Inside the Therapeutic Plasma Exchange Procedure: From the Nurse’s Chair | TPE Blueprint #17

During the plasma exchange, obviously we have people like we're captive for a couple of hours so we can really talk about like their symptoms and you know, what they're focusing on as far as toxin avoidance.

Yeah, it's interesting because this is a whole different aspect of care. You know, it's this personalized medicine. And you mentioned prevention, so. And yeah, the healthcare system definitely does not seem set up for preventing things. It's more aiding or what, going after the symptoms after something's already popped up, Right?

That's correct, I guess.

What? Yeah. And you're re energized. So like what aspects are you seeing? And maybe it's like with some patient stories, anything you can. Like are there some trends or things that are. You're seeing now that you're kind of in the driver's seat that are different from what you've seen in the past?

Well, I've seen people who like my very first patient that I did here in Detroit, and she pretty much ready to retire and give up her career because she is so fatigued and tired. She's gone through all kinds of treatment with immunoglobulins.

And she just really has like chronic inflammation and some autoimmune disorders. But she's done three TPE sessions and she said to me, even after the first one, she, she's like, I'm not really sure if I could tell you that I have more energy, but I can tell you that I've said yes to more things and I've took on more projects, whereas she was before ready to retire. And that's super. I mean, that's huge to me. Because if a person can feel energized to keep going instead of just hanging up their hat, that's huge.

That's. I mean, that's like a whole new re. What refresh of someone who. Because I mean, are there, are there trends like in the ages that you're seeing of, you know, the type of people in there and maybe some of these turnarounds like that?

Well, it's interesting. I've been to the Chicago Clinic and the Detroit Clinic. I haven't been to the Orlando one, but I talk to the nurse Mitch there all the time and he seems to see like older populations. I seem to see middle aged populations like myself. And there's some younger patients in the Chicago Clinic. So the younger set seem to be. Either they're having autoimmune.

Symptoms, like inflammation symptoms, and they want to get rid of them or they want to prevent that they've gotten Their toxin test. And they're like, no, we're just going to go through this exchange and get rid of that. Which actually happens to be the boat I'm in because I had my toxin test and.

I need to go have a plasma exchange. That's what I've just said.

Me too.

Well, is that typically. And of course, like we talk about the test and Dr. Savage has been on here multiple times talking about know your own data. Is that something that you walk people through? Like, are you a part of that conversation at all with folks?

Not usually ig full time. And I went back to school to become a nurse practitioner and the whole through line through all of those is that we don't really do anything to prevent people from getting ill. We treat. We treat people when they're already ill. And the big thing that opened for me, like when I got into this position with plasma exchange is that we have an opportunity to help people before they get ill, to either delay their symptoms or prevent chronic illness altogether. So I am actually re energized in nurse practitioner school because I'm like, instead of just writing prescriptions for people because with their chronic illness, we have a way to actually help them.

Because, I mean, yeah, you as a nurse, you're in the front line where not a lot of people are communicating with patients to the depth that you probably are. Right?

Yeah, it's. Primary care is like the whole idea of primary care is to help people, like to, you know, to stay well, to have a relationship with them. But our primary care practice is broken in our country. It's very rare. Like if you're a healthy individual and I'm just saying healthy, generally healthy. You go to see your primary care physician once a year, maybe twice a year. You got your labs. If they're good, that's fine. It's hard to get back in to your primary care doctor if you just have a basic illness. Most people go to an urgent care because it's quicker. And I feel like during the plasma exchange, obviously we have people like we're captive for a couple of hours so we can really talk about like their symptoms and you know, what they're focusing on as far as toxin avoidance.

Yeah, it's interesting because this is a whole different aspect of care. You know, it's this personalized medicine. And you mentioned prevention, so. And yeah, the healthcare system definitely does not seem set up for more preventing things. It's more aiding or what, going after the symptoms after something's already popped up, Right?

That's correct.

I guess What? Yeah. And you're re. Energized. So, like, what aspects are you seeing? And maybe it's like with some patient stories, anything you can. Like, are there some trends or things that are. You're seeing now that you're kind of in the driver's seat that are different from what you've seen in the past?

Well, I've seen people who like. My very first patient that I did here in Detroit, she pretty much ready to retire and give up her career because she is so fatigued and tired. She's gone through all kinds of treatment with immunoglobulins.

