Charles Runels: We’ll start with some research that I think is worth paying attention to and then we’ll answer what questions might have appeared in the past week or so and then a quick marketing tip about how to use our poster. So that’s what I have planned for today but as always, we’ll take any questions that you guys have on the call.
If you’re not a subscriber to the Journal of Sexual Medicine, oh, by the way, we also have some really crazy good press that came out this month on the current Men’s Health magazine.
The one that is on the stands now. It’s the issue that has Mark Wahlberg on the cover. So it’s in every Wal-Mart, every bookstore right now and we have an article in there. It’s titled, “New Year,” excuse my French but that’s the title of it. “New Year, New Dick,” that’s the name of the title and the guy talks about our priapus shot.
As often happens, he doesn’t get the legal part right and he spells Priapus incorrectly, but he puts shot with a lower case “s” and leaves off the registered mark (®) so there really is some pretty sloppy journalism going on (since a little research shows that Priapus Shot® is intellectual property intended to mean a particular way of using PRP injections in the penis and post op and pre op protocols).
But, Andy Warhol said, “I don’t read the reviews, I just measure them in inches.” But this is a really good time to talk about the Priapus Shot®. I’ll send out an email to the group to let people know, but the Priapus Shot® porcedure is really in the news. To put an ad in that magazine costs you quarter million dollars and we have an eight page article now about the Priapus Shot® procedure in Men’s Health, so it’s a good time to talk about that.
So back to this research, it’s pretty easy to summarize and this has been out for a few months and I’ve been wanting to bring it up. It talks about this thing that we all know that women who are put on Serotonin Reuptake Inhibitors often have a drop in their sex drive.
This is the paper that came out... Click to Read Abstract<--
But what isn’t talked about a lot is that even after you stop the medication, often times they keep the low sex drive. So I have a little formula that I use before there was an “O” shot that I’m happy to share with you and then I think combining it with the “O” shot, we should get even better results. But I wouldn’t pretend like only rejuvenating the tissue of the vagina could take care of all the problems that might be going on metabolically in the brain secondary to months on an SSRI.
What I have found works the best is this. I make sure that, I’ll just bring this up where I can kind of type it out. I’m going to put this where I can make it where you can see it. This would be my of handling this and I’ve found that just one thing often doesn’t work. The first thing I put on is I like Depo-testosterone, Depo-testosterone. This is one of those drugs unlike some, where generic is fine, I don’t or I’ll compound it, can even be better in some cases. I don’t like to start a woman with creams because she may forget them, she may sweat them off down here in the south where it gets hot. Lots of things can happen.
Maybe she’s not absorbing it well and if a month later, her libido isn’t up, I have to do blood tests to know whether or not she’s even using it or absorbing it properly. But if I start off with Depo-testosterone 50 mg IM every 21 days, which is a pretty whopping dose and so you have to obviously, you don’t just put her on that and forget her. You have to bring her back about a week to two weeks after the second dose at the latest and you redo blood tests and see how she’s doing. They’ll often say their libido pops up towards the end of that 21 days and then pops back down and then comes up after the second shot and stays there. Then I’ll adjust it and then swap her over to creams or pellets after you get her libido back. But otherwise I’ve found I fiddled too long where that I know it’s in there and I know if testosterone’s going to help, that dose will help her.
1. Depo-testosterone 50mg im every 21 days. 2. Wellbutrin 3. O-Shot® 4. Family &/or Sex Therapy
Then if she needs an antidepressant, which often times she will not after you have her on testosterone, but I like Wellbutrin. It seems to, I’m spelling that wrong Wellbutrin. Anyway, you guys know what I’m trying to write, Wellbutrin. The slow release at 150 mg somewhere in that range. That will help the depression and also help with sex drive. Then of course, the “O” shot can go in that formula now and I like to make sure of course, that someone’s thinking about whatever else might be going on at home socially, or emotionally with the woman. It’s just sexuality and orgasm is such a complicated thing. I have done some of this, talking and counseling and trying to get husbands and wives in. But, it’s time consuming and I don’t attempt it anymore. A marriage counselor or a sex therapist or both. And that combination I think, well I know, that combination has pulled without even using the “O” shot before there was an “O” shot, has pulled my people out of that.
But the reason I wanted to bring up this research, is that most people realize there’s an SSRI syndrome that causes decreased libido, but it’s not often talked about that it persists in many women for unclear causes, even after you drop the off the medicines. I’ll copy this link into the chat box so it you guys want to check that out, you’ll know where to find it.
This is the paper that came out... Click to Read Abstract<--
Okay, so that’s the research for the day and let’s get to some of the questions. If you guys have any questions, just type them in there and while I’m getting to this other research, if you want to contribute to that cause I see some gynecologists on the call, just let me know and I’ll unmute your mike because I know that many of you have experience with this and may want to add to what we just said. And I would love to hear from you. So, there should be a little thing to raise your hand if you have your mike. Some of you don’t even have a mike turned on, but if you do and you want to contribute your ideas to that, let me know because I’d love to hear from you. Let me pull up the next question.
So this is a good question I think. It says, “What’s the longest we can wait after drawing the blood and before spinning and injecting? We’re performing “O” shots intraoperatively at the end of the case, who have a longer case. We like to draw blood prior to surgery. Any thoughts?” In the thoracic suite where people are doing heart bypass surgery, this is one of the places where this has been used PRP, to help healing of the sternal wound postop. The number I’ve been quoted is up to six hours, even after you centrifuge it, it can sit there. I think it’s certainly okay to let it sit there for three to four hours as you’ve indicated here in this question and then throw it in the centrifuge and inject it. That’s the answer to that question.
Now of course, after you push it through the needle or you add calcium chloride to it, all bets are off and I like it to begin the person’s body, preferably in less than a minute or two and I’m always trying to put it once I activate it with calcium. Which I hope you’re doing if you’re doing the “O” shot, activating it either with thrombin, which some of the kits have, calcium chloride or calcium gluconate. After that activation happens, it should be in the person’s body in less than three minutes.
I see Kathleen, if you don’t mind I’m going to have you pull up this next question, talk about how you deal with the ladies in your practice who have been on SSRI’s. Are you there Kathleen?
Kathleen Posey: Yeah, can you hear me?
Charles Runels: So for those of you who don’t know, Dr. Posey has seen thousands of women in her practice, is a gynecologist down in the New Orleans area. So talk to me about how you deal with the women either who are on SSRI’s or who have been on SSRI’s while I pull up the next questions. If you don’t mind.
Kathleen Posey: Very similar to you, that’s why I didn’t say anything except I agree. I mean if they come in on an SSRI and they have diminished orgasm ability, which most of them do I don’t stop their SSRI right away, I just add Wellbutrin and usually the combo is fine. Before I do the O-shot though, I really want the O-shot to work and I really try to ween them off the SSRI on to the Wellbutrin and a lot of the times I’ll do the same thing, I’ll give a shot of testosterone in it at the same time I’m doing a pellet, or I’ll give a shot of testosterone when I’m doing the O-shot because I just want them to get started and pretty much do the same, I use the pellets more than I do the injection but that’s just my preference.
Charles Runels: Okay so when you do, let me catch up with you. So when you do, someone comes in and they’re on an SSRI, you might start Wellbutrin and give them a testosterone injection or a pellet and then either do that O-shot then or bring them back and do the O-shot later is that correct?
Kathleen Posey: Yes but I keep them on SSRI because a lot of times, you know most of them have been on the SSRI so long I find if you just stop it and then just try to get them to go to a [inaudible 00:11:18] it doesn’t work that well. Wellbutrin makes them a little bit more nervous, it’s not as sedating and if you just give it, that’s why even the therapeutic does at 150 the therapeutic dose is 300. So if you just give them 150 it seems to work with the SSRI and then I’ll let them go a month or two talking about the O-shot, talking about testosterone and I usually try to ween them, eventually [inaudible 00:11:56].
Charles Runels: Okay. Alright.
Kathleen Posey: I know a lot of the psychiatrists do it that way too, they’ll just add …
Charles Runels: Add the Wellbutrin, okay beautiful. Alright so here’s another question, it says where do you get your 30 gauge needles and your 1/16th syringes? So if you go on to the, hopefully it’s on here, if it’s not I need to fix it. If you go on to our website what I’ve tried to do is on the how to do page, so you’ll be coming from a different direction but … There should be a link to everything. Maybe there’s not. Nope. I’ll just put, I know it’s on the O-shot so let me pull it up there and I’ll add it to the vampire facelift. If you go to … by the way I just added to, let me pull this up, [inaudible 00:13:08].info … okay.
So in all the others, which I haven’t done yet on the facelift but I need to, all the others there’s a dashboard and when you go to the dashboard there’s a place where it says supplies and sources, also on the how-to-do procedure and when you click on that I just didn’t realize it didn’t have it there, maybe I overlooked it. But I know where it is on this one and right there is where I get most of my stuff from McGuff pharmacy. They have lure lock connectors, they’ve got the needles, they have the 1/16th syringes with the lure lock connection to it and I buy these by the box full for not much, there’s the part number and I’ll put this link in the little chat box and add it to the webpage where we put the answer to these questions.
O-Shot Provider Member's site P-Shot Provider Member's site Vampire Facelift Provider Member's site Vampire Facial Provider Member's site
So actually most of the questions this week were on the vampire facial website and if you guys aren’t yet doing micro needling or offering it for postpartum stretch marks it’s something to think about because I’m hearing more and more that, that’s working. Sign them up for two to three treatments and it’s really working well from what I here, I haven’t treated enough to tell you first hand but I have people in the group who have treated a lot of people with that. So, but there were quite a few questions in the vampire facial and then after these questions I’ll give you guys some marketing tips on how to use those posters. Oh by the way so here, before I get to these four good questions here I just added a new dashboard and a lot of extra content to the facial. So if you go to the vampire facial dashboard I uploaded some new videos, taken from our workshops and so this is the new facial dashboard and if you go to the how to do page you’ll see some really detailed videos where some of the stars in our group, like this one. Of course Dr. Bowen’s published some stuff about this, there’s some really nice videos, especially this one where some people who do a lot of micro needling talk about it.
So, let’s see back to our questions on this page and then we’ll talk about the posters. Four good questions here. Okay first one, where’s the quiz. I’m not sure why that’s not showing up but I’ll put that, make sure it says well there’s a little quiz there to take from some people but if you’ve already had a hands on course then it’s not going to show up. You’re not doing the hands on course you’re certified. But if you’re learning this as part of an online course then there should be a quiz that shows up. Let’s see this one, good morning I have a patient who’s [inaudible 00:16:44] hair PRP after a transplant, he’s been using Minoxidil, it’s on a low dose Finasteride. The hair is now thinning considerably, what about using the PRP after a hair transplant, any noticeable difference back on Finasteride or not?
So I’m going to approve this so it’ll show up and see if some of our hair people will help answer it but what I know is some of the people have told me that they are using PRP. Of course we know it’s being used as part of the hair transplant procedure with improved results, so most of the hair transplant surgeons are doing that now but the idea of repeating the PRP every six months or so is also becoming a thing that’s done standardly to help maintain it. So the short answer to that is yes, there’s evidence that it will help as far as putting people back on Finasteride it makes sense that it would help. There’s this talk of the occasional person who gets depressed from that and I don’t have an answer for that part of it but I know repeating the PRP every six months or so has been talked about among our group as being something that’s helping. Let’s see so how many treatments are recommended for the hair restoration?
So this again there’s not one standard, I will tell you from the things I’ve seen at the meetings, what I’ve seen that’s been published and there’s been a growing number of papers published and some of this there is not a known this is the answer but I’ll tell you what I think is the consensus for now. So how many treatments? Most people go three treatments at four to six weeks apart. How long until they’re visible? It can be up to six months, they have to be patient. But most of us are stopping if we don’t see any results a month after the second treatment, which would be two to three months in and results, as in documenting with photographs, if you see new hair growth and you keep going, most of us are stopping if you’re not seeing anything after the second month. But to be actually happy with what they’re seeing it can take six months to a year.
How long until the peek effect? Just answered that. How long do the effects last? Most people are redoing it every six months or so, just one treatment not the whole serious of three. What’s the recommended fee for each treatment? Anytime I spin blood it should be at least $600 because you have cost of good and your time. Most people are charging and that’s really almost losing money because you have to pay, not only the cost of good for these kits, which can be expensive but your time, the office time, there’s this engine running every minute in your office, you should calculate what that’s costing you by the time all the people are getting paid and the lights and the taxes and everything. Every minute that engine turn cost you money. So to really come out on this, really most people are charging a series of three for somewhere between 2500 to three grand and obviously that’s worth it if you get good results and we’re not keeping the money if we don’t get results. What type of anesthesia do you use? I put on the facelift … I need to put it on the facial side. That’s why this guys probably hasn’t seen it. But on the facelift side, I just put up a new video about hair. Actually, two new videos. So, here’s one of them. 20 minutes from one of our providers up in Canada. And then, this one. This Dr. Mario is been doing hair for a long time. I think it was 20-plus years he’s been doing hair. We filmed his technique for both doing hair, and blocking the scalp. I was somewhere down in Florida when we filmed this. So, those are two new videos that I recommend you watch to answer both the blocking part, and the technique part.
Okay. So, I think that answered all those questions. Next questions, if a patient has Botox recently, how long do you recommend waiting before scheduling a Vampire Facial? So if you think about it, the Botox binds to the nerve blocker about … it takes about four hours, so we tell our people, if you get treated with Botox, wait four hours before you lie down, stand on your head, all that stuff, so that it doesn’t migrate and cause atosis. Now, if you reversed it, and you did the Vampire Facial, you could immediately do Botox. If you did the facial first though … excuse me.
So if you did the facial, you could immediately do the Botox same visit. No big deal. If you did Botox, you could do the facial and probably get away with it anywhere other than the more exacting spots, like the lower face or the corner of the eye, where migration would cause a problem. If you were microneedling under the eye or the forehead, it wouldn’t really matter. Ideally it’s either same visit, go facial then Botox immediately afterwards, and I do that quite a bit with the facial and the facelift. Or, if they’ve had the facial, just give it four hours, so it could be the next day, or later that day if you just forgot and did one in the wrong orders, if you did the Botox first. And I think that’s all the questions on this.
Dana Kirk just put in something that is interesting. Okay. So she says, “At the last International Society of Hair Restoration Surgery … ” You know what? I may just unmute you if that’s okay, Dana, and let you tell us what you … sounds like you were at a cool meeting recently. Let you educate us. Hold on a second. If you’d rather not, that’s okay, but I’d rather you just tell them instead of me having to rehash what you said. Are you there, Dana?
Dana Kirk: Hi. Yeah, I’m here.
Next Workshops with Live Models<-- Find O-Shot® provider Find Priapus Shot® provider Find Vampire Facelift® provider Find Vampire Facial® provider Find Vampire Wing Lift™ provider The Cellular Medicine Association (who we are)<-- Charles Runels: Beautiful. Talk to us. So, you were just at a big meeting. Tell us about the meeting.
Dana Kirk: Well, it’s every other year, and it’s internationally, so they talk about the different protocols. And PRP, probably six years ago, was something that they kind of dismissed as being a standard protocol, and now it’s part of the mainstream.
Charles Runels: Beautiful.
Dana Kirk: Yeah. The recommendation is to … In the perfect scenario, you’re doing two treatments one month apart before the actual transplantation.
Charles Runels: Okay. Beautiful.
Dana Kirk: The jury’s still out as to if they do any A cell or anything during the transplant itself, but during the procedure part, they will go ahead and inject PRP at the same time.
Charles Runels: Uh-huh (affirmative).
Dana Kirk: We do not discontinue the Finasteride. That’s continued at one milligram, and that just stays constant.
Charles Runels: Okay.
Dana Kirk: The Minoxidil is just temporarily for about two weeks, withheld.
Charles Runels: Uh-huh (affirmative).
Dana Kirk: And then, you resume every six to nine months with the maintenance, so that they don’t lose the remaining hair. These treatments won’t affect the transplanted hair, but it’s in preservation of the existing hair.
Charles Runels: Beautiful. Very smart. Thank you for adding that. And then, you mentioned something in your note to me just a moment ago, about low-level laser. Have they started making that part of their standard protocol?
Dana Kirk: Yes.
Charles Runels: Interesting.
Dana Kirk: Yeah.
Charles Runels: Do they have a particular brand that they are mostly recommending, or is it pretty much whatever you round up?
Dana Kirk: I mean, it’s across the board. It’s more about the diodes or the [diudes 00:24:45], depending on what part of the country you’re from how you say it.
Charles Runels: Yeah.
Dana Kirk: How many basic lasers are within that. But for the most part, the device needs to have a minimum of 30, and they need to wear the device anywhere from two to three times a week.
Charles Runels: Beautiful. You got this down. Thank you for all the help. So, stay on the line and have … you and Kathleen both have your mics unmuted right now. There’s another question here from … let’s see. Who’s this? It’s from David. I’m gonna unmute you, David, so you can ask us your question. Hold on a second.
Okay. So maybe the mic’s not working. So David asked, “What’s your current protocol for the O-Shot? One? Or plan on repetitive series?” So, here’s the deal with that. When I survey our patients and when I survey our providers and I ask, “What happens first and second and third shot?” What I hear is that the first time around, across the board, the hard cases and the easy cases, this isn’t merely incontinence where we get closer to 90% or more depending on whose hand it’s in with one treatment for stress urinary incontinence. Not for that, but just averaging them all together. So, this is including hard cases. A woman who’s never had an orgasm in her life and she’s trying to learn how to have an … you know, trying to get her body to respond.
We have 65% of women are delighted after the first treatment. It jumps to 85 after the second one. And so, I had the idea of maybe just making it standard protocol that everybody gets two treatments, sort of like we do with the hair. You know, you sign up, you get two to three treatments everybody. But to me, that somehow didn’t feel fair to those women, which is more than half, who are perfectly happy after the first. Now the other thing is, a lot of people are happy after the first, but if you repeat it at eight weeks, they then love it. So, after the first treatment, her pain went away, Dyspareunia resolved. But after the second treatment, she was unchained, was the word she used. Whatever that means.
So, it does seem to be additive in some people. But again, I didn’t want to make it necessary if it isn’t necessary. So the short of it is, [inaudible 00:27:20] are happy, and they seem to be still wanting to cooperate with you as a patient, do it again about eight weeks later. I wouldn’t do it any sooner, because otherwise you don’t know the results of the first one. So, do it again. And then, if they don’t respond after the second treatment by eight weeks, now you’re into 16 weeks. Eight weeks after the first one, you can repeat it. Eight weeks after that one, you can repeat it again. Then, I would give them their money back. So, that’s kinda how I go by it. If they come back after the first one and they are better, but they still haven’t seen all the results they want, most people want to pay you again. But, if they just saw zero results, I’ll usually repeat the second one without charging them, and then give them back their money if they’re not better after the second one. So, I think that’s probably the answer to that question.
Anybody else have a question?
David: Can you hear me now?
Charles Runels: Now I can. Yes. Now I can. Beautiful.
David: All right. Sorry.
Charles Runels: Any follow-up question to that? It’s good?
David: Okay. The reason I asked that, and I think I asked it once before about three or four weeks ago, is that, you know, I did an O-Shot on Diane. She had absolutely incredible results on her bladder concerns for about 10 days.
Charles Runels: Okay.
David: She was just exquisitely pleased.
Charles Runels: Yeah.
David: And then, she saw that start wearing off, as I’ve said in past conferences. Now, I’ve teamed up with someone. You know Debra Parker, I presume?
Charles Runels: Uh-huh (affirmative).
David: She’s an RN. She said that she has found that some of the practitioners she works with … she’s an RN in Tennessee or Kentucky. I can’t remember. She has said that the protocol that they’ve used in the clinics that she’s working with now, it’s pretty much go to standard three injections and charge $2100 bucks for a combination of three, and that their success has been 95-plus.
Charles Runels: Yeah. I couldn’t argue with that. You know, you may find that some people are well after the first one or two, and are not really wanting to go further, but I couldn’t argue with that at all. It’s what we do with them. Any other PRP procedures, you know, the Vampire Facial’s a series of three. So, absolutely. I think it’s worth considering.
Charles Runels: I wouldn’t consider it bad medicine considering it’s a fairly safe thing to do. In everything we’ve seen, it seems to be cumulative. The other thing that helps if you have … ’cause some people, it doesn’t wear off until a year out, and so do you really? That’s the question I have, do you really want to have everybody go through a series of three if maybe whatever percentage of them would have been fine with just one? I don’t know the answer to that. I could argue with making it a series of three and having a higher success rate. I’m just kind of deciding on a case by case, after each shot, deciding if they need another one.
The other thing that would add to it I think is combining it with some sort of energy source. So when I talk to the people who do energy followed by PRP whether it’s laser or ThermiVa, they do energy then PRP same visit. Their success rate of the first round seems higher and it seems to hold maybe a little longer. Again, do you want to make it the standard for everybody? It’s probably not needed since many people get better with just one O-Shot®, that’s it, that’s all it takes.
But when I talk … and we don’t have the numbers, that’s part, I want to just put in another plug for this. If you go and do our patient survey, which hopefully you guys are still putting people in, we’re trying to get a feel for that because part of the questionnaire asks people, it’s sent to them by text message, all HIPPA compliant, costs you guys nothing, I can give your data back to you. But the person who puts the person in the study puts in, did you do a laser device? Did you do a radio frequency device? Then we can follow survey data about why they were treated and maybe get an idea if it’s truly what I’m hearing, which is close to 100% if you do energy followed by O-Shot® on the same visit first time around.
David: That’s interesting. Okay, well that, thanks for that. I just want to give you an upgrade and to the point …
Charles Runels: Thank you.
David: … Diana said she wants to go ahead and repeat it once or twice, because she had such good results, she wants to have a repeat …
Charles Runels: Beautiful.
David: … and she’d have no problem in doing so.
Charles Runels: Beautiful. Well, thank you for the feedback.
Hey, just hang on the line, let’s see if you have anybody … no other questions. Any other feedback that anybody has, raise your hands, otherwise, I’m just gonna do a quick like five minute, “How to Use our Poster to Get Patients,” tips.
Okay, don’t see any other hands.
While you’re on the line David, have you used our poster to recruit patients? If so, how have you used it?
David: I haven’t really, because I deal with someone who has an existing cosmetic practice, who just has some concerns about artwork and style and things like that, so I don’t want to push it.
Charles Runels: Okay.
David: I have no problem. I have not done it, I have no problem with it, she does, so I’ve kind of backed off.
Charles Runels: Yeah, interesting. She doesn’t think it matches the office, that’s okay.
David: Yeah. I’ve used the brochures and she has no problem with handing the brochures. She has no problem with my talking about it on Facebook Live, etc., etc. I don’t know, I haven’t revisited since the first time I tried, so I’ll do it again.
Charles Runels: It does bring up a good point in that some people … and I’ll meet you here in a second Kathleen, ’cause I know Kathleen’s used her poster some. But it does bring up a huge point in that some people are embarrassed to have it, because they realize you now have a sign in your office that’s talking about sex. It could be that’s she’s saying it doesn’t match with the décor, but what she’s really saying is I don’t want a sex sign in the office and that’s okay. It’s her office, she can decide whatever she wants. Then you’ll go to an office and you’ll see, they got a Cosmo on the table and the front cover is about 16 ways to give a freakin blow job.
Charles Runels: Here’s my thing about offices, my number one rule is, if you’re not taking control of the environment of your office, in my opinion, you’re losing one of the main effects of an office. I have had people occasionally come to my office and I’ll come out to bring them back to the exam room and they are sobbing because they’ll say, “I feel like this is a healing place.” What they’re feeling is that I have taken control of their environment, there is not poison in the air, there’s no TV blaring, if somebody donates magazines to my office, they go in the garbage can, because everything that you can see, read or hear in my office is good for you. I’m controlling it and if a magazine comes in, I’m gonna be advertising Botox and they’ve got an add for some stupid cream that’s supposed to work like Botox in Cosmo, so all that stuff goes out the door.
Then as far as what we put in there, everything that I’ve done, I’m trying to take the John Grisham approach. John Grisham has a rule that he never writes a book that he would be embarrassed that his mother read it. If you look at our stuff, I try to keep that in mind. These posters by the way, sit in India, they sit in Maine, one of my providers sits within a short drive of the LL Bean store, places where … I’m in Alabama in the Bible Belt, so it could be that, and I’ve heard people say, “Oh, I can’t put a poster, because it has about sex.” Again, I don’t know the situation in your office, it may not even relate to what I’m saying, but your comment triggered some stuff that probably needs to be said, which is most people find that they’re patients are so needing something to break the ice. They’re so needing anything to break the ice, because they’re afraid and they’re embarrassed to bring up the subject. Anything that you can do to break the ice, they love it.
They also have on the O-Shot® website a little five questionnaire that says something like, “Do you have pain? Are you able to have arousal?” The last question is, “Do you want to the doctor?” Adding that to the intake form gives you an icebreaker to let you know if they want talk or not.
Having said that, I’m gonna open your mic Kathleen and then I’m gonna give my steps on how to use the poster.
Okay, let’s see, you’re on mute.
Kathleen Posey: Okay.
Charles Runels: Are you using poster?
Kathleen Posey: Yes. I’ve used my poster for years, it fits in my waiting room along with the books that are in the waiting room. All my books are in all my exam rooms.
You’re talking about the patients are saying it’s easier to talk about sex. They’ll come in and say to me, “I can’t believe that you’re gonna let me talk about sex now?” What’s also interesting in what you were just talking, what I’ve also realized, I’ve gotten a lot easier to talk about sex.
Charles Runels: Interesting.
Kathleen Posey: I’ve been doing this goin on five years now and I would probably say six years ago, I either didn’t have the time, I wasn’t comfortable or I didn’t know really how to help them to say, “You know, do you have orgasms?” Now, I have no trouble asking a person about their sex life.
Charles Runels: Interesting.
Kathleen Posey: Six years ago I did and I think most gynecologists do even though we are who we are. My poster has helped, because I’m just a routine gynecologist, it’s helped my practice knowing that I’m doing something different, and if they don’t an email or whatever and having the books. A lot of times the books disappear, but I could care less, because if they disappeared in the waiting room or the exam room, they’re reading it or they’re going to give it to somebody else. I actually give out a lot of books. If they’re a hairdresser and I find out they’re a hairdresser and they an O-Shot®, I give them about 10 books, because they’re talking to everybody.
Charles Runels: Beautiful.
Kathleen Posey: The posters really help me get more comfortable about talking about sex and it’s also, I think, gotten the patients more comfortable that they can ask me.
Charles Runels: Beautiful.
Kathleen Posey: When I was doing surgery, I’d just wanted, you want to put that hand on the door when they start asking about sex, you want to run through it, I don’t feel that way anymore.
Charles Runels: Beautiful. Well, you bring up several good tips. One of them is, which before a lot of things that have happened over that last few years, not just with the O-Shot®, but other things. Why bring up the subject if you don’t have lots of options or at least some number of good options as a solution? You don’t want to bring up world hunger in part of your visit, you can’t fix it. Obviously sex isn’t world hunger, but we didn’t have as many options even five – 10 yeas ago. Now that we do, it’s more easy to bring it up. By the way, I think …
Charles Runels: Yes sir.
Charles Runels: Yes.
David: Dave again.
Charles Runels: Oh, yeah.
David: One of the things I’ve used as a … I don’t have as many stories as you do, so I use your stories.
Charles Runels: I mean good.
David: I strongly suggest people do until they have their own. I had a woman in the office today who came to me for orthopedic issues. As you know I’m an orthopedic surgeon and I do a lot of orthopedic BLP and stem cells and peptides and whatever. In the process there of, she said, well you know she knew my associate very well, said, “I’ve known her forever, she’s done all my facial stuff and everything else. What else do you guys do?” Man that was just a perfect opening to be able to discuss. I didn’t have a poster in the room, but I turned on my verbal poster and I started telling Charles stories about your urologist friend and taking off the market by the FDA of the product for urinary incontinence, how horrible slings were except in the cases that had to have them and it when on to the girlfriend and the banker and to this that and the Sunday afternoon when you tried it on yourself. She was just like, “Oh my God, this is incredible. I had no idea that this existed.”
I encourage people to use you until they have their own stories.
Charles Runels: Beautiful and that also brings up another thing, the people that have done well with us, like super well, like Kathleen where they’ve had really really good results as far as the marketing piece, they are out there telling stories. They’ll do a YouTube video, they’ll interview a patient, patients tell their story. Stories are the best way, that’s really how a lot of people learn.
This is where the shot lives, if someone wants to pick one up and I’ll try to expand it where you can see it a little better. That didn’t expand it, just made me try to order one. But anyway, it’s written in a … Here’s the quick way to how to use it and we’ll shut down the call.
If you guys don’t mind I’m gonna mute this a little bit, I’m gonna mute some of the microphones, but I’m happy to unmute them if somebody needs that done.
Here’s my quick version of how to use the poster.
You have it sitting at a place they will be staring at it if there’s any moments waiting in your office. Not just this poster, any poster, something you want to you sell. If you notice, the bottom of the poster has a website on it. You would like for them to go to that website on their iPhone or their iPad while their waiting and find out something about it. If they ask you what the O-Shot® is and they haven’t done that, it’s a very difficult thing to explain in the office. Especially for your staff, whose phones ringing and they’re busy, they don’t want to explain it. They’ll tell them just enough to scare them off.
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When they inquire about it, the best thing to do is do what you heard Dr. Posey do, which is hand them a book or a brochure. Something that they’ll have with them physical to look and think about so that they teach themselves about it. I wouldn’t even really try to push it to a conclusion while they’re in the office, it’s too much for them to figure out what PRP is and whether they want something. You just let them know that it’s available. You don’t want to push it on someone who hasn’t thought about it and is pretty certain that’s what they want anyway. You hand them a book or brochure. I have mine in a little stack, with a little not by it that says, “Free, take two or three.” Otherwise, they feel guilty about taking one.
I have a standing challenge, so far no one’s ever called me out on it. If they do I’m happy to keep my promise, which is that if you give away 10 O-Shot® books in your office, I don’t mean throwing them out like at one of our Mardi Gras parades or stacking them up at the gym, but I mean someone taking it from your office or you handing to someone and saying, “Here, this tells you more about what’s on the poster.” Or, “Here, I think this may help you.” If you don’t get at least one patient for those 10 books, I will send you 10 more books. That’s a standing invitation, because if you don’t get one after 10 or 20 books, then I need to talk with you more about how you’re talking about it. You should be having at least one or two, often times you’ll get two or three people for those 10 books. You’re not just obviously doing a procedure, you’re changing their life. You’re changing their relationship many times.
That’s the quick version of how to use these posters. You don’t want it in the hallway where they’re passing it. One of our providers actually has it in the bathroom, so when they’re urinating, they’re staring at the poster. It could be anywhere where they have to sit for more than a couple of minutes.
I see Kathleen’s hand back up. Let me undo your mic and then I think we’re gonna call it a day.
Kathleen, you’re back live.
Kathleen Posey: Actually, that was an old. My hand was …
Charles Runels: Oh alright.
Kathleen Posey: … a while ago.
Charles Runels: Okay, so you guys have a wonderful week.
Kathleen Posey: I was actually gonna ask you a question about …
Charles Runels: Okay, go for it, I’m in no hurry. Go.
Kathleen Posey: It was back with the testosterone. Before I give testosterone or pellets or even an O-Shot®, just personally, I get their pre and total testosterone levels.
Charles Runels: Yes.
Kathleen Posey: What do you think the normal levels in a female should be? What is the limit of high that you will let it go to? I do the thing because again, it’s so conservative I want it for the boards to show that it was frankly non-existent and that’s why I gave them the testosterone. What do you do?
Charles Runels: Okay, so …
Kathleen Posey: What do you think?
Charles Runels: We’ve sat through these lectures before, as you know listening to Erwin Goldstein speak who edited the Journal of Sexual Medicine for seven years. He’s high on this website, which I’m gonna through into, post into here, which is using pre and total testosterone and sex finding globulin to calculate the pre testosterone level. If they’re having symptoms, then I like for … this is showing you all the calculations that computer’s doing for you … I like for their pre-testosterone level to be in the upper 25% of normal, that’s what I calculate for. If it’s in the lower 50th percentile, then I’ll add to it. If check it and if it’s high, and it’s above what’s normal for free, I will drop the level. I think if you don’t do that then you are sort of opening yourselves up for problems. If you’re looking at problems, not I don’t think medically, but politically it’s interesting how testosterone because of the athletes abusing it, it’s become a target for all the things with three letters, the DEA and all that.
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Even though there’s lots of evidence and I know there are physicians and women out there who feel better with the pre-testosterone that’s higher than what’s normal for a female, and I don’t think there’s anything medically wrong with it if you’re following them clinically. I’ll tell you one scenario. I had a poor little lady in her 80s who fell and broke her humerus and was teetering ongoing to a nursing home. I make no apologies, she was still bright minded and just a beautiful hearted woman who lived down the street from me. I put her on a man dose of testosterone, sent her to my favorite physical therapist and we got almost 10 more years of her living independent at home. She got a little hair on her lip, but we’d go have tea every day and she loved me and she was independent for another almost 10 years. Was that bad medicine? I don’t think so. I’m not giving her prostate cancer, she didn’t care about the facial hair so much and we had a good time. But, as far as politically goes, I think pre-testosterone that’s what you follow and there’s the calculator for it, which I’m told is more accurate than letting the lab calculate it for you using those two. You get a sex hormone bonding globulin along with the testosterone level and that’s how you get it.
Again, I start them on that 50mg IM and they get the feeling of it and they kind of blast them off and then I can drop it if I need to.
Okay, you guys have a lot of good information. A crazy good call and happy with all the participation.
Okay, I think that’s it. You guys have a great day. Good-bye.
Charles Runels, MD
Inventor of the Priapus Shot®, O-Shot®, & Vampire Procedures® (facelift, facial, breast lift, wing lift)
Charles Runels: So, let’s start with a question. I’m going to start off with a question that comes up quite a bit concerning the Vampire Breast Lift®. And it’s a nuisance problem that happens either … so the question is from Dana Kirk out of Texas. She says, “I’m considering the breast lift to improve the rippling effect that women have following breast augmentation.” Most notice it usually in the lower pole or the lower lateral quadrant. And, it’s true. You can do things to try and make that better using either AlloDerm graft or sometimes people just replace the whole implant.
So, here’s a couple of ideas. Let me show you some pictures. Best way to answer that, I think. So, let me swap what we’re looking at. This is … I don’t know if you guys can see that. Can you guys still see what I’m showing you? Anyway, so this is one of our providers, actually, who had this nuisance, double bubble. And, not so much a nuisance, but still somewhat a bother, the cleavage was a little bit further from the midline than you would want. And even further on this side than the other.
So, what I did was I took two syringes of Juvederm, and, basically, used it like a liquid Allo graft. And pulling the tissue away from the breast … and I’ll show you a diagram in a moment how that works. But pulling the tissue away from the breast, and then putting two syringes of Juvederm Ultra Plus here, and one syringe of Juvederm Ultra Plus there. And, by the way, this was after a second surgical procedure. So she had this done by an excellent breast surgeon, and had it repeated, and this persisted. And, so, this was three months later. And, so you can see, not only is this rounded out now, but this is better and that continued to … it’s now been over a year and continued. And she went from wearing this bathing suit to hide the double bubble, to wearing that bathing suit.
So, that’s what’s possible. And I’ll show you where to see in even more detail as far as rippling goes. If you go to … if you just actually Google Vampire Breast Lift®, once you just pick up Vampire Breast Lift® … because a lot of these articles picked up one of my patients who had rippling. And you can see this is what she had, and I did the same thing. She wound up taking two syringes here because there was so much volume loss. So two on this side, but it took only one to take care of this rippling. These are saline implants. But you can see there’s almost just skin on top of tissue.
So, the technique here is important. And if you got to our website here … I’m on the Vampire FaceLift® now, on the members side. This video … and it’s also that same videos on the breast lift where I show in detail how to do that. And you never have to worry that you’re puncturing the implant. So, it’s actually one of those nuisance things that we have a solution for, and much, much more satisfactory than going back under the blade. So, thank you, that was a good question. We get that a lot, so it’s nice to finally have the answer to your own video.
Now the other question I got today had to do with hair growth. And I’ve left this here … again, I’m on the Vampire FaceLift® how to do page, the member side. And I have here a pretty detailed recipe for vampire … for growing hair using PRP Vampire Hair Growth. And I put a link here to the Acell site. I should probably take this down because most people doing this now are not using ACell as part of their injection. I’ve talked about this some before, but I worry about cross-immunity using animal products. I know there’s no serious sequelae that I know of that have been reported, but, still I was involved in a smallpox study once where we had to stop the study because people were getting subclinical myocarditis from the cross-immunity.
And so I’ve become more wary of this. I’ve left it here because people ask me about it. The ACell people market their product. It’s an acellular matrix of pig bladder. They market their product more for wound care, anyway. And the research that I’m seeing coming out for hair growth is impressive and growing, but it’s used with PRP alone.
Anyway, someone asked me about what my protocol is. I’m mostly just using PRP as a stand alone, now. But if you want the recipe that includes other things that may be of help, it’s right there. Now, as a help to you guys … I haven’t posted this yet, but I’ve got two videos in the queue from two separate experts in hair. This Dr. Mario Stephan has been doing hair for many years. I think he’s had over 20 years. And he shows how to do the block, and he shows how to do hair. And then here’s another one of our providers up in Calgary, Canada who’s a prominent teacher there. And I’ve just kind of had this in my back pocket. But I will post this to the websites for you guys to review if you want. You can see they’re both a couple of months old. I just haven’t posted them yet. So, that’ll be on the membership site. I’ll put it on the facelift website. So, that should answer all the questions about hair.
There was … let’s see. So we had that question. There wasn’t any questions about O-Shot® this week from our providers, but I had a couple questions about marketing that I thought were very good. And it’s things that I don’t normally cover except on my hands-on workshop. But I thought I would go ahead and answer it. And it has to do with how to make a webpage.
So, this is how I would make a webpage in literally less than five minutes. So, if you’re looking at … you’re just staring at the internet and you’re looking at anybody’s webpage … let’s say that you want to make a page about … I don’t know. Let’s just pick something that’s not even our stuff. Let’s pick Botox. And you live in San Diego. And you’re thinking, “What does the top page look like?” So, if you Google Botox in San Diego … so, this is the first step to making a webpage in five minutes.
Okay, so, step one. You Google what it is and the city you live in. If you don’t live in a major metropolitan city, put in the closest metropolitan city to you and maybe even your state, but at least the closest city. Step two is you scroll down, and the first thing you’ll see usually is ads. You scroll past the ads, past this where Google is directing you to places. And you start looking for the first website that is not … you’re looking for the first website that is an actual provider.
So, you’re not in competition with Yelp. This looks like the may be … so the second one down looks like it may be an actual provider. So we go to … we click on that. Okay, so, what you’re looking at now is the cheat sheet. Because what you’re looking at is what Google thinks is the top website for someone doing Botox in San Diego. So, how do you take that and create a webpage that, preferably, beats this one?
So, I would start by doing step two, which is you now … I’m looking at this, and the browser I’m using is Firefox. I like it because, as a programmer or website builder, it works more functionally for me. But when you want to see what Google likes, you want to get Chrome. And so you just Google Chrome web browser, Chrome browser. Because Chrome, by the way, what is a browser? All a browser is is something that takes computer code and turns it into something like this, so it looks like a newspaper or a magazine. But if you look at the actual code that is creating this, it’s something that only a computer person can basically read. So Chrome and Firefox and the others are just computer programs that turn code into a magazine page, basically.
But, if you want to make something that Google likes, you want to see the world through Google’s eyes, and that is Chrome. So you would go to Google Chrome, and then you would download that for the next step, of course I’ve already downloaded it, so I’m going to pull up my Chrome browser and I’ll swap over and let you look at it through Chrome for the next step, okay?
So we’re still doing this step by step. So we found the webpage that looks like what you want to … That comes up first for what it is you want to do. So now I’m going to the Google Chrome thing, and we’ll put in that same thing. Actually we could have just started with Chrome. But there’s the web address, and now we’re looking at it through Chrome’s eyes.
Now, here’s the next thing you do. You go back one, we’ll hit the little back thing. And, let’s do this again. So I’m going to Google Botox and San Diego. All right. Now, if you go all the way down, at the bottom here, Google is telling you other things that people pop into the search engine when they are looking for Botox in San Diego. They’re giving you the cheat sheet. So if people are googling Botox San Diego prices, maybe you want a webpage that’s about your price. If they’re googling Groupon, in my opinion don’t really want the Groupon people, but maybe you make a page that’s called Botox San Diego Groupon, and then you talk about why you don’t like Groupon.
But these are the things they use, so we’ll get back to that. Those are, when I say they use, these are the words that people often type into the search engine when they are looking for Botox in San Diego.
So what we did is we found the first one that wasn’t a company, we found the first provider and it’s that. Now the next part, I’m going to have to expand my thing here where you can see better. So I’m going to show you my whole screen and let you see what I do next. So don’t let this freak you out because it’s going to look a little bit scary, but I’ll show it to you step by step.
All right. Up here in the left hand corner, hopefully you can see my arrow swishing around. In the left hand corner you see view, I clicked on view. And then if you go down you see developer, and you see view source. View, developer, view source.
Now if I click on this, it changes it. This is the actual code. We’ll go back and look at this for you. So that was … That’s the code that was making that pretty page we looked at a minute ago. But it’s given you what … So Chrome is the software that turns this into something that looks like a magazine page. So Chrome and Firefox or whatever browser you’re using, are just software programs that make this look like a page.
But this is what it’s doing for you. There’s the title, and so if Google likes that, maybe you should make your title Botox, San Diego, maybe put La Joya in there. Anything that’s true you might add to it. And that little straight up and down line right there, you don’t have to know how to make it but if you want to know, it’s above the backslash on your software. But we’ll get to that.
So then if you scroll down, you’ll usually see something that has, you don’t have to read the code, you just, I’m looking over here to the left for something that says description or keyword. So you see this where it says description? So there’s her description.
And what this does, it shows up in the little search box thing, so offers same day appoint- late appointments for Botox plus great specials and deals in San Diego. Get the inside info with our Botox buyers. That’s a huge thing. People, Botox is an emergency. It’s often a true emergency. People are thinking, oh my grand baby is going to be born next week by Ceasarean section and forgot about my Botox, I need to get it today because it’s the only day I have before the delivery. That sort of thing.
So if you’re not offering same day appointments for Botox, you’re losing patients like crazy. And this person’s smart enough to know that and put it in the description. And late appointments. So there you go.
And then if you look down here somewhere, not always but usually you can find some key words. I’m just looking, there’s a description. Let’s see, what else do I see? Organization. This looks like these are key words right in here.
Okay, so you just note those things and you put them … What we’re going to do is take this and copy it. Watch this, I’m going to copy that. And let’s go back to looking at it like a normal person looks at it.
Okay, so this is the source and this is that. Now I’m just going to pull up … All you have to do is have whatever you do to write a letter. Whether it’s Word, or if you have a Mac and use Pages. And we’re going to make a new document.
So a new document. I’m just in Pages, this could be Word, whatever you like. And then we’re copying that description. Okay, and I’ll go back over here and I’ll get the title too and throw that in there.
So first of all what is a website? I want you to start thinking about your website like … This was the same title that I showed you how to get a moment ago. Think about a website as just an electronic filing cabinet. That’s it. It’s electronic filing cabinet. So let’s go back and look at this and see how your filing cabinet is organized.
It’s a lot easier to build a webpage in five minutes if you understand what they are. So looking up here at the address, your domain name, think of it like the name of your filing cabinet. So this person’s domain name is LJCSC. Which is kind of cool that they’re able to get a five letter initial. Those are kind of hard to come by now. But LJ for La Joya I guess, Cosmetic Surgery Center. So LJCSC. That’s the name of her filing cabinet.
Now the first part here where it says face, that would be the name of a folder. So you can make a folder that is about face, and if you’re a gynecologist you can make a folder that’s about whatever. About hysterectomies or dyspareunia or whatever you would like to treat. And then the next thing is the name of a page in that folder.
So that’s it. First part is the name of your filing cabinet, and then the forward slash. The second part is the name of a folder, and the third part is the name of pages in your folder. That’s all a frickin’ website is. Just a filing cabinet.
Now, with that in mind, let’s talk again about how you’re going to make this page in five minutes. So back to what, and I’ll tell you want to do with this in a moment, but you’re making, you don’t have to be a coder. You’re going to make your domain Doctor whatever it is, XXX.com, forward slash, Botox, forward slash. Or if you do lots of things for the face use face, that’s what she used. And then put Botox.
And now, this is the name of your filing cabinet, this is the name of the file in the filing cabinet, and this is the name of the page. It used to be, back when Clinton was elected, when Clinton was elected there were only 33,000 or so websites in the world. It’s hard to believe now that recently they’re just so … You would get a domain, you would get all the search engine traffic just by having a name that was the right thing, so it was much simpler. Now it takes a combination of things, but I promise you, if you do what I’m telling you now, you can rule a city and most times rule your state, or within a 200, 300 mile radius of where you’re sitting using the techniques I’m about to show you. It is important how you create the web address, so the person, you’re not going to have to make the website, but you’re creating the document. You’ve probably figured that out by now, that you’re going to send to the person who’s going to build it for you.
If I just give you this blank page and say, “Okay, you need to make a webpage, or type out what you’re going to do with a webpage,” most people … I don’t like looking at a blank page. After doing websites since 1998, however many years that is, I can stare at a blank page now and do okay with it, but I still prefer to start with something. That’s what we’re doing. We’re starting with what we know Google loves and we’re creating something that’s going to turn out to be personalized. Your domain name will be different than hers, but you’re still going to use the Botox. Look at this, she used Botox-her name of her city, so that might be a good thing to do too, right? No reason why you can’t do that same thing if you live in San Diego. You can see why Google’s going to like that.
Back to what we’re doing over here, the document we’re creating is going to be Botox-San-Diego, or New Orleans, or wherever you live. There’s your title. Only, instead of La Jolla Cosmetic Center, of course you’re going to put the whatever, Dr. Jones Clinic. I would go ahead and add in, remember that cheat sheet we looked at a minute ago, there’s no reason why we can’t outdo this person. Let’s go back over here and look at that cheat sheet. Here, so this is where we started, so the cheat sheet was this down here at the bottom. Which one of those … Why don’t we take that, let’s just copy all these into our document. Here’s sort of my philosophy, you write for people, but you don’t write for Google, but you use words that Google likes. I guess that’s a little counterintuitive, but that’s how I think about it. Let’s get that crazy thing out.
All right, so which one of these might we put into our description? It liked Groupon, prices. Even if you don’t use Groupon there’s no reason why you can’t put it there and just say in your page that, “You don’t do Groupon,” but give them a reason why you don’t. We could put … Why don’t we put, prices? It likes the word, injection. It’s got San Diego, Mission Valley. Why don’t we put San Diego in there too? Now, where would this title show up? Again, if you look at the … If you go back to here, her title was whatever it was. Hold on a second, we’ll look at it. The title’s important. Her title was here, right? San Diego, La Jolla Cosmetic Surgery. We pulled that from the code. You didn’t have to, because you can see the title. When somebody Googles something, that’s what they’re looking at, the titles. Your person who’s going to build your website for you now needs to know what you want the title to be.
What we just did over here is we created a title that included things that we got … Well, I put San Diego on there twice, didn’t I? We included things we got from her, because we knew Google liked her website the best, but we added in something we got from the other words that Google likes, okay. I’d probably put a little thing right there. No, I’m not. It’s hard to say. I would put something there, but that’s not what hers did. Sometimes the least little thing like that can make a difference. Okay, so now we have a very well thought out title that’s going to show up over here and help bring attention based on what we know. All right, so we’ve gotten a title, we’ve gotten a description, we’ve gotten keywords. Now we still need to write the webpage, so how are you going to do that?
We go back to this lady who’s beating them. The next step is going to feel like not a good thing. It’s going to feel like it’s somehow illegal, or not proper, but it’s okay and I’ll show you why after we do it. What you’re going to do now is you’re going to go … I’ll let you see my whole screen again. Go back to my main screen and up to the top we’re going to say, “Edit, select all,” okay. You can see now we’ve highlighted her whole page basically. Then you go, “Edit, copy.” Now, as soon as I click the copy thing, you had a flashback to the sixth grade when you were taught you’re going to go to the principal’s office and be extremely embarrassed if you copy somebody else’s work. We’re not going to copy her work, we’re just going to use it as a guide. Let’s go back to our pages thing and then we’re going to say, “Paste.” It’ll take a second because it’s a lot of stuff.
Now, let’s paste it in there and we’re going to make it better than what she’s done, but we’re going to use her website as a guide. I would start off with, this picture is not a picture of the doctor. Actually, it’s a picture, see, of a patient. It’s a pretty picture. I mean, she’s got her shirt open. You can see her little bra right there. That’s kind of a sexy picture, but people want to see the provider. They don’t want to see a picture, in my opinion. The first thing I would do is get rid of this and you’re going to want to put in the place of it a video that you make about Botox. What would that look like? I’ll show you some of our people that have done … Been to my class and what they’ve done. You just … Let’s go back over here. Let’s see. Let me just see who pops up here. I put, “O-Shot video.” I’m going to go down till I find one of our people.
Okay, here’s one of our providers. I’m on YouTube, I want to be on his website. Let me see if I can find that one. Here’s an example from one of our providers who’s done well and if you look at her … This is her O-Shot page, and she’s been to my class, and obviously successful before I met her, but you can see on her page at the top of the page is a video of her talking about the O-Shot. Then there’s another one of her doctors that works with her talking about the O-Shot. That’s what I mean. You just shoot a video and I have on the membership sites, in the marketing side, I have videos that tell you how to make a video. Of course, I teach that in more detail in my workshops and we practice it, but people want to see the face of the person who’s going to do their stuff and they will judge you more by a video and the people who don’t connect with you will go away, which is a good thing. But, many of them will connect with you for many reasons. People who would never connect with me will connect with you but they don’t have an opportunity if there’s not a way to connect with you. The best way to do that is a video. At the top of this, I’m just going to put a placeholder that says video that you’re going to make. Many of you will hear me say that and not do it. Let’s go back to the page. I just put video. I’m telling you the top people in our group, do videos. If you’re not sure of that, go to the membership site. Look under marketing and watch one of the videos or come to my workshop. You can watch that and get started with it. It doesn’t need to be fancy. You can have someone hold an iPhone. Most of our people, that’s what they do. Somebody just holds an iPhone and you talk.
You put a video there. This is the copy of the page that she did. That one thing is going to make your site perform better. People ask me, “Well, how do you do … ” Can you not hear me Kathleen? Is no one hearing me? Can you guys hear me? You guys type in the chat box, if you would, if you hear me ’cause I, Kathleen said she can’t. Okay, all right, you guys can hear me now. Okay, so must have faded out there for some point.
Back to how to do this thing, thanks Kathleen, I guess I missed it whenever I was faded out. Now, let’s look at this and see what’s good and what’s bad. Let’s see, we can take that out. Botox, professional, okay so here we’ve got a quotation, let’s just take this out and put in here testimony. She didn’t even put the person’s name, just said it’s a real person. I would prefer that you get their name. Get somebody that you’ve helped and put their real name there. There’s another place where you can out perform.
This crow’s feet, brows line, persistent expression, whatever, comma, that looks kind of salesy to me. What I would do here is just say list things that you treat. Basically, problems. As soon as you want to possible certain things, I should call it problems, as soon as you can, because people get Botox because something bothers them. They want to see, on your list of problems, their problem. Now you’re really kicking butt, because you have a video here where you’re talking about the procedure, you realize this would apply to any procedure or product, now, you have a testimony, then you have a list of the problems that you treat. So, with Botox, maybe it’s migraines, crows feet, gummy smile, what else you treat? You get the point, droopy brow, one eye smaller than the other, whatever advance techniques you do, you put them there.
Then, same day recovery, that’s interesting. Same day treatment I would say, but same day recovery, whatever, they seem to like it, and then book a free consultation. I don’t really do free consultations, but if you want to do that, that’s fine. I would say book your appointment with a link to wherever, whatever software you use to book appointments. I’ve been using Calendly, I’ll show you that. You go to, and I’ve had good results with that, but there’s lot of software out there. Calendly.com. They have a really nice software for booking appointments online.
I think you get the point, basically, you, back to review what we’ve done, you Google it, you find the top one that’s a doctor or provider, you take their title, you take the key words, then you tune up the title using the key words, you use, if you can, a very similar address, thinking about what a website is. Using your domain name for the name of the filing cabinet. Next name is a file, then next name that. So, under face, you might also have Ampar Facelift, whatever. You just tune this up. You keep, well, obviously that’s a generic Botox picture and before and afters that you could keep, if you’re doing Botox and using Allergan, which you should always be doing, getting it from Allergan at your local provider to keep everything clean and legal.
There you go. Then, these before and afters, I’m not sure if that came from the Allergan website or not, but they do have stock photos that you can use. Use yours, if you can. If you did that, with any web page, I haven’t got to where to send it yet, but I’m getting to that next. If you did that process with any web page, now you have a Word document, or whatever you word editor document that you have, and now the next process is you’ve got to have somewhere to send it.
Let’s go back over here and I’ll show you options. There’s several options. One is, first of all, what kind of website do you want. I still think the best thing to build it with is a WordPress website. WordPress, in the old days, WordPress was not so secure, it could be hacked more easily, it was basically a blogging software. But that’s not true anymore. It’s very secure, and something like 40, I don’t remember the exact numbers, but it’s something like 40% of the websites online are now WordPress. It’s secure, but the thing it does, because there are so many WordPress websites out there, it does a couple of important things in my opinion.
One is, it allows you to create a post without having to call your web design person. I can show you how easy that is, very quickly. Let’s say that I wanted to make a new page for the [Oshot 00:37:18] website. All I would do is log into it. Look over here to my different browser, hang with me. Firefox is what I use to do this with. Won’t matter with you if you’re not, if you’re just posting and not programming, but I prefer Firefox. So back in, this is me logged in to the Oshot member’s site. So if I wanted to add a page, all I have to do is click Add New Post, and be patient. It’s going kind of slowly, for some reason. Then type in the title, type in what I want to say, and it works just like your Word document. So I could say example, and then I could say here blah, blah, blah, this is my example.
I could put in whatever pictures I want by just clicking on add media. If I need to upload a file, I can just upload a file. Let’s just take the media library and we’ll just put something up there, just to show you how easy it is. Pop that in. Okay. Then I’ll publish it just so you can see how easy it is. I’m going to click and publish it. Okay. Then, I’ll let you look at it. It’s that easy. Basically you just type it in like you’re typing a Word document.
There it is, came up. There you go. So that’s how easy it is to make a web page. Easy, easy, easy. So, obviously, I need to take this one down so let me take it down. But, if you’re website, so why would I not want you to do this? If I’m building websites, here’s some tricks. Oh, I haven’t told you how to get this done, let me just discard this for a second, then I’ll show you how to get it done. So I want to discard, move to trash. Okay. Gone.
This is just a list of stuff I’ve posted. Whenever we finish these webinars, I’m filming it. I just take the recording, and I post it just the way I showed you. But, while I’m, before we go further, I’ll show you where you can get this done. So, go to Upwork.com, this is my favorite place to go, and when people, you can hire people here, they’re legit, they get graded like a Uber driver, so if they rip you off they know they’re going to not be able to do business here.
I recommend you use somebody they’re from the U.S. or the Philippines. Philippines seem to understand us well. People from India are kind, I have more trouble with the language, but they’re kind and brilliant. You get but, you, this is where you put out a bid, people for work for you, when they are working, their screen, when they have to log in through Upwork, and that starts the clock. They’re either pay you, or you pay them by the job or by the time they spend working on it. You can get some really nice work done here and that’s what I recommend.
Charles Runels, MD
Charles Runels: I’m doing this broadcast from Las Vegas today. There’s an [A4M 00:00:12] meeting and I was trying to make sure I’m up to date on a few things. I bumped into one of the authors of this textbook.
I’ll try to let you guys know what I’m doing to try to keep up with our area of interest. I found … One of the authors who’s a Pharm D [Angela Pressman, PhD], wrote a chapter of this book and she alerted me to it. I haven’t read it yet, but I bought it and I’ll let you know, but it looks like it could be relevant to what we do.
Let’s see what else is going on. I want to let you guys that we’ve put out some … We’ve put out a press release about some of Dr. Posey’s research about the O-Shot® (Orgasm Shot®) procedure and treating lichen sclerosus …so you may get some questions [from your patients] about that. I thought you might want to know more about what you should treat and what you shouldn’t treat if you’re doing lichens sclerosus. She’s actually on the call so I think I may undo her mic so she can tell you some of her thoughts about this research and how to know when to treat this and when not. She does a class and you might qualify to begin that class and that’s classroom … That’s a good thing. I’m going to unmute your mic, Kathleen.
Here we go. You there Kathleen? Hello?
Kathleen Posey MD, FACOG: How are you doing? Yeah, I’m here. Can you hear me?
Charles Runels: Yeah, so I just want to brag on you a little bit. I know this … I’m getting a lot of inquiries about lichen and some of it, non-surgeons are qualified to treat and some you refer instances like this. Maybe you can address what to look for, and how to take care of people, and not get into trouble. Your latest … I know that where you’ve been working for this protocol now for … Of course, you working on the surgical side and me taking notes on the PRP side, and doing the … Well, we published two papers with Andrew Goldstein and we published this so you talk about what you’re seeing and what your latest thoughts are of treating lichen if you don’t mind.
Kathleen: Okay, what I see a lot or hear a lot is the patients come in and tell me they are having painful intercourse, and they either bleed, or they tear, and or their ability to have an orgasm has really decreased. Usually, by that time, they have pretty advanced lichen. I do my exam, but they haven’t had a biopsy. I do biopsy everybody. Then I give them the offer. I offer them the option of doing the O-shot along with other PRP after I release the adhesion at the …
The main adhesions that are stopping them from having intercourse are down at the [inaudible 00:03:27]. It’s a band that forms there and there’s a lot of hesions between the vagina and the rectum. The clit, the formosis of the clitoris, I find, decreases the sensitivity and some have pain, but some have no pain. It’s more that they want to look normal and feel like a woman again, and they think their clitoris has gone away, which, of course, it hasn’t. It’s just covered over by scar tissue.
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With these patients, I start off releasing the various adhesions. Especially like this lady in the picture, you couldn’t even get … You couldn’t even do an O-shot right from the start because her vagina’s about the size of a pinball and you can get in there, and you can’t really get too much by her clitoris. I will release all the adhesions. By the time she left, I was able to do an O-shot, but where I also put the PRP is anywhere I’ve done surgery. Then I really infiltrate about 3 cc’s down to the post [inaudible 00:04:29]. I’ve also taken a 15 blade knife many times and gone up and down making slits and then spreading it so that they’re wider in the posterior part of the vagina, and the put the PRP on top of that.
About half the time it takes two applications. The second one I do six or eight weeks later. I’ve been doing this now for four years. This lady’s pretty bad, but I saw her about a month ago and she’s got more adhesions about the clitoris. I just … At first, this one, she couldn’t even urinate correctly. I had to release some more … She’s still able to have intercourse not hurting and not … I treat her about once a year, now, that lady. There are some ladies … Go to the last picture.
Charles Runels: This one?
Kathleen: No, go to the last picture. Keep going. Another one.
Charles Runels: That one?
Kathleen: Okay, this one. Yeah. Okay, that is the same one. This lady is not so complicated, but it still is hard. That clitoris is really bound down. When I first saw this lady, I was really afraid I’m going to have to take her to surgery, I’m not going to be able to do this, but this lady, I was able to unroof her [inaudible 00:06:04] and then you see what I’m talking about in the post [inaudible 00:06:08] is that band there?
Charles Runels: Yes.
Kathleen: You see that, Charles? That band?
Charles Runels: Yes.
Kathleen: You’ve got to release the band. Show that previous picture. Yeah, no the next picture where she’s treated. Where she looks normal, that’s it. See, she’s pretty … She came back … Can’t remember this, but I’m thinking one of the worse … I think it was six months later, I only treated her one time. Yeah, it was treated one time and she said, “I just put a white … Walk around where my index finger is, will you please retreat me?” She was having no pain, you’re unable to have intercourse where that first picture she was having a lot of pain.
I think that I’d be willing to train anybody who has some surgical procedure. This one, probably anybody that could do surgery, some surgery, can do. Those other ones, I don’t know. I think you’d probably have to be a gynecologist or urologist to really feel comfortable because you can get into some bleeding.
Then there’s the other patients that really … I had patients that have no scarring about the clitoris and just have that little band. I think you could treat that too. This lady-
Charles Runels: Yeah.
Kathleen: That to that, to that.
Charles Runels: Let me catch up with you in a bit. Let me just come in on a couple things that you say. I have seen now probably a half a dozen women and some of them in the classes I was teaching had a complaint was decreased ability to orgasm. No one had diagnosed the fact that you couldn’t get to their clitoris. They weren’t this to this degree, or just basically all scar tissue, but still there was enough phimosis … It couldn’t really get to the clitoris.
I saw a study presented at one of the meeting where someone actually documented … We say it doesn’t effect the clitoris, but there’s actually a study documenting that, that with lichen sclerosis it effects the hood and the clitoris is spared so as you said, I think the clitoris is gone if they’re lucky enough to be diagnosed which they often are not. If you have someone who complains of decreased ability to orgasm and you cannot expose the clitoris, even if it’s not lichen they probably should see someone whose … There are other causes for that and someone should look at them.
I think … Because you said, I think probably most people could learn to lis that, but they don’t want to because there’s something wrong. In my opinion, you would be a … You would have trouble explaining yourself unless you’re in some sort of surgical specialty. I think it’s better sent to one of our people.
The other thing I wanted to emphasize about what you said was that … As far as the biopsy goes, I don’t think that everyone in our group needs to be doing a biopsy, but not, like I said, difficult, but they may not want to do it. They just need to make sure someone’s had it done recently and actually treating the person. They should be sent back for follow up with whoever’s doing the biopsy. There’s a 10% chance [inaudible 00:09:36] carcinoma. We think …
Andrew Goldstein, I talked about this recently. We’re hopeful that because we’re showing decreased inflammation, that the chance of cancer is being decreased, but, which it is not using clobetasol. The cancer rate does not go down, but we’re hoping that our PRP decreases that rate.
Charles Runels: Anyway, I just wanted to kind of emphasize those things. Any other pearls about lichen? You’re bringing them back at six weeks and retreating, right? Is that what you’re still doing?
Kathleen: Most of the time, the last patient it’s about 50 50. Can you hear me? Can you hear me?
Charles Runels: Yes.
Charles Runels: I can. I can hear you.
Kathleen: The last patient, yeah I had only treated once and I thought that was a six month later picture. They’re running about 50 50. Let me go, there’s another picture, a couple other pictures in a camera of the one more.
Charles Runels: That don’t need the retreatment?
Kathleen: Yeah, there are some people that don’t need a retreatment or they don’t need a retreatment at six weeks. They may need another one at six to 12 months. They’ll call you and say, “I’m having itching.” I’m from out of town. She’ll call up I’m having itching. When I went there, she had found a loner. You just got to exam and look and see what’s going on.
Charles Runels: Yeah. Okay.
Kathleen: There’s another picture, a previous picture.
Charles Runels: This one? This one?
Kathleen: No. No. Yes. It was that. No, you passed it. The one that had all the white on it.
Charles Runels: This one?
Kathleen: Yes. Yes. Can you hear me?
Charles Runels: What point do you want to make about this one?
Kathleen: What I wanted to say about this one is this lady, with a friend of mine had actually had a [inaudible 00:12:03], had posterior [inaudible 00:12:05] removed, painful intercourse. This is what I want to keep pointing out, that the pain is there. It didn’t help it. She comes in, and I was able to unroof her clit in the second picture, do the O-Shot, do PRP and got her. Then, three weeks later she had pain free intercourse. That after picture is three weeks later.
Charles Runels: Yeah, I think we should emphasize because we haven’t said it already, this lady had seven years without sexual intercourse, seven years since her husband had been able to have a penis and vagina intercourse when you treated her.
Charles Runels: Oh was it 12 years. Yeah, even though she was being seen by a dermatologist. These are extremely dramatic, life changing things that are going on in your office. I think part of the take home message is just knowing what to look for, whether you’re going to treat it or not, and if you see [inaudible 00:13:16] like this, to send it to one of the gynecologists in our group who knows how to do this, and I want to reshow everybody what you can do to let people know that you’re treating, willing to look at people with lichen because they’re eager to be treated.
If you click on buyer and provider, I have icons set up and so there’s a legend at the top, and there’s an icon for if you’re using radio frequency. There’s an icon for laser, an icon for if you treat lichen, and an icon for if you’re participating in our research. I’m not sure why it’s so slow to load. Hospital, excuse me, I’m on this hotel internet, so it’s moving kind of slow. Anyway, if you want to treat lichen, then please send me an email or just call our office and let us know, and we’ll put that little icon by your name. Let’s see what else.
Kathleen: Charles, I’d like to-
Charles Runels: The other thing while I was on the subject. Go ahead.
Kathleen: Oh okay. I’d like to add one thing. I see a lot of people from out of town, and I’m having a lady, I can’t remember where she’s coming from. I think she’s somewhere in Florida, but I would like to treat her the first time and get rid of all her Adhesions, treat her, and then probably send her to somebody closer to home that can do it. I know I’ve seen her pictures. I know she’s going to have to be treated at six and eight weeks, six or eight weeks, and then if I find the people that are interested, I’ll send those people back to people that can handle them after the Adhesions have been taken care of.
Charles Runels: Yeah, that’s a good thought. I hadn’t thought about how it goes both ways. Yes, there’s actually one of our providers, I think in Oklahoma that sent some one down to New Orleans to see you. She was bragging about how much better she got but then the provider in Oklahoma was following it with a repeat treatment.
Here’s the little legend I have. We put this cartoon of a red labia and so if you want that by your name, just let me know so there it is. Any client, there’s yours. People are looking for that. Let us know and I’ll stick that by your name.
I wanted to just list out while I’m at it and talking about the O-Shot, what I would consider to be the easy things that we treat versus the more difficult. I get a lot of questions about follow up and when do you retreat or not retreat and that sort of thing, so just wanted to recover that. Here’s our easy one. Nothing is 100% but these are the ones I think where over 80% of the time either after the first shot or the second one, you’re going to have an extremely happy patient. Maybe over 90% of the time in some cases, would be [inaudible 00:16:47], decrease orgasm, and someone who’s already able to have an orgasm. This would be the lady, she can have one but it’s not like what it used to be. Decreased orgasm but can have orgasm.
Then, it would be urinary incontinence and someone where things are intact, where bladder’s not falling out into the room. Even urgent continence, we’re seeing some great results. It’s usually a mixed bag for both, but then [inaudible 00:17:43]. I know that’s a basket diagnosis, but I mean even in the ones where it’s uncertain ideology, that doesn’t mean we don’t try to work it up. The person who’s had a work up and no one’s really sure what’s causing it and they’re still hurting, that for some reason that person seems to do well with us often. The one with pelvic floor tenderness, trying [inaudible 00:18:19] injection, you inject a trigger point with PRP so pelvic floor tenderness for mesh pain. I know you’ve got some ideas about that. I’ll let you talk about that in a second.
Mesh pain and the more difficult ones, the ones where if you’re new, I wouldn’t even try these people for the first two or three months, you don’t get discouraged, I treat these people but I think in these cases our success rate is maybe closer to 50% and maybe even less, 40% depending on the person’s age and other factors. It would be never had an orgasm in their life. I think those ladies are a little more difficult to treat. A person who wants to have penis and vagina orgasm. They can have one from a vibrator, but they can’t have one with sexual intercourse. Of course, we don’t have control of the penis of that equation. Both of these two ladies, we have successes, quite a few successes, but I think that our success rate on these ladies is probably less than 80%.
Can you comment some on this mesh pain? Are you still there Kathleen?
Kathleen: Just, yeah I’m still here. Can you hear me? Hello?
Charles Runels: Yes, very well. I can hear you.
Kathleen: I’ve done it when they had perianal pain from the nerve endings around the rectum, and I’ve just injected it all around the rectum. I’ve just injected it all around the rectum and it seems to work real well. Isn’t the doctor in Europe – [crosstalk 00:20:12] yeah, isn’t she putting PRP around the pudendal nerve to ultra sound for mesh people. The lady from Spain.
Charles Runels: I heard a couple people talking about doing an old school pudendal nerve block. There was one study where the mesh was taken out and then infiltrated the field with PRP, but no one has done the study yet, showing our procedure helps it. Although, we’re seeing that even injecting the anterior vaginal wall where the mesh is. You’ve has some experience with how the mesh becomes wrapped around the pudendal nerve or something; can you talk about that? [crosstalk 00:21:00] Or something you read in –
Kathleen: One of my patients is a general surgeon at [inaudible 00:21:13] and there was an autopsy on a mesh patient, and the mesh was all entrapped with the pudendal nerve when they did the autopsy. But, even taking it out, it just has to come out in pieces. It’s so difficult. From my understanding, from that pain, injecting PRP around the … I wouldn’t do it. There are some people, that I think, do it. In Europe.
Charles Runels: [crosstalk 00:21:45] When you do it, is there some worry about injecting?
Kathleen: Yeah, just the anatomy. There’s too much you can screw up. I just don’t have the experience with ultrasound and looking around the vessels where the pudendal nerve is there.
Charles Runels: When we do pudendal nerve blocks … We did those in labor and delivery years ago. I’m hearing that just that will calm it down. Is there something about that that makes you nervous? I would have thought that was a pretty safe thing to do.
Kathleen: I think that’s safe. I’ve just done most of my deliveries with epidurals and not pudendal nerve blocks. No, I think that would be safe.
Charles Runels: Okay.
Kathleen: I would like to see what they’re doing [crosstalk 00:22:40].
Charles Runels: While I’m at it, I’ll make the list for the P-Shot® … What? I’m sorry what did you say?
Kathleen: I didn’t say anything. Nothing. I didn’t say anything.
Charles Runels: Oh, okay.
So, while I’m at it, I thought I’d do a list to the easy wins for the P-Shot®. So that would be decreased erection … And a reason for making this list, again, is all of us want to take care of people and not just take their money and make them well. When I don’t get someone well I give them their money back. I try to mostly take care of people I think I can get well. If you’re mostly taking care of the hard cases, I’m losing money. I recommend that you mostly take care of the easy wins, especially in the beginning, so that you don’t become discouraged.
I’ve seen a couple of our providers, just right out of the box, try the really hard cases. If the first two O-Shot®s you do are in women who’ve never had an orgasm in their life, and they don’t work, you lose confidence in the procedure. So stick to the ones that we know have a high percentage of success.
For the Priapus shot, we have decreased erection, but can still get an erection. In other words, on that erection scale from 5 to 25, they’re above 10, at least somewhere in that neighborhood. They’ll bump up about seven on that scale from your shot.
Peyronie’s disease. The interesting thing is, our easy win is most other physician’s hard win, so you still can be a hero and do wonderful things for people if you stick to the easy stuff.
[inaudible 00:24:35] Closed prostate surgery to help with recovery, but it’s in the person who could get an erection prior to surgery, of course. You do the whole protocol, and that’s on our Priapus shot website. Where you include both for Peyronie’s and the prostate surgery, including the pump and maybe even low dose Cialis as part of the protocol.
Again, lichen, we’re going to get lichen too. Lichen sclerosus, not planus … Although, I think you treated some lichen planus didn’t you? Kathleen?
Kathleen: Yes. Yes.
Charles Runels: [crosstalk 00:25:26] We had that anecdotal initially; I should put this up here. I treated a woman with extremely severe scleroderma, and they can have horrible problems with intercourse. It was a life changing thing for her with one procedure. Lichen sclerosis in men is an easy win.
The hard wins for men, I think, if their main reason for getting the shot is for penis growth … Although, sometimes that can be very rewarding. It can be frustrating, often times, in the men who has the most urgency about growing. So the men who has the three inch erection responds, in my experience, less dramatically than the guy with the six or seven inch erection or a five inch erection.
It’s a percentage of growth than the absolute. So if there is 10% growth on the smaller penis, it’s less noticeable results. Then the person who has long standing diabetes or whatever cause of erectile dysfunction, basically he has no response at all. [inaudible 00:26:55] There’s no response at all to Viagra or TriMix, and that person who probably has some vascular disease proximal to the penis is not likely to get well.
Those are my easy wins and hard wins for the Priapus shot and want to stick to these easy wins in the beginning.
Anything you’d add to that, Kathleen?
Kathleen: Nope. I think you got it.
Charles Runels: Okay.
I always like to cover something with marketing too. Let’s see if I have any new questions from the [inaudible 00:27:32]. There weren’t that many on the websites on this time around. Let’s see. I don’t see any coming through.
I think there is something meant to be noticed about, as far as the marketing goes, what I’m doing right now. This is a wonderful way to create interest before I was part of this amazing group of physicians. I would do webinars, just like this, for patients.
Back in the day, before I started doing the internet, it wasn’t webinars. It was a conference call. I would record the call and put that on the website. So, if you, as a marketing idea, the best marketing is to teach people how to be well. If you put out an email to your patient, whatever it is you want to talk about … Maybe it is dyspareunia or erectile dysfunction, or urinary incontinence, or something that we’re not even talking about here; maybe it’s something to do with the way you do Botox. If you want to do a webinar like this, the software is very simple to do both setting this up, as well as recording it. Then you have something that can go on your website and play, and play, and play.
I thought I would show you guys where I do this. I know you have to log in to go webinar.com to get here. This is the software … GoToMeeting.com or GoToWebinar.com and they have plans that are not that expensive. Then, you send out an email to your people, you schedule it … and what you’ll find is, that even if just one person shows up, that the content you deliver is on a different level than if you sat down and just said “okay, I’m just going to record an audio or a video about urinary incontinence.”
Then when you’re done, you have the video and you can tell your webmaster to put that on your webpage somewhere. It looks like this. Most of you guys have seen this, but when I do these webinars, I put the recording either on the membership site or I put on our Cellular Medicine Association website. It just sits there to play.
This is probably the best advice I can give you about marketing to your patients. If you teach people about the disease and how to get well, then they will trust you to take care of their disease. If you go through the trouble to teach them how to be well, then they’re much more likely to trust you to take care of them.
So, the short version: teach people about the disease and they will trust you to take care of their disease.
It’s really an amazing time that we live in that we can just, almost no money, wherever you are on the planet, you can just sit down and have a conversation like this with your patients. Then when you’re done, you have a video that you can play for them perpetually on your website.
I think that’s all I have for today, unless you guys have other questions. I’ll put the transcript for this up within the next 24-hours and a link to the book that I recommended, and I’m always honored that you’re here.
Thank you for the help, Kathleen.
Kathleen: Thank you too.
Charles Runels: Alright, you guys have a good day. Bye.
Cellular Medicine Association<–
I’m just back from an ISSWSH meeting, which I highly recommend that you guys do if you haven’t been yet. Here’s their website for the Fall course. Maybe once every year or two I recommend. You can see the content is pretty amazing. These are the handouts that they had. I thought I would just run through some of the highlights of the lecture that Andrew Goldstein gave on dyspareunia.
Dyspareunia, as you guys know, to a gynecologist, it’s like saying back pain to a orthopedic surgeon or an internist—the etiologies are so numerous that it’s almost the name of a symptom not a diagnosis. Although there was an article, an editorial, in the Green Journal Obstetrics and Gynecology about three years ago now where the editor said, “We’re not treating it as well as we can, and often times it really does go undiagnosed.” But even with that being the case, it’s worth looking at in more detail, the different diagnoses/etiologies
I’m going to unmute your mic, Kathleen, because I know you’ve been to this meeting (ISSWSH). You are going to have things to say about it. It would be very helpful to talk about it, I think. I don’t know if you’re able to talk. Can you hear me, Kathleen?
Kathleen Posey: Yeah, I can hear you. Can you hear me?
Charles Runels: Yep. We’re recording this because even though not so many compared to speaking, not a huge percentage of our people make it to the call, usually it’s in the neighborhood of 20 or 30 people out of over 1,000 people, I think it’s really worth thinking about pain/dyspareunia.
The good news is that often times when we have pain and it’s not easily diagnosed, our O-Shot® procedure seems to be working. Whether it’s healing damaged tissue or if it’s causing a decrease in inflammation like it does with lichen, I don’t know. But I thought we’d run through these known causes. I don’t pretend to be giving this presentation the way Andrew Goldstein gives it, but I’ll hit the headlights, the highlights. Hopefully, you guys can hear the lecture for yourself sometime in the next year or so.
This is the textbook that he helped edit about dyspareunia, which I highly recommend that you go through this. Eventually, I think there will be a chapter about an O-Shot. You can find this on Amazon.
This is the one, the version that he wrote for patients.
These are the known causes [see video]. Talk about this for a second, Kathleen. What on here do you see us helping with? Obviously, we wouldn’t try to treat fibroids with an O-Shot, but talk about this list for a second, and just the diagnosis of dyspareunia in general. Can you see it?
Kathleen Posey: Yeah, I can see it. I basically put PRP wherever the pain is. I map it out. I rule out the things like yeast infections, chlamydia, endometriosis, PID. I treat them just like we would treat those, but usually when there’s no reason, I just get out that Q-tip or just my index finger and say, “Where’s the pain? Does it hurt here?” Then I put the PRP.
Actually, a case I talked about a couple weeks ago was a anal cancer in a 40 year old that had radiation and complained of menopause and decreased lubrication. She went to a plastic surgeon who did Thermi-va on her, which only made her small vagina smaller. But mainly the pain was a posterior fourchette. I did put the PRP and did an O-Shot® because I do both. About two to three weeks later, her pain got better. That’s my method.
You can look at all these diagnoses. We know how to treat most of these things, but it’s the unknown ideology of the pain that I think the PRP helps. It doesn’t always. I had a classic vulvodynia around Hart’s line that was real painful, and she really didn’t respond that well, but that’s just one out of the many that I’ve treated. I’ll still try it on another patient like that, too. I wouldn’t limit it to that.
Charles Runels: Beautiful. Let me add to what you just said.
First of all, I agree. Most of the people, by the time they get to us for an O-Shot®, the patient’s already, before they are willing to pay cash, they’ve already been to other physicians and had lots of tests done. The good is that most of these things, if they were there, have already been treated.
The other thing I would add, which I know you do this, Kathleen. I know you treat some people for free, as do I, and that we’re both careful not to keep money if people don’t get well. I highly, highly recommend that everyone do that. If you’re treating pain and someone doesn’t get well and you keep their money, they feel like we stole from them. Even though we’re not used to giving back copays or whatever, insurance doesn’t refund money if we don’t … Obviously, we know we can’t get everyone well, highly recommend that if you treat someone for pain, and they don’t get well, either repeat it or refund their money.
By the way, the reason I’m talking to Dr. Posey for those of you that don’t know, you’ve been involved with the group right now for quite a few years. She’s been teaching it to other gynecologists. She’s a gynecologist, board certified, out of the New Orleans area, who has recently presented some research where she treated lichen sclerosis with a combination of surgical procedures and PRP, and teaches that method. A lot of experience seeing many thousands of women over the years as gynecologist and very well-trained, busy surgeon in the day. Back in the day, I know you were a high … Anyway, lots of experience.
Back to this list. Back to the list. The endometriosis, obviously, you wouldn’t treat it. The psychological, that hopefully is going to be teased out with your conversation. I wouldn’t try to treat psychological, obviously, with PRP. But let’s get to some of these pictures, though, because I think a lot of our providers don’t really know what to look for. I know that you’ve seen quite a few people who are being followed by a gynecologist-
Charles Runels: Some of these women, saw gynecologists who never diagnosed the pathology the gyn just went for the pap smear and never stopped to look at what was going on.
You just mentioned … This, by the way, is his algorithm for pain. I don’t show this, obviously, expecting anybody to memorize this whole thing from my overview here, but I just want people to realize there’s some thought that goes into figuring out pain. They’re not just willy-nilly treating someone without making sure that someone, if they’re not a gynecologist or a dermatologist, that someone hasn’t thought through a differential diagnosis … If there’s a rash for example, it should be biopsied. Someone should be thinking about that.
This first one is a big one. There is a pain disorder that’s associated with low testosterone. This is stressed over and over when I talk to people who treat a lot of vaginal and vulvar pain. The vagina and the vulva needs testosterone to stay healthy, and there’s a actual syndrome associated with pain and birth control pills, which almost always drops testosterone levels. Some women are susceptible to that, and some are not, but that’s something to think about.
This vestibulodynia of different ideologies is a whole subject in itself, but interestingly, I did meet a woman at this last ISSWSH meeting who had a woman with long standing vestibulodynia that was of this [neuroproliperative 00:09:01] type that responded to our PRP. Somehow it decreased that inflammatory whatever makes things go on here. This is a whole area for research that we need to take up, talk about. But obviously this is not a healthy looking vestibule. When you have this erythema around Hart’s line, then it’s worth thinking about testosterone creams. I think it’s worth trying our PRP as a way to modulate that.
Again, I’m just skimming through this just so you can see this should be thought about. This is that Hart’s line that you just heard Dr. Posey talk about that one. That’s inflamed, and this responded to using testosterone and estrogen creams.
Our O-Shot® is not the cure all, end all, be all, but I think it’s an extra tool that can be used in the thoughtful treatment of these problems, so I just-
I just wanted people to get a look at what some of this neuroproliferative. Vestibulodynia is a horrible problem. Basically, someone stays inflamed to the point that then if the inflammatory agent is removed they still stay inflamed.
A lot of times, they’re treated with creams that have some sort of propylene glycol or paraben in it that causes the inflammation. You’ve got inflammation, you treat it with a cream that actually causes a chronic inflammation to the point that when it stops, sometimes they’re left with a continued process that turns into this.
I think that was the main thing. The other thing to think about is here’s the pelvic floor muscles. Normally, these have been treated historically by palpating, as you heard Dr. Posey talk about, palpating and finding the place where a person’s tender, just like you would look for trigger points in a tender back and in the same way that physiatrists are now injecting PRP to treat this.
When you find that tenderness, you can now inject PRP. That will usually hurt worse for about a week and then it goes away. You have anything to add to these pelvic floor injections?
Kathleen: Not really. I’ve never really done them. I refer to pelvic floor PT, but I will say that even of the lichen sclerosus patients I’ve seen, a lot of them have pelvic floor dysfunction. You just touch them and their levator ani muscle just almost goes into spasm. It’s interesting, a lot of women when they’re touched, they wanna squeeze that butt together and I’m telling them, “Look, put your butt down into the table.” There’s a lot of comorbidity there with vulvar pain and then these muscles getting involved is what I see.
Charles Runels: Just to add to that, we do have people in our group who work with the pelvic floor therapists. I know you have them in New Orleans. Our little town doesn’t have one. But that’s a good referral source. One of our people actually had a pelvic floor therapist put a satellite office in their office actually they had a good working relationship [inaudible 00:12:30]. His O-Shot helps her therapy work better. That’s worth looking into.
The way that he established that relationship is he just had her bring one of her patients over and he treated the patient with the therapist in the room so she could see what was involved. Then she went back and did this therapy as she normally would and had a nice result. It’s a way both to help their therapies work better and to help everybody’s business. Let’s see.
Kathleen: At the conference in Boston, they talked about putting Valium in the vagina.
Charles Runels: They did.
Kathleen: Did they talk about that at all?
Charles Runels: They did. It didn’t seem to be as helpful, at least the feeling I got from the lectures, as using Botox. That was something that was talked about.
We don’t have the research showing that our PRP works with pelvic floor trigger points, but it should apply, since that research has been done in the physiatry literature with back pain.
They did talk at ISSWAH about trigger point injections of Botox and they mention diazepam and suppositories, but Botox seemed to be the first choice on the menu (before diazepam).
100 units is what they talked about using, which would be one bottle of cosmetic Botox. Some are doing it under anesthesia. I know Andrew Goldstein was saying he likes to use it without general anesthesia so he can tell better about where to put it.
Let’s see. I think that was the main thing I wanted people to see was just that. Oh, yeah. He does a vulvar vestibulectomy but he says he does a whole lot less of these than he did in the beginning of his career when people were not using testosterone creams.
It was really talked about a lot, especially in someone who’s on birth control and how common it is that that gets dropped in people who develop these pain syndromes, not just this vestibulitis pain syndrome. But this is a last resort, obviously, but it’s something that’s done just to know what’s out there. It can be done if somebody develops this pain that just won’t go away.
I think that we’ll find that there’ll at least be a subset of these people that get better with our O-Shot. We’ll see. I think that was the main thing I wanted to show. I don’t feel like it’s my place to just put all this stuff out since it’s their intellectual property, but I just wanted people to see that there’s a lot of stuff out there and it’s worth, I think, attending one of their meetings. It’s called ISSWSH, International Society for the Study of Women’s Sexual Health. Maybe go there once every couple of years and get a good update.
Okay. We didn’t have as many questions this week as we normally do. We had one question that showed up on the Priapus shot website about has anyone used PRP combined with amnion with the Priapus shot. Some of us have, but I don’t think I have enough experience yet to tell you that it’s working better. I think it would be worth trying if someone didn’t respond and you were treated Peyronie’s disease especially if you’re trying to heal scar tissue, or someone just wanted to get the best that you knew to do.
Again, amnion is not stem cells, it’s where you’re harvesting the proteins from the amniotic membrane and then they gamma-radiate it. There’s nothing living in there. You just have the cellular proteins, the amino acid peptide chains that code for wound healing. That research has been done. I think just as a general help, I always like to add in a couple things that have to do with marketing and something to do with business.
We got a really big hit that’s worth talking about when it comes to the Priapus Shot® procedure. If any of you guys are doing this, it’s worth talking about. Dr. Gaines is in our group and he popularized the Gains Wave™, which is combining the Priapus Shot® with shockwave therapy.
You can see the guy in the Men’s Health article talks about the Priapus Shot® itself, or the P-Shot®, and it’s a very complimentary article, somewhat sensational, but he’s an entertainer. This is “Men’s Health,” this is not “The New England Journal.”
Obviously, we don’t make claims we can’t fulfill and you want to have a consent form and make sure that your explanation is not the same as “Men’s Health” magazine, but Lord knows we get huge amounts of negative press that’s absolutely uninformed and factually wrong. Someone wants to make this a little bit entertaining by talking about his penis he claims was 10 inches when he put it in the pump, I don’t know, maybe it was 10 inches. Who knows? But I’m not one to dispute him.
It’s a nice article that at least can start the conversation and maybe lead to you helping some people who need your help for their erectile dysfunction. That article’s there if you just Google “Priapus shot in Men’s Health.” Some of us are combining the shockwave therapy when people want it. Just so you know, if you look on our director, PriapusShot.com/members/directory, I added a logo so that if you’re using shockwave therapy people can find you.
Also, I know Dr. Posey uses the- That right there, that’s our shockwave logo.
If you are doing shockwave therapy and want the logo by your name, let me know and I’ll add it.
If you go to the O-Shot® directory, we have a logo now if you’re doing radio frequency. I think what’s gonna happen is as the research becomes more available, as we do more research, then people are going to want different flavors of our procedure based on their problem. I know there are some things that one of these machines, like Dr. Posey just mentioned, someone who had dyspareunia had a small, constricted introitus, that’s not the place to use your radio frequency device.
But you can see I added this. This is what I added, Kathleen, to indicate you’re doing radio frequency. If you want one of those by your name, just send it to support. I’m gonna put it in here…
I just put it in the chat box. You just send that and let us know and we’ll put the little thing. This means you’re treating lichen, this means you’ve put five people in our research project or a survey, this means that you’re using radio frequency device, and we have one for laser’s too. I need to update.
This is the legend so that whomever’s using this directory knows what these little symbols mean. I just added this last week, so I need to add that to the legend so that people know that means you have Thermi-O or radio frequency device.
So, let’s see Dr. Desmond Ebanks just put something in the chat box. So, the automatic pump he uses, I don’t, the guy talks about this pump like it’s the bomb. Who knows if that’s part of his journalistic license, but he talks about this pump as being a pretty intelligent thing, so I’ll ask Dr. Gains what brand of pump they’re using.
Let’s see whats the other question…
which shockwave device do you recommend? As far as the shockwave device, what I have right now is the E-Vive. There are others out there, I think they’re all made by, or most of the main brands are made by the same company. They’re kinda re-branded, depending on who’s selling it. So I think a lot of it comes down to who you want to work with. And who’s having a good deal, and good support. But right now, I have the E-Vive, which is the one Eclipse sells, in my office.
Let’s see, Dana Kirk just said here, okay, so here’s the question from Dana. She says, “Often the Vampire Facial®’s being administered for acne scarring often have some leftovers. Anyone injecting into the larger pock marks? If so, is it worth activating?”
Ok, so this is a good question about acne. When I treat acne, I use micro-needling. But two tips on that….
First of all, if it’s in their budget to do Juvederm. If you think about what happens to the divet, or say the divets in say a basketball, if you put more air in it? The divets become more shallow, just from expanding the ball. So even before you treat the pocks marks, or treat the acne scars, if you’ll use some Juvederm, if they can tolerate it, as in, do they have any room for some improvement in the cheeks, and if it’s a female, almost always they do, unless they’re obese, they’ll have some. You can add to their cheeks and things look better. And the acne scars are already smaller (before you actually treat them). At least the ones in the cheek area.
Then, micro-needle with PRP (Vampire Facial®), but also go intra-dermal and sub-dermal with your PRP, subsize/undermine the scar, just like you would if you were treating acne scars before we had the Vampire Facial®, so taking the bevel of your needle and sub-sizing the scar releases it some. I
Inject a little PRP sub-dermally, inject some intra-dermally, and then micro-needle on top of it. Intra-dermally as in blanching the skin.
And all those combined will get a really nice result. Usually I treat them every six weeks for three treatments, and they love it.
As far as activating it for the face, I usually don’t (I used to do so). Because I don’t think it adds to it enough to warrant the extra pain. In the face. But I do activate the PRP in the O-Shot®, the P-Shot®, and for loss of sensation in the breast.
So Sherry, I don’t see your question, it just says … maybe you can type it again. Okay, wait, here it is… “Does it matter which order you do the p shot, the shockwave therapy, and did the p shot … okay….”
So, the way I think about the energy, whether it’s shockwave, laser, or radio frequency, the way I’m thinking about it is, if you’ve ever used, say, insulin or growth hormone, if you just take, if you buy Omnitrope or a growth hormone, or Genitropin, whatever brand. These are small amino acid or peptide chains. It will tell you not to shake, to gently stir when you put the water in. Just shaking the vial, it mechanically shears the amino acid protein chains, so it’s like taking the words of the sentence and just chopping them up and turning them into letters. And now that amino acid chain no longer acts as a small peptide signal. Right? So these amino acid chains act as signals that plug in to receptors on the cell, and that’s how growth hormone, that’s how insulin, it’s how all those amino acid chains work.
Over 200 made by the pituitary gland that we know about. Peptide chain signals. So, imagine if you did that, I have no research to back this up, but imagine if you injected a peptide chain, and then now you hit it with shockwaves. In the same way, imagine what happens to an egg when you put it in a skillet and fry it. Obviously those peptides or those proteins are being changed.
So the bottom line is, I like to use the energy, whether it’s shockwaves, lasers, radio frequency, whatever it is. Use that on the tissue first. And then immediately afterwards, same visit, then apply your PRP. Now if you want to, if you did the shockwave yesterday, or last week, or three weeks ago, or a month ago, and you wanted to do PRP after that, that’s fine, you’re not hurting anything. And if you want to, if you did the PRP three weeks ago and now you want to add the energy, you can. But in my opinion, as soon as you add the energy, you are probably shutting down whatever growth was taking place, from the PRP that you put. So it’s like you’re stopping, it’d be like you just watered a seed, the stem cells are [inaudible 00:25:26] stem cells that you just put there. And now if you’re trying to generate more growth by damaging tissue, now you’re crushing the little sprout or whatever tissue is growing. You’re crushing it or injuring it, in my opinion, if you didn’t do the shockwave therapy before it has a chance to mature.
So I would try to do them back-to-back on the same visit. And not do anything else mechanical to disturb the growth of the pluripotent stem cells until at least six weeks out, maybe even eight. To give what you did a chance to work.
So if you did the P-Shot® three weeks ago, yeah, you could do the shockwave now, but you’d probably be stopping whatever further benefit might have occurred from that original P-Shot®. It might be better to give it at least another three weeks before you did the shockwave therapy.
Okay. Let me give you guys, I don’t see any other questions that are up. I want to give you guys one quick marketing tip, and then unless somebody has another question, we’ll shut it down.
This one has to do with when people get to your website. It is something you can ask your web designer for. This is my old internal medicine website. And this is just a form and here’s the scenario that will happen. And this is why this form is so important. You don’t have to make it, I just want you to know it exists, and this is a ten minute job for your marketing person. And if you don’t have one of these, you’re losing about at least 30 to 40% of the traffic that you could be getting to call your office.
So let’s say that you’re in, let’s say that you’re, you do an o shot, or you do a vampire, or you just do a pap smear on someone. And they go back home, and they go to Thanksgiving dinner. And they tell their mother, sister, friend, cousin, whatever, how wonderful you are. And they say, oh, what’s their name. And they say, oh, it’s Dr. Posey.
So now they take out their cell phone, or they remember the name and tomorrow, day after Thanksgiving, they google you. And they wind up on your website. If all you have is stuff for them to read, they read it and they go away. And there’s very good chance that a week from now, they’re not thinking about you. It’s all done. They will never become your patient.
If you put something on here that they can have for free, that costs you nothing, not a free consult, it’s gotta be something that costs you nothing. If you put something on here that they can have for free, and we’ve all done this before, that’s worth something to them, but costs you nothing, somewhere between ten and 30 percent of the people who land there will do that.
And then, now you have their email address. They start getting your newsletter, and a certain percentage of those will eventually become your patients. So it gives you a chance- this is not the main way you get your patients. Most of your patients are gonna be word of mouth, or someone googling you. But this plugs the hole, and it will increase the number of people you have by about 20 to 30 percent, that come in through your website, by capturing those people who would have never called you, had you not created this form.
And the way you ask for it, is you decide something you’re going to give away, first of all. It could be, and I, it should be a podcast or an email, or downloadable book. It doesn’t even have to be your podcast. What I’m giving away here is a podcast where I’ve just recorded for an hour the benefits of walking. So it says, number one weight loss melt secret, free immediate download. So that takes them, you ask them for the first name and email address, and when they give you that, now they’re on your email list, every time you send out an email, they get it. And as soon as they do that, and you can sign up for this so you can see how it works, as soon as they enter that data, they’re taken to the place to download that.
So, it could be an email, excuse me, it could be a podcast or a video that you made. I know Dr. Posey made one on incontinence. So it could be free video on the treatment of incontinence. In exchange for first name and email. And so you tell your, here’s what you say to your web person, if you want to do this, you should write this down. And this works for Constant Contact, A-webber, Ontraport (what I use most), Mail Chimp, all those different places.
All those different places, it all works the same. And you can go online and figure how to do this yourself, but it’s a 30-minute job at most for whoever does your websites for you. You say you want a form and you want it to be in the right upper-hand corner of your website. On the homepage at least, maybe on all your pages, but at least on your homepage. And it should offer the thing that you’re giving away. And it should only ask for their first name and their email address, that’s it. If you ask for last name, you’ll lose about half of them. So first name and email address.
And then you let them know that you’re putting out a new health lessons every two weeks. Don’t call your newsletter a newsletter. Nobody really cares about your news. Give them a name that implies some sort of benefit. So I call this Health Lessons. You can call yours whatever. And then tell your person to put that on the form.
If you supply them the link to the thing you want to give away … You realize also on Amazon, there’s a lot of books for free. You could literally find a book that you can read on Kindle for free and give that away. But I recommend you find something either audible of a podcast or a video. Preferably something that you did. And that’s it. That one thing is gonna increase the production of new patients by your website by 20 to 30 percent. Now we talk more about this sort of thing in my workshop where I teach marketing, but there’s your freebie right there that is just some of the best stuff.
Okay. Let’s see if there’s any other questions and then we’ll shut this down. We didn’t have a lot of questions on the websites. Okay. I think that’s it. You want to add anything? And thank you for helping us, Dr. Posey. I know you’ve had a lot of … I think more experience with treating lichen with PRP than anybody.
By the way, the way I think about this, it’s all the freaking O-Shot, it’s just we’re varying the way we do it. Just like you do a hysterectomy and you vary the method based on who you’re taking care of. It’s all the same thing. But Dr. Posey made a good point and this is worth remembering, because some people asked me if they’re there for incontinence, do you still treat the clitoris? Or if they’re there for sex, do you still treat the anterior vaginal wall? Or if they’re there for lichen, do you still do the rest of the O-Shot? Or for pain, do you still do the rest of the O-Shot?
There’s two reasons why you treat all of it. One is people lie about sex. Everybody does. And so if someone says they’re there for incontinence, maybe they’re not. Maybe they’re just too embarrassed to tell you. Or maybe they’re living alone, single and they don’t want to tell you they have a lover. Whatever reason. Maybe they just decided it’s not your business. And of course, you would want to treat the clitoris if you’re treating for sex, but you would also want to treat it for incontinence because if you look at the anatomy, the clitoral tissue actually comes around and forms some of the structure for urinary incontinence.
Also, it could be that those nerves of micturition that come down through that area are helped and our clitoris is acting like the wick to help rejuvenate those nerves of micturition. We do know that we have people with urgent incontinence that are getting better as well. And we’re not sure exactly why.
So I always treat the clitoris even if it’s for incontinence. And of course, if you read Grafenberg, the urethra is very erotic in women and you would definitely want to treat (even if there for sex). Also, you have the female prostate gland or the Skene’s glands, so you would definitely want to treat the anterior vaginal wall, not just the clitoris if you were treating for sex because the urethra is such a sexual organ as well.
And if you’re treating lichen and you’re hopeful that it’s going to get better, and you’re down there anyway, why wouldn’t you go ahead and treat the structures that have to do with sex so that that can be recovering at the same time you’re treating the lichen itself?
One big plug though, if they have sclerosis or phimosis, where you cannot pull that clitoral hood back, which many of them do, then you can go ahead and treat them, but make sure that you don’t stop there and you refer them to Dr. Posey or someone else in our group who knows how … If you don’t know how, someone else who knows how to free up that clitoral phimosis. So if you can’t retract the clitoral hood all the way back to see the shaft, if all you can see is the tip of the glans or if you can’t even see the glans, then they need a surgical consult from one of the people in our group so that that can be exposed and be more responsive. It’s hard to have good sex if you can’t get to the clitoris.
Okay. I think that’s enough rambling. Anybody else have any questions? If not, I’m gonna shut it down. Thank you for your help, Dr. Posey. Thank you guys for being here. I’ll put a recording up by the end of the day.
Kathleen: I just wanna say something that I hear … I mean it’s going off on a little bit of a tangent. But to me, a lot of times, they want the O-Shot because they want that penis and vagina orgasm. And yes, it does help that somewhat, but I’m really … I look at a lot of vaginas, and I’m really paying attention to that distance between the clit and the vagina and/or urethra. And it really … You oughta start looking at it, Charles, because it varies with women. Some of them, it is like five to seven inches.
Charles: Yeah, it’s huge.
Kathleen: When I talk to those people, they have never had a penis and vagina orgasm. It might be something to really examine the person before. And if you really talk to them about why they really want the O-Shot, I’m seeing 70 percent of them really want that penis and vagina. And it’s being advertised or said it’s gonna make them have that. Just be careful because if that distance is a long way, yeah, the orgasm will get better. But to bring you to surgery, in my opinion.
Charles: Let me add to that. First of all, what you said is backed up by research. And that research I think is actually on our O-Shot website. But there was MRI studies showing that the further the clitoris is from the vagina, the harder … It was a correlation between … It was done about two years ago. You know this research, so you’re seeing it actually in your patients.
But there was a study where radiologists looked at women who can easily have orgasm and those who have trouble. And the distance from the clitoris to the vagina correlated with ability to have orgasm. And the size of the clitoris correlated.
Now, her conclusion was that she showed it, but there was nothing to do about it. Actually, we do know some things to do about it, putting someone on testosterone is going to make the clitoris larger. And it could be that doing our O-Shot® procedure actually helps, even though it’s not going to make that distance shorter or smaller, it could perhaps make it more responsive. But there’s also always a place for surgery, and there are ways to do that that you specialize in and others in our group to bring things closer together.
Now, and I’ll also say that of the things that we treat, trying to help a woman achieve penis and vagina orgasm, who is able to have it with a vibrator, is one of our more difficult problems. I think our success is probably in the 30 to 40 percent range in that group. Where if you’re treating incontinence in a younger woman, stress incontinence is probably closer to 80 to 90 percent.
So I agree that something ... And it brings up another point in that I recommend, especially in the beginning, that people stick to the problems that we have the high success rate, so the provider doesn't become discouraged. I know you were very motivated and trusting it. But way back, years ago, when we didn't have so many people doing this and we had less research to back it up. But anybody, even with our current researcher who is just starting out, they should probably avoid treating, I think, until they have some success under their belt, the people who never had an orgasm because those are the people who are more difficult and probably they're always gonna need testosterone on top of what we're doing, I think. And the people who we just mentioned trying to have an orgasm with penis and vagina sex, they're more difficult. Stick to the stress incontinence, the dyspareunia, the lichen sclerosis, the women who can have an orgasm and wants to be stronger, those are our more easier cases. And in all cases, always, always, always, in my opinion, if they don't get well by the end of 12 weeks, then either offer them another treatment or give them their money back because we can make a profit and take good care of people without having to have people feel like we ripped them off.
Anything else, Kathleen?
Kathleen: I didn’t mean to say it wouldn’t help because I do think it helps and I do think you can even … I think the O-Shot, by putting it in the vagina, does shorten the distance a little bit. And maybe millimeters like what the P-Shot is doing. And it can get better, it just can’t … When you really see a big long distance, I would ask them and then I would just say, “Your orgasm is probably gonna get stronger, easier to obtain, but it may not help that.” I don’t know, it’s hard to give them a negative … I wouldn’t give them a negative embedded command. Just watch it if they’re there for penis and vagina orgasm.
Charles: I’ll tell you what I tell everybody. It’s good advice. And what I tell everyone when I’m leaving the room is I’ll say, “You just spent whatever amount of money it is. And for that much money, you have to love it. And if you don’t love it, I want to know about it.” Because of course, I’m gonna be following up with them. But what I found when I follow up with some of the people … So when people contact me and they tell me they’re not happy, I refer them to the doctor who took care of them because I’m not their doctor. So I don’t need to be involved. But it’s helpful for me to know who took care of them. Then I call the doctor and talk to them and see if I can offer help.
But back to this thing about satisfaction and setting expectations. I think that what I’ve seen happen sometimes when people are not happy is they never let their doctor know. Because maybe they’re afraid they’re gonna hurt their feelings or there’s gonna be some sort of conflict or something. I think it’s helpful to actually tell your patient, “I want to know. I want to know if you don’t love it because I want to take care of you, and I don’t want you to feel like that our energy and time and your money has been wasted.” And that really helps a lot, both with you getting them well and helps prevent them sliding away disgruntled without you ever knowing about it.
And in the process, you can say what you just mentioned, Kathleen, that if it’s a more difficult case, it’s worth telling them, “This is something that a percentage of,” if you’re dealing with someone who’s trying to have an orgasm with penis and vagina sex, “This is something that doesn’t work as well. We have a much higher percentage with treating stress incontinence, but we do have successes that by our surveys, are in the 30 to 40 percent range. If you want to try it, we’ll do it. But I want you to love it. And if you don’t, let me know. And we’ll either repeat it or we’ll figure out something else, including, I won’t keep your money.”
And in the end, although you give back money occasionally, you wind up making many more people happy and making more money and you sleep better at night.
Okay, I think that’s it. Thank you guys for your attention ’cause this thing … What we’re doing here, I think, is really changing medicine and I’m the facilitator between all you guys thinking about it and all the feedback and all the good research. So keep it coming and I’ll try to keep pouring our money back into it.
We have two double-blind placebo studies going on now. We’re having a little trouble filling the orgasm study (click to help), so I’m gonna put out a link to that again. So if you guys know people who live in the Washington D.C. area … Bottom line though is we’re investing into the research. We’re investing into supporting our group. And I think you’re gonna see medicine change a lot in the next five years from what we’re doing. Okay, you guys have a good day. Thank you, Dr. Posey.
Charles Runels: All right so we’ll get started and we’ll go through questions that have been posted on the various websites.
Let’s start with the vampire facelift. By the way, after we finish these questions, I’m going to go over a very quick and easy way to create an email that your patients will love to receive and it will help them both attach to you and want to come see you for the things that you do that will help them. We’ll do that after we cover some of these questions.
We’re on the Vampire Facelift® website. “Hello, does calcium chloride help create better results with vampire hair? Also do you have a contact we can order from? Finally, how much do you mix with the PRP and do you just draw the PRP into a syringe and then draw the calcium chloride up after it, and has it been injected with mix or do you mix it differently?”
I just posted an answer to the activation question. If you go to our company website, cellularmedicineassociation.org, and then you look down here where it says, Questions and Answers activate, and I spent some time right here talking about the different reasons you should and shouldn’t activate, and when you do and you don’t, versus hair versus face, O-shot and P-shot and such. So it’s all right there.
As far as mixing it goes, I like to use a stock bottle so if you have, if you already have plasma in the syringe and you take that syringe and you put a needle on it and you stick the needle into your stock bottle, of course you’ve contaminated your bottle because you put a needle that’s attached to blood on one side in the syringe now into your stock bottle the calcium chloride is in. So I’d pull the calcium chloride out of the stock bottle into a sterile syringe and the pull the PRP up into that syringe that has the calcium chloride in it exactly right when I’m ready to do the procedure because you need to be ready to use it.
Let’s see what else you have. As far as from where can you order it, if you go to our dashboard, you’ll see the dashboard is here. Then if you go to, down here somewhere, it should have where to order everything. Let’s see. That’s all different procedures, ways to do it, well maybe I didn’t put it there so I need to. I get it from Mcguff in California, and I’ll pull it up for you right now. Mcguff compounding pharmacy. There. Mcguffcompoundingpharmacy.com.
So let’s see what other questions we had. On the vampire facelift site. By the way if there are questions from you guys that are attending just push the button and I’ll unmute your mike, the noise gets pretty bad in the background so that’s why I don’t have it unmuted at this point. Lets see, are there frequently asked questions for each procedure that we can use? Where are they located on this site?
So the way I’ve tried to structure … so there’s two sides to the membership sites, or the websites, and they all work the same. There’s one side, so vampirefacelift.com/members, that’s for us. Then vampirefacelift.com with nothing behind it, that’s for the patients. The all have the same format. So there’s O-shot.info, that’s for the patients, there’s oshot.info/members, that is for us.
So when you say frequently asked questions for each procedure that we can use, where are they located, the best place to send people if this is for frequently asked questions by a patient is to send them to the main website. I tried to anticipate the questions. If you look at the number of times this has been edited, you can say, click in here and try to edit the page it will tell you how many times I’ve edited it. It’s probably going to be hundreds of times, we’ll look at it here in a second. But what I do is every time somebody asks a question I try to put it into the website and embed it there so then hopefully they see it. Oh, only 65 times, so of course this is third version of this website but on this particular page only 65 revisions. So those revisions aren’t to make things look pretty, most of the time it’s changing a word, adding a link, you can see there’s a video that needs to be redone. Sometimes something dies. You can see I added a Wikipedia article. I add thins so that every, if someone asks me a question hopefully we anticipate it and hopefully next time they won’t ask that question. So that’s where the frequently asked questions live on the websites.
They’re also put, on most of the websites, on O-Shot®, P-Shot®, I think it’s on the breast lift, you can see I added a review link. Oshot.info/reviews. Here’s a tip right now for getting free advertising, like crazy. I tell people this but still less than a dozen of our providers do it. If you go there to reviews tab, that’s where people ask questions and hen we answer them. Well if you answer a question here, and you can see ,I don’t know I think there’s 300 or so posts or something like that.
So if you go in and you answer, Dr. Posey answered someone’s question right here, then people see that and you can see it links to whenever you answer a question. Whenever you answer a question it links to your profile, so Dr. Seilar answered a question and, from one of the patients, and when you click on it, it takes you to know more about him. There you go, you’re on his website. And when people who go to these pages, they always want to read the reviews, so there’s your way to both find the frequently asked questions and to just throw in a couple of words here and there, taking part of the conversation, and people will see it, they’ll be impressed, and they will come find you. And for some reason, like I said, that’s still very uncommonly done by our people even though it’s a way to get amazing, amazing advertising without really having to do anything as far as money goes.
So here’s another question. Dr. Runels with the current available information, what’s your top PRP harvesting centrifuge in terms of initial cost, for patient cost, ease of use, especially commenting on the clips, insight, [inaudible 00:08:12], TruePRP, they left Harvest out and there are others.
So this technology is changing, the prices are changing and when I look at analysis of the blood itself the numbers are all over the map depending on who paid for the testing. What I can tell you is that I know of failures and, oh they also left region off this list, I know of failures and wild successes with all of the things on that list. My recommendation to you is to get your best price with the best service. If you ask me what’s the best, a Chevrolet or a Ford, I would say that I would never buy a Ford because I had a Ford Pinto when I was 16 and it broke down and so I’m angry at the Ford Motor company since I was 16 years old because they took my money for a lemon. Ford Pinto was the one that would explode when you got hit I the back. But that’s my personal bias, they ripped off a 16 year old boy and I will never forgive them for it.
But maybe you didn’t have that experience, maybe you love Fords, same thing applies to centrifuges. Cut your best deal, all of these kits work, and hopefully our research will show, for example Magellan gives you five times baseline, do you really need that or not? Maybe? Or maybe not. I can give you a more specific thing but it could be out of date by next week so talk to them , cut your best deal.
Let’s see, Thomas asked, do you have any experience using antioxidant serums just afterwards?
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Section 2 of 5 [00:10:00 – 00:20:04](NOTE: speaker names may be different in each section)
Charles Runels: Antioxidant serums just afterwards the Vampire Facelift. The facial or essential oils. I use a HA mist, seems to work well. Sometimes can cause peeling, but not sure if it’s the mist or the facial. What I can tell you, with the facial, whatever you like to use on the face, whether it’s peptide creams … I always like, I’m still an old school 0.1% Retin-A, not Retinol, like Retin-A prescription strength 0.1% cream. Whatever it is that you like, after you do that Vampire Facial, you’ve opened up the skin and you’ve created thousands and thousands of little puncture wounds, so that this material can now be absorbed. So that’s your answer. Whatever you like, use it.
And I find it’s a good time to get people back on a regimen, because they want to protect their investment. It’s like when you check out of Best Buy and they say, “Well do you want the warranty?” Same thing, they’re checking out of their Vampire Facelift, you say, “Well, you really take care of your investment here, and what you’re doing to take care of yourself. We should have you on this, and this, and this.” And I like the Retin-A. And so even if someone has used Retin-A in the past, they may have used it inconsistently, and that motivates them to start using it more consistently.
“Can you give us guidance on hair restoration, and how to know where there are active hair follicles, and where the PRP will work? Is it necessary to do the microneedling?” I don’t think it’s necessary, but I think if you said, “Okay, you have one chance to make this person’s hair grow, and If it doesn’t work we’re going to, I don’t know, run your car off a cliff.” You would probably do everything you know to do, which would include subdermal and microneedling. Doesn’t take that much longer, the cost of goods are reasonable on the expendables for the microneedling device. So I usually do … I do think it’s necessary to do the subdermal, and close behind this on the microneedling, but I always like to do both.
As far as how to know where there’s active hair follicles, you can see where the hair is thin but still present. Obviously you want to treat that. And then there’s this margin where the hair seems to go away. I think it’s worth, if someone has a reasonable hairline, you know, they’re not like a cue ball, if they have a reasonable hairline, I think it’s worth just treating all the way to where the hair line used to be. And I say that because we’ve seen absolutely shocking results in some people where hair grew back where we weren’t expecting it, and others where nothing happened. When I talk to our providers who do hair for a living, they’re hair transplant surgeons, and one guy even wrote textbook on hair … They still can’t tell me how to predict who will respond and who won’t. But the general consensus is to do a series of three, four to six weeks apart. If after the second treatment you see no results, stop, give them their money back, it’s probably not going to work. Thankfully, that’s usually a minority of people.
So, thoughts for using cannulas for PRP. I don’t. And the reason I don’t is when you use a cannula, what do you have to do? You have to make a puncture wound, and then you have to put the cannula through that wound with the idea being now when you extend deeper into the tissue, the cannula avoids further trauma. The thing about PRP, if you’re putting your needle in much further than the puncture wound itself, you’re probably causing unnecessary bruising already, because one of the beauties of PRP that it hydrodissects. You don’t need a needle. For example, with Juvederm, you can’t just inject it and expect it to spread out. It’s going to make a big glob, unless you fan your needle. That’s not so with PRP. You just get the level beneath the dermis and inject, and it just hydrodissects and spreads out as if you were pouring water on the floor. For that reason you don’t need a cannula because when you put the hole through the skin to make the hole for your cannula, that’s as deep as you need to go to inject the PRP, so you don’t really need it. If you like using with a Hyaluronic Acid filler, that’s fine, go for it, but I find it’s about half and half with our providers.
Next question is, “I have a patient with mild acne pitting, with slightly darker skin. Do I set my speed faster and the depth deeper with the microneedling? How many treatments? Expectations?” As far as speed and depth … First of all, with speed. I have a blender that has one switch, on and off, and that’s it. It’s got a steel rod, so I think you can throw nails in there and grind it up. But it has one speed. You’ve seen these blenders that have 16 things: puree, frappe, soupe. How many different words can we use to describe something just spinning around? And it’s bull. Total bull.
I actually talked to the man who invented the Dermapen. And he said they only put three speeds on there because they knew if they didn’t put three speeds, someone else with a pen would brag that they have three speeds. What they found is, as fast as it goes works the best, because you want to make puncture wounds, as many as you can, as fast as you can, to get it over with. So the speed is just whatever you’ve got, plug it in, make sure the battery’s charged if you’re using a battery operated device, and make the depth whatever depth you need to get it to to cause punctate hemorrhaging. Which is going to change, based upon where you are on the face, and whose face your treating.
How many treatments and expectations. Expectations is … That’s like an hour lecture, but as far as if you’re referring to the mild acne itself, then expectations are tremendous. If you do a series of three treatments, six weeks apart, four to six weeks apart, most people are going to love it. So hopefully that answers your question.
Next question, “How do you correct when there is a deep dimple just below the middle of the lip in some patients? Do you use more Juvederm on adjacent sides to get more lift?” A deep dimple just below the middle of the lip in some patients … So, I think I’d need to see a picture, maybe you can post a picture of what you’re thinking about. I hesitate to say much about that without seeing a picture. I will say though, and as a general rule, if someone has a dimple, or a defect, or a pit, or whatever you want to call it, if there’s a place that needs to be filled and it’s deep, as you say here, then I’m probably going to use an HA filler to correct it, and then polish it off with PRP. PRP alone probably won’t work as well, but I guess deep is relative, so to really answer that intelligently I would need to see a photograph.
So I think that’s all of the new questions on the Vampire Facelift, we were a little bit behind on that one. There’s two on the Priapus Shot website. First one says, “I recently attended a Vampire training course in Las Vegas with Dr. Zimmerman, and I had a question about the penis pump. How much pressure? I found that some information says more than 4.5 can damage the penis. I believe that the course recommendation was seven to ten. Do you have any papers that document the most appropriate pressure?” That’s a good question, and I would need to go to the research. The dogma that I’ve heard from urologists and from going on the blogs where the guys … There’s a subculture of people just using penis pumps.
I compare it to what went on back in the ’70s with weight training. I was a teenager in the ’70s and when I went to buy a book on weight training, there was one in the library. And no one knew who Arnold Schwarzenegger was, he was just a weird guy to most people. He was winning these weird contests called Mr. Olympia. And coaches were still telling guys that weight training could make you clumsy. If you go back to the ’60s they recommend to athletes to not lift weights. The point I’m making from all that is there was a subculture. Even physicians came out of this, physicians in the 1980’s
Section 2 of 5 [00:10:00 – 00:20:04]
Section 3 of 5 [00:20:00 – 00:30:04](NOTE: speaker names may be different in each section)
Charles Runels: Even physicians, get a load of this, physicians in the 1980s, late ’80s was the first time that physicians published a paper saying that anabolic steroids actually made you stronger. Up until then, they would say the bodybuilders, that was just water weight. They weren’t really strong. All I have to say, there can be a subculture of people who are basically experimenting on their bodies. You can sometimes be ahead of the physicians about what works, and athletes, especially, are prone to do that. I think, to a certain extent that is happening in the subculture of people who use penis pumps. You can go and find some of those blogs. Like, if you Google, if you Google my name, sovietisms I’ll come up in some of these penis pump blogs. Let’s see if I can find one. If you read the protocols, or following … I’m not saying that’s where we learn how to be … Here we go, the PhalloBoards Penis Enlargement surgery, phalloplasty. This is proboards… phalloplasty.proboards.com. This is all about growing penises. If you go on these blogs, the common dogma seems to be 10 – 20 minutes at a pressure of somewhere seven to ten.
Honestly, I don’t know. I will look at the research and see if I can get you a smarter answer. That’s the number I hear from the urologists and the blogs. More than that, you just create edema, bruising, and you can get damage. Let’s see, what was the other question. All right, let me add to this one other thing that, I know some people use pumps without a pressure gauge. I don’t recommend that because sometimes people, I’ve found, they’ll either pump it up too much, or they will think they’re getting a good pump, and then give them a pump with a gauge on it, they say, “Oh, this is more than 10 [inaudible 00:22:16].” Without that, you really don’t have any objective measurement of what you’re doing. By the way, there was another paper published in The Journal of Sexual Medicine two months ago showing that using a pump, this was in an animal model, we have them with people, but there was another one with an animal model showing that this helps with peyronie’s disease.
Dr. Grow, I have two questions regarding two patients. Patient One, middle-aged man, non-smoker, moderate erectile dysfunction, and he does react to Viagra/Cialis. During intake there seemed to be no psychological etiology. Had a P-Shot two months ago, with [inaudible 00:22:58] PRP, no improvement whatsoever. He said he used the pump daily. So far my patients have always some kind of improvement. This one had none. What is your advice about the P-Shot? Maybe two? What about the cost? Two things I would recommend. First, as far as the cost to the patient, I have … I posted a video about why I always do things for free if they say nothing happened. How I do it, why I do it, but that’s the bottom line. If someone says “Oh, it worked but I want more benefit.” Then I charge them for the next one. If they say “Nothing happened,” then basically, as far as they’re concerned, I stole their money if I stop right there and don’t give their money back, that’s the way I think about it. Maybe it’s not the way you should but it’s what they think. I respect that. As far as I know, anyone who has given me any money, since 2003 when I went to all cash, they either got better and were happy with what it did, or I don’t have their money anymore.
As far as what to do, what else you might do, I do think it’s worth doing this again. I would do it in combination with our whole protocol. If you go to priapusshot.com/peyronies, even though this man doesn’t have peyronie’s disease, the protocol that I put here works for erectile dysfunction as well. For example, using the pump has been shown to help with erectile function. We’ll need less Viagra. Let me add this too. If you go back to think about what we’re doing here, this happened to me once. Someone said “Nothing happened, nothing happened.” So I told my staff and then they delivered that message to me. “Okay, have him come in.” As he was getting on the table to get his repeat Priapus Shot, I said, “Now you’re taking Trimix aren’t you? Have you changed the dose on it?” He said “Yeah, I’ve cut the dose in half.” That’s a win, that is an expected win. If someone’s using Viagra or Cialis, which this man is, it could be that he’s getting the same kind of erection that he did with half the dose of his Viagra or Cialis. That’s the best we can do.
You have to remember to ask them that and also remember to tell them that when you treat them, that we’re not giving you an 18 year old penis, we’re giving you your penis five years ago which is going to be … you’re going to cut your Cialis dose in half or your Trimix, if that’s what you’re using. Anyway, the other things you can do to support it, just like if you had surgery, you have your cholecystectomy and the next day you’re doing LSD, smoking two packs a day and drinking Jack Daniels, you’re probably not going to heal very well. I’m exaggerating obviously but the point I’m making is, there are things you can do to support healing and there are things you can do to interfere with healing. The things that you do that … those things are exactly the things that would support of interfere with platelet rich plasma because we are triggering the healing response.
Here’s the whole protocol for Peyronie’s and for the same thing works for erectile dysfunction. If they’re not on Cialis then I wouldn’t feel the need to start that. But, post prostate surgery and for Peyronie’s disease you might want to because Cialis actually has some biochemical effects that could help prevent the peyronie’s from progressing and cutting off the mechanism might actually help with the reversal of it as well. The research backing all this us is at each link, there’s a video, we’re going to talk about it. You can actually give your people this website, priapus.com/peyronies and suggest that they follow it. I then have sources for them to buy this stuff. On Amazon.
Let’s see, I think there was one more part to that question. I think that’s all that question. Patient number two, who used cocaine and Viagra during his holiday, experienced some kind of pain during sex, ignored it. In the days that followed, sexual sensitivity dropped massively. Urologist and neurologist seen no abnormalities. Neurologist did, actually nothing. The urologist performed an ultrasound. They sent him to a sexology psychotherapist. They could not do anything. According to the patient, there’s no mental cause here, otherwise that, almost never getting erect anymore, which puts a lot of negative pressure on him. The only possibility to get an erection somehow is with tensing his pelvic muscles and straightening his legs. He asked if a P-Shot would help him and how many? I told him I would ask you because of the rapid onset and [inaudible 00:28:40] P-Shot at this kind of onset.
So, if you took out the drug stuff and the story about straightening his legs and tensing his pelvic muscles and standing on one leg and saying three Hail Marys, I would say the next thing I’m about to tell you, I would do. But, with this particular person I would steer clear and just say “I’m not sure if I could help you.” There’s just this red flag feeling when I hear odd things and history of drug use. I’m not saying that this is the most horrible thing and makes people unreliable. Still, cocaine goofs with your ability to have sex. If he’s using cocaine and I give him a P-Shot and six months from now he tells me “My P-Shot’s not working.” Now I have to be the freaking drug police and ask him if he’s still using cocaine. I don’t like to do that. I’ve worked at a drug rehab center, I think I’m good at rehabilitating drug people, very good actually. I don’t like to do it in concert with Priapus Shots. I would want him off of this for a year before I would become his erectile dysfunction-
Section 3 of 5 [00:20:00 – 00:30:04]
Section 4 of 5 [00:30:00 – 00:40:04](NOTE: speaker names may be different in each section)
Charles Runels: Before I would become his erectile dysfunction doctor. But anyway, let’s assume he’s not doing the cocaine and he doesn’t have the story about straightening legs and pelvic muscles and doing three Hail Mary’s to get an erection. In that case, if it were just a history of trauma, and some loss of sensation, I would tell him, lets do two P-Shots, eight weeks apart and not use the pump. For some reason, I’ve found people that have loss of sensation, they do better if you don’t use the pump, if that’s their main thing they’re trying to treat. Not use the pump, two treatments, eight weeks apart and see if he doesn’t get better.
After the second treatment, have him wait a full twelve weeks before we decide if it’s worked or not. So that’s going to be shot, eight weeks, second shot, twelve weeks. So that’s going to be 20 weeks, but these are nerves. They don’t grow like your hair and if you don’t wait that long, you don’t really know what you’ve done so setting that up is to be the deal. I’ll even write it out and have him initial it so he understands what you’re doing. But that’s for people who don’t use cocaine it goofs up your ability to have an erection so I wouldn’t play with it.
Okay, so those are the two knew ones on Priapus shot. Let’s see there’s … on O-Shot. Here’s the only new one. Dr. Kline said “Can the shot be performed on a patient with a mid-urethral sling in place and if so, does the place of the injection need to be altered or the amount of PRP placed in the urethra?” I actually think, if the shot were done when people do mid-urethral slings, they would probably get better results and more rapid healing. But, we would need someone like Amy Brenner or one of our gynecologists who does slings to tell us the answer to that. I know there was one study done where using the O-Shot in concert with removing mesh gave a really beautiful result and resolved pain. So, the other thing to think about, no matter what the surgery is, say it’s mesh, sling, hysterectomy, all of those things … Well, hysterectomy and mesh, that study’s actually been done. But, one study using PRP with hysterectomy helped healing. I just told you a study taking out mesh helped the pain, helped the healing.
If you’re creating with PRP, something that is normally made with injury to help the healing process, then with any surgery, you can make the argument that using PRP would help the healing process. Therefore, there should be no problem with using it the next day, the next week, the next year. Using PRP should help and there’s no real contra-indication. The only thing is that if I were not the surgeon, I wouldn’t want to be the one doing it post-op until the surgeon released the person and said “Yup, they’re out of the woods, no sign of infection, everything’s working great”, so I don’t get blamed for some post-op complication.
The only other new thing that came up, which I already answered here in words, but the problem is, is amnion stem cells or not? Well, technically, amnionic membrane is a rapidly growing stem cell-like material, but stem cells are alive, or they are just proteins. And the amnion that you’re buying that has been micronized in a syringe or comes as a powder is not living cells. It’s just the amnionic tissue that’s been dehydrated and then Gama radiated and reconstituted so there’s no … Well actually first it’s reconstituted and then Gama radiated, so there’s nothing alive in there. Otherwise you have to worry about catching some disease from the person who contributed the amnion. So there’s no living cells. Now there is [inaudible 00:34:39] who supplies us with the amnion that we sell to our providers as a distributor/wholesaler. They give us a price that’s at the wholesale price. They have a different product that is true, living tissue that is much, much more expensive and it’s not available to us yet. I’m not sure we’ll even need it, but it’s coming. That’s a true living cell. Amnion is not, no matter where you’re getting it.
Now these amino-acid protein chains, or peptide chains, are very, very powerful. That’s the growth hormone, it’s just a peptide chain that codes … You know there’s two types of hormones, there are the steroid-based hormones like testosterone or estrogen that are cholesterol derived. And then there are the peptide chains that are proteins. So that’s why you can’t take insulin by mouth, but you can take [inaudible 00:35:43] by mouth. The acid in your stomach breaks the peptide chains that are in insulin and it just becomes amino acids. As far as your body knows, there’s no difference between eating a hamburger and taking insulin by mouth, because once your body chops all those peptide chains up into individual amino acids, you just have amino acids like in your meal.
But, if you take a steroid like estrogen by mouth, then the acid doesn’t break it apart and it’s absorbed in tact. The point I’m making, is that the peptide chains, even though they’re not alive, they’re very powerful. It’s what’s released from the platelets. So you have peptide chains that are released from platelets, they’re the [inaudible 00:36:35] and all the things that make PRP work. And some of them are exactly the same things made by the pituitary gland, like Somatomedin-C or [inaudible 00:36:41] released from the pituitary gland. Well, growth hormone is released by the pituitary gland and then it causes the tissue in the body, like the liver, to produce Somatomedin-C or [inaudible 00:36:52]. Over two hundred peptide chains are made by the pituitary gland. Over two hundred that we know about so far.
So I think there’s no way to know everything that’s going on when you take these peptide chains from amnion, but what we do know is we have years, much more than with PRP, we have many years of research with amnion showing that these peptide chains have healing properties. I’ve posted some of that research to, I can’t remember which website I put it on now, but I’ll put it here too so it can be found. I think I put it on on the Cellular Medicine, but I recently posted … cellularmedicineassociation.org and then look over the recent post, Amniotic Membrane, Research. So here’s some other papers and actually some of these links open multiple links. So, for example, this one opens multiple papers. Some of these links open ten papers, just with that one link. So that’s some of the relevant research.
Okay. Let’s see what other questions. I think that’s all the new questions on the O-Shot. The Breast Lift, there was one here about sensitivity. “I have a patient that’s had breast implants”, and then after this one I think let’s stop and let me show you a quick, easy way to create an email that’s interesting to your patients and will bring them to you for the things you know how to do. This is one of my hacks, it really kills it. It’s easy, it’s fun, you’ll like it. It makes you smarter. And it brings people to your office.
So, let’s answer this one last question. “I have a patient who had breast implants and has loss of nipple sensitivity. Her primary concern is to regain the sensitivity back. She asks what percentage of people who have received the Vampire Breast Lift do in fact have [inaudible 00:39:03] improvement in sensitivity and are pleased with the results. If you can provide me with an idea of this percentage, that would be helpful.” So, I have had 100% with this. I’ve probably treated, I don’t know, I’ve been doing this fairly regularly for eight years now, and when I’ve surveyed and asked some of our providers on another call what their experience has been, I’ve heard everything from 80% to 90%. I don’t like saying anything is 100%, but for run of the mill, loss of sensitivity for implants or breast feeding, it is very, very, it’s more than 50%, I think is a safe thing to say.
For breast reconstruction post breast cancer, not so good. I don’t even promise them anything. It’s more about aesthetic treatments when I do that.
Section 4 of 5 [00:30:00 – 00:40:04]
Section 5 of 5 [00:40:00 – 00:58:14](NOTE: speaker names may be different in each section)
Charles Runels: Okay. I think I’ll show you my little email hack, and then let’s call it a day. So, let’s say … Here’s the process, let me pull this up for you and we’ll [inaudible 00:40:15]. And I’ll just demonstrate it. This is how to write … This is how to write … an email, very quickly, that you people want to read.
Okay, so I first start with what I want to sell. The market, what am I marketing? In other words, let’s say it’s the O-Shot®, as an example. So, I don’t want everybody to come see me for an O-Shot®. All I want to come see me for the O-Shot® are people that I can really help, like if someone’s got … They need a hysterectomy because their cervix is hanging out of their vagina, they don’t need to come see me.
But there are certain things that I do know how to help. So, let’s say that one of them is dyspareunia. So instead of talking about … I always have to think about how to spell that word. So instead of talking about my O-Shot®, why don’t I talk about one of the problems that I do know that I have a high success rate for? Dyspareunia.
Now I know this is like back pain, there’s lots of things that cause dyspareunia. So, we could just pick one of those, but I’m just going to leave it at that for now. We can say dyspareunia post episiotomy, let’s just say dyspareunia. Actually, why don’t we say dyspareunia post-partum. Post-partum, and just make it more fun.
So, this is what I know. Dyspareunia post-partum, we’re the bomb, we’re the O-Shot®. So now, so that’s step one. Number two, and then we’ll just follow this, and I’ll show you how to do this. Literally, five minutes, you’re done with an email. That just kills it.
So number two, you say … okay, so first it’s the what do you want to market? Next, is what problem do you want to solve with the thing you’re marketing? And I’m trying to move this down to number two because that really should be number two. So, make this number two. Ugh, it won’t go. Okay.
So, what problem? Dyspareunia post-partum. Now you’re going to go to PubMed and go to Google, and see, you’re going to find some research. And this is where it gets fun because you should be wanting to read this anyway if you’re treating it. So, let’s just Google it first. We go Dyspareunia post-partum.
I’m telling you, I’m giving you the keys to the kingdom. This works so very, very well. Okay, so definition, not interesting. Okay, this looks like a full text clinical trial that’s underway, but clinical trial’s probably not finished, so … I’d like to find something that’s done.
Okay, episiotomy and the development of post-partum dyspareunia. Done. Apparently, Google likes that. So this will save me from doing the PubMed thing. And let’s just quickly scan it, see what it’s saying. Now here’s the thing. If you have a patient, or if there is someone out there, not even your patient, is dyspareunia post-partum. They can look at this, smart women, they can look at this, figure it out … But even though they’ve figured it out, sort of, they’re not sure if they’ve really figured it out.
And they would love to have a physician think about it with them, and tell them, “Yeah, this is what it means.” And they would even better like it if it’s their physician who’s thinking about it. So, let’s just scan this really quick. Episiotomy, common surgical procedures, a study, episiotomy [inaudible 00:44:11] 39%. [inaudible 00:44:13] sex life, largely unknown. Three months post-partum. More severe dyspareunia … Okay, the aim, assess the impacts, development of post-partum.
So, materials and methods. Let’s just scan it. [inaudible 00:44:32]. Interview, questionnaire, so these are questionnaires, visual analog scales, so we’ll skip down to the results. Of the 200 hundred patients that participated, 100 had vaginal delivery with episiotomy, 100 had C-section all were primigravida. In ages 22-24 years old, okay, characteristics, average incontinent scores, dyspareunia was present. 21% of of group one and 8% in group two. So significant increase in the presence of dyspareunia. So that’s the conclusions right there. Present, not present, so there we go.
So now, situation, whatever [inaudible 00:45:34] dyspareunia. Okay now, here’s how you write the email. Let’s go back to our list, we’re going to need this link right here. So I copy that link to the research and let’s get the numbers down here. Was it 21% versus 8%. Okay. So now, let’s write our email. I like to do Ulyssis, but you can do whatever, I don’t like all the extra stuff in my way when I’m trying to write. So hello, and then you’re going to put first name. Dyspareunia, painful, painful intercourse can put a huge strain on family and relationships. Recent research looked at the percentage of women who suffered with pain after delivery, and found that the percentage jumped from 8%, if there’s a C-section to 21% or about 1 in 5 with vaginal delivery. Now, can you see now you’re talking to your patients like who they are, smart people. And you just learned something. The solutions, my cursor just jumps around, solutions to this problem can be very unsatisfactory. We’ve found that the O-Shot®, procedure can be helpful in most women. Okay. If you know someone who suffers, of course this someone could be the woman reading this, maybe she knows her mother, sister, best friend has problems. If you know someone who suffers with this problem, would you mind letting them know about possibilities of seeing better. I’ll just stop there. Possibilities with the O-Shot®. Sincerely, okay.
Now, you can take this and copy it. However you send your emails, alright, we’re almost done. I don’t know how we’re doing for time here. However you send your emails then. I like using Ontraport.
So you can see I have my contacts sort of sorted out into lots of different categories. For now, you should probably just have one list that your emailing to, but, I have a list of O-Shot® patient inquiries. So about 6,000 people. So we’re gonna send an email to all these people and try to get them to come see you.
So I’m showing you how to write an email. So now selected all those people and this is how you finish off the email. Use [inaudible 00:51:03] contact, whatever you use it will work the same way. So email for me, and then let’s say new, I like to have a promise embedded in the subject, so, 21% of women would be interested in this after childbirth. Okay? Now I take that, what we just copied that we wrote. And again I like using it in whatever your favorite editor is. Now I need to put in the first name and how this works with your software, it’s going to be very similar, but now we need to put the website. So I can say click to read the research. Then you come back up here and find that paper, so back over here, and you just copy that domain name, and then come back to where you’re writing your email, you still with me?
So, click to read the research. I’m showing you how to write something, and the reason people are not going to put this..they’re going to read your emails if you send them emails like this. What I just did was I copied, paste that into that link and I always want it to open up a new window. It’s just a little hack I do to that makes people stay with you.
So they all work the same, they’ll have a little chain link picture, you highlight whatever you want the link to be, then you click on the chain link and you place the domain into the box. And then make the target a new window and then you save it. Alright?
And the we want people to go to the O-Shot® procedure and find you guys, so I am going to the directory for the O-Shot®, O-Shot.info/ actually, I’m just going to put the O-Shot® webpage and then web coach. Now, that’s it. And then you put name, its helpful I think if you have your signature as a picture so you can add your signature in. So, we’ll find my signature, put that in. And even if you have someone else do this, at least if you understand how this can be done you can create the content and have somebody else do this. I think its good to put your phone number and then always put a P.S.
I like putting the little reverse arrows if I want somebody to click on something, because they see that and it slows them down.
Okay, so lets go back and look at what we’ve done. Now I’m going to send it here in a second here in a second and let you see the final. So we first thought of what we’re going to market. Then we decided it was going to be the O-Shot®. And we decided a problem that thing we’re marketing would fix and we picked dyspareunia post-partum. When we googled it we found some research, then, we wrote by an email, just letting people with the problem know about the research and offering your solution, see number 1. So that’s where you put the link. That’s it. Then you send it. Alright so lets go back here, and the other thing before I send it, is I like the text to be at least a font of 16, because people reading this on their Iphone and a lot of them are like me and need reading glasses, they can’t see the little letters. And it’s nice if you put a new picture so people remember what you look like, remember they’re not really thinking about you that much, they’re thinking about their own problems. They don’t really care that much about you. So putting a picture there helps them remember you. And then we send it.
Before I send it I will often make sure to make sure that they do work. So you can see now if I click to read the research it opens a new window, it takes me to that research. And then if I move to the O-Shot® I made that window just taking them there so they will find you and I then I should find the science here and I send them to the research page. Make sure that one works. Yep, were on the research page. So it’s ready to go. And that’s your formula so you go ahead and send it. Hopefully some of these people will actually come see you. So save and send. I think with that we are right at the hour and hopefully you guys got something from the questions and my little tip about how to send out emails to people who actually want to read. Those will rarely go into the spam folder and you’ll get about a 30% opening rate, consistently, if you do what I just taught you. Alright I guess that’s it. Let me see if there are any questions and we’ll shut this down. None? I don’t see any questions so thank-you guys, you guys have a good week and I’ll post a recording to this to the CMA website.
Section 5 of 5 [00:40:00 – 00:58:14]
Hope this is helpful.
Charles Runels, MD
Cellular Medicine Association