JCPM2018April4.PenisPump.Needed?FreePress.PumpIncreasesO2.DrDelucia&FreeTVAppearance.DrGoodmanOnInnovation

Topics Discussed Include the Following…

*Can you pump too much? Do you really need a pressure gauge?
*Where to buy a penis pumps wholesale & how to adjust price
*Do you have to use the pump after the Priapus Shot® procedure?
*Other side effects of the pump.
*Dr. Delucia & The number one reason doctors do not get free press?
*Here’s one of my favorite articles about penis pumps–showing that the use of one increases transcutaneous oxygen concentration
*Briars, Woods Walking & Medical Innovation
*How to measure web traffic. One of my secret tools.
*A way to get a free appearance on your local TV station
*Dr. Michael Goodman talks about innovation in medicine & funding research

Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips

Transcript

Penis Pump Research

Next Workshops with Live Models<---

Charles Runels: Let’s start by talking about penis pumps. I received two pretty interesting questions in the past week about penis pumps. One of them had to do with … Oh, by the way, we’re also wanting to speak a little bit about amnion research, and an article that came out today giving us some free press about the O-Shot, and about how to use that press, to leverage it for your own practice.

First about the penis pump. This is a sampling of some of the research that’s out there about penis pumps (click), and some of this research answers questions that were posed to me. One sent me a photograph of a penis where they did a Priapus Shot, this story, guy has an erectile dysfunction score of about 15 or so. So he has some function, but it’s not like what it used to be.

So he comes in for a Priapus Shot® [procedure]. After the shot, the pump was applied. Then, when they took the pump off, the patient had some looked like vesicles on the glands’ penis, filled with clear fluid, three of them, and some increased bruising, more than what would be expected from just the injection. The question was, what might’ve gone wrong?

My first question was, what pressure was put on the pump? This provider had … By the way, there was no permanent damage, so I’ll just go ahead and tell you the ending of the story is good. But the provider, rather than follow our protocol, which is that you apply a negative pressure of 7-10, provider had found somewhere on the internet the recommendation of a pressure of minus 15. The cause of that, that’s what created those vesicles and the increased bruising.

Can you pump too much? Do you really need a pressure gauge?

Along those lines, I wanted to show you one article that shows that over inflation, as you might expect, there’s one of many. There’s case reports out there of people doing stupid things like hooking their penis up to the home vac system, and it just gets ripped off. Obviously, we’re not going to do anything like that in our office. But this is just a simple case where a 66 year old gentleman used a vacuum erection device, but he bought one without a pressure gauge.

I think that’s really dangerous to have people using something that you cannot measure. They get overzealous, maybe there’s loss of sensation already from diabetes or injury. They can’t tell what they’re doing. If you do a Priapus Shot®, by definition, you’ve probably put some topical anesthetic or maybe did a block, and so they don’t have the pain as a feedback.

I think it’s really dangerous, in my opinion, to either use or recommend that someone use a pump without knowing what they’re doing. Now, if you go back and you look at the research, which this is representative, but there’s others I’ll mention shortly. You’ll find that it is, if it’s done the proper way, this has been a therapy that’s been around since 1974 or so, and it’s known to be a safe and effective treatment. Provided that you use it intelligently, just like almost everything we do in medicine, there’s a sweet spot in less is less effective, and more is damaging.

Same with this, and if you’ll go back to the old protocols that people were using, they were going sometimes up to a pressure of 15. It starts to sound like people comparing notes with lifting weights or something. Where is it better to do high intensity heavy weights for short repetitions or small weights with high repetitions? It sounds a little bit like people comparing notes at the gym.

I think there’s still room for thinking about this, but there’s couple of papers in the Journal of Sexual Medicine that you can go look at. The patent, which I think was very tightly edited by Irwin Goldstein, where it showed that using a vacuum pump increases the effectiveness of Viagra and Cialis. Men taking those therapeutic medications get a better result if they use a pump, intelligently, which makes sense. You’re just basically stretching out a water balloon to make it easier to blow up, but if you look at the old protocols involved, sometimes going to pressure 15, but most people think now, if you’ll look at the protocols being used in penial rehabilitation therapy where you also find a lot of this pump research.

Rehabilitating the penis post prostate surgery. The usual protocol’s a negative 7-10, and some guys, they seem to be really sensitive, and that’ll complain of pain at three or four, that’s okay. Just something that increases the erection equivalent or maybe slightly more than what would be experienced with a normal erection using the vacuum pump. That seems to be the place to where people see some improvement.

There was also this article, and another, looking at … Yes, this one. This is the journal of sex … Wrong one, I’m sorry, excuse me. This one.

Yes, so this was The British Journal of Urology, nice paper where they took people who had Peyronie’s disease scheduled for research, 31 people, and over a course of 12 weeks they had them use a pump twice a day. Half of them canceled their surgery, because just the mechanical makes sense. You have the scar tissue, stretch it out every day, a couple times a day, it might straighten it out, and it worked. When I talked to Ronald Virag who published the most recent, I think, landmark study about using PRP for Peyronie’s, which you can find if you go here, you go to our website, priapusshot.com/peyronies

By the way, I think this relates very nicely with the work that Andrew Goldstein did for us, with lichen sclerosus, because it all relates to the PRP down regulating the autoimmune response. If you go to, let’s see. If you just go /peyronies, which I recommend you give this website to your patients, because I put on here everything that I could find in the literature that had been shown in a really nice study to help with Peyronie’s. One of which was the Priapus Shot, which we can now say now.

If you go to just click on the references, so give them that, PriapusShot.com/peyronies so they will include all of those things in their protocol. For example, there’s a higher incidence with smoking. They’re sort of undoing the things we do if they don’t quit smoking, or at least try to do that. Not this one, this one.