And she just really has like, chronic inflammation and some autoimmune disorders. But she's done three TPE sessions. And she said to me, even after the first one, she's like, I'm not really sure if I could tell you that I have more energy, but I can tell you that I've said yes to more things and I've took on more projects, whereas she was before ready to retire. And that's super. I mean, that's huge to me. Because if a person can, you know, feel energized to keep going instead of just hanging up, you know, their hat.

Yeah.

I mean, that. That's huge.

That's. I mean, that's like a whole new re. What Refresh of someone who. Because, I mean, are there. Are there trends, like in the ages that you're seeing of, you know, the type of people in there and maybe some of these turnarounds like that?

Well, it's interesting. I've been to the Chicago Clinic and the Detroit Clinic. I haven't been to the Orlando one, but I talk to the nurse Mitch there all the. And he seems to see like, older populations. I seem to see middle aged populations like myself. And there's some younger patients in the Chicago Clinic. So the younger set seem to be. Either they're having autoimmune.

Symptoms, like inflammation symptoms, and they want to get rid of them, or they want to prevent that. They've gotten their toxin tests and they're like, no, we're just going to go through this exchange and get rid of that. Which actually happens to be the boat I'm in because I had my toxin test and I need to go have a plasma exchange. That's what I just said.

Me too.

Well, is that typically. And of course, you know, like, we talk about the test and Dr. Savage has been on here multiple times talking about know your own data. Is that something that you walk people through? Like, are you a part of that conversation with folks.

Not usually. I'm usually seeing the patients after they've already talked to our physicians and they've settled on a plan and they're ready to go. So then after they, I see them when they're in the chair, just, you know, before we talk and have conversations about what to expect.

Yeah, that makes sense. Well, how about like on, in terms of. Because now you're likely getting. Prior to your, in your nursing life, you weren't thinking probably as much about toxins, but like now. And I'm thinking of like, what are some of the most common, maybe illness trends or toxin related symptoms that you're seeing that maybe folks listening or watching might be like, oh, interesting, you know, like, sounds familiar.

Probably fatigue.

That's a big one.

Looking back.

I've had fatigue for a while myself and there's different things that you can do, but that's.

Something I think is more related to toxins in our body than I ever knew before. So that's part of the eye opening process for me. And I, I feel that the patients I've seen that is the hugest or the big, the biggest symptom that they have. Sorry. Is fatigue and they want to get rid of that so they can function and take care of their kids, grandkids.

I'm, I'm at 40 and I feel like, I don't know if that's the younger of the TPE group or if that's the middle age. I don't even know what I call myself but, but like I'm thinking of fatigue because I'm like, yeah, I feel a little tired. You know, I have two little ones at home, have my own business. Things like this, managing things. Obviously this podcast is part of it too. Like, are there common, I guess signs of fatigue that you would rank as like, oh, that's maybe that's something worth exploring a little further.

Yeah, there's a normal fatigue that you have, like running after little ones, being busy with your career, you know, you want to stay healthy. But if you're finding yourself just like at the end of the day or four o', clock, five o', clock, just, I can't function anymore, I need to just take an applicant. You're literally hitting a door and you, you can't even move or you aren't able to like get up and take care of yourself, those are like serious like signs of fatigue. That isn't the normal, I'm tired, I've been running all day.

Yeah, yeah, that's true. It is a different Feeling.

I think people should pay attention to those signs more. It isn't really. I. I think I thought for myself, like, I'm just getting older. You know, this is just a part of getting older, and I think it's just a part of being overloaded with toxins. Like, we don't know how good we actually can feel because we're so used to kind of feeling like crap the whole. For a while.

I think that's. That's a pretty common thing that I. I see here in these chats, but also just. I mean, just chatting with my own friends and family is. Yeah, everybody has their own thing or different lifestyles, but we're all exposed to toxins. Right. So.

Yeah.

And until we really know, you know, do the test for ourself and understand our data. Like, I know I have a bunch of mold in me. I'm like, didn't know that before.

Right.

I didn't think I would be in a hot place. But you don't know until you. You actually see your own data. Right. And then you can kind of map a little bit more of that to maybe a symptom you're feeling.

You can say, there's so many toxins to avoid in the whole world. And when you start looking into it, like. Like I have in the past year can be overwhelming. And that's what I try to talk to patients about, is just making small changes. You know, every day just pick one area to make a change in, and then once you have that down, like, make another change. Like. And when you get your toxin test, you can see what you really actually need to focus on. Like, I have a really high level of BPA in my blood, so I was not even thinking of BPA as being, like. I thought that would not be what would be in my system.

