Welcome to Special Guest Episode 438 of The Intermittent Fasting Podcast, hosted by Melanie Avalon, biohacker, founder of AvalonX, and author of What When Wine Diet: Lose Weight And Feel Great With Paleo-Style Meals, Intermittent Fasting, And Wine, and Barry Conrad, actor, singer-songwriter, and creator and host of Banter with BC. 

Dr. Meadows is a dual boarded physician holding certifications in both Physical Medicine and Rehabilitation as well as from the American Board of Electrodiagnostic Medicine. Dr. Meadows has expertise in neurological rehabilitation, musculoskeletal medicine, diagnostic and procedural ultrasound, and electrodiagnostic medicine. His background as a collegiate athlete at the University of California of Los Angeles where he played cornerback and wide receiver for the Bruins, was instrumental in developing his passion for sports performance. He carries what he’s learned in these experiences to develop a unique and scientific approach to patient care where he incorporates principles of exercise, nutrition, supplementation, and recovery guiding patients to maximize their own performance either at the gym or in the work place. His training in Physical Medicine and Rehabilitation gives him a keen understanding of tissue specific modalities for optimal performance and healing. This set him up with a great foundation and a natural pathway towards Regenerative Medicine, where he has focused his most recent efforts into understanding and applying. His Regenerative Medicine approach focuses on best practices for health optimization, injury recovery, and age reversal.

Dr. Meadows has always enjoyed teaching. In residency he was peer-elected to be Chief Resident where he supported curriculum development. He has maintained his academic roles over the years serving as the Associate Program Director for the St. Luke’s Rehabilitation PM&R Residency Program, Clinical Assistant Professor at the Department of Medical Education and Clinical Sciences at the Elson S. Floyd College of Medicine at Washington State University, and Clinical Faculty through the University of Washington School of Medicine. He’s also contributed as an author to major medical texts in the field of Rehabilitation Medicine.

Outside of work, Dr. Meadows puts into practice what he teaches by committing to a life of health and fitness with regular exercise and focus on nutrition. He enjoys strength training including olympic lifting and has recently taken up racing triathlons. He also remains passionate about youth sports by volunteering as a coach for his young children and running athletic development programs for high school and college athletes.

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Links:⁠

⁠The Melanie Avalon Biohacking Podcast Episode #211 - Christian Drapeau⁠

⁠The Melanie Avalon Biohacking Podcast Episode #280 - Christian Drapeau⁠

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Our content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and answers to personal health questions.

TRANSCRIPT

(Note: This is generated by AI with 98% accuracy. However, any errors may cause unintended changes in meaning.)

Melanie Avalon
Welcome to episode 438 of the Intermittent Fasting podcast. If you want to burn fat, gain energy, and enhance your health by changing when you eat, not what you eat with no calorie counting, then this show is for you. I'm Melanie Avalon, biohacker, founder of AvalonX and author of What, When, Wine, Lose Weight and Feel Great with Paleo Style Meals, Intermittent Fasting and Wine, and I'm joined by my co-host, Barry Conrad. Actor, singer-songwriter, and creator and host of Banter with B.C. For more on us, check out MelanieAvalon.com and BarryConradOfficial.com. You can submit questions for the show by emailing questions at iapodcast.com or by going to iapodcast.com. We would love to hear from you.

Please remember the thoughts and opinions on this show do not constitute medical advice or treatment. So pour yourself a mug of black coffee, a cup of tea, or even a glass of wine. If it's that time and get ready for the Intermittent Fasting Podcast. Hi everybody and welcome. This is episode number 438 of the Intermittent Fasting Podcast. I'm Melanie Avalon and I am here today with a very special guest that I am so excited about because we are going to tackle a topic that honestly we get questions about all the time and we have never really had an expert on to address it. So the backstory on today's conversation, maybe like a year ago or so, our mutual friend, Ben Greenfield, who has been on the Melanie Avalon Biohacking podcast, introduced me to an incredible doctor, Dr. Cameron Chestnut, and I had him on that show. The topic, he does a lot in the world of cosmetic surgery and cosmetic procedures with a, I would say like a biohacking, like a holistic, a regenerative medicine, a biohacking type approach. And so friends, if you have questions about all the cosmetic things like surgery and fillers and Botox and everything like that and recovery, definitely check out that episode. We will put a link to it in the show notes. So I just had the best time having that conversation and he also has a really incredible following on Instagram that you can check him out. So that was Dr. Cameron Chestnut. In any case, through him, I met another incredible doctor at his practice, Dr. Christopher Meadows, and we did a call to just like learn more about him and what he does and what he focuses on. And his story is really incredible. We're going to talk about it on today's show. He has a background in actually like college football at UCLA. My, um, not my nemesis, but I went to USC, so it's all good. In any case, he has a really incredible backstory of his sports background and then transitioning into this world of regenerative medicine, rehabilitation, recovery, all the things. And with talking to him, I realized he was so educated and nuanced on the role of fasting in surgery, recovery, health in general. And I just knew that this would be a really epic conversation to, to really talk more and dive deep into that. And I'm sure we won't just talk about that. There's so many things that we can talk about. I have so many notes here, but in any case, Dr. Meadows, thank you so much for being here.

Dr. Christopher Meadows
It's such a pleasure to be here. Thank you so much for the warm introduction. And I'll try not to hold it against you, our alma mater nemesis here.

Melanie Avalon
know, it's all good. I think we talked about this when we talked. What years were you there at UCLA?

Dr. Christopher Meadows
I was there, I graduated in 2009.

