JCPM2025.10.28

The following is an edited transcript of the Journal Club with Pearls & Marketing (JCPM) of October 28, 2025, with Charles Runels, MD.  

>-> The PDF transcript of this live journal club can be seen here <-<

Topics Covered

• MRI Documentation of the Effects of PRP on the Knee (and one may be as effective as two spins)
• Shine the Light on Your PRP
• Time of Day Matters with PRP
• HA Helps PRP Do Its Job
• Using Machine-Based Learning (or AI) to Help Create Treatment Algorithms
• A Simple Step-By-Step Method of Practicing “Vampire Marketing”
• Choose Your Range of Writing
• Know and Consciously Choose the Continuum of Medical Therapies
• Bones vs. Flesh (Never Send Out the Bones without Adding the Flesh)
• Teach the Chat
• How to Add the Flesh to the Bones
• Question: Should I Use Ice After the O-Shot®?
• Question: What’s the downside of not using an activator when doing the P-Shot® procedure?

Charles Runels, MD
Author, researcher, and inventor of the Vampire Facelift®, Orchid Shot® (O-Shot®), Priapus Shot® (P-Shot®), Priapus Toxin®, Vampire Breast Lift®, and Vampire Wing Lift®, & Clitoxin® procedures.

Transcript

Last night, we were attending our Cell Doctor Forum and reviewing some marketing tips when my internet connection suddenly went out, and I’m not sure what happened. But it seems to be running strong tonight and all day today. So, I will also cover at the end of our journal club, I will go back and cover what I intended to do last night, which is how to use some of the more recently developed tools like AI, and another tool that Google makes available for free to tap into the flow, which I call Vampire Marketing: as a vampire lives off the energy of someone else’s blood, instead of trying to be big, you tap into something that’s already big and make use of that to expand awareness about your own ideas.

This is what I initially used when we first launched the Vampire Facelift procedure. At that time (2010), the Eclipse movies were very popular. There was a misconception, I think, among most physicians, because most of us are not in our 20s and grew up at a time when vampires were portrayed as ugly and scary, such as in the Dracula movies of the 70s, where he was very scary-looking. But in the Eclipse movies, vampires are beautiful and very sexually virile and also potent, which together is a very sexy combination.

And so launching the procedure under the name Vampire, at the time, those movies were very hot, and the books helped us tap into the flow and practice vampire marketing. However, you can do that at any time you want. And I’ll show you an example of that at the end, which I intended to show last night.

However, first, let’s review four papers that were published this week, which are helpful, encouraging, and somewhat enlightening about our work.

MRI Documentation of the Effects of PRP on the Knee (and one may be as effective as two spins)

The first one involves an actual MRI that examines what happens when platelet-rich plasma is injected into the knee.^[1] And they compared it with a placebo group, a saline group. As you know, we often cover papers about the knee. And in the past couple of years, it’s gone from ‘maybe it works’ to now, to me, it’s almost malpractice to start with cortisone, because we know the pain relief from a cortisone injection in the knee is often early and dramatic. But the pain relief at six months and a year is much better with PRP. And with the cortisone, the knee continues to degenerate. But with the PRP, degeneration has slowed dramatically in comparison. Anyway, but no one’s documented that much using actual imaging studies. And in this one, they did.

What’s more surprising, it’s not surprising that they documented improvements, I’ll go down to the conclusions, you can look at the pictures, I’ll give you copies of this, it’s open source, but the conclusions were also surprising in that, they had a double centrifuge and a single centrifuge, and the double and the single performed equally well. That’s surprising because the accepted dogma is that to get full effect on osteoarthritis of the knee, you’d need a double centrifuge to achieve a higher platelet count.

So this is not in congruence with other studies, but it’s encouraging for those who might have a single centrifuge, as your method was just as effective. And of course, both groups that had the PRP dramatically outperformed the saline group. That to me was the surprising part of that study.

Shine the Light on Your PRP

And this one, although I haven’t done it yet, I’ve been watching the dental literature because they are about 10 years ahead of us. The dentists were using plate-rich plasma routinely, especially in surgery, and the periodontist had been using it routinely for 10 years before it was pulled into the cosmetic and urinary space. So, if you watch, since they’re 10 years ahead of us, observing what they’re doing gives us hints about what we should be doing.

They drew the blood, they centrifuged it, and while it was outside the body, they hit it with infrared light.^[2] They then took measurements of the growth factors. And demonstrated that, you see, so you can see they have non-irradiated PRF. This is not PRP; it was PRF. So they let it clot.

This works well if you’re trying to treat it because you’re not pushing it through a needle as much. You’re oftentimes packing it around an area or into a wound. So, PRF is much more suitable for that use than injecting it through a 30-gauge needle for an O-Shot procedure, which I do not recommend.

But it makes a good point in that the tissue, the cells in the PRF, and supposedly in the PRP, would respond to this near-infrared light. And then they analyzed the structural changes and the growth factors and found that they were improved.

Does that mean we start zapping our PRP with a light before we inject it for the penis or the O-Shot®? I don’t know, maybe. I want to examine this further and determine the cost of these lights. Maybe we do a study looking at the difference. We’re still working on getting the world to accept the idea of what we’re doing, just our base O-Shot®.

But this is what I mean about the dentist. They’re over that. They knew 15 years ago that PRP helps with the healing and regeneration of healthy tissue. They’re past that. They are also exploring ways to further improve it. That’s the surprising part. You don’t just prove something and you’re done. You stack the research to show something works, and then the number of possibilities becomes infinitely enlarged. The need for research expands logarithmically due to the numerous variations that arise once the concept is proven. And that’s where the dentists are.

So I wanted you to know about this. Some of you, a few of you have talked with me about how you’re doing this already. And if anybody on the call is doing it, click a button so you can tell us what you’re seeing. But the dental research supports the idea of adding this to our cosmetic and sexual procedures. Okay.

Time of Day Matters with PRP

This one is interestingly related to the fact that when you draw blood, platelet counts in whole blood exhibit significant circadian fluctuations, with higher levels observed around noon and 4:00 PM compared to the morning.^[3] It’s a somewhat odd idea, but the notion that you might achieve a better result or have more growth factors if you see your patient around lunchtime or near the end of the day, rather than first thing in the morning.

We have previously reviewed papers on other factors that affect the effectiveness of PRP, such as drawing blood immediately after aerobic exercise, fasting for an extended period, and using a protein-sparing fast.^{[4] [5] [6]}

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This was new to me, so I’ve included it here. I’m not sure it would affect any particular patient, but it may change. It could change how you schedule if you have your choice between first in the morning and somewhere around noon for your patient. That gives you a reason to do that.

HA Helps PRP Do Its Job

And then this one, I’ll skim over, to tell you that there’s more and more coming out about what we already know, which is that when you combine HA with PRP, the research is overwhelmingly in favor of the synergy.^[7] And the idea of which HA to use is being discussed. However, for a knee, it’s best to use, if your patient can afford it, not just PRP for osteoarthritis, but also inject Synvisc or Hyalgan so that you have both options available.

And of course, this is what you’re doing when you do a vampire facelift, where you inject an HA, Juvéderm, or Restylane, whatever your flavor is, and then PRP on top of it; there’s a synergy that happens.

Using Machine-Based Learning (or AI) to Help Create Treatment Algorithms

This one (refer to video), about using AI and mathematical models to create effective treatment algorithms, is really fascinating because, finally, I’m starting to delve into some of the mathematical books that relate to the survey data my wife, Alex, and I are analyzing. We’ll be presenting in a couple of weeks in Morocco.

So I’ve gone back, the first and the classic on a^[8]nalyzing data from a survey, which is what we did, we have on the O-Shot, if you haven’t seen it, if you do an O-Shot on someone, you can enroll them in a survey where they are asked questions the day of the procedure, three days, three weeks, six months, and to one year. And we’ve had that running for 10 years now. So I have quite a number of patients. We had 2004 is the data set we’re using. It’s noticeable, strong, and helpful.

And reading today, I finally received it in the mail: this 1965 classic on statistics used to analyze surveys. It discusses non-random versus random sampling and the correction methods. And 80% of it is past me, but I’m going to try to turn that into 20%. I have read three different versions of the most recent one.

And the fascinating thing is how they talk about the available software. In ’65, it’s hard to think about. They were doing this with slide rules, a pencil, and paper; that’s what they had. And then, starting about 10 years ago you started to see more about choosing the proper software. And then I just got the most recent version of something similar. And I think they’re still behind, even though it was printed about a year ago. With the advent of AI, it’s becoming even more possible to think on a deeper level. And by using what these people did, I’m getting rid of this paper and utilizing software to help you think and discover trends that may be hard to find with a slide rule or even with the software of a year or two ago. And what they’re trying to do, of course, is the question that we are all trying to answer: find who’s going to get well from our procedure and how much better they will get.

We want to be able to predict that. I’ll give you a hint after reviewing the data for the O-Shot®, and, of course, we now have data from the paper we published about Clitoxin®. This is without the Clitoxin®, just the basic O-Shot® with PRP. It appears that you’re going to have a much greater chance of seeing results if they’re actually in the range of sexual distress, meaning they score 11 or higher on the female sexual distress scale revised. And that is on the O-Shot website. If you want to look at it, it’s available for download. It’s quick, much easier than the female sexual function index to administer and grade.