Yes. Wait, this is not the Ronald Virag, it’s another nice study, but this isn’t the Ronald Virag study. Definitive study is … Yes, this one. This one. This is the one that I love.

Dr. Virag, who I think is amazing, he’s a legend, because he was the first guy to think of doing the TriMix injections, vascular surgeon turned ED expert, because of that idea. Here in this study, he showed that using PRP works better with fewer side effects than Xiapex, really nice research including some objective data using imaging. I’m kind of going in a circle here, but if you talk with him, which I have, shared the podium with him a couple times. If you talk with him, he’ll say in practice he combines PRP with the pump.

Circling back to what the original topic was, we have a pump study showing that mechanical traction helps Peyronie’s disease. Then we have this really nice study showing that PRP helps Peyronie’s disease, and when you talk with Dr. Virag, he’ll tell you that in practice he combines the two. Of course, when you’re doing a study, you just want one variable, but in practice, that combination is really nice, which is what we’re promoting when people come to us. Back to the pumps, you need to know what you’re doing, in my opinion.

Where to buy a penis pumps wholesale & how to adjust price

I think you use a pump that has a pressure of somewhere between … that you could measure, and then you have them put that pressure somewhere between 7 and 10. Now, I’ll show you where some people have trouble finding this, for some reason, so I’ll show you where I have a link. Where you can buy it wholesale, penis pumps, and I’ll tell you how some of our people are using this to create, not only a better outcome, but more profit, which is really nice when you can help people tremendously, and also the combination of doing more creates more profit. Let me get to this and show you.

If you go, sort of coming in the back way, so let me have one more click before I show you what you’ll see. When you login to the Priapus Shot membership sight, and then when you land, you’ll be on the dashboard, which is the next page I’ll show you. Here. Then when you click on the how to do the procedure part and scroll down, unless it’s somehow fallen off the page, which somehow computers do that sometimes, I’m not sure why, but if you scroll down, there should be a clicking link here somewhere where you can buy that. That’s it.

That is a wholesale, place to buy wholesale pumps. There’s a hand pump, an electric pump. This pump, not saying that you should have to use this, but I like this pump, because it’s a heavy duty metal device, and it has a pressure gauge on it. But, what some people are doing to increase both profit and outcome, is ordering this electric pump, which has a retail value of around $500, give or take.

If you go, this is the wholesale sight of this website, if you go to the retail sight, this has a perceived value of around $500. So some are buying this at wholesale, giving it to the patient, and charging, instead of our usual 18 or $1,900 for the Priapus Shot, charging them $2,200, but you’re giving them a device that’s worth $500. The overall perception of value, and the real delivery of value is actually more. This works well, because you can just set this.

One guy who came to me who had some nice results, he said he just set this and read the Wall Street Journal for an hour a day. I know that’s more than most people wanna devote to a pump, but the point is that if you set it at a nice low … and he used the pressure of seven and had really great results before he ever got his Priapus Shot. I feel like I need to talk more about this, because this is something that sort of freaks people out, and they’re not familiar with it. The other thing that I would tell you is that most people, if you get somewhere around 2-2.2, this is the diameter of the cylinder.

It’s going to fit most people, and seldom will people need the other tube, so maybe you buy one of those to have it on hand, one of each of these, but if you keep the tube to the 2.2 on hand, most people will fit one of those. You kind of see what you’re dealing with, and if it’s the average sized penis, you give them one of those, and give them this. Most of us are giving them a pump as part of the procedure, and just figuring it into the price. Anyway, that’s all there for you.

I kind of cut that deal for you guys, and if you wanna see the retail side of that, this guy Dr. Kaplan, Joel Kaplan out in San Diego. I went and checked him out, I like to meet people personally and see them. It’s interesting, if you go to his “office” it’s a huge warehouse literally stacked up 30 feet high with penis pumps, and about five people manning the computers. He’s making so much money with these pumps, because he delivers a nice product at a good price, but this is the patient side of it, which I like them being able to get to, so I don’t become the pump service repairman.

Whatever pump you give them, I like it to be something they can get … if something breaks on it, they can just order another cylinder without calling your nurse and turning her into the pump mechanic. If they want to get a different size something, because they grew, which happens sometimes, or whatever, it’s all on here for them to measure and do all that. This is the company from which you’re getting the wholesale version of this, it also gives them a way to see that you’re actually giving them something. I said $500, it’s 495 for this system that you’re giving them, or depending on what you’re attaching to it.

Somewhere between 4, 500 bucks, roughly, that you’re giving them, along with your procedure. All right, so that’s one problem, and you have research that shows the pump is helpful mechanically for Peyronie’s. If you go back to PubMed and you look at this, because the other question I get is, “Do we have to do the pump?” I actually had three questions this week about pumps.

Do you have to use the pump after the Priapus Shot® procedure?

One was, “Do we have to do the pump?” No, you don’t really even have to do the shot, right? They could just watch game shows and not have sex, but if you want to get the best effect of this thing, if it’s Peyronie’s, we have good science showing that it could be helpful as a standalone. If you have erectile dysfunction, we have studies showing that it could be helpful.

If it’s done intelligently. If you have prostate surgery, we have good studies showing it’s helpful, and if you want to read that, you just go to PubMed, and put in penile … That’s not PubMed, let me get back to PubMed. You put in “penile rehabilitation,” and a lot of science about how to recover post prostate surgery, and you’ll see that almost all of these protocols involve some combination of Cialis, low dose daily with a pump used daily.

Now, let’s just stop and quit thinking science for just a minute and just think commonsense. I’m a big fan of Richard Feynman, because he had two Nobel Prizes in physics, but he wasn’t into the limelight. He would actually use a fake name when he was going to lecture at universities, because he only wanted the mathematicians in the room. He didn’t want anybody showing up just because he had a Nobel Prize in physics, but he was a big fan of commonsense.

You do the math, but then you stop looking at the math, and you think what I’m looking at, is it commonsense? If you think about what we’re doing, as far as just mechanically allowing a balloon to be easier to blow up, then it makes commonsense that it would be helpful. Now, the other thing, can we take the commonsense thing one more step? There was a time, not so long ago, that I can actually remember, being 58, I can remember as early teens, 12, 13 year old, trying to figure out how to make muscles grow.

There were still people, at that time, who thought that lifting weights was somehow not good for you. If you go all the way back to the ’50s, it was actually … athletes were discouraged from lifting weights. But you had physical therapy post stroke. Physical therapy post stroke, after an injury, trying to recover strength.

It wasn’t until the 1980s, when I was in medical school, that the first article came out that actually said, “Yes, anabolic steroids actually make you stronger.” If you go back before that, they were saying that, “Well, maybe it’s just water weight, they’re not really that much stronger.” But the athletes all knew that was wrong, and I was working as a trainer in the gym, and we’re looking at people lifting the whole side of the gym, so I knew that was not right. Commonsense said it was not right.

Now, back to penises. If we have something that seems to be working for rehabilitating the penis, so if you use that analogy with weight training, why wait until the injury? Is what I’m saying. You don’t wait ’til you have stroke to go get rehabbed with your muscles, you lift weights to try to maintain strength so you don’t fall and break your hip, or you go walking, or some sort of weight resistance, so you don’t wind up like astronauts, where your bones break for standing up, which happens to the elderly.

Back to this. I think that the old will become new. Penis pumps were a thing before we had Viagra, I think they’re becoming a thing again, as we start to rethink how physical therapies might help penial help. Okay, that’s me just kind of trying to think like one of my heroes, Richard Feynman, with commonsense, without looking at the literature. But go read the literature, think about it.

The questions I got were, this week, three of them, “Do you need the pump?” The answer is, you don’t really need it, but you’ll probably get a better results if you use it intelligently. The one exception of that is probably if you have loss of sensation, just anecdotally, what I’ve noticed is those guys, if their only complain is loss of sensation, you’re maybe better off without using the pump. I figured this out, or noticed it in multiple patients.

Penis Pump Research (click)<--

That also makes sense if you’re trying to grow fragile nerve endings, perhaps the mechanical stretching may not be so helpful. That’s the exception to that things we’re using the pump for. The other question was about … Should you use it? My answer is probably yes.

Can you over use it? Do you need to get something with an actual gauge on it? Yes, I think you do, and this guy claims he’s got something that’s FDA, a device that’s been evaluated by the FDA, to where you actually have an accurate pump on it. You don’t want to get blamed for somebody else’s impotence, which is what happens if they over pump, consistently.

Other side effects of the pump

The other side effects are that their skin can become darker, so you just tell them that, and it will reverse if they stop pumping, and they can get some edema if pump for a long time, even if they don’t over pump on the pressure. Should you use it? Yes, for everything, maybe except for loss of sensation. Get something with a gauge on it, and I’ve shown you where to get it wholesale from our website.

Now you have a protocol that you can follow. There’s also a nice little video here that kind of talks you through it. Normally what I do is, I’ll do the shot, I’ll get the pump going, most people are afraid of them. I de-stigmatize that thing by calling it yoga for your penis, and that seems to, I don’t know.

Maybe one of you guys should do that penis yoga, but I think that seems to kind of calm them down a little bit, and I recommend that they not try to hide it. Just take the thing out and pump it up when you’re watching TV with your sweetheart and try not to make it into some big giant secret. The worst thing about porn is people keep it secret from their lover, and then it takes on this mystical thing that turns women into porn widows, where their husband’s off jacking off to porn. Where it loses power and usefulness, I think, when it becomes more shared.

Here’s one of my favorite articles about penis pumps–showing that the use of one increases transcutaneous oxygen concentration (click)<–

Okay, so I went off and made lots of circles there, but that’s my ideas about the pump. Now, let’s see, what else did I promise you guys? Maybe I should open up … Anybody want to comment about that? That’s on the call, I know there’s some people on here that have done really nice work and had lots of success.

If you just click the button, I’ll unmute you where you can talk to the group, I have a really nice group tonight, and you probably want to comment more about the pump thing. Okay. The other thing I promise we talk about is just to show you guys where some of the amnion research lives. Oh, you know what?

Free marketing for the O-Shot® [Orgasm Shot®] procedure

Let’s take a break from the research for a second and show you some free research thanks to one of our many amazing people, Carolyn Delucia, who is on the call. I’m gonna unmute you Carolyn, ’cause we have two crazy good articles. Before I unmute her, let me just show you, this is a gift from Carolyn, who’s created a really nice relationship with this lady who’s been writing about our stuff, I think, very intelligently. Here’s one that came out March the 11th, about the O-Shot, and here’s one that came out, check this out, April the 2nd about vaginal rejuvenation.

Wait, let me click on this thing. I went down too far. It talks about many of the things that we do, so this is a … I think an intelligent way and a balanced way that doesn’t over promise things. So, this is another nice thing to show your people, and so, how do you show people?

But before I get to going here, maybe Carolyn can talk a little bit about not just the procedures … I just un-muted you, Carolyn, but maybe just kind of some words of wisdom because she’s been teaching for us. She’s managed to get some amazing press. Part of it is because she’s in a nice town, but part of it is that she hustles and she knows how to talk with the press. Okay, are you there, Carolyn?

Carolyn Delucia: Hi everybody. Kind of shocking to be unmuted here but that’s okay. We love you, Charles. When it comes to getting press, I’ve been very fortunate to have gotten by accident noticed by one of the … Daily Elite, I think, was the first one, and once that happened, I was invited to give opinions on many articles. I think that the point there is if they ask you, say yes, and answer their questions quickly, and they are kind enough to alert you when they actually publish something that you have said, and it gives you, without any merit, truly an expert status, which is kind of comical, but we do these procedures day in and day out, helping our patients, and never really expecting anyone to notice, but if they do, it’s a way of letting everybody else know that this is available, and it’s been my soapbox for quite a number of years now.