Melanie Avalon
That's right, because we think we might have like, because I was there 2009 as a freshman. So I probably saw you, yeah, play, which is wild because like, especially freshman year, that's, you know, like freshman year is like the year you're like really, really invested.

You go to all the games.

Dr. Christopher Meadows
games. Exactly. In the student section.

Melanie Avalon
Yep, in the student section. Oh my goodness, I'm gonna get emotional. It's all good.

So in any case, with that introduction, yeah, where to start. So well, first of all, I would like to start there. Did you always have goals of playing like sports in college? Because that's a big goal.

Dr. Christopher Meadows
Yes, I grew up a huge sports fanatic, athlete, loved playing sports, loved watching sports. And from very early on, I knew that I wanted to play college football. I wanted to go beyond that, play in the NFL. That was my dream. So I knew that from a very young age.

Melanie Avalon
It's so interesting, especially like when if you've like been to college, the college football players, I mean, you guys are like celebrities, you know, like if you're like in a class with one, it's like, oh, so yeah, that's really amazing.

And appropriately enough, though, I'm so I actually interviewed last week, Dr. Heather Sanderson, and she has a book called reversing Alzheimer's. She talked about this holistic approach, she actually published, I think the first study that shows their their lifestyle type interventions actually reversed our reverse cognitive decline, I think. One of the things she talked about was just things that you could do, you know, to support your brain, one of which was sports and movement, but only certain types, and one of which was avoiding sports. So she literally was said, like, don't play football.

Dr. Christopher Meadows
Yeah, the head trauma can certainly be a negative impact. So I mean, it's not a not an easy decision when you're thinking about it.

People ask me all the time because I have two boys and are you going to let your sons play football and right now they're in flag football, which is a growing sport, which is awesome to see and is going to be in the upcoming Olympics. So I'm super excited about that. But oh, it is. Oh, yeah.

Melanie Avalon
Wow, I didn't know that.

Dr. Christopher Meadows
Yeah, so that's a growing sport. And I know in Southern California, it's very popular amongst the youth and much safer environment. Obviously, you're not running and colliding into each other and creating head trauma. So a lot of benefit to that.

So I'm torn on that. We can go into that in more detail in my opinions. But certainly having recurrent head trauma is not beneficial for long term cognitive health. That's for sure.

Melanie Avalon
Yeah. Did you ever have any intense injuries while playing?

Dr. Christopher Meadows
I always joke when I say this and say, I don't remember. But no, fortunately, I kind of stayed safe. I was a coroner when I played college, so I was in the outside and for the most part avoided big collisions that running backs and linebackers play on a regular basis. So I didn't have too many major head traumas, but there's certainly enough there that I'm going to be paying attention to my cognitive health as I get older.

So what happened?

Melanie Avalon
So you did the football, you had thinking of going to the NFL, what transitioned with your career?

Dr. Christopher Meadows
Yeah. So as I started thinking about what I was going to do long-term, of course, I still wanted, you always have to have this vision that you're going to go to the next level, right? If you're not, if you're not actively thinking about how I'm going to get better or how I'm going to kind of try to get to the next level of competition, then you're not really coming with the mentality of competing, right? And so of course, when I was early in my college career, I still had that mindset.

I wanted to go to the NFL, but I started to have more and more conversations about what I'm going to do, you know, from a professional standpoint, what is it you're going to major in and what are you going to do after football is over and thinking realistically about life after. And it's a hard conversation for many of them. You talk with anyone and they all really kind of tunnel visions. Like I don't, what do you mean life after football? What is that? What is that? I don't, I don't know of anything outside of what I'm doing now. That was when, and, you know, along with that, I had a couple injuries and that sidelined me for a bit. And so that's when, you know, things start to hit. You have a little bit of a reality check and say, no, you really need to start putting some thought into this. And I always had interest in health and medicine. I always had this idea that I was going to go into the healthcare field to some degree that I started as physical therapy. I had my, my mindset on that because I had injuries and I was in the physical therapy office and I really liked that environment and helping athletes get back, get back to the field and get better playing. Then unfortunately, I had a shoulder injury that required surgery and I was introduced into a orthopedic surgeon. And that's when I thought, wow, this is really where you want to be. This is the space where you're knowing medicine to its fullest. You're knowing all the ins and outs. You're seeing surgical interventions and getting exposed to the inside of anatomy. And I was just blown away with the surgeon's knowledge and the outcome that I had from my surgery. And so that's when it was determined that medical school was the route for me. And when I made that decision, there's conflict there. There's only so many hours in the day and I could not invest to my athletic skillset as I needed to, to keep up with the competition that was coming in. And so I saw that I was kind of reaching my limit and my peak capacity on the sporting world as I started to put more time and effort into the academics. So there was a challenging time there where I had to come to the realization that my sporting career was coming to an end, at least at the collegiate level. I still maintain my identity as an athlete to some degree and still maintain that pursuit for my general health now. But I knew that I needed to spend more time with my pursuits on the medical side. And so I had my sights set on medical school and that's where we are now.

Melanie Avalon
Wow, so many things. Yeah, I thought about this a lot with the with the whole sport thing and that so I personally, I was never a sport person. I think I like in elementary school, middle school, like I played every sport at least once. I think my dad was convinced if I like, you know, I think he made me play everything at least once because he was hoping I would like like one of them. But I've thought often what you were just talking about, about this identity crisis shift that probably happens because, you know, if you're doing these really grand sports where it becomes your career and your life focus, so football, the Olympics, all the things, then I can't even imagine what it's like for that to just, you know, end for people. So I'm grateful.