Sure.

So now I'm really going to hone in and focus on how do I not expose myself to BPA and plastics in the future.

Yeah. Which it's so hard. Right. With the world of, like, literally everything seems to be wrapped in plastic and it's like, why does that even need to be there? Like.

Yeah.

Why are you wrapping an apple in plastic for? Stop it.

Right.

But it's, It's. Yeah, but we. Lifestyle choice is a. Even, you know, after tpe, of course, is very important.

Yeah. What are your thoughts on that, too? Because, like, of course you can clear the slate through TPE and get rid of a ton of toxins, but there's still the changes after. After the fact.

Yeah. I kind of. I Think an analogy. So I kind of think of it like, you. Your toxin load is like a bucket. So once you go through tpe, then your bucket is pretty empty of toxins. So then you want to just kind of keep it as low as possible.

Yeah.

But every now and then, you're going to have a rainfall of toxins and the things that you can do to, like, scoop out so your bucket's not full. The biggest thing is just to avoid them, so.

Well, I'm ridiculous. I didn't even wash my vegetables until I got this position. I mean, I rinsed them, but I wasn't like, I'm just like, a little dirt never hurt. Like, I'm like a typical nurse. Well, you're either a germaphobe as a nurse, or you're just like, whatever, I'm not dying. And I was the. Whatever, I'm not dying kind of a nurse.

Yeah.

Now I'm, like, using vinegar and soaking my vegetables and fruit.

All right, that's what I was gonna ask. Like, what's your protocol? So it's vinegar. And so, like, literally walk me through, like, you get a bunch of vegetables from the store. Yeah.

You get, like, your vegetables. I definitely peel. You, like, peel my cucumbers. I used to leave some of it on for the nutrients, but now I peel them. Grapes. I kind of used to just rinse under the water and not soak them. So now I soak them in, like, vinegar and water.

And, like, lettuce. I have, like, a vinegar water spray that I spray and then rinse and pat dry.

Hey, you laugh, but it's like, these are all things that are like. I'm like, I'm not doing that.

I know. Yeah.

That.

That was me. I mean, I would probably eat even some dirty grapes, like. Cause I just thought it was dirt. But I've read studies even about, like, spinach and all of the heavy metals that are, like, just on a spinach leaf. And I'm like, oh, man, I'm so dumb.

Yeah. I mean, well, you're not dumb, but it's. But I mean, I think all of us can be, like. Can probably say guilty, you know? Yeah.

Very guilty. Yeah.

And you don't know what. You're like, you're going eating out. I guess you're hoping for the best.

Yeah.

Spray bottle with you everywhere. But.

Yeah. I think I don't drink out of plastic containers anymore. I.

I love coffee, and I really struggle with not using my Keurig, so. Because it's so fast, but it's so bad.

So I have the plastic cups, right?

Yeah.

What do you, what do you go for coffee then instead?

Well, if I was real good, I would do the pour over and grind my own beans, but I'm not that great. I'm still opting for a little bit of speed. So I have a single use coffee maker that I just have my pre ground beans and go. But it's like an aluminum or stainless steel basket.

So that's better. Yeah, I, I do something similar with the espresso machine but like, yeah, pour overs are great but like what do you always have 15 minutes in the morning or whatever it is to do it all? Yeah, most people don't, but. Well, no cool insights and that was a little diversion from what I was thinking.

Yes, that's good.

It's all good. What, what do you think, like now that you're, you're in this whole, I mean you're working with MD lifespan and you're, you're literally getting patients coming to you because they know they're toxic, you know, and there's toxics and toxins in them. Is there any like misinterpretation of detoxing or like is there a different frame that you give people or an understanding of, I guess what that means and how to do it? Because TPE is part of it, of course.

A lot of people that I've seen so far are really knowledgeable about toxins and they want, you know, to detox. They're serious about the lifestyle modifications that they'll need to do to keep their toxin load down. I think if I've seen anything, it would be that you can just do plasma exchange and you're good to go and then you can go back to your lifestyle and you'll be fine. But I haven't seen that too much really. What I've seen are people who understand that detox isn't just like a liver cleanse or something that you can drink or it really is modifying your lifestyle to avoid taxins your toxin exposure, knowing that you're not going to avoid toxins all together.

Yeah, it's. They're not going in a way and going away at all in the world.

No, no.

Seems like there's a lot more popping up, so. And we've had a lot of episodes. We probably won't go into it in depth here because I have some other ideas. But yeah, definitely for listeners watchers, go watch some previous episodes with Dr. Savage and I mean almost everybody else talking about like how, what, what things to avoid, you know, air, water, um, just inside the house. Cleaners and things like that, right?

Yeah. Yeah. Dr. Savage has some great recommendations for air filter. That was also another thing that I did once I got this job is got an air filter for my home and water filter. I was just drinking the dirty Detroit water from the city, not filtering it.

Risky.

I mean, you know, I live on.

The wild side, but that's most people, right? Like, you just don't know. And. Yeah, I know there's places. There's ways to actually look up your area code or your zip code and see, like, the kind of stuff that's floating around in your city water, county water, and it's pretty eye opening. We have someone coming on pretty soon to talk more about that.

Oh, that's great. Yeah, it really is eye opening to start. Pay attention to that. Yeah.

Yeah. So when it comes to tpe, because I want to walk through kind of like, some of the. I guess, the experience that someone has when they go through a procedure. Of course, selfishly, I want to kind of know what I'm in for, too.

Yeah.

But, like, before that, if someone's listening, watching, and they're. They're just kind of understanding what TPE is like, could you, I guess, describe it in a way that would. That's almost empowering? Because I know some of it could be a little bit overwhelming or a big commitment, you know, but, like, I guess, how would you frame it to someone who's just kind of learning about it from a nurse who's literally doing it daily for patients?

I think of the concept, and Dr. Savage says, like an oil change. I really think it's empowering because. And this is how I talk to people.

Is a procedure. It's not a. It's not a small. You're not going in for surgery. But it is a procedure, and some people are quite concerned about it, like, rightfully so. I think if you come into having a plasma exchange knowing that it is a procedure and you have to take it seriously, that's great. It's not just like going to a med spa and getting hooked up to an iv. That's not it. But it is an empowering thing that you can do to proactively change your life. You might not feel the effects from it. You might not feel any different, even after three or five, like, exchanges, but you will be rid of all of those toxins. And depending if you have no symptoms, then you're. Then that might happen. You might not feel any different. Most people feel a little bit different. Like, they have more energy Less fatigue, but you're doing something proactively that you might not even know for the next five years. Like, you might have these toxins in your body and. And you might not feel any symptoms for five years or so. But by the time you have a symptom and you go to your doctor to treat the symptom, like damage is already done and might not be reversible. You just have to take a medication for that, for whatever chronic disease you have.

Got it. So basically go into the source early, right?

Yeah, that's how I really, I think of it. And if you do have symptoms and you already have like an autoimmune disorder or some other kind of chronic inflammatory disease, this is one of the best things that you can do outside of just taking treatment for whatever it is, like, to change your way, because you're actually like, resetting your immune system so your immune system can function properly. Like, our bodies are, you know, diseases of aging, like my age happen because of chronic inflammation, and it just creeps up on you. You don't even really see it. And this is just kind of a way to reset your body to do the things that it's normally supposed to do. Like, our bodies are amazing. They're wonderful. I mean, we all have superpower of healing within us. We're just overloaded, you know, like, kind of like a. Our immune systems are kind of like a crane that has too much weight on it. It just function. It can't function. Then it breaks down. So plasma exchange is like getting rid of that load so your body can go in, fix your immune system, and then you're good to go and you can carry the regular immune load that you're supposed to carry.

It's a good analogy with the crane too, because like, yeah, we are taking on so much even without knowing. But, like, like we talked about just the toxin load and burden that we're all carrying already, but then just our lifestyles. Right. Like in stress, inflammation. I mean, like you said, that's the source of basically everything, right? Like all the disease.

It really does boil down to that, you know, the chronic inflammation of our life.

Yeah, yeah. And. And getting to the cell cellular level where you can clean that out and actually have that function properly again from the ground up. Well, how about let's walk. So let's. I'm your patient. Let's just do this because. And maybe, maybe you'll actually help me. I don't know if I'll go to Detroit or not for my tpe, but, you know, I'M thinking. It's almost like my brain logically is like, okay, what do I got to know before I go? You know, I'm signed up. You know, I know my. I've done my toxin test. If anybody's curious, you can go see it. We did a whole episode on it. So that's where I'm at right now. So, like, what's the stuff beforehand? I should be kind of preparing myself for and then. And I want to get into like the during and then kind of the after. And for me, for me, I have five sessions that Dr. Savage recommended. I heard it's what, three to five typically for folks, right?