Charles Runels: So, can I bring up something because … I won’t interrupt you for too long, but I want you to address a couple of times as you talk.

Carolyn Delucia: I’m done.

What’s the number one reason doctors do not get free press?

Charles Runels: So, one of them is this. There is an unspoken rule among physicians that is a really scary rule, and I’m going to speak it out loud. Here’s the unspoken rule: You don’t really have a right to be in the spotlight until you’ve published for many, many years, and maybe you have a professorship or something somewhere, and if you jump around, and you get a lot of attention before that happens, maybe you might be breaking a rule. Now, there’s no one who comes in and arrests you for that, but there’s uncomfortableness about that, and do you think I’m making that up, or what’s your experience, and how do you deal with that?

Carolyn Delucia: I think that the only reason why, without tons of publications, that I’m able to speak on this topic is that everybody else is afraid to, and I feel that women have got to know that these treatments are available even if it’s before all the literature comes to fruition, and I think that keeping it secret and not speaking of it and not being … I think for OBGYNs, mainly, our issue is that it’s not yet approved or officially condoned by the American College of OBGYN. So, with that, it’s making everybody a little bit uncomfortable to try it, and to speak of it, but we’re seeing such amazing results, and internationally, the literature is there. Whether I’m publishing it or not, I can certainly refer to plenty of literature defending these procedures. Whether they’re completed in the US already or not, they exist, and the results are in the great promise that we see in our patients.

Charles Runels: So, let me-

Carolyn Delucia: So, I don’t care.

Briars, Woods Walking & Medical Innovation

Charles Runels: So, I want to point out something, and let you elaborate this, and I want to pull in Dr. Goodman because he’s on the call, and as you know, he did some of this research, and was in it before we were in it, and I think the ways …

I always imagined myself when I was six. I used to go bird hunting with my dad, and we would go … Down in Alabama, the forest is so thick, and there’s a lot of … I don’t know what you call them up north, but we just call them briars down here, and those briars will just literally rip your skin, and I remember my dad walking ahead of me, and stepping on things, and knocking the briars out of the way so I would still be cut enough to where I’d feel like I went to the forest, but he sort of blazes the path for me, and so I feel like we, the people in this call, are blazing that path, but I think Dr. Goodman was kind of the daddy up there that took a lot of the heat before we got involved.

But before I pull him onto the call, I want to say that there was something key to you’re saying more in tone than in words, but you hinted at it in words. You believe in this, and you feel like women need to hear it, and I think that part of what makes what we’re doing important, maybe, to somebody is that you know this is at least working for some people, and there is some research and a growing body of research. Some of the anchor stuff actually done by Dr. Goodman, who I’m going to hopefully speak up in a second. I’ve got him muted for now, but they need to know, and because we’ve seen families and lives change because of it, we’re sort of willing to take some hits, and we do take hits, right?

Carolyn Delucia: Yes.

Charles Runels: We do all take hits, and we bleed. Metaphorically, we bleed, and the people on this call, I think, have a right to say, “At this point, we’re still in the early innovator stage, trying to get the research.” By the way, I was on the call today with Johnny Peet, and I think we’re going to very soon blast off with placebo study with incontinence. Andrew Goldstein is proceeding. I just kind of revived our recruitment for our double blind placebo shot for the O-Shot for orgasm, and our group is contributing literally hundreds of thousands of dollars to helping make some of this happen. I haven’t paid Dr. Peet anything yet, and he thinks he can do that one fairly economically, but the point is we’ve got some funds. Our group is financing a lot of this because there’s no pharmacy to kick in, and we’re risking taking the heat.

So, I think the thing that was in there that you, being humble, didn’t emphasize much, but the biggest thing to be talked about in the press is, one, getting a little attention, but then having the courage to actually do it. So, my hat’s off to you. I think part of the reason Italians ruled the world twice is Italian women so I mean, you’ve got the courage [inaudible 00:30:38] to do the thing, right? So, I’m doing to pull in Dr. Goodman and see what he has to say because I’m …

Now, one other thing about these words. I know Dr. Goodman, for every reason, has a right to the rejuvenation. I think that Dr. Matlock actually may have a trade mark on this rejuvenation word, and we just launched a website called Vaginal Reconstruction. It’s going to be just for our surgeons in the group that do the O-Shot, and it’s going to be … It’s in the preliminary stages, but I have plans to drive a lot of traffic so people aren’t confused about what’s surgery and what’s rejuvenation.

One of my big favorite authors is Thomas Moore, who wrote Care of the Soul, and he has a book about writing where he says [In Thomas Moore on Writing], “Everybody sort of has their own personal dictionary.” So, my grandmother always called a car “fliver.” I don’t know where that word came from. We all have different meanings for word, but the thing here is that when people have a lot of time and energy and money invested into a word, it’s an important thing, and for example, when I started using the word “facelift” associated with an injection procedure, I caught a lot of criticism from the surgeons who wanted facelift to mean just a facial surgery, and I understand that. I mean, I have a crazy respect for facial plastic surgeons. That is not an easy thing to put a face back together after you go through a windshield, and I would never pretend to do that, but I sort of took that word and made it mean something else, and then I thought anything lifting the skin away from the skull should mean facelift, and so there is some emotion tied around this word, I think, for a good reason.

So, I’m going to unmute Dr. Goodman, and just recognize him as someone who took the heat before I even knew this was a ring to get into, and he was getting punched up and doing some research. So, I’m going to unmute Dr. Goodman, and he will have-

Charles Runels: Hey, Dr. Goodman. Are you there? Michael? Hello? Dr. Goodman?

Okay, so are you there? Okay, so we’ll see. Maybe he’s not able … Maybe his microphone’s not working right now, but anyway, so anything else you want to say, Carolyn?

Carolyn Delucia: I think you’ve said it all, Charles. I really do. I think that the most important thing is that women are aware that these procedures are available, and that is not a cure nor a promise, but it may be a help, and I think that the main point is getting the word out, and that’s been my journey.

Charles Runels: Yeah. So, thank you for speaking up, and thanks for being courageous. Now let me see if I … If you don’t mind, Carolyn, can I just leave you unmuted, but let me see if I can give you guys a couple of tips on what to do with this because now this is here. It’s talking about lasers. It’s talking about surgery, and it’s talking about, of course, the O-Shot so it’s all here, and even though I take heat, the good thing I’ve learned to do, although not as well as I would like, is to realize that even bad press can at least bring attention to it, and if you’re okay with bleeding a little bit, and it brings attention even if you catch criticism, it’s okay to let that go.

So, what do you do, I guess, when you have this? How do you take this, and turn it into patients coming into your individual office? There’s a system I have. First of all, you want to look at Alexa, and see if it’s worth noticing. So, can you see that pop-out screen, Carolyn, that shows-

How to measure web traffic (one of my secret tools)

Carolyn Delucia: No.

Charles Runels: Okay, all right. So, you guys can’t see it. Okay, so I’ll just show you. If you go to alexa.com … I guess the first thing that I like to do is to make sure someone’s listening. If I look at a website, whether it’s good or bad, and it turns out it’s someone’s little blog that nobody’s reading, it doesn’t really matter if I post something to it. I’m not sure this allows … I don’t think it does, but most of the webpages where something like this happens, it allows you to comment. This one allows you to make a question, answer a question, but usually, there’s a place to comment, and why take the time to comment if it’s a blog that no one’s reading?

So, I use alexa.com. You go to A-L-E-X-A.com, and then you can just copy the address from where you were just at, and put it in here, and it will give you the traffic. So, here’s the traffic on this website, and it’s ranked 27000th in the US. That’s really very high. That’s very, very high so that’s worth noticing. So, that tells me that if there was a place to make a blog post here, that people are going to read it, and then that gives me a free ad perpetually after that. Is there … I’m going to show you an example if you Google “vampire breast lift” because I’ll give you an example of another article that Carolyn did where a lot of us got some press out of it. So, breast lift Cosmo is the one that really allowed us to make a lot of comments. Power to Cosmo for Cosmo …

So, if I told you, you could get an ad on the Cosmo website for free, that would be worth huge amounts of money because to have a display ad on Cosmo would cost you many thousands of dollars, but when Carolyn got this article about the breast lift, at the time, I don’t know if it’s still here, but at the time … Let’s see if they’re letting you do it. Well, it went away, but usually, they let you … There was a place to make a post.

The point I’m getting at, if there’s a place to post a comment, you do it, and you do it in such a way that it’s not an ad. You just make an intelligent comment on the article, and then you will have basically a display ad on that website, but before you do that, the first test is to go to Alexa, and see if people actually visit that blog. So, Cosmo, if you do an Alexa thing, it’s not showing you, but it comes out at 1000, and 27000 is this one. If you do say, for example, Botox Cosmetic, it’s about 130000 to 150000 in the US. Our O-Shot is usually about 50000 so we’re not this much traffic, but we’re much better … Anyway, there’s a lot of traffic so it’s a respectable site, and you would make a comment if that’s possible.

*Next step is that you then take that link for it, and you just write an email that goes very simply something like this, and this is what you send to your patients, “Hello, I thought you might be interested in this procedure that helps urinary incontinence. Here’s a nice article about it. If you or someone you love,” always put you or someone love, “has this problem, and is interested, please give us a call or shoot us an email,” …

*and then you put a link to the page. It’s that simple. You don’t have to become Thoreau. You just write a very simple article like that, and post it, and then you can take that same thing, and I’ll show you how you can put it on Facebook very easily.

You just copy the address, and then if you want, you can just click the Facebook link and it puts it there, but if you want to very quickly make something more individualized, you just go to your page, and watch what Facebook has the … See, I’ve already done this, but I wanted to make a more intelligent comment about it, if you put the link in there, it pulls up the page, and then you can just make a comment about it into that box, and you’re not seeing the pop-up box, but it pulls up a pop-up box, and I’ll just show you an example, and then when you post it, now you can see. I just typed in an example right there, but I could’ve put something like, “Come see us about this procedure,” or whatever suits your personality, but all I did was in this, right here, I posted the HTML address into that space, and then it pulls up the picture, but it allows me to type something else there so that’s how you do it. I better take this away. That’s how you do it to Facebook or Instagram or wherever.

So, for me, it’s an email that’s two or three lines as if I were writing it to my mother or my girlfriend or sister or something, and then with a link to the thing with a plea for them to either call me, or let someone they love know about it, and they will think about that. It gives them the chance to help their sister or their best friend or whatever, and they will forward it to them. Okay, and now you’re using the national press to promote your practice.

A way to get a free appearance on your local TV station

*One last thing, and this one’s a big one if you have the courage to do it. Then what you do is you should have in your pocket, in your cell phone, the phone number of the health reporter for the news channel in your town, and then you call them, and say, for example, when this hit Cosmo, if you would’ve called your local channel and said, “Hey, there’s a thing in Cosmo about the vampire breast lift,” and you’ll notice they said this was the most looked at thing on Cosmo that month, but think about it. What could possibly pull more traffic than the word “vampire” and “breast” and Kim Kardashian during the Halloween season? I don’t know what other perfect lining up of things you would have to do to be able to generate traffic.

So, all of those happen. You got crazy amounts of traffic, and so, at that same day, and this is your step-by-step thing so I’m about to give you the next step. First, it’s a two line email to your people linked to the thing, asking them to call you or to forward it to someone they love that may have the problem. Second, you post to Facebook or whatever social media you’re doing. Third, you call the local news reporter and you say, “Hey, that thing that just happened or that’s on Cosmo, I’m doing that,” because, if you notice, the news reports on the news …

It’s really funny. You watch CNN, they’re talking about what the Fox News people are saying. Fox News is talking about what CNN and NBC is saying, and you’re watching the people on CNN, one reporter interviewing another. When did that get to be news when two reporters interview each other? But you see it all the time, but the point of that is that the news is hard up for news. It’s hard to think of something new every day, especially in your local town where there’s just not as many people to make things happen. So, when you give them something that is timed to the national press, that’s the point of all this, they will usually gobble it up, and they will call you for more things if you have the courage to do it.

All right, so, anything else you could say about that, Carolyn, and then I want to get back to the science a little bit.

Carolyn Delucia: No, not at all. I think that’s fantastic. Great advice.

Dr. Michael Goodman talks about innovation in medicine

Charles Runels: So, still have you unmuted, Michael, if you could hear me. I’m not sure if you’re there or not, but I’d love for you to jump in here about some of this research that we’ve talked about. Anyway-

Michael Goodman: Charles?

Charles Runels: Yes? Hello?

Michael Goodman: Can you hear me?

Charles Runels: Yeah! There you are! Beautiful!

So, back to this article because I don’t know if you heard me because I couldn’t hear you, but I’ve been bragging on you because I know that you must’ve taken a lot of heat back in the day. Talk to us some because I know I’ve heard Andrew Goldstein talk about that first paper you put out about how some of the cosmetic procedures made physical sex better. Talk to me some about the … And you’re too humble to talk about to talk about your courage, but at least some of the conflict you had to deal with, and give us a little sage advice because you’re the guy who was taking the briars and who created the path.

Michael Goodman: I heard you earlier, actually. I was in the garden sitting, my spring lettuce-

Charles Runels: You’re making me hungry.

Michael Goodman: Yeah, I had my headset on. For some reason, I didn’t connect so I came inside, and I’m on the-

Charles Runels: Thank you.

Michael Goodman: So, I can hear you now, and thanks for all the comments earlier. As far as early on, the journals and organized medicine really don’t like to things that happen outside of the university, and happen outside of officialdom. So, way, way back when [Camden John 00:44:58] and Harry Rich and several others and myself started doing advanced operative laparoscopy, and we’re dealing with ectopics in the late 70s, and doing hysterectomies and ovarian cystectomies and so forth in the early 1980s, and we tried to publish our first series back in ’84, I think, it was near ’84, none of the journals would have anything of it. In fact, the Green Journal called us cowboys, and basically wouldn’t hear of what we were doing.

We had the audacity of operating at a conference through a scope, and removing ovaries through the scope, and Harry Rich and I doing hysterectomies through the scope, all of which is just sort of standard practice today, and it was the same thing when plastic surgeons started to do breast augmentations for cosmetic reasons, and it’s exactly the same thing today, and it’s interesting. There is a decent amount of evidence based research in the Aesthetic Surgery Journal and in Journal of Plastic and Reconstructive Surgery and in the great journal, the American Journal of Obstetrics and Gynecology, and then certainly in the Journal of Sexual Medicine, there’s tier one evidence about changes in sexuality and in body image in women undergoing vaginal aesthetics.

It’s evidence-based that yes, there’s improvements in body image, and yes, there’s improvement in sexual satisfaction, and it’s all there in the literature, but ACOG really won’t hear of it, and when they quote the literature, they don’t quote any of these articles, so it’s pretty selective. That’s, you know, Charles, you run into that, and a lot of us who have done things, who have been in community medicine rather than in academic medicine. I have an academic appointment, but I’m a community physician.

Those of us that are community physicians, our voices aren’t heard as much. The interesting thing, when you look at results from procedures or results from treatments, everything has to be evidence-based. I’m definitely someone who believes in evidence-based medicine, but I’ve come to realize that anecdotal information is not chopped liver. The reality is that certain things will never, unfortunately, get the stamp of approval of evidence-based because there’s no money for funding.

That’s where the Cellular Medical Association comes in, and where it’s been, where you’ve been so helpful in that, is providing some funding money. When you take a look at things like treatment of PMS, you know, the official treatment of PMS is either risperidone, which is an anti-anxiety medication, or SSRI antidepressants. Those are the only things evidence-based that work for PMS. Why? Because there’s no studies that talk about caffeine avoidance, and talk about exercise, and talk about progesterone therapy.

There’s no studies that talk about progesterone therapy because nobody’s going to pay for them. They’re not patentable, and that’s what it sort of ends up being. If you have something that’s patentable, you can get money for research and you can prove whatever you want to prove. So much of the stuff in the literature is not comparing one treatment with another, but it’s just evaluating that singular treatment.

I mean, I’ll quit now while I’m ahead rather than use up all the air time, but I think what you’re doing as far … What we’re all contributing in as far as doing studies about the effect of the O-Shot®, and these treatments that no one will put money into because things aren’t patentable. You can’t patent the use of platelet rich plasma in Gräfenberg’s area and in the clitoris, and so there are not going to be studies unless someone like you or someone else takes the plan and says, “No, we’ve got to, let’s put some science into this.”

There’s always battles to be fought, and unfortunately, medicine is going into such a place where it’s sort of run by insurance companies and doctors have very little say and end up being employees, and it’s really hard to spend time with women and understand what their goals are, understand what’s bothering them, understand what their goals are, and try to meet those goals. One other thing, Charles, you still there?

Charles Runels: Yeah, and don’t feel restrained with time. You may not realize it, but you know, your thoughts are very encouraging to us as we just got through speaking. Carolyn’s been … I hope you guys know each other. I think you do. You know Carolyn Delucia, right? You guys know each other?

Michael: I don’t know if we do. Carolyn, do we know each other? I don’t know.

Carolyn Delucia: I don’t think we’ve ever met face to face. I don’t think so, actually. We’ve been at a lot of conferences together but never actually met.

Charles Runels: I’m glad you guys are meeting at least this way, because it does take … It’s scary sometimes, to be doing what we do, but yet we do it because we know that some of our women will be helped profoundly by it, and we try to do it intelligently so that we … We’re doing it in such a way there’s minimal harm always, of course, first do no harm. But it’s scary, and Carolyn has been hauled in and taken some blows, and out there. So, it’s good for us to hear, back in 1984 when I was still in college, that you were out blazing trails and yet you survived it, and you’re smarter and tougher because of it, so it’s good to see, and it’s very encouraging to me and I think probably to the others.

Carolyn Delucia: Absolutely.

Charles Runels: Of course, it’s not me doing it. There’s nothing I could be doing. I’ve become mostly a facilitator of conversation and a note taker and basically a pipe for the money to flow through to the research and the marketing and the lawyering. Anyway, I don’t really take credit for any of it, but just being maybe an admirer of people like you and [Bill Say 00:51:56] and all those guys who were out there taking the hits when I was still wiping my snotty nose.

Michael: [inaudible 00:52:04] a major role [inaudible 00:52:06] that we’ve taken with Andrew Goldstein, and Andrew and I have been friends for a long time. There’s no way he would have been interested in this and taking his ability to write up a good [inaudible 00:52:23] and get things published. That wouldn’t have happened without your facilitation. What I was trying to search for before was operative gymnasts, that’s what we called them in an editorial in The Green Journal, operative gymnasts, because-

Charles Runels: Operative gymnasts, like people who do flips on the balance beam?

Michael: Operative gymnasts; back in those days, laparoscopy was used for diagnosis only and tubal ligation, period. The fact other things were being done through the scope was heresy, but a lot of things start that way. You know, we were talking about the term vaginal rejuvenation.

Charles Runels: Yes, talk about that.

Michael: Yeah, I go way back with that term. The term initially, as you noted, the term initially was put forth by David Matlock, and I don’t know how many on this call know David. I’ve known him personally for about 15 years, and Davis is the penultimate marketer. I mean, no, maybe not the penultimate. You may be at this point, but maybe back in the day, you know, David has an M.D. and an MBA, a masters of business administration, and this was back when docs were not supposed to market at all. It was just sort of bad form to speak about your own practice and to market.

David had the audacity to try to patent the term laser vaginal rejuvenation. He was unable to patent it. I think he was unable to trademark it also for various reasons, but that term, vaginal rejuvenation, was, when David was talking about it, had nothing to do with machines, had nothing to do with radiofrequency, had nothing to do with laser. It was doing a surgical vaginal tightening operation. It was a modified, it was pretty much what we’re doing today with some modifications. It was a modification of a posterior colporrhaphy by adding in a levatorplasty, adding in the bulking of the scar tissue underneath the vulvar vestibule and perineum and distal vagina.

Where the laser came in, and that was his kick, where the laser came in was he was using a touch laser fiber as a surgical tool. Now, laser vaginal rejuvenation has nothing to do with the fractional CO2 lasers or erbium lasers that are used today. That’s not what laser vaginal rejuvenation is. It’s use of a touch laser fiber as a cutting tool. You can use a scalpel, you can use a scissors. I use a radiofrequency needle, same difference, it was use of a laser as a cutting tool for a surgical procedure.

That was there, and I remember John Miklos and I had an open discussion at one of the vaginal aesthetics meetings many years ago, where he was beginning to use the word vaginal rejuvenation. At that time, I spoke up against that saying, “That’s a can of worms.” For example, I’ve talked about this before, if you have a 65-year-old woman and she’s maybe 12, 13 years post-menopause and she hasn’t been on hormone therapy. She’s a widow, and her poor vagina has become very atrophied, she barely can put her little finger in there, and she’s met someone and she wants to have sex, and you work with her with vaginal estrogens, and you work with her with dilators, and over time, you get her vagina back so she can have sex, you’ve done a vaginal rejuvenation.

[inaudible 00:56:31] with the word vaginal rejuvenation is that it’s become a marketing term, and no one knows what the hell it means. If you ask 10 people what vaginal rejuvenation is, you’ll get 10 answers and unfortunately, patients feel that vaginal rejuvenation is going to cure their ills, whatever they are, whether they’re sexual ills, whether they need tightening, whatever it is. Vaginal rejuvenation is such a nonspecific term, and I still … Because it’s so nonspecific. I mean, what does it mean to you, Carolyn? What does it mean to you, Charles? What does it mean to everybody?

It’s not specific. Does it mean surgery? Does it mean levatorplasty and a full perineoplasty with elevation of the perineal body? That’s very different than using DHEA suppositories or estrogen in the vagina for your rejuvenation, and that’s very different from using, from resurfacing tissue. You resurface the face, you can see those changes. You’ve gotten rid of acne pits, and you’ve gotten rid of blemishes and so forth.

What does resurfacing of the vagina with laser mean? What does it do? What is resurfacing of the vaginal mucosa with radiofrequency? What does that mean? How often? We do it [inaudible 00:57:54] times, a month apart. Where did that come from? Why shouldn’t it be more? Why do we just do it two? How often do we do it? What kind of results do you get? Unfortunately, I’m seeing patient after patient after patient, well, just two patients after patient, I’ve seen several patients that have put out several thousand bucks and say, “You know, I felt a little different for a few months. Maybe there was something there, and it really didn’t do much.”

They put out a couple thousand dollars for vaginal resurfacing that really didn’t suit their needs. That said, I’m talking to doctors who say, “You know, my patients love it. I’m doing diVa,or I’m doing ThermiVa or I’m doing one of the other Vas, and the patients seem to be happy, and the greatest thing is they keep coming back and the money keeps flowing in.” But, are we really helping patients? I think sometimes we probably are, but the term is so nonspecific that we really have no idea what we’re doing, and it’s very hard to get any even anecdotal, even a compilation of anecdotal results, because one person’s rejuvenation is not another’s.

Charles Runels: I have a suggestion about what might, what I think might be evolving, and I have a lot of respect of course for you and the other guys like Dr. Matlock and Dr. Bill Seay and those guys that blazed the trail. But I think what I’m seeing is that you’re exactly right, rejuvenation has become more like, instead of the specific thing that it was intended to be, it’s become more of a, as you said, almost meaningless umbrella that can mean whatever is being done.

The reason I have this pulled up, I have a suggestion based on data. I like to look, and this, I’m giving away one of my secret weapons here. I’m a big believer in, how do people think about words? That word Vampire Facelift was not haphazard. I had the procedure, but I thought about the name for it for about a week of studying numbers to learn about words. I’m giving you one of my secret weapons, it’s called Wordtracker. You go, you log in to Wordtracker. It costs you a little bit, but you log in and you can put in a word, and you can see how many times people are using it.

I have a suggestion based on this. If you look at vaginal rejuvenation, it’s been used about 33,000 times in the past month, in the United States, of people looking for something. Now, these numbers talk about competition, so for example this is the number of Websites where it’s in the title and it’s in the text, and there’s a back link coming back to it, so just the word vaginal rejuvenation.

Now, notice this number, 33,000 in the past month, and then here’s some related ones. Here’s, and I’m telling you, this is worth gold what I’m showing you guys, now if you put in vaginal reconstruction, I don’t think there’s anybody that can make this into something other than a surgery. I don’t think anybody’s going to imagine I’m going to reconstruct, although maybe on a cellular level, I think … Not maybe, I think we are on a cellular level reconstructing things when we use platelet rich plasma and when we do energy therapies. But, I don’t think anyone’s going to ever evolve into thinking reconstruction is anything other than changing the mechanics and the surgical procedure, and it’s a pretty amazing vein of gold.

Now what I mean by vein of gold is this. In the early days, when Bill Clinton was elected president, there were only 33,000 Websites on the planet. If you made a Website that had to do with anything that a lot of people were looking for, you were the sole source of a lot of people looking for that thing, and they would be dropping dimes in your pocket or coming to your door, whatever it was you wanted them to do.

Now, there’s a Website for almost everything, and there’s very few veins of gold left out there where not many people are talking about something that a lot of people are looking for. This is one of the tools I use to look for those veins of gold. If you look at vaginal reconstruction, it’s not 33,000, but it’s still over 5,000 people, and there’s only two Websites with that in the key word, and one of them is ours, VaginalReconstruction.com. Then, these numbers are crazy good, because the higher the number the more competition, and this number is only 3.12.

If you look at this last one we were looking at, at vaginal … If you remember, if you go back to vaginal rejuvenation, I’m giving you marketing advice here, but maybe not just marketing, but ways to educate our patients. Rejuvenation, and so if you look at this one, that same KEI number is almost 100. The other one is only three, and that means that there’s a whole lot more people trying to capture this amount of volume.

Even if the volume is less but still significant, if there’s not many people catching it, you’re going to get a lot of traffic. I have given as a gift VaginalReconstruction.com, which costs me I won’t say how much, but it had a noticeable number of zeros behind it, and I bought that domain using our funds from the O-Shot® to create a Website just for the surgeons. Now, there’s always a selfish reason in everything, so if you go to VaginalReconstruction.com, this now belongs to us.

I’ve just put something as a placeholder until we develop it, so I got a little something from Red, and something from Michael, and a textbook, and another textbook, and a little bit from Carolyn up there in New York. But, my rule is going to be only surgeons who do the O-Shot® can be on this Website, so it also feeds the O-Shot® side of people who don’t do surgery. But, it’s a way to capture that really low KEI number so there’s the significant numbers of people who are looking for vaginal reconstruction get funneled to the excellent surgeons in our group.

So, that’s what we have going, and what I’m suggesting is that you can decide yourself what vaginal rejuvenation means, but I don’t think anyone’s going to ever get confused about what vaginal reconstruction means, and that if you start using that in your posts, if you’re a surgeon, I’m going to make that, if I’m able, into a word that starts to dwarf the 33,000 that’s used for vaginal rejuvenation, or at least approach that same number. That is my intention to make that happen, so I’m kind of showing my cards to this group because this is a group that’s all friends and in the same thing. We’ve gone over an hour, so I think I’ll probably shut it down here. Hopefully that was useful to you guys.

The last thing on my list that I promised was to show you where it lives, the research that has to do with the Amnion. I’m not going to talk about it much, because I’ve already gone over the hour, which I don’t like to do. But there’s a link, you know what? I’ll just put it in the link under the recording from this thing. But we have, on the cellular medicine site, a really nice list of the research that has to do with Amnion. I’m interested what happens with you guys as you start to maybe use that as a combination with your PRP and your hard to treat cases.

I better shut this down since we’re over an hour. Thank you very much, Carolyn, and thank you very much, Michael. I don’t know if you realize it, but it’s a huge encouragement to us to hear about how you blazed a trail and continue to do so. You guys have a good week, thank you.

Carolyn Delucia: Thank you, thank you.

Charles Runels: Goodbye.

Both Dr. Delucia & Dr. Goodman offer hands-on workshops and can be found on the following directory…
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