Anyway, that number I just gave you is an example of how machine learning can help predict who might benefit from an O-Shot. And that’s just based on looking at the data for a couple of weeks, but it’s data that was collected over a decade. I can’t wait to see what we discover there in the numbers, and it was refreshing for me to see that in the area of platelet-rich plasma, the science of mathematics is being plugged into it to help us with our clinical decision-making about who should be treated and who not. And we feel like we know it. I think of course, if you’ve done the thing for 15 years, you have this idea that’s pretty strong and probably will turn out to be right.

But it’s much more helpful, of course, if we can combine. We had 235 providers enroll 2,004 patients in four different countries, so that’s real-world data that can be used. Having access now to AI to help us think about it is very exciting. That’s the main thing I wanted to point out about this: we all have it now. I’ll show you my favorite mathematical tool in a moment. You’ve got to be careful, though; it will spit out junk. So you still have to know what the words mean. And it’s fun having Alex around; she’s a better statistician than I am, but I’m trying to catch up with her. And if you are not careful, it will give you junk and you’ll believe it. However, if you know how to communicate with it and remain honest with yourself, you can achieve great things.

I encourage you to experiment with some of your own numbers to see what you can come up with if you’re collecting data on your own patients. And I think we should watch this very carefully.

A Simple Step-By-Step Method of Practicing “Vampire Marketing”

Now, let’s shift our focus to how to apply the concept of Vampire marketing. We can write very compelling content, whether it’s an email, a video script, or a web page, and tap into the energy that’s already out there. Instead of trying to be big, we can tap into something big. So, let’s switch to that.

Alright, I’ll walk you through the process and then show you; hopefully, you can follow it and complete this task.

It’s not complicated.

First, you want to know what people are looking at, what they are thinking about. And there’s a way to connect everything to everything, but we’ll get to that.

I want to go straight to what people are thinking about medicine. You could advertise the O-Shot® or the P-Shot®, or the Vampire Facelift®, and connect it to the World Series if you wanted. But I mean, obviously, there’s a commonality there if you use metaphors, we’ll get to that. Let’s start with straight-up medicine.

So if you go to trends.google.com, that’s the first step.

You want to know where it’s flowing. Now I have another software program that I use that is paid for, but this part’s free. And then you go to Trending Now, and by the way, the software is called Word Tracker and you can see that trending, overall trending, it’s about how long the World Series was last night. My mom is heading towards 90 and she keeps up with all of the baseball and she was telling me stories today about the players and the game, so every age is watching the World Series.

But we want to go to categories and find health. Where is it? Health, there it is. Now, tonight, or today, trending is Tylenol, where the state of Texas is suing the Tylenol company because of the idea that it causes autism, and this outbreak has to do with measles. We could run with that, but yesterday was better.

I should cover this right now. Let me talk about what to do if there’s nothing directly related to medicine. How would you tie into that? So let’s show you that.

I’ll deal with it because I keep avoiding the issue. We’ll come back to the medicine. I think this is better drawn than described.

Choose Your Range of Writing

So one of my favorite books ever is The Art of Nonfiction by Ayn Rand and she talked about a range of writing. You have pure newspaper type writing. It’s just factual, Toronto played Los Angeles last night, they went 18 innings, and you’re already bored because it’s just news. I’m not in it, it’s just straight up factual, concrete facts. And then you have pure philosophy. So you’ve got a Immanuel Kant or Socrates talking about whether something’s real or not, and there’s not much concrete about that. It’s just pure ideas.

And then you have the mid-range. And this is what people love. Your child loves this. This is The Boy Who Cried Wolf, where you have a concrete event. The boy cried wolf, there was no wolf, he cried wolf, there was no wolf, and then he cried wolf, and there was a wolf, and nobody came because they didn’t believe him, and the wolf gobbled him up, or something like that.

This one starts with facts, and then it pulls it into the mid-range where philosophy and facts intersect, which we all love.

This is Rocky. I read a recent interview, and he said he understood Rocky and why people connected with him, Sylvester Stallone, but he actually connected more to Rambo because his dad was very strict with him, and he had a lot of anger about that. So it’s a story of a soldier that has to do with directing that anger.

So it’s facts, and then it comes to directing your anger towards a purpose, which is combining facts with philosophy. That’s the mid-range. So what does that have to do with writing an email? What you can do, and it works very well, most people don’t have the bravery to do it, but you could do something like this.

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What’s the most talked-about thing on the internet? The most talked-about thing was the long World Series.

And what do you want to talk about? Let’s pick P-Shot®.

Can you think of anything in common with a P-Shot® that has to do with men swinging bats for a long time?

You can make a connection, but do you have the bravery to write something like this?

As an example, the title of your email is the 18 Inning Game and Why Your Lover May Want to Think About a P-Shot®. And then the email goes something like this. Last night I was watching Toronto and LA play, and as the game went on and on and on and these athletes were still swinging their bats and finally win with a home run, it occurs to me how many men never make it to the plate because their bat just won’t work or they make it to the plate and they’re out of the game after the second inning. And it may seem maybe a stretch, but it was on my mind, and I thought I should tell you that there is a better way. And if you or someone you love is suffering that way, you should really check out our page about the P-Shot® now. Then, you add a link to your page and a link to the research.

Do people respond to that?

Actually, they do because you are in it, your concern for them is in it, and it’s the equivalent of an Aesop’s Fable or a Grimm’s Fairy Tale in that something happens and you get a moral out of it. So using that, you can literally connect anything to anything if you just use a little bit of imagination and find what do they have in common.

I’ll give you another quick example. The top search tonight is related to a measles outbreak. And so you could say, I was reading tonight and try to always make it a story if you can, I was reading tonight about how there’s an outbreak of measles, actually, I’m looking at it now. Avian flu is outbreaking too.

Okay, we’ll go with avian flu. There’s an outbreak of the avian flu currently affecting Canada, with eight more flocks now reported to be infected. And that makes the news, but what’s more sad than that is there’s an outbreak of sexual dysfunction right now, and 40% of women are upset about their sexual function. But why is that not in the news? It should be, and we have a way that might help you, and a combination, and then you’ll discuss your combination.

So you just took an outbreak of the avian flu and you flipped it into discussing sexual function in women.

And the reason it works is that people are thinking about the avian flu, so you, like a vampire, tap into that flow.

IMPORTANT: You can’t trick them. You can’t mention an outbreak of the avian flu and then not include it in your email—not even once.

That’s a trick.

You must legitimately use it as a metaphorical springboard. If you can tie the two together in a fairy tale type fashion, people respond to that. All right, so let’s go back to it. If you just go straight up and can actually find something about what you want to talk about, it’s the other principle, which is this principle of continuum, and I should point that out before I finish showing you my process.

Know and Consciously Choose the Continuum of Medical Therapies

So you have this continuum, and over here is things that everybody knows about and insurance pays. This would be, if we’re talking women’s sexual function, it would be Flibanserin; for men, it would be a PDE5 inhibitor.

Okay? Insurance pays for it, everybody knows about it.

Then over here you have quackery. This is, I don’t know, what have I heard about lately?

I heard about harvesting the penis bone. Raccoons have a bone in their penis. And it’s harvesting the bone out of the penis of a raccoon and making a necklace out of it. If I said that is actually a thing in the deep south, believe it or not. But if I said wearing that necklace around your neck is going to help you have better sex, that’s quackery. But in between here, where insurance does not reach, but the research makes sense and it’s strong. This is where you can work miracles and make money. Why is that? The reason you can work miracles is the doctors who are afraid to do anything, not just fearful of doing something insurance doesn’t pay for, but, whether conscious or subconscious, they’ve come to believe that if insurance doesn’t pay for it, it’s quackery.

They don’t recognize that this middle range even exists.

They don’t even acknowledge it.

I’ll give you a simple example that I discussed last night before my internet connection was interrupted. This research has been ongoing since Cooper conducted it 20 years ago: VO₂ max is a better predictor of your risk of heart attack than smoking or diabetes.

So, how much oxygen can you burn per kilogram of body weight per minute?

That is a better predictor than whether you smoke or have diabetes. The only better predictor of heart attack than VO₂ max is a previous heart attack. But when’s the last time your doctor measured that? They measure lipids, blood pressure, and hemoglobin A1C, all of which are less predictive than your VO₂ max.

But to measure this takes a mass spectrometer. It’s the thing, if you remember the scene in Rocky where the Russian guy’s running on a treadmill, breathing through a face mask that measures the amount of oxygen he’s burning. And you can calculate his VO₂ max.

And I bought one of these things. Insurance did not pay for it, but the bad part of it was that people didn’t really want to do it either, because they had to jump on that thing, on the treadmill and go until they couldn’t go anymore, because that’s what it takes to measure your anaerobic threshold.

Are you running so much that your oxygen consumption cannot be kept up with, and you go anaerobic? And that has to do with everything from how much air you can move, to your RBC count, to the number of mitochondria you have.

So, this is not the thing to have. Insurance didn’t pay for it. People didn’t want to do it. The only people who wanted to do this were athletes who didn’t really need it. They just wanted to know how fit they were.

So, what you want in here is something that insurance doesn’t cover. And the reason it allows you to do miracles is that, as I mentioned earlier, most doctors are not willing to operate in this range because they usually lose money.

Another example is that we know walking has a better preventive effect against heart attacks than any diabetes medicine on the market. That’s known, but we don’t want to sell walking shoes.

So, you need to find something (if you want a cash component to your business) where the research is strong, but insurance doesn’t support it; it’s not quackery, and patients like it.

And that means sex and beauty (which has to do with sex).

I’ve got some protocols for type two diabetes that I think are better than what’s being done, but it’s hard to get people to pay for that; they will pay you for sex and beauty.

So, this is the sweet spot where you get to be a doctor, experience great soul satisfaction, and get paid for your time. Then, if you want to do the doctor stuff for free or essentially for free under insurance, you can do it.

Now, we’re down to the bones versus flesh.

Bones vs. Flesh (Never Send Out the Bones without Adding the Flesh)

Okay. First, you see what’s trending.

And you can start with all categories. And if it occurs to you to do something like I just talked about, where you basically tell an allegory and tie something maybe not directly related to whatever you want to talk about, then you can go for that.

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Otherwise, you can just go for health and see if there’s something related. If that bombs, then you can go to PubMed and just see what’s the latest that’s out about your topic. So, sort by. So, if it’s O-Shot for dyspareunia, you could put in dyspareunia, and then you could search for it. And then you could sort by the most recent and do something like that. But here it’s a little different, because you’re not tying into the flow of something. You’re just looking for the news and trying to create flow.

What’s better is to actually tie into the flow.

Well, we were lucky, because last night the flow had to do with the new drug that’s out. I’ll pull up where I found it. There’s a new drug that’s out to treat hot flashes. Here it is. There’s this thing. Someone actually conducted a study and found that talking sweetly to your chat is better than being rude to it.

So, I don’t go overboard, but I’ll tell it thank you every now and then.

So, after I saw last night that the drug, Lynkuet, was the top search, I thought, okay, I don’t know much about that drug.

So, I went to my Chat and I said, tell me how it works. And it told me there’s a dual antagonist effect. And it cuts off the ability when… What happens is when estrogen goes low, the midbrain loses its ability to act as a thermostat, and your body starts to have hot flashes. This blocks it by inhibiting the NK-1 and NK-3 signaling pathways.

So, I pulled that up, and I thought, all right, remember, I want to talk about the O-Shot. However, this only works if I genuinely want to help women be well. Otherwise, it’s a very shallow marketing technique, and people will see through it, and it will be completely ineffective. May be effective for a while, but eventually it just goes to dirt.

There has to be sincerity about wanting to take care of the people who reach your email. Therefore, some people experience hot flashes, and our O-Shot does not alleviate this condition.

Teach the Chat

So, now I’m going to teach the chat something. Seems to me, I said that the O-Shot can help with dryness and those who can’t take hormones. So, if you use the O-Shot for the dryness and the Lynkuet for the hot flashes, seems to me that would be a good thing.

So, I’m suggesting to Chat that it learn that idea. So, it has to think for 37 seconds, which is quite a long time for an AI. He says, “Yeah, there’s peer reviewed ongoing clinical research showing that vaginal PRP can improve the GSM symptoms, including dryness.” I didn’t need it to tell me that, but I needed it to learn it. And I wanted it to learn that it should be thinking about it in combination with the O-Shot. So, it tells me about these studies that I already know about, plus 10 others for every one it quotes. And notice that it’s finding… This is PubMed, PubMed, PubMed. But somewhere down here it starts to talk about… Actually, it quotes some of our websites. All right. So, then it says, “If you want, I can come…” And then it tells me how the Lynkuet works. And then it says, “I could put these into a one-page literature handout with study details for how they might be combined.”

I said, “Yeah, but make it for my patients.”

So, you see what I’ve done so far, is I’ve used the first step was trends to find what people were talking about in medicine. And then I’m using the Chat to help think about how to write something that combines one of our procedures with what’s new. This addresses one of the primary concerns that most people have. And here you can see it’s starting to quote our website.

One of the main things is just staring at a blank screen. Most people don’t know how to get started, but they’re very good at editing. I’ll show you how to get started. And once you get to one or two more steps further, you can edit it and run with it. So, almost there.

So, then I say, ‘Okay, let’s create something for my patients that combines the ideas of the O-Shot with Lynkuet.’

So, I don’t know how it does this, but somehow I found something on my Google Drive, and it ended up on the internet, discussing all of this together. And then it gives me, it says, “You want me to merge these together into print?”

And I said yes, in which it does. And then what I really want is an email.

So, I said, “Make this into an informational email with links to the relevant research and encourage those who may be suffering to seek counsel from an O-Shot provider.”

So, it wrote this email, “Dear friend,” and quotes some of our studies, including one by me, and quotes others. And it sounds absolutely like a sales pitch. If you send it straight out from the CrapGPT, it will look like crap, but it’s correct. And this is what I meant by what you saw in that last note to myself, bones versus flesh.

This is the bones.

If you send this to your patients, it’s like sending the skeleton without the flesh and blood.

And why is that?

Because you are not in it!

I’m nowhere in this.

I picked a study that I published, but otherwise, there’s no mention of me in here. Now, and this is the last point, if your email is just about you, you’re a reality TV star, you’re Stallone. And I think he’s got a family thing now or you’re a Kardashian. And people will go away, because Kardashians are more entertaining than I am. I don’t have cleavage. I can’t tell a joke. I’ll lose if that’s the game I’m playing. But I also lose if I’m just rehashing something on Wikipedia.

How to Add the Flesh to the Bones

So, now what I do is I take these bones and I flesh it out by saying something about my personal experience with breast cancer, and my sister dying from it, and how much I hate it. I add a little line or two about that. I emphasize the importance to me that this be considered. I add what I know, which is that some women will be helped with their hot flashes by taking progesterone or testosterone, which downregulates estrogen receptors, but not all doctors feel comfortable doing that. And so, check it out with your physician.

And I just edited this into an email,

And before I did that, if I take and copy this, this is the last step. If I copy and paste this into my software, which is Ontraport, the formatting is all over the place.

I told it to make it into an HTML thing, and you don’t have to know what any of this means, and then I copy pasted this into Ontraport.

The reason I like this process is you’re part of it. Sorry, excuse me. It’s almost there. Okay, so after I took that code that I just showed you, then I paste it in here by clicking source and then I just paste it in there.

I don’t have to know what any of it means, but it keeps the formatting, and then I click it like this, and now I can edit it, and you can see how, “Hey, I lost my sister. I hate it. One in eight women have. Today I was happy that the FDA approved a new drug, Lynkuet, to help women.”

And then the rest of it was pretty much what the chat gave me, except I added something about progesterone here, and it got the links wrong. It goofs that up a lot. So I had to go to pubmed and get the right links, and you can see I’m sending them to you. I’m not sending them to me. And then I tell them to find a provider.

The entire process took approximately 15 minutes.

How does this relate to something I want to discuss?

Have the chat combine the two ideas. That’s my bones, edit it, add the flash, put a link to what I want them to do.

Now if you want to see, like really dive into this, this is all you really need to know, but if you really want to dive into it, you do my 5-Notes program, 5notes.com and just spend an hour or two of this once a week and work through it and you will get a lot of the mechanics of how to do this or you get your marketing person to do it for you.

And with that, let’s see if there are any questions, and if not, we’ll call a night.

Sometimes when I start talking about the software, people run out of the room. Hopefully, that was not too much. If you run through it, you’ll have this video. If you go through the 5-Notes course step by step, it’s very empowering.

Without these ideas that I just showed you, there would be no CMA. I’m convinced I would still be making rounds at the hospital, begging insurance to pay me less per hour than the massage therapist at the Hyatt near my office.

This is what built the business: using Vampire marketing combined with emails, and having a genuine concern for both my patients and physicians who want to live a better life and take better care of their people.

Question: Should I Use Ice After the O-Shot®?

Let’s see. There are two questions.

“I don’t use ice after the O-Shot®. I don’t really see a purpose for it.”

It’s a good question. I get that a lot. If you do it right, they won’t have any pain.

My aftercare instructions are to go wash this numbing cream off because sometimes it will be irritating and have sex with your husband.

That’s my aftercare instructions. Of course, if they got a laser, you can’t do that, but there’s really no reason for it. They might have a spot of blood or two, like any shot, so you give them a panty liner, but other than that, if you do it right, they’re not going to be hurting, they’re not going to be bleeding. They should go home and wash it off and have sex.

It’s fun to have your aftercare instructions: “Go have sex.”

Question: What’s the downside of not using an activator when doing the P-Shot® procedure?

Also, an excellent question. We’ve covered papers here and there, and there are quite a number of papers that discuss the differences in growth factors that activate versus those that do not, and it’s very significant.^{[9] [10] [11] [12] [13] [14] [15] [16]}

The number of platelets that are actually released, the growth factors and the spectrum that are released varies with what you activate with. It can be thrombin, it can be one man sells a device where you activate it with vacuum and then you inject it. It could be of course, calcium chloride, calcium gluconate, and it makes a difference.

Now, has someone done this study where they do activation versus not with the P-Shot®?

Needs to be done. No one’s done it yet. I started by activating it because the first kit I used was Selphyl, which comes with calcium chloride to activate it as part of the kit. It’s the only one that comes with it, to the best of my knowledge.

Regen offers a kit that includes a thrombin activator.

And when I swapped to the other kits and they did not include a way to activate, I started diving into the bench research and vitro studies, and it’s dramatic—there is a huge difference in growth factors with and without activation.

And then, anecdotally, we will receive calls at our CMA headquarters from staff members who say, “Oh, my O-Shot®’s not working,” or “My P-Shot®’s not working.”

I’ll get them on the phone, and what often happens is that whoever sold them the PRP kit was a jock in college—their primary job requirement. Now they’ve had a year of experience selling centrifuges. Still, somehow, they’ve convinced this doctor that they don’t have to pay attention to what we’ve seen (at the CMA) now, after 16 years of this procedure, and of reading the literature, and they’ll tell them, “You don’t have to activate, but the needle does it for you,” or some other fairy tale.

And then we’ll say, “Oh, well, maybe you should try doing it the way we teach it.”

 And then they’ll start to get good results.

Another way to think of it, and we don’t know, again, the study hasn’t been done, but if you just take PRP and you set it on the counter, you can sit there for four hours and the platelets think they’re still in the bloodstream where you can then add calcium chloride to that test tube and watch it, and within a few minutes you’ll get a precipitate that looks usually like a little rubber band that runs down the center of the test tube, and that’s the platelet-rich fibrin matrix.

Another question might be, instead of asking what the downside of not activating it is, why wouldn’t you want to activate it?

If you’re visualizing that happening quickly within the body by adding calcium chloride to the platelet-rich fibrin matrix, forming a gel that holds the growth factors in place and recruits stem cells to the area where the needle is inserted, where, without it, there would be more diffusion.

Now, you still get results in the scalp and face; I often do, without using calcium chloride because it causes more pain in the face.

But in the genitalia, if you do it the way we teach it, they’ll have little or no pain, and I think you’ll have a better result. As far as the umbilical exosomes and other growth factors, when I talked with someone last week who wanted us to use such things, and I’m not saying don’t, it’s just I always get nervous when someone’s telling me, “Just don’t put it on your website, don’t talk about it.” And then they have this 10-minute lecture about what I’m supposed to be writing in the chart so that I don’t get in trouble. And it sounds like I’m using semantics to avoid being punished by the FDA.

I tend to stick to things that I can discuss openly. Now, of course, I always have a disclaimer and a consent form and say, “Not everybody gets well. Results can be unpredictable. There could always be a side effect that I don’t know about.” But I don’t have to hide the fact, I can openly say, “I’m going to draw your blood, make platelet-rich plasma, stick a needle in your penis, and inject it.” And I can put that on a website, but I can’t really say that about the growth, the birth products without somebody teaching me how to document it in my chart and exactly what I can say and not say without getting in trouble. So I’m not saying don’t do it. We have people who do stem cells. I’m saying that’s the reason I don’t do it. It’s just a choice I make because I don’t want them knocking on my door.

I could have made a lot of money by taking a piece of other people’s products more aggressively, but, obviously, because I’m at the front of our group speaking, I have to be more careful with my behavior, as I’m sure I’m a target. But that’s not the target, I don’t want the drama of three-letter people knocking on my door. DEA, IRS, FBI, all those people, I would rather have them find another door to knock on.

I would suggest if whoever’s selling it to you, just ask them to show you what you’re supposed to show the FDA if they knock on the door and what you’re supposed to say if one of your patients ask you about which institutional review board you’re using it under because the last time I looked, that’s what the FDA website tells your patients to ask. So don’t lose sleep over it. I’m not saying don’t do it, but I’m just telling you why I don’t.

Okay, I think that’s all the questions. I hope that was helpful. Have a good night. I’m always honored when you come to our meeting. Bye-bye.

🡨

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References

Fermín, Theodorakys Marín, Jacob G. Calcei, Franco Della Vedova, et al. “Review of Dohan Eherenfest et al. (2009) on ‘Classification of Platelet Concentrates: From Pure Platelet-Rich Plasma (p-Prp) to Leucocyte- and Platelet-Rich Fibrin (l-Prf).’” Journal of ISAKOS, August 2023, S205977542300545X. https://doi.org/10.1016/j.jisako.2023.07.010.

Ghadamzadeh, Mostafa, Sayyed Amirhossein Mohsenzadeh, Seyed Morteza Bagheri, et al. “MRI Findings after Injection of Single and Double Centrifuged Platelet-Rich Plasma and Placebo (Normal Saline) in Patients with Knee Osteoarthritis: A Randomized Double-Blind Clinical Trial with Six-Month Follow-Up.” . . NUMBER 13, no. 9 (2025).

Hamilton, Bruce, Johannes L. Tol, Wade Knez, and Hakim Chalabi. “Exercise and the Platelet Activator Calcium Chloride Both Influence the Growth Factor Content of Platelet-Rich Plasma (PRP): Overlooked Biochemical Factors That Could Influence PRP Treatment.” Original Article. British Journal of Sports Medicine 49, no. 14 (2015): 957–60. https://doi.org/10.1136/bjsports-2012-091916.

Kohir, Shreya, Arun V. Kurumathur, Ajay Sharma, Lavanya A. Sharma, Seyed Ebrahim Alavi, and Reshma Suresh. “Comparative Photobiomodulatory Effects of 660 Nm, 810 Nm, and 940 Nm Diode Lasers on Platelet-Rich Fibrin: An Ex Vivo Study on Structural Remodeling and VEGF/PDGF-BB Release for Enhanced Periodontal Healing.” Lasers in Medical Science 40, no. 1 (2025): 446. https://doi.org/10.1007/s10103-025-04688-1.

Magalon, J, A L Chateau, B Bertrand, et al. “DEPA Classification: A Proposal for Standardising PRP Use and a Retrospective Application of Available Devices.” BMJ Open Sport & Exercise Medicine 2, no. 1 (2016): e000060. https://doi.org/10.1136/bmjsem-2015-000060.

Platzer, Hadrian, Alena Bork, Malte Wellbrock, et al. “The Time of Blood Collection Does Not Alter the Composition of Leucocyte-Poor Platelet-Rich Plasma: A Quantitative Analysis of Platelets and Key Regenerative Proteins.” Current Issues in Molecular Biology 47, no. 10 (2025): 788. https://doi.org/10.3390/cimb47100788.

Sheean, Andrew J., Adam W. Anz, and James P. Bradley. “Platelet-Rich Plasma: Fundamentals and Clinical Applications.” Arthroscopy: The Journal of Arthroscopic & Related Surgery 37, no. 9 (2021): 2732–34. https://doi.org/10.1016/j.arthro.2021.07.003.

Smith, Oliver J., Selim Talaat, Taj Tomouk, Gavin Jell, and Ash Mosahebi. “An Evaluation of the Effect of Activation Methods on the Release of Growth Factors from Platelet-Rich Plasma.” Plastic and Reconstructive Surgery 149, no. 2 (2022): 404–11. https://doi.org/10.1097/PRS.0000000000008772.

Smith, Stephanie A., Richard J. Travers, and James H. Morrissey. “How It All Starts: Initiation of the Clotting Cascade.” Critical Reviews in Biochemistry and Molecular Biology 50, no. 4 (2015): 326–36. https://doi.org/10.3109/10409238.2015.1050550.

Toyoda, Toshihisa, Kazushige Isobe, Tetsuhiro Tsujino, et al. “Direct Activation of Platelets by Addition of CaCl2 Leads Coagulation of Platelet-Rich Plasma.” International Journal of Implant Dentistry 4 (August 2018): 23. https://doi.org/10.1186/s40729-018-0134-6.

Ulasli, Alper Murat, Gokhan Tuna Ozturk, Bagdagul Cakir, Gulsemin Erturk Celik, and Fatih Bakir. “The Effect of the Anticoagulant on the Cellular Composition and Growth Factor Content of Platelet-Rich Plasma.” Cell and Tissue Banking, ahead of print, August 28, 2021. https://doi.org/10.1007/s10561-021-09952-6.

Vassallo, Valentina, Celeste Di Meo, Antonella D’Agostino, et al. “Biomechanical and Biological Features of Hyaluronic Acid in Combination with Chondroitin and Platelet Rich Plasma for Regenerative Medicine Applications.” Frontiers in Bioengineering and Biotechnology 13 (October 2025): 1607469. https://doi.org/10.3389/fbioe.2025.1607469.

Zhang, Jianguo, Jian Gao, Haoyu Feng, and Wei Liu. “A Machine Learning and Nomogram-Based Study: Effect of Applying Biologically Formulated Platelet-Rich Plasma (PRP) on the Degree of Pain Relief after Rotator Cuff Repair and Prediction Modeling, Integrating Biomedicine and Artificial Intelligence.” Frontiers in Medicine 12 (October 2025): 1647551. https://doi.org/10.3389/fmed.2025.1647551.

Tags

PRP, platelet rich plasma, regenerative medicine, Vampire Facelift®, Vampire Facial®, O-Shot®, P-Shot®, Clitoxin®, female sexual wellness, erectile dysfunction treatment, sexual rejuvenation, platelet therapy, cosmetic medicine, aesthetic procedures, hair restoration PRP, hormone therapy alternatives, menopause treatment, vaginal rejuvenation, sexual function improvement, natural healing, non-surgical facelift, medical aesthetics training, Cellular Medicine Association, Dr. Charles Runels, PRP injection therapy, platelet activation

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