Correct. It's typically three to five.

Number one, you can go to any of our locations and our nurses are going to be amazing. So you will be taken care of. So beforehand, you really.

Just have to prepare yourself for the day. So if you're going to fly into one of the locations, just prepare yourself that you're going to be tired like that night of probably the next day if you're. You should probably not drive. Like, I have patients that drive to me, so I typically like, recommend don't drive until you know how you're going to feel. Some people feel great and they can drive afterwards. But the first one, we really want you to just take care of yourself and not drive because you could be really fatigued afterwards. And I would expect that. I would tell you you're going to be real tired, kind of like you have the flu, achy. So don't plan to do anything. Like don't run a marathon the next day. That's what I would tell you.

Yeah. Yeah. Okay.

So plan it out. Like you're gonna need a day or two to recover.

And are you seeing most people traveling in for the procedures?

It's like half and half. Yeah.

Half and half. Yeah. So this, I mean, this is applicable to most people, for me especially, but. Cause I'll. I'd be flying in and essentially flying back out.

Yeah.

Fairly quickly, but I wouldn't be driving, so that's good.

After this whole journey, what I really learned here is like, there are a lot of health conscious people. I think I'm considering myself one as well. But no, there's a lot of things, no matter what you do, you. How much you pay attention to it, how much you avoid it, and sometimes it just got in. And I think TPE give me a good opportunity to restart my body again.

Is there any prep, like, let's say before I hop on the plane, or like, you Know, is it like a week before or just days before going to an office?

Like the day before. We don't want you to eat anything real fatty because if you have like lipids in your blood system, it could affect the exchange. Just there's sensors on there that can. If you have like a fatty meal the day before or that the morning of, like, it'll affect the exchange. So we really just want you to like, eat a normal healthy meal. The meals the day before. But the morning of which is really hard for a lot of people because there's people who are fasting or just don't eat breakfast the morning of. We want you to eat a good meal, good protein, like some carbs. And when I think of a hearty meal, I don't know why, but potatoes always like pop up.

Yeah.

So, yeah, eat a good, A good meal the morning of that just helps prevent like, like low blood sugar during the process with hypotension afterwards.

Yeah. And I've, I've. I've read that as well. It's like just go in full. Right. So you're not fast during this whole thing. You said not a lot of fatty stuff, but get good protein, some carbs and. Yeah. It's essentially satiate yourself in a way where you're not gonna, you know, because it's gonna be a procedure. Right. For a handful of hours. So.

Yes. Yeah.

Got it.

Now the other thing is we don't want you to hydrate the morning of like, don't get up and drink a ton of water. We want you to stop drinking an hour before you come and to your procedure because we. You're in the chair for a couple of hours, so having to get up and go to the bathroom is not an option.

Ah, yeah, I've heard of that. Where. I think it was Dr. Lee, Ed leaves. He was telling me about one of his patients. And yeah, they had to cut it short because one of the patients had to use the restroom.

So we could. We do have urinals and bedpans, but nobody wants to do that.

Right, Right. Right. Right. Point is just. Yeah. Cut off the hydration hour. Ish. Before. Okay, that's fair. Well, how about that? So like Angela, I walk through the office, I greet you or you greet me, like, I guess. What does that look like? What's the, what's the day look like once I get there?

Well, once you get here, I'll ask you if you have to go to the bathroom. Then get your height and weight and your vital signs, let you get comfortable. People usually bring a phone or know ear.

Like earphones. You can talk to me the whole time. I'm totally fine with that. Some people don't like to converse, so they just listen to podcast or anything like book on tape. So then I will scan your arms with an ultrasound to look at your veins. I want like the best vein possible. So we'll start two IVs, one in each arm. So one is the return IV, and that's like a smaller IV. And then the other one is a little bit larger gauge of an iv, because that's the one we're going to pull the blood from that will go into the machine and separate your plasma.

Gotcha. Okay. So basically lounged out in a chair, two arms out. Yeah, yeah, I see different IVs. I like the ultrasound concept because it helps you but also helps the patient not to do a miss or so.

It really is helpful because we want to make sure that we're not putting the IV access up against a valve.