Prepare, Repair, Optimize (P.R.O. Process)
Hello, I am Dr. Tait, Regenerative and Functional Medicine Specialist here in Tucson, Arizona, and today I want to share something that’s very near and dear to me, and it’s actually a framework, a process that I have been working on in my practice here over the past four and a half years now into our fifth year. And it’s really a system that I use to evaluate patients that come to seek us out for situations where maybe they have been in pain a long time, they haven’t been able to quite fix that problem. They have had a lot of treatments given to them, many of them are symptom based treatments because they are basically told there was nothing else that they could do for them or they are looking for an alternative to address the pain that maybe does involve a surgical intervention. I want to give you a little sneak peek inside this framework that we use to evaluate patients, what we walk them through in our initial consultation. How do we get to those deeper root causes of pain and inflammation and factors contributing to that ongoing pain that they are having, and really develop a long-term solution to it rather than just masking the symptoms? So that’s for the review.
Prepare Repair Optimize Process
Here is the process. So, we call it the PRO-Mend Process (Prepare Repair Optimize). The reason for that is our body has this incredible unique capacity to heat itself or mend itself. So, if somebody is coming in to see me, say for knee arthritis, very common issue that presents in my consultation in multiple times per week. Often times they are told this is a degenerative process, your knee just wears out, the cartilage wears down, and it’s not completely true. There are several other metabolic biochemistry type factors within the body that influence that joint, provoke more inflammation, provoke more pain and, yes, can contribute significantly to the rate at which the arthritis deteriorates that knee joint over time. What I do, a little bit differently, is I spend a lot of time in the first phase of our treatment which is the preparatory phase. So that’s step one here, preparation. In this step, I like to think of this as a base camp style. I like to hike, go up in the mountains, do things, and sometimes we find if we jump right out there and try to get right to the top, and we don’t, like, climatize a little bit first we are going to have some real problems.
So, in this preparation phase we are learning a lot about that patient, the root causes, maybe that got them there, some of the prior injuries, accidents, contributing factors, but then digging deeper into that biochemistry. And what do I mean about that? Well, there are several different factors, and the first one we will look at with everybody is really nutrition. So, if you have issues with nutritional gaps your body is just flat out not going to heal, right, it’s vital, right? Vitamins, vital, we need them. They need to get into the cells. They need to power these chemical reactions. They need to help these cells turn over and regenerate. If we don’t have the nutrition we need in the proper balance within these, well, that can dramatically influence the rate at which things deteriorate.
A Healthy GI System – A Look at the Gut
The next step that I evaluate that goes in and hang with that is the GI system. So again, if we can absorb the nutrition we are putting in our body we can push that nutrition into the cells. And the second piece is really the microbiome. We hear a lot about this, what does that mean? It’s the compliment of bacteria that we have living in our gut and that really keeps us healthy or not. It influences a lot of other systems in the body including your immune system which can be a driver for inflammation. So, we evaluate that second.
Food & Environment Factors
The third step is, we are going to look at food and environment. We are going to look at the sensitivities or the allergies. You know, allergies are spectrum. Many people can have sensitivities to food, they can have intolerances to food, like lactose intolerance, but these things can be drivers for inflammation. And many people try to figure this out on their own, they’ve worked through an elimination diet but ultimately to get to the real root of it, for a lot of patients, we have to do some testing. We get some specific testing and then we see if that is a contributing factor to people. The other thing that we are going to discover as we are working through some of this is there may be some other toxins and other things on those labs when they do come back that are contributing factors for those patients. So, we want to identify those. Sometimes it’s kind of a mystery to figure out what is going on in their environment that could provoke some real problems there, so we want to know that.
And the last piece that we will get into with some patients is really looking at genetics. So, the genetics can really influence, often, many things that are growing in our body, obviously, is the genetic code we are given but these factors here, if we look at them, these are the happy genetics. So, we think about genetics as your hardware. We think about all these other factors, your environment, things around your genetics as the software. So, we have the ability to change that base on the choices we make, the nutrition we put into our body and the other things that we do to help the body heal. So, if we know these things and we can start to fine-tune those things, we get the body prepared in a state that it can actually heal and repair and regenerate. Because, believe it or not, the default in your body is to regenerate. These cells are going to keep turning over until you take your last breath. The question is, how are they turning over? What type of cells are we rebuilding? How healthy are they? How resilient are they to the demand that we want to put on them? So again, garbage in, garbage out. If we are putting garbage in our body that’s probably what these cells are being remade, regenerated rebuilt, well, so really super-important that we look at that. So that’s step one.
Post Evaluation – Repair Phase
The second piece that we move to is actually the repair phase. Once we are starting to repair this, the underlying systems in the body starts to repair, starts to regenerate, right? We are a system of systems so as we start to repair these things the systems in our body start to do the things that they are supposed to do at a higher level, at an optimal level, right, not struggling as many of us feel symptoms as we are in pain. There can be fatigue, there can be other things, we are just not feeling our best self, you know, that vitality we used to have. So, tuning up these systems allows us to lay the foundation for this entire framework of how we treat people on the next phase of my practice which is really Integrative Orthopedics. So how is Integrative Orthopedics different than standard, say, pain medicine, orthopedic medicine? Well, a lot of those treatments often time entail some symptom based treatment. So we are trying to suppress inflammation with anti-inflammatory medications. We are trying to help joint pain by putting a little cortisone in that joint to settle the inflammation down. And there is nothing on the surface wrong with that but it really is a short-term strategy. And what I am trying to look at is building long term strategy for people, to get the problem to go away, to not impair their life, allow them to do the things that they want to be doing.
Thought Process Behind Treatments
As we move over into here we want to think about, what are treatments that can actually help the body or enhance those innate or natural repair mechanisms that our body has. The three main categories we use in our practice, Cellular Treatment, platelet therapy or what’s referred to as PRP, and Prolotherapy. There are multiple different types of treatments out there, we won’t get into that in today’s video, I’ll do that in a future video and really break out these individual therapies. But the root of this or what we are trying to accomplish with these treatments are again, stimulate the body’s natural healing mechanisms, right? It’s this turnover process, and if we can accelerate that turnover process, we can build new cells or alter progression of that degeneration, because ultimately, what it is, it is a balancing act. You know, patients come in to see me, they have been told they have a degenerative knee, right, so some of that cartilage has worn away. It might be mild, moderate, some people even bone on bone. There are some residual cells in there so they are not completely obliterated. And the concept with Cellular Treatment is that we can potentially repopulate some of those cells in there and make that joint more resilient to the demand we want to put on it. So, very simply stated, these cells, stem cells, platelets, they are natural healing cells in the body, right? They can see cartilages of damage or orchestrate the influx of cells to actually repair tissue. So that’s the incredible thing about it. What I find just most amazing about this, when we work with patients is that we are using your body to heal your body. So, we may apply one of these therapies. We may stop here if that’s all it takes to get people where they want to be, but often times when people are coming in with a state of osteoarthritis that may be moderate, really compromising their ability to do things, we influence that situation by using these types of treatments here.
Post Treatment – Optimization Phase
And the last phase of our framework is optimization. What does optimization mean? We want to do the opposite of maintain. Maintenance to me is much like pain management, right, there is not much to do so we just kind of want to manage the symptoms of this problem or put you in a maintenance state. And on the surface, that doesn’t sound like a bad idea but what I want to try to influence people to be is optimal, right? So how can we prepare the body to heal? How can we repair the body, right, using your body and node systems to repair itself? And then how can we move way over here to this optimization stage where now we start thinking about, okay you’ve gotten where you have wanted to go with the initial problem, now what’s the next step, right? And nobody comes to me usually with isolated osteoarthritis, they have other medical issues. The beauty of this framework is that we are starting to address those underlying issues, you know, whether it’s diabetes, whether they are overweight, other conditions, right? We are going to influence that as we move them through the progression. And then here we can start to build true optimization strategy for the long hall, that’s going to allow them to continue to put pieces into play to affect their body over the long term. It’s no longer going to be s symptom treatment, and that’s it, wait out your days, maybe get that knee replacement. Can we actually alter that partway for you? That’s what we are trying to do as patients. That’s where we have had success with many of the patients we have treated here over the past five years, and that’s what I’ll continue to work on. It is developing the next level, basically, of these treatments that we are doing with folks, and being part of the research that’s driving this forward to give people more options.
If you found this video interesting, if this is a concept that resonates with you, if this is your vision of how you would like to treat this knee or other problems that you have, I’ll be happy to see you. Please check out the link below, there is more information to my website there, you can read about me, you can read about the processes here that I put up on the board today, and look for future videos. We are going to dig into some of the nitty-gritty on each of these individual items. Thank you.