I'm grateful that my goals and passions from when I was little weren't things that had a ticking time bomb on, you know, then potentially ending due to like age. I mean, age, I guess, really. Yeah, wow. So kudos to you for the career choice that you made, because that's incredible.

That's no small feat. Are there I have so many questions. So looking back with everything that you've learned, do you approve of some of the rehabilitative work that you experienced when you were a college athlete? Do you shutter at some of it? Would you have done things completely differently? The same? Like, what do you think looking back?

Dr. Christopher Meadows
Yeah, that's a good question. And it's tough to say because medicine is changing so fast. You know, there's newer surgical techniques, there's newer treatment options. You know, we live in a world now where regenerative medicine is at the forefront and that just simply wasn't available at that time. I was fortunate, despite all of the injuries that I had, that none of them were surgical except for the one shoulder surgery that I had. So, you know, I've always had the mindset of trying not to undergo surgery if not needed, taking the more conservative approach. That doesn't mean you're not aggressive from a rehabilitation standpoint. You know, undergoing surgery is a difficult task and it's, you know, it requires its rehabilitation process. And so anyways, I was fortunate that I didn't have any major surgical needs at that point. And so I am happy with the rehabilitation protocols that I underwent at that time.

However, if we were to replay that with what's available now, would I have pursued additional techniques or options? I certainly would have. And so that's just, you know, I would have hoped that that would have given me an opportunity to return to the field faster, recover faster, recover to, you know, instead of being at 80%, be at 90%, 95%. So those are some of the things that could be offered in the regenerative medicine space. But again, it's just simply wasn't available at that time. So I think I was in the right hands with what was available at that time. And, you know, again, medicine is just changing so fast. And that's a good thing. We're getting some newer techniques and newer developments. And that's just the way of the world. Things get better with time.

Melanie Avalon
I'll share a little bit of your bio involving your medical career because it's really intense. So you've served as the associate program director for the St. Luke's Rehabilitation PMNR residency program, clinical assistant professor at the Department of Medical Education and Clinical Sciences at the Elson S. Floyd College of Medicine at Washington State University, and clinical faculty through the University of Washington School of Medicine. And you've also contributed as an author to major medical texts in the field of rehabilitation medicine. So not only are you learning it, you know, practicing, but also, you know, teaching as well, your passion with this work that you do.

How do you feel like when you're teaching about it versus like doing the work in clinic? Like where's, where's your heart? How do you feel when you do those different things?

Dr. Christopher Meadows
Yeah, that's a good question. I've always envisioned myself as a teacher, even with patients, you know, yes, we're diagnosing disease and we're coming up with treatment protocols, but a huge majority of what we're doing with patients is we're educating. We're educating on the background of the disease process. We're educating on what the expectations are moving forward. What are the outcomes with various treatment options that patients are pursuing? So there's always an underlying theme of being a teacher as a physician.

And so that's always been something that I've carried with me and I've had a natural inclination to be able to share knowledge to patients in a genuine way, in a way that's understandable. And that's carried over into the educational side for, you know, learning physicians. So residents, resident physicians who are young physicians that have chosen the specialty in physical medicine and rehab, which is what my specialty is, I've been able to, you know, have the privilege to take them kind of under my wing, so to speak, and to teach them the pearls that I've learned over time. And that includes lecturing, that includes having them in clinic with me and allowing them the exposure of the clinical pearls that I have. And it's just so natural for me to share that with them. And it's fun to see how they develop over time and improve on their skill sets. And when you see light bulbs go off and they start to make these connections and they feel confident in their skill sets, they feel confident in their abilities to take care of patients. I mean, that's such a gratifying experience for me. So I love doing that. So it extends in both, in both realms, both in front of patients and how I'm educating them, which is a unique skill set, but also teaching residents as they grow up to become full blown attendings. And so they're both fun for me.

Melanie Avalon
I love this so much. This is literally what I look for. Honestly, whatever I'm trying to find a doctor for whatever it may be, because I think especially in today's conventional healthcare system, it can often feel very, you know, systemized and like there's not usually a dialogue that easily can happen between the patient and doctor at least in my experience again with like the conventional system. And so what I'm always looking for is a doctor that is, you know, learning and educating and having those conversations. And so this is just the best of both worlds. So thank you.

Before we get into some questions about, you know, surgery and recovery in general, what type of procedures do you actually do?

Dr. Christopher Meadows
Yeah, so my practice is primarily in the orthopedic space. In physical medicine rehab, we train to be experts of the musculoskeletal system as well as the nervous system. And so we learn in detail pathologies of tendon, pathologies of joints, pathologies of nerves. And so within that, you know, again, with my background in the sports medicine world, that was my interest is I wanted to treat patients and athletes to help them recover, help them improve, help them to get back on the field, you know, and recover from injury or even prevent injury.

So a majority of the patients that I see are coming to me with joint related concerns, tendon related injuries, whether acute or overuse injuries. And so in my practice, I do a lot of diagnostic ultrasound that is really key for my evaluation process because it allows me to see the structures underneath and no radiation involved, no real significant side effect profile. So I can just at the bedside see what's going on with muscle, see what's going on with tendons and joints. And from there, make really clear diagnoses to whatever issues are going on. And so if we do find a pathology, then we can talk about treatment options, which are primarily peripheral joint injections or tendon injections. And so this is where we get into what's available regarding regenerative treatment approaches, including things like PRP, PRF, stem cells. And so the majority of treatments that I offer are bedside ultrasound guided injections to areas of pathology to stimulate regenerative capacity.

Melanie Avalon
Awesome. And then would you ever do surgery or refer out for surgery?

Dr. Christopher Meadows
Yeah, so I'm not a surgeon myself, so I can refer out to surgeons if that's needed.

Melanie Avalon
Awesome. So okay, big question here, because I feel like there's two, you know, two big camps of, and this is me not, I mean, you're doing this every day, so I might be wrong with these camps, but I would envision there's like two big camps of people, people who, you know, have a recent injury and, you know, they know it caused it and it's fresh, it needs to be addressed.

And then these people with chronic injuries, you know, like shoulder pain that never went away or whatever it may be, is there a different, do you have a different approach to addressing something that happened more recently compared to something that somebody's been struggling with for a long time?

Dr. Christopher Meadows
Yeah, that's such a good question. And you're absolutely right. These are different pathologies, there's different mechanisms of injury that result from these different scenarios that you describe. So in an acute injury, you have usually a trauma or you have, you know, some sort of abnormal position that a person was placed in. Oftentimes we're talking about in an athletic competition, you know, there's a mechanism of injury that you can see clearly caused an injury.

And that is vastly different from a chronic overuse injury. So use the example of shoulder pain, an individual who's had shoulder pain, maybe 15 years, 20 years, maybe has had a couple of acute issues there where they fell on it or something, but never really had any significant trauma that required surgery or anything. And so it's been a long time of just recurrent injury pain that's never really gone away. Maybe you've tried therapy here and there, and it's just lingered. So that type of progression is dramatically different. If you look at these different types of pathologies under a microscope, you would see totally different types of immune responses. You would see different types of changes to tendon or to cartilage. And so certainly you would not want to have the same approach because they're completely different. And how you address that, how you choose to utilize whatever your treatment protocols are, are going to be very different in those two circumstances.

Melanie Avalon
For the chronic example, have you found when you do your investigation or ultrasound, you know, you isolate what the problem may be. How much of it is a one-to-one for you can see the problem and that correlates to what the person is experiencing versus how much can be, I don't want to say in their head, but you know, we have this concept of like phantom pain or, you know, people who will ongoing injuries, but when you actually look at it, it might not signify that that would be what they're experiencing. Like, so how is it usually like you see the problem and it's pretty obvious or is it sometimes not?

Dr. Christopher Meadows
Yeah, that's a good question. And that's that's the challenge to the clinician is in particular when I'm doing diagnostic ultrasound, oftentimes, I'm finding lots of pathology, I'm seeing lots of different areas of abnormality. And the trick is to say, well, which one of these is actually causing the pain. And that's one of the nice things about ultrasound is that I can just do this at the bedside.

And I can actually have you move and I can say, well, why don't you show me what causes the pain and I can see it immediately under ultrasound and find that oh, this bursal gets all punched up, pinched up, and it gets, you know, inflamed, I can see it bulging out under certain movements. And so you get both ends of those spectrums where on the one hand, there's multiple abnormalities, and I have to figure out which one it is. And on the other end, you say, wow, well, this is a relatively normal exam, I'm not seeing anything, and trying to tease out, you know, how much of this is, you know, inorganic versus something that's made, you know, come from somewhere else. And you mentioned phantom and oftentimes, I don't run into too much phantom pain, but I do run into referred pain, which is pain that can be kind of your nervous system is designed to sense pain and tell you, hey, that's coming from this location. But when it comes to and that's, that's easily recognizable on your fingertips or something that has a high sensitive high nerve innervation ratio. But you know, your joints can be particularly difficult to really pin down, you know, oftentimes says, well, my whole knee hurts, it just kind of hurts everywhere. And that's where things get a little bit more challenging. But again, when you can see things under ultrasound that does help you, it is challenging when you say, or when you have a case that you just don't see any abnormality and trying to pin out, well, what is it exactly that's going on in those require a little bit more workup. But that is the challenge for the clinician to, you know, go through a thorough physical exam and a thorough diagnostic ultrasound to really find that and I find myself on the opposite end of that spectrum more often than not, which is I'm finding multiple areas of abnormality. So which one is it that we think is actually causing your pain?

Melanie Avalon
Interesting. So, you know, some areas are, like you said, are abnormal, but they actually might not, but they're not causing symptoms. Correct.

With those types of things, is it fine to just, like, let that go then? The ones that aren't causing symptoms?

Dr. Christopher Meadows
Yeah, you don't want to over-treat and you don't want to diagnose pathology or create diagnoses that aren't there. I don't want to make bigger issues than they are.

At the end of the day, when we think about pain and function limitations, those are really the areas that patients, I want to feel better, I want to be free of pain, and I want to be able to do XYZ, right? And so that's what I'm here to do, is help you get back to functioning or get back to your exercise regimen or get back to playing with your kids, whatever it is that you have interest in doing that you're being limited because of this pain, that's ultimately the goal. And so if I go and treat other areas that aren't bothering you or are not pain limiting, then we're not really achieving a whole lot. Now you could argue on the other side, and I do see this, where patients would say, well, why don't we just treat that from a preventative standpoint? And so we have to have those conversations on what to expect, what are our expectations in doing a preventative treatment approach? And so that's also a different conversation and a different regenerative mentality to think about when we're just doing preventative treatment as opposed to treating something that's abnormal and trying to get us back to function and reduce pain. So there's just different buckets of patient populations and different approaches to take in those circumstances.

Melanie Avalon
Yeah, I can totally see, especially in the biohacking community, you know, like for me, for example, if I were to see all the things, I'd be like, Oh, I will. Well, I want to fix all the things.

I've had an interesting experience because I have like a tight shoulder knot that is kind of always there. And I also get kind of, I get not too much pain, but tension and some issues, but it's all on the right side of my body. And every time I've had any sort of scan done by whoever is, you know, analyzing it, they've always told me the problem, same with like my mouth, like I have TMJ issues on my right side, I'm always told the issue is actually on the left side. And so that it's, and so that's what one of the reasons I've been so intrigued by, you know, the experience of the pain versus where it's actually coming from, because that always blows my mind when they told me that about things.

Dr. Christopher Meadows
Yeah, that's such a that's such a good point.

And then on the other side of that is, you know, when it comes to imaging and when you say you've had imaging, are you talking about ultrasound or x rays or MRIs or all of the above?

Melanie Avalon
So I've had MRIs, X-rays, I don't know if I've had ultrasound, definitely X-rays and an MRI.

Dr. Christopher Meadows
Yeah. And these are the things that we always talk about, you know, when I'm working with residents and doing some teaching, we have to be cautious on two fronts when it comes to imaging and these, you know, advanced imaging like MRI, they're static positions, you know, and oftentimes not normal positions, you're lying down and, you know, sitting there for 45 minutes while the magnet is spinning around you.

And it's oftentimes, you know, you wonder, well, what happens if we were to change positions, because there's always this standard position to be in, we think about that all the time when it comes to low back pain or neck pain, and we do an MRI of the spine. And you say, well, this person is laying down what happens when they flex forward? Or what happens when they side bend? And what kind of changes are you going to see in these different positions that could show more of what's going on? But again, going back to my previous topic about not over diagnosing things, you can't call every pathology that you see, there's a certain range of normal, right? And you say, okay, well, this disc is a little bit big here, or this disc height is a little bit, you know, small here, you have to really be a clinician and think about what is actually outside of our range of normal, and what is it that's truly causing this pain and discomfort. And so when you say, well, I have pain on the right side, but they always say it's the left side that bothers me, that doesn't mean you go and start treating the left side, you can, you know, focus on the side that's giving you problem, maybe you look somewhere else.

Melanie Avalon
Yeah, this is it's so fascinating to me. Quick question, because I actually appropriate timing. Yesterday, I got back a lot of data from a genetic sequencing. Actually, they're called sequencing was the company. And it generated all of these different reports for my, like my genetic tendency for different disease risk categories. And I was pretty much in the clear for most things, with some exceptions.

And one was which I, my, my mom has really experienced actually a lot of people in my family have had issues with arthritis, that type of pain. I came back like in the red for all of that, which I found was really interesting. So my question, I have not experienced that I'm aware of any arthritis pain to the at this point. But the role of genetics and epigenetics in any given situation. So when you when you see a person, like, like, how much do you look at their genetic data? Does it even matter their genetic data because of the power of epigenetics? How do you feel about the role of genetics and pain?

Dr. Christopher Meadows
Yeah, that's a good question. And genetics can certainly be an additional piece of information that can help guide you. And that could be in a circumstance, well, we see all these pathologies and we know what your genetic profile is, maybe it does make sense for us to be more aggressive and talk about what sort of procedures would be helpful or exercise routine or dietary approaches. So I don't do that standard with most of my patients.

If we do have, you know, you get a history and you talk with patients about what's going on, like you mentioned, you have a family history of arthritis. So going into that history can help to say, you know, maybe we should explore this a little bit more or you have patients that have recurrent injuries and you think, gosh, well, why is it that you're, you know, you're back again and now it's your left shoulder and we've already treated both knees and the right shoulder and now you start to kind of, you know, raise your eyebrows as to is there anything else going on? And you might think about doing some genetic testing to see, you know, a lot of those things give some good information and can certainly be additional pieces of information to maybe augment your approach and, and think about being a little bit more aggressive from a preventative standpoint, both from a treatment and preventative standpoint. So those are certainly helpful. We do that with a part of our practice is functional medicine where we do that, you know, more routinely for all of those patients. It's not routine for my patients with the exception of these circumstances that we think, gosh, we need to do a little bit more investigation to see if there's something underlying.

Melanie Avalon
Gotcha. Okay. Yeah. Yeah. I was like, when I got the report back, I was like, well, that makes sense based on what I know from my family history. And still, like, I don't ever want to feel destined by my genes that, you know, I'm going to manifest a certain condition because I think people have so much agency, you know, with what they with their lifestyle.

So when you're working with, you know, this population with pain, what is the role? So you mentioned like, you know, different types of injections, and we can definitely talk about those. And also at the same time, what is the role of the lifestyle that the patient is following? Is there, does that majorly affect either way, the effectiveness of the treatments that you're doing?

Dr. Christopher Meadows
Yeah, that's a good question. And this goes to my approach regarding treatment of patients, which is not a single modality. I just don't think of treatment with patients as a single modality, one size fits all type of approach.

And you mentioned earlier the introduction regarding Dr. Chestnut's approach to recovery, which is this multifaceted, you know, post pre and post-operative rehabilitation or recovery. And I think the same in my space on the rehabilitation side that a procedure is one piece of the puzzle. It's also thinking about your biomechanics and how you're moving. What made you susceptible to this injury? And what is it that we can augment in other areas from a nutritional standpoint or from an exercise regimen standpoint? Now, not every patient is really interested in going into that much detail or that much depth for their recovery, but those that are receptive and really want to approach this from a multifaceted approach and thinking about all of these additional areas, then that's when we can really have good conversation regarding, well, I'm going to do a procedure. I think this is going to help. But if we also do this exercise regimen on top of that, particularly when the first, you know, handful of days after a procedure where things are inflamed, but I want to keep things circulating. I want to keep muscles active. I want to keep tension on the tendons. All of those things are going to help in the efficacy of your treatment, regardless of what it is, whether we choose to do a PRP or a stem cell injection. They're going to support and augment your recovery process to help things not only recover faster, but allow for the full efficacy, the full potential of the treatments that we're doing. So I do have those conversations with my patients regularly.

Melanie Avalon
And so you actually touched on something I had a big question about. So you mentioned, you know, this inflammatory state that people can be in. What is the role? I'm very haunted by this actually.

So I think people are pretty familiar with the idea of acute versus chronic inflammation and you know how acute inflammation is actually in theory, a healing process. Like it has a purpose there compared to chronic where it's just not going away and it's creating more damage in that initial injury phase where there's inflammation or even like inflammation, post-surgery, whatever it may be. What is the role of like reducing and suppressing that inflammation versus letting it play out? Like, do you need that inflammation?

Dr. Christopher Meadows
Yeah, that's such a good question. And my perspective is that we do want that inflammation when we acutely injure something. You know, you say you're walking, you sprain your ankle, for example, and it gets swollen, it gets red and hot and uncomfortable. The pain sensitization goes up, so you're more sensitive to any stimuli. And that's part of the initial inflammatory phase. And this is part of the healing cascade. And you want it to naturally transition from that inflammatory phase into the proliferative phase and the remodeling phase. Those are your phases of wound healing. And you want it to do that.

And there's, when I was in medical school, actually, we had a lot of conversations regarding acute fractures and what's the role of anti inflammatory, specifically NSAIDs, which is like your ibuprofen, your Aleve, your aspirins, those sorts of medications, which are intended, they're anti-inflammatories, they go in and they block the inflammatory response. And you will feel better, it reduces the pain, it reduces the swelling. But what impact, what potential negative impact does it have by skipping the steps to go through the rest of the wound healing cascade? And so I still maintain that approach. I'm not a big fan of utilizing anti-inflammatories in the acute phase. We can talk about the post procedural approach that I have as well. But the natural cascade of the inflammatory process that peaks after an acute injury and is allowed to go through its full progression will allow for the maximal amount of healing that is necessary for that area. Now, if we have recurrent trauma, or we get back to play or sport too soon, and we now have recurrent injury, and a now low grade inflammatory response, and it swells up again, and we have more pain, and whenever I do this, it really swells up and starts to bug me. You know, those are those are signs that we've not allowed for full healing, we've not allowed this to to fully recover. And so we need to be more aggressive with our rehabilitation, we need to maybe scale back on the activity, we need to scale back on the intensity of exercise or what have you. And we want that inflammatory phase to fully subside to fully come down and allow maximal healing before we start to put in more stresses. But so again, I am against I am against the idea of trying to blunt that response just to allow for improvement in symptoms.

Melanie Avalon
And what about so you're talking in the role of, you know, like pharmacological insets and things, what about if people were to do, you know, high dose, I don't know, turmeric, and, you know, omega threes and cold exposure, what about those ways of doing, you know, creating an anti inflammatory response during the inflammatory phase?

Dr. Christopher Meadows
Yeah, that's a good question and that kind of stems from where the inflammation is coming. I think when people are doing those, they're talking about systemic inflammation and what's going on, you know, full body cardiovascular health, overall metabolic health. And I think those are great for that type of inflammatory response, the systemic. Those are also great when we have infection or wounds and they can help to reduce the inflammation. What's nice about those is they don't blunt the inflammatory response in the same way.

When we talk about NSAIDs, we're talking about direct implication or direct inhibition of specific cellular mechanisms of the wound healing response, so specifically platelets, which are the main responder in that inflammatory phase. And so when we have medications that are going after and inhibiting them directly, then, you know, that can have a negative implication moving forward. But when it comes to these more, you know, herbal remedies, the turmeric, those sorts of supplements that we're taking, they don't have the direct inhibitory response that you see with these sorts of pharmacologic approaches. So they're not as negatively impactful. They do not blunt the immune response in the same manner. They do not impact the wound cascade in the same manner. So I don't see any reason with having to worry about taking those in the acute phase and they can potentially support that inflammatory process as well.

Melanie Avalon
Awesome. Okay.

And I don't know if this is specifically in your wheelhouse, but it's a question that I have all the time and I actually had today and it kind of relates, so I'll just go ahead and ask it. So I often will do M-sculpt for like muscle building, and I usually do like a cryotherapy session right after. Do you have thoughts on the post, you know, strength training session doing anti-inflammatory type things? Does that hinder muscle growth? And this is a tangent question, but I don't know if you have thoughts on that.

Dr. Christopher Meadows
Yeah, that's a good question. I mean, same similar process, right? When we think about an exercise regimen, we are, again, causing an acute inflammatory response. Now, it's not as robust as the ankle sprain example that I gave earlier, but it is still causing muscle damage.

You're having tissue and tendon injury that is of lower grade and is creating a stimulus for remodeling such that we can get stronger, right? Muscular hypertrophy and tendon strength. When it comes to, there's good literature out there regarding the blunting effects that cold plunge can have after strength or cold therapy can have after strength training with specific to the hypertrophy and strength gains. So that's out there. When it comes to body composition, I think there's less impact that that has from a negative standpoint. It's not going to impact that as much, but we know that the cold exposure can blunt that strength force development and hypertrophy effects. So that is something to think about, but it's not hugely robust and it's not a big thing to worry too much about, but it can.

Melanie Avalon
There's basically from what I've seen, there's just enough studies to make me like nervous about it, you know, okay, that that all that all makes sense. Also, while we're existing in the the lifestyle realm.

So fasting and this is something you and I talked about, talked about on the phone and something that I get questions all the time about. So what do you see the role of fasting so intermittent fasting on people's, I guess, inflammatory state pain state, and in particular, recovery from injuries, surgery, I can ask more specific questions, but in general, just fasting. Is that something that you recommend to patients that you like? What are your thoughts on it?

Dr. Christopher Meadows
Yeah, I'm a huge fan of fasting. I do it personally for primarily for metabolic support. So that's where I really got introduced into fasting and its potential for, you know, supporting insulin sensitivity, supporting cardiovascular disease, blood pressure, lowering, etc, etc. So that's my introduction to fasting was in that realm.

But what's been fun to see is how that's really carried over into the regenerative medicine space where fasting has been shown to support stem cell health, support stem cell number and regenerative capacity. And so, you know, talking with patients, again, if they have interest in pursuing this, fasting is a great potential additional tool that you can use to help regenerate. And in my space with doing peripheral joint injections or tendon injections, the recovery state like the, you know, caloric requirements post procedural is not significantly high. And if you can add a fasting, you know, a period of time of fasting after procedure, it can certainly help with that regenerative process. So we do talk about that with patients. Again, we have we have a variety of patients and their perspectives and their interest in doing that. But it's also well known that if we support the metabolic health of patients that their regenerative capacity is going to improve. So when we say, well, your fasting is not only going to support the recovery from this process, but from a general health perspective, your stem cells are going to be more effective, you're going to have more numbers of them. And they're going to be the capacity for regeneration is going to be higher and support you for the recovery of this injury, but also the prevention of future injuries and risks of future injuries. It's a great tool to use, obviously, it's low cost, and it's not a significant burden to anybody outside of the discomfort that you have when you're fasting. And you know, you can you can scale that back and have a different duration of time for which you do undergo a fasting window. But it is a great tool to use and use it regularly with my patients for the recovery and regeneration aspect.

Melanie Avalon
Awesome and something you said in there is like the question that we get from people which is you mentioned if the caloric needs or the you know protein needs I'm not sure I think you said caloric needs aren't too high. How can people know if they're in that state or not with it like a surgery in particular?

Dr. Christopher Meadows
Yeah, and that's where things get a little bit more challenging when you think about surgical states because these are more intense, you know, if you have a surgery, the catabolic aspect of that is so high and you really want to ensure that you have good caloric supplementation to meet the anabolic aspect of it that comes after the surgery. And so your surgeries are generally listed as mild, moderate to severe when we think about risk of perioperative surgical interventions. So that's one tool that you can use, but the duration of the surgery along with the location of the surgery can be a big factor to help you decide whether or not you want to embark on a fasting. Of course, you would want to talk with your surgeon to see. It's not uncommon, of course, as you know, you would be fasted going into the surgery, right? You're usually not eating by midnight the night before of a surgery. So you do go into your surgery, you know, varying degrees of having a fasted state. If you're eight in the morning, not as much, but maybe you have a 3 p.m. surgery and so you're fasted for a little bit longer. And if it's a pretty major surgery, they might keep you without eating until you have movement of bowels and you're starting to pass gas. And that's the typical kind of thought process around almost all surgeries.

But when you have things that are intra-abdominal or intra-thoracic, you're really getting into these large surgeries that fasting is probably not going to be a beneficial approach for you to take. Once you can start eating, you really want that caloric supplementation to help the recovery process and the protein supplementation, as you mentioned. So those are big aspects of the healing cascade that you want to make sure you're not limiting your body in addition to the micronutrient demand that you will have at that time. You know, zinc and magnesium, all of these micronutrients that you want to make sure you have in, you know, an abundance so that you can maximize your recovery. But it also is not uncommon for patients to fast in advance of a surgery to be going into it in a slightly fasted state. And the idea around that is having higher levels of ketones, which ketone bodies can be great for recovery as well. But as far as knowing what threshold, there's not a clear line of what the threshold is for what type of surgery, but those would be the considerations. If it's something intra-abdominal, if it's something intra-thoracic, the duration of surgery, those are going to be things that are going to help determine whether or not you would want to have a perioperative fasted state. If it's something that's really relatively minor, that maybe is on the periphery or cosmetic, that might be a better option to seek a fasted state in, you know, pre- or post-surgical.

Melanie Avalon
Actually, and a question related to that because you're, you know, you're talking about speaking with your surgeon about, you know, what is the best approach for people to implement with fasting and, you know, that lifestyle. We actually got a question, it kind of relates, what can people do?

This is not the question, I'll read the question, but if people are having a surgical procedure done, again, in the conventional medical system, what can they do to know how to appropriately integrate different recovery methods. So be it fasting, be it more regenerative things like that that we can talk about, but I'll read this question that will kind of like illuminate what I'm saying. So Macy, for example, she said, I literally had surgery yesterday and the biggest struggle has been finding out what works for post surgery protocols. My doctor who's totally supportive didn't feel comfortable with giving me timeframes for PEMF or red light therapy. It's a fine line to want to utilize all the tools at your disposal, but also not wanting to negatively impact recovery. So I can see this situation probably being pretty common for people because, you know, not everybody is always getting these procedures done with, you know, somebody like your practices approach. So how can people know like what they can be doing on their own to help their recovery in the more regenerative sphere?

Dr. Christopher Meadows
Yeah, that's such a good question. And I think it's difficult to say where patients can, you know, it's hard to make blanket statements to say, this is what you can do.

I mean, this is what I run into in my practice quite regularly, actually. It was where patients are having surgery and they're saying, what can I do to support my surgery, my recovery? What can I do in the weeks leading up to my surgery? What can I do post-operatively? And it is really unique to the specific surgery and, you know, what was intervened on to know what is gonna be safe and effective. For the most part, I mean, thinking about, and it's not, you know, again, seeing doctors that just don't have as much knowledge in this space kind of be uncomfortable. And so I do talk with patients about that who we would do consults with and say, here's what's gonna be great. And then having the collaborative conversation with the surgeon, if we need to, to say, here's what I'm thinking, this is what I would do, and here's what our potential side effect profile is gonna be. And most of these are really low risk when you think about PEMF and red light therapy, you know, again, depending on the location of the surgical incision and what it looks like. The one that really requires a little bit more knowledge around is gonna be hyperbaric because of the pressure involved. And so when you're thinking about intrathoracic surgery, you know, I had a recent patient who had a resection of a portion of the lung, and you know, you certainly would not want to increase intrathoracic pressure by putting in patient in a hyperbaric and you can run into some problems there. So that's one that you would certainly wanna look out for. But for the most part, there's not a whole lot of risk, but these are conversations that I would advise to speak with a provider who's knowledgeable in this space. And if there are any questions that come up, you know, they can contact the surgeon and they can have that dialogue as far as what would make the most sense. And it goes beyond some of those modalities, right? It's also nutrition and supplementation and medications, postoperatively, pain control, bowel support, hydration status, I mean, all of those things are factors that you wanna think about.

Melanie Avalon
Awesome, awesome. Yeah, I think it's, it can be hard for people, especially because if people are wanting to use like insurance and it can be hard to find like the dream, you know, doctor who can do the surgery and also be really knowledgeable on all of these more holistic approaches that people can be doing.

So going back to what you were saying you do a lot of in your clinic with the injections, you said, is it stem cells, exosomes? What type? Is it actually stem cells?

Dr. Christopher Meadows
We do stem cells, exosomes, PRP, PRF.

Melanie Avalon
So what's the latest on the stem cell legality situation?

Dr. Christopher Meadows
That's a good question. You know, this language around whether or not stem cells are legal or illegal I think is not really the right verbiage.

There are FDA approved pathways to utilize stem cell products and they are available here in the United States. You don't have to travel abroad to get stem cell products. But you know, there are certain requirements and tissue handling and tissue, you know, practices that need to be utilized that's overseen by the FDA. And as long as you're following suit and following those guidelines, you're well within the means to utilize stem cell products, exosome products for tissue repair for treating patients.

Melanie Avalon
And what do you see the timeline of healing or resolving of pain with these approaches? So I actually, I've had one stem cell treatment. I did something to my knee, I guess in like 2021 maybe. And the pain just, it was really bad at the beginning. And then it was just kind of chronic, like it would act up, especially if I wore heels or it just always, yeah, it would act up essentially.

And I got a stem cell injection like directly into it. And the thing that's hard for me to gauge is I can confidently say now that it's gone. Like it doesn't flare up. I don't feel it anymore. But it's hard for me to know if it would have been gone anyways because of the time.

Dr. Christopher Meadows
That's so good, yeah, you're exactly right and so I guess your question is like what is the expected timeframe for resolution of pain or symptoms for some of these issues and certainly it depends primarily on what the initial injury or what the pathology is. As we talked about earlier, in acute injury, you sprain your ankle, I'm expecting that to get better with time as long as we give it the right environment and we can try to augment that to speed it up but as we've all experienced, you get an acute injury and hopefully that heals well with time.

Then on the other end of the spectrum, you may have an injury or something just kind of gradually starts to bother you and before you know it, it's been a couple years and you try some therapy, it doesn't work and now it's five years and it just keeps lingering and you kind of try to do some measures but nothing seems to be working and those are where it gets a little bit more complicated because when you run into these degenerative conditions, you know we talked about arthritis earlier, these are conditions where the cartilage is starting to wear down, the tendon is getting a little bit more frayed and thick and tender and these types of injuries are really the ones that are more challenging to deal with and it's no secret that there hasn't been and you mentioned the traditional healthcare space, there have not been great tools to try to help these conditions. We have steroid which is great, again just like the anti-inflammatories, it's going to reduce the inflammation, it's going to reduce pain and you're going to feel great but it offers no regenerative capacity and it does not allow for, it certainly doesn't offer anything from a regenerative standpoint.

So when we think about how we're going to approach these chronic conditions, we have to say, you know this is a little bit more, it's going to take a little bit more time to reduce the pain and to improve function and it's not the same approach that has historically been where I'm going to reduce pain and you're going to feel better tomorrow. No, this is going to take some time, we're going to have to invest into this a little bit again thinking about all of the multifactorial ways in which we can approach this, lifestyle intervention, etc.

But when you look at the research out there around different regenerative products, the outcomes seem to peak around six months. So it's again, it's not a quick fix, it's something that takes time.

And when you look back historically at these patients that have been suffering with pain for five years, ten years, when they have improvement in symptoms immediately after, not immediately but you know three to six months after a procedure, you can directly correlate that to the procedure that was done because most of the time these patients have tried everything that's available and have not had sustained relief. And now the studies are going out to three years, five years and even seven years where you're seeing that persistence of pain reduction and improvement in function.

Dr. Christopher Meadows
So you're starting to see the long-term benefits of these as well.

So that's what's exciting about this because it's allowing for long-term healing, long-term pain reