, education, management.

Precepted some students. That's actually where I learned. Well get into a minute is the ultrasound IV skill was down here in Florida after I graduated and that kind of followed me into travel nursing. Did a little bit of travel nursing in the emergency department. Really opened my eyes to different types of populations, different types of individuals, all different walks of life and everything. And then from there again they wanted me for my ultrasound IV skills. So I would go around just ultrasounds. There got to a point where I just wanted to focus on that. Went to pediatric pick nursing actually complete departure from when I was before. Still seeing a lot of sick kids. And then we'll touch on this but they also seem sicker than from before. Even years before when I started.

Then from there I just wanted another change. I really delve into my ultrasound IV skills and that's actually what elicited me to for a job find. And I got stumbled across MD Lifespan, stumbled across Dr. Savage from there I just went through the interview process, met Dr. Savage, knew immediately like this was something I wanted to do. He's so enthusiastic about toxins and fairly something I've never really heard of or worked with which is TPE therapeutic plasma exchange. At first I was like oh you know, it's probably Just, you know, another procedure or anything that's going on. But as the kids say, he brought the receipts. So he showed me, hey, this is what it works with. And one of the things that really resonated with me, coming from a physician, a colleague, is I respect what you do. And that's something that's really paramount, I think, for all nurses. But kind of starting the TPE journey, going up to Chicago, learning the machines, learning that it's taking out these toxins, and doing my own research on the side, figuring out we're surrounded by them. I mean, there's toxins in almost every. Everything that we have. There's toxins in the shirt I'm wearing, dry cleaning even, and going back into conventional. The conventional hospital and thinking, like, you know, they really talk about this. They don't talk about. They'll talk about pesticides, the more. Bigger, I guess, toxins that they think about. But, man, they don't talk about, like, pfas forever chemicals. They don't talk about, you know, treclosins, phenols, all these other things that we're always in contact with that caused the inflammation and caused the things that I've seen in the ER or caused the things that I've seen putting in a PIC in one of these children or one of these adults. So really working with Dr. Savage, learning more about it, and coming up with this procedure, this plasma exchange protocols that is all encompassing to help get rid of those toxins and improve either longevity, immunity, and really just a person as a whole and as a nurse, you know, that's what I signed up to do, is to help people. And it's been a great journey so far, about six months. I work with a great doctor down here that works with Dr. Savage. And I mean, it's. It's been going strong. I've been enjoying it. That's great.

It's so interesting to hear your background going from a travel nurse, you know, working in ER and all that stuff. So you're seeing a lot of symptoms, Right. And then now you're almost like, on the completely other side of the spectrum where, yeah, you're at the root of the issues. I mean, you're trying to get that out with tpe, right?

Yeah, and I'm glad you brought that up. You know, in conventional medicine, we were treating a symptom. Really, you come in. I'm having an asthma exacerbation. Okay, here's an inhaler. And X, Y and Z. Okay, cool. It's dicks. Goodbye. You know, there's other diseases that toxins do cause or they can create more of a problem with and exacerbate more. Alzheimer's being a big one. I talked about, we've talked about on the podcast, I'm sure a lot, the study which really pushed us forward. But you know, other diseases, autoimmune diseases, even down to rheumatoid arthritis. I even have people who have long term Covid who are coming to see me. And I have one patient actually did this week who their smell is getting better. They haven't had smell since they had Covid. So really seeing that we're treating the cause rather than just a symptom is really telling. And as we continue to do research and as we continue to support these patients, seeing how well and better that they are getting, again, not just as symptomatically, but as a whole.

Well, it's going to be interesting to dive in with you here because like I said, you're on the front lines. Like, well, you always have. But now with this different version here with TPE administering, how would you, I guess, how would you describe it to someone if they're first coming across TPE this concept? How would you describe that to them? So they kind of understand it, they get comfortable and of course we'll dive in deeper.

Yeah, I mean, Dr. Savage coins it. Well, it is an oil change for the body. And the body is a machine if we really think about it. And I guess another way that you can describe it's like dialysis. I think a lot of people kind of understand what that is or even just giving blood. But what we do differently and what I like about it is the machine that we use, the amicus, the apheresis machine for these plasma exchanges is basically like a fail safe. And I say that because when you talk about dialysis or you talk about even donating blood, like red flags already kind of come up like, oh, how am I really going to feel after this? Ooh, that seems like really excessive. Pretty invasive. But really what it is is two needles in the arms taking the blood out. It spins it. And then unlike, for example, plasma donation or plasma or blood donation, we're giving you back something so that it's not a full, you know, draining you of 500 MLS. And hey, good luck on your own. Here's some crackers. It's more of let's clean you out, let's replace it with something called albumin and just kind of help with your blood volume there. My machine, I always tell people when they come in, like it's loud, it's gonna yell at me, beep at me. But really that's just either for me to change an albumin bottle or if you just need to fold your arm out more. There are some things that may occur, but really it would be like lightheadedness, feeling faint. And that's just because, you know, we're pulling out some of the fluid. But, you know, me and the other nurses, we do a great job preventing those really, like, kind of smaller level side effects, I guess is the best way to say it. Some other things are like, it eats your blood sugar a little bit, but we always ensure. Hey, did you eat? Let's check your sugar. We'll give you some sugar packets. Hey, I know your arms are immobile, but here's a juice with a straw to at least help with that. Other things that we try to do is like at least fill you up with fluid, get you a little bit of normal saline, just help you out a little bit in terms of the fluid aspect, but really it's. It's individualized. It's not the same for every person. And what I like to describe, at least your first TPE experience would be more of, hey, it's more of like a consultation and a consultation with you and the machine. I figure out which veins work best for you, which catheters are going to work best for you. How do you react while you're on the tpe? Do you get lightheaded? Okay, perfect. If you get lightheaded, I know, next time, here's some blood sugar. And normally, once I address those concerns, 2nd, 3rd, 4th, 5th TPEs are running smoothly.

And that's what I really like about it, and that's what to really expect is, especially on that first time, is I'm going to talk to you, I'm going to be really assessing your arms. I'm going to be really assessing how you feel. And it's always great to come back, especially after that first TPE and hear somebody say, you wouldn't believe. I have so much energy, my brain fog is already going. I can remember some things. Let's just go on to the next. Keep harping on that first tp. But that's what people are genuinely anxious about and afraid of, which rightfully so, but just to kind of lay it out there, like, we really take our time to make it a comfortable experience for you and to meet the goals that you're trying to meet.

So, Mitch, I'm curious, like, after, you know, if someone understands this, like, I'm Curious. What's like a surprise that you commonly see that people have? Like, are there some pretty common experiences that like you mentioned, like the whole like, oh, I feel like not lightheaded or a lot more clear minded, you know, Are there other surprises I guess throughout the process that people kind of.

Experience that you've seen? Yeah, everyone's different again, TPE. I know Dr. Savage and other physicians have talked about this as well as on the podcast. It's not necessarily a cure for things. It works for everybody in a different way. I had one surprise was somebody has something called a, A, a geographic tongue. And it's kind of like where it almost looks like the tongue is really dry and it looks a little cracked. One day they just came up to me. We're like, hey, weird. I don't know how if this has anything to do with what we're doing. He was like that. You know, it was for two weeks. I didn't really have that geographical, like tongue how it normally looks like, like it kind of smoothed out a bit and I thought that was really interesting. And I always like letting my doctors know, like, hey, this is happening over here, this is happening over there. I've had people who, as we know, rheumatoid arthritis. Like some of them, they come in for like a brain protocol, or let's say they come in for immunity protocol, and they'll be like, you know, my fingers have been moving a lot better. Like, I have better dexterity. I was like, oh, well, you know, X, Y and Z. Autoimmune. Conventionally, past few decades, it's been used for autoimmune disease. So that makes sense. Again, let me let my doctors know.

Other surprises. Again, that surprise with the smell too, you know, that's something that everybody had when they had Covid was their smell went away. And it's just so great, like having people come up and be like, hey, like this smells coming back again. Everybody's different. But just hearing like these, these small things, like, I'll hear like the bad, like, oh, I was really tired after it, which is normal. After the first CPE, we take about 66% of those toxins and that fluid kind of shifts between the vascular and the, and the extracellular tissues and everything. So shifts a lot. But they're like, you know, for two weeks I was able to go to the gym and I was at the gym for, you know, four times the amount I was there. Or oh, my husband, he's more alert, more awake. We're able to talk, we're Able to have a great conversation. So simple things like that. And I always have a cheer and a win forward because there's results that are happening there. I even had somebody say, oh, they're able to catch themselves now, like, even if they trip or realize that they're kind of slipping up when they're talking. And those are just really big things for me. And I always ask my patients whenever they come in, what's good, what's bad, what do I need to fix?

That's a good question. I use that for other things too. Right. And I like that you're communicating back to the doctors as well, you know, just because. So it's kind of like this feedback loop. Right. So it's helping other folks in the future.

No, definitely that way they're also aware. And like I said, you know, Dr. Savage, it's very, very personable. You know, we're all in the same goal, we're all in the same concept, and that's to provide the best care that we can to meet, have people meet their goals and create a modality that is going to be changing. You know, it's going to be ever changing, especially within the medicine world. So having that strong team and that strong teamwork and I don't know if you know, but like, we're different centers. So, like, for example, I'm kind of like, I'm here, another nurse is up here, another nurse is here. We have a doctor maybe near this nurse, another doctor that's working in this office. But you would think that those would be barriers. But the communication has been really great and just being able to get in touch with them. And there's been times where I would call, let's say, Dr. Ng just on the phone, hey, this patient has a question. Yeah, sure, I have time. Like, let's talk. And I think that really resonates with people. And even me as a provider, as a nurse, I'm like, I've never had that before and it's so refreshing.

And that helps. I mean, that's the whole, like, kind of network of partners, basically, with MD Lifespan communication. So everybody's learning together and. Yeah, and that's why we're featuring folks on this podcast to talk about their experience. So.

Hello, my name is Kerry Stewart, and I did the brain protocol for the MD Lifespan. I was struggling to recall names of couples, and so I shared this with the doctor. That's when he introduced me and said, I think you're ready. And let me explain to you a tpe, because this is going to Help your memory, your focus, your clarity. And I truly believe you'll be a wonderful candidate for this. I have had five TPE protocols, and each time I have improved. And it's not until this last one that I honestly, I am feeling so back on top of my game. Like my brain fog is gone. I am focused more. I have more clarity. This was life changing for me, and I feel so much better for it.

I'm curious of, because one of the first things you started about was your ultrasound IV skills. And I'm curious of, I guess, why that's important, just to talk about that, you know, with this whole procedure. And, yeah, anything, I guess we should know when it comes to that side of things.

Like I said, a lot of people come in really anxious about it because that's the main part, is it's the IVs and getting access. I know on one of the earlier podcasts, Dr. Savage kind of touched on it a little bit, but he really wanted nurses who are ultrasound IV trained and even better if they could be what we call VABC certified, which is Vascular Access Board certified. So national certification. That's something. Actually, I think all the nurses currently have. And what that is, is it kind of helps us dictate the proper veins to utilize. That helps us dictate how can we assess and troubleshoot any issues that may come up? Because during tpe, you know, we're pulling blood. It's not like a normal infusion where we're just pushing things in, like, oh, you have a vein, there's a tube. Like, things can go through it. Perfect, done, call it a day. TPE is more of, okay, let's critically think which vein has the better diameter and what we call a catheter vessel ratio. Normally, you want it at least 33%, not even half like you want at 33%. The reason why and why we take so much time with the ultrasound and ensuring that that's the right vessel is to ensure that the diameter at least meets that 33% so that there's also blood flow going around. Because if we just put in, like the same size into the same vein, there's no blood flow going around. Really? You're just going to be sucking in nothing? Actually, no vacuum, right?

Yeah, it's.

It's. Yeah, like a vacuum, you know, because it's all negative pressure. So having those ultrasound IV skills also allows us to be like, hey, like I. Let's say we're during the tpe, right? I talked about those alarms. One of the things that those Alarms could go off for like a ding, ding. To let us know is something called there's a high pressure. Typically what happens is if you have a catheter, let's say it's my pinky, and you have a vessel, and if the negative pressure is too much, the vessel vein can collapse and kind of squeeze almost like a Capri Sun. We just want to make sure that the Capri sun stays filled. So whether we need to, let's say, slow down, how fast it's pulling the blood out, whether it's. We need to reposition the arms, some of the muscles around the veins aren't constricting it too much. Maybe it's, hey, we just need another tourniquet on. You have the vascularity there. If we put on another tourniquet, maybe it could pool with blood a little bit more. So we're actually also able to assess during the procedure and see what could be going on live time, without being like, oh, oh, well, that doesn't work. Let's poke you again. Something that I actually learned from my pick nursing days from an amazing team that I have here in Orlando I used to work with, was the more times that you stick somebody, the body kind of remembers that, and it's going to be even harder to do the next iv.

So is it every, every time, do you have to switch locations for each TPE session naturally?

No. Like, if you go pretty well through it after that first stick, you can use the same vein. Like I normally say, hey, that vein works for you. That's what I'm going to use. Because in all reality, that intake is only in your arm for about two hours. So. So it's not causing a lot of damage. For example, if it was in, let's say, during a hospital stay. So nine times out of 10, you're able just to use the same vein each time. And that way the patient also kind of knows, hey, this is the vein that you used. You did great last time. It worked well. Didn't really feel a thing.

Got it.

And that was another thing, too. In the pre assessments, we really do like our vein choices, see what works best. We can see valves, we can see what we call bifurcations where veins split. I even try to assess and see if I need to use a regular catheter or if I need to use the actual apheresis steel needle, because that can also play a different type of a change. So really, I feel as if that confidence within that machine and that technology kind of calms people down. And I also like pointing, like, hey, this is what I'm looking at. As long as people are in squeamish and being like, hey, this is what I'm looking at. This is what I'm going for. Feel free to watch. I'm confident within it, and I can see where it's going. I can see how it's going to last, et cetera. And I think once they understand that as a patient, kind of all other anxieties go away, especially after the two needle sticks there. And from there, it's just playing around with the machine. What speed should I do you at?

Do I need to give you a glucose tablet? Do I need to give you a TUMS to help with calcium? But the ultrasound IV skills is definitely something that is a game changer in this form of work and in this procedure. Because if you don't have a good line or if you don't have, you know, a good IV or your vein choice is poor. You're not going to have a good procedure or a successful one.

Yeah, I respect you and anyone in that position of even drawing blood or any. Because, yeah, I've definitely had some, Some. Some misses that I think we all have. And that leads to. Well, you said, like, the squeamish type of folks, because I know a lot of people who are in that boat. Like, how do you. How do you calm those folks down? Maybe pre procedure, as you're getting into.

It again, everybody's different. I like, if I know that they're a little bit more anxious about the actual poke. And they'll tell me too, like, oh, like, I don't like being stuck. Like, you either. Tell me 1, 2, 3. Some people tell me don't even count at all. We also have something called like a panties. It's almost like a little spray that we can use to help with a little bit of an initial pinch. It's like a cold spray, so it kind of tricks your mind. But really just any nurse's discretion like that, like, hey, let's talk about it. This is where I'm going. This is what I have confidence in it. We'll try it out. At least give me one shot. If I can at least prove my skills, show that I hit it, then nine times out of 10, they'll be like, okay, yeah, this isn't as bad as what I thought. I have had patients that say, oh, just don't go here, don't go there. Okay, Like, I'll have a look. And that's why I also like showing them the screen. Like, Hey, I see it. I'm not feeling like I visually see it. It's a video game. Like, I'll just let it. We'll treat it like that. And even using that terminology like I just used, hey, it's a video game. That's just my target. Sometimes they'll calm down from it. They'll see it more as, like a kind of fun experience rather than a. Yeah.

Make that the image of this podcast now, right? No, but, like, the way you're describing it does take the mystery out of it. And I think that's what I'm trying to do here is, you know, take. Take the mystery out of. From the, from the patient's perspective. It's. Yeah, there's a target. It's very logical. You have great tools and awesome training, you know, and everybody's helping each other as well in this process. And the cool thing is, what. There's a series of. Of these sessions that are happening. Was it between 3 and 5, typically?

I think, yeah. Typically 3 and 5. I like to say, on average, you'll see more of the 5 range. And that's kind of like what we like to keep. I know earlier podcast as well, we talked about, oh, 66% in the first TP, then another percentage in the second, third, and fourth and fifth. But again, it's individualized. It's. It's per the. Per the patient. Whether they just want the TP itself. That's also an option. Do you want an IV bag after? That's another option. And our team does a really good job of saying, hey, this is what we think will work best for you. We'll work around it, and we'll make it feasible for you and your own goals. Again, but normally three to five, I think I only had, like, one, at least in my line of work, one just regular TPE to try it out. But then they continue on to do further TPEs just because they wanted to try it, and I guess they had a great experience.

That's a good plan. Yeah. Well, I'm curious with being in Florida, like, do you. And, you know, you haven't done this in other states, but I'm curious if there are, like, regional toxins that you're seeing or any kind of trends maybe from others that you talk about or talk with. I'm just curious if there's, like, a regional, like, consistency of trends or, you know, from the patients that you see when it comes to, I guess, what, what's getting taken out or even the, The. The feeling afterwards, you know, the different effects of tb.

Yeah. In terms of toxins, you know, Florida is, we're a bed full of golf courses. So pesticides is definitely one of them. Many toxins that deal with pesticides, anything that comes from aerosol cans, think sunscreen. I mean, we have sun basically year round. You know, everything from what's in our water, etc. Like, that can definitely play a part in terms of how people actually react to the tpe, I think is again, dependent on person. You can have somebody who comes from Massachusetts or even let's say Denmark, for example. Like if somebody comes from Denmark, they have clean water, they have different, like filters systems, etc, but if they're still around, like a different type of specific chemical, like they could have higher toxins than me. Like whether I have, you know, four to five or six on the little, on the blood test or the urine test, the toxin test to, you know, figure out what I exactly have. But region does play a role. Like I said, pesticides is definitely one of them. But really it's all about getting tested and seeing what you have, what you're around. You'll be surprised. And one of the things too, I actually have one of the headquarters for some of the containers that we buy, like the plastic containers. So I'm sure there's some plastics, you know, even in the, in the air. And we also have a paper mill kind of down the road a little bit. So I'm sure that's in the air. So there's definitely a bunch of different environmental factors there. But again, it's what we do. What do you do in your home as well? What is your lifestyle like? Because you're always going to have toxins everywhere. So one of the things that we did. Yeah, well, you can't escape it. But you know, we got rid of all of our plastic containers, we have glass containers now. Like simple things like that. Yeah, it's not taking everything, it's not the tpe, but it's at least keeping your toxin levels down. Like, for example, there's certain chemicals or certain toxins that only last 21 hours in your body. If you can get rid of where those are coming from and change that, then you won't have that specific chemical or toxin going throughout your body as well. And that's what we really also try to learn and teach and educate our patients with our different protocols. And our plasma exchange is, hey, get rid of this, you know, skillet. Here's a concept here. Or all the rage are the Stanley Cups. You know, like, at first I Was like, oh, Stanley cups, another fad. But then when I started this job, I was like, oh, yeah, get those bottles out of here. I even go to Duncan sometimes. I'm like, no, get that out of here. Before, you know, it starts warming up.

I had a whole podcast with what Dr. Fine, who. It'll. It'll be released somewhere in the future. But yeah, she was talking about just how much, how much stuff is leached from these coffee cups, plastic bottles. It's just ridiculous.

We all take it heat to it, you know. And.

Mitch, I'm curious of, like, what, what happens post tpe? Like, is there testing or like that happen that, that you guys do or that you're aware of? And I guess anything that you kind of see in that phase after procedures.

After every tpe, I try to at least reach out. Especially if you had something interesting go on. Whether interesting, like a lightheadedness or anything, I always try to reach out to them within 24, 48 hours. Hey, how are you feeling? Let me know if you need anything. I'm just a Cerbo, which is our charting system, just a message away on there. I'll reach back out to you within 24 hours.

But specifically in terms of testing, like you said, we normally wait at least six weeks after your last cpe. And what this does is I talked about the mobilization of toxins as well. That's about the amount of time that it would take for your body to kind of like relax and let things settle where they are so that we can get a good idea of where your toxins are after the fact. So really, what you have to look forward to after the TPE in terms of communication is you'll hear from one of us nurses. Hey, how are you doing? Even before your next TPE will send you an email or some form of reminder. And just to let us know that we're available for any calls. I've had patients message me the good hey, I'm feeling really tired. Oh, you know, that's normal after the first cp and we can talk about it. But again, testing is more after the fact, and we do subjective and objective testing. And what I mean by that is you have objective testing, which is like your lab work, your urine, your blood. Those are things that give you those results. Just flat out, these are the facts. Subjective testing is more like surveys. So we do do questionnaires at the beginning and at the end. Some of them include like a quality of life questionnaire, fatigue scale. And what we're trying to do as well is See, is your quality of life also getting better based off of the tpe? Do you feel you have more energy? Is your fatigue gone? How is your mood? So that's something else that will also repeat at the beginning and at the end from there. And that's what makes that plasma exchange so great and also makes our research behind it. Well, is, oh, like, looking at the full person, not just the physical attributes, but how is your, you know, your sense of self, how's your mental, how's your holistic, your spiritual, and, like, how are you doing as a person? So that's also something that you can see after in terms of signs, symptoms, what you might feel during the tp. Like I said, you might feel a little lightheaded a lot of times. That's just a glucose table. It could be your sugar. You might get tingling in your face. That just lets us know you just need a little bit of calcium. Whether we give you Tums or we put. Put it in the albumin bottle before we hang it. That way it goes back into your system. But definitely after first, second, third, you'll feel at least a little fatigued after it. It's okay. Take a nap. I mean, your body literally went through a whole cleansing, right? Yeah. And especially with that fluid shift and that mobilization of the toxins out of the tissues to prepare for the next one, you might feel a little groggy, and that's normal.

So I like to let people know that as well. Like, you will feel tired, especially at the first one, because we're taking these toxins, whether they've been in you for hours, days, weeks, years, and we're actually getting rid of them. Now your body's like, oh, well, now I have to kind of reset, figure out if there's things I can actually focus on as we decrease your inflammation and as we increase your oxid, decrease your oxidative stress. I mean, that's.

There's so many. So many shifts happening all at once in a short period of time, but I know it's spaced out, what, about a month between procedures? Right.

So.

Yep. Gives a little. Little time for the body to circulate and.

Yeah, exactly. And like I said, you know, you'll normally see those changes, I would like to say 48 hours after, because 24 hours after, typically, your plasma will regenerate itself, whether from, you know, hydration and the electrolytes, which can help your plasma regenerate, which we do give vitamin bags as well at the end of the session. So you're not as, like, depleted I guess, or as tired, for a lack of a better term, because the TPE does take out some of those electrolytes, but we would like to replace them and then help with what we call performance iv. And even give you some of those good amino acids, give you some of those good zinc and those immunity raising vitamins like vitamin C we give. And it really helps out people's immunity. I actually had a patient who told me, she was like, you know, like, I think it was second or third tp. She said, everybody in my family is kind of sick. She's like, I never got anything. And I was like, oh, wow. I was like, I mean, it could be because of the extra electrolytes. It could be because we're rebooting and helping your immune system, getting rid of those inflammatory markers and those oxidative stress to help out. So, like, you know, hearing those things is really great. Like, going back to your question, it's normally like, just mainly like a fatigue that you'll feel after it. Some people, they might not even have it. I have one guy that goes out and runs or goes to the gym right after, which I don't. I don't suggest doing, but he does. He's like, yeah, I felt great. I just went. I said, okay, cool, but just let me know.

Yeah, yeah. That's what I've heard from everyone else who I've chatted about with or. Or folks administering. Yeah. And that's pretty common. But I guess just to wrap it up, like, what. I guess what. What excites you for what's to come with tpe? Because it is so new. You're only six months in. Yeah, I don't know anything top of mind because, you know, the more that. And I like to ask this because I feel like at the end of these conversations, typically it's like, whoa, there's a lot of toxins everywhere. What the heck can I do about all this? But, like, there's gotta be some hope to it. Some. Some, you know, and. And obviously you're talking about the actual way to cleanse. So I felt like it's. It's very hopeful conversation, but where do you see.

Yeah, definitely, you know, tpe, I guess just that's the exciting part about it. We're utilizing it in a way to get rid of these forever chemicals and these toxins that have been in our bodies for so long. And Dr. Savage said it. Well, like, we need to be educated on toxins. TPE itself, it is fairly new, and it's. It's not for everyone in terms of whatever that may be. But there's still ways that, you know, we could. You can help and you can help your. Yourself and keep away from these toxins just to create a healthier environment and a healthier life for yourself. A lot of that is what you consume, what you do, you know, visit our website. We have a bunch of learning tools and education materials. Go ahead and do a consultation, talk about it. We don't mind. Like, I talk to me. So I do some of the consultations, sometimes talk to the Dr. Ng, Dr. Savage, all of our amazing team, and it's just a quick phone call away just to discuss, hey, I have this one question. Or hey, I was subjected to a mold. Like, how can I help with that? And really that's just what excites me about is the education, the, the research that they're putting into it and just being a part of a company that everybody's excited for. Yeah. And the prospects and of course, you know, the, the, the just what I've been seeing on my end and what patients have told me, how they feel. A lot of that is just. That's really exciting for me and just to continue pushing forward and seeing really, in a sense, results rather than just, hey, try it out. No, it didn't work, you know, so that's what really excites me about it.

Yeah, well, you're doing, you're doing great things, man, and I'm happy. Yeah, you've seen from the ER side of things, and that's. You were helping folks there, but now this is like a whole new way. And I know there's going to be many others that are, like yourself, who are helping others as well. So we'll keep doing the education on our side of the podcast. I know you are, too, so I'm excited.

Has been great because. Been doing great with it. So thank you.

Well, thank you, Mitch. And yeah, maybe, maybe I'll go join you for a. For a TV session. It's a little far.

Yeah, come on down, Come on down. You know, World of the Mouse.

There you go. I bring the kids for that one, though.

Yeah, there you go.

All right, man. Well, have a good one. Thank you, Mitch.

Thank you. You did the same, Joe. Have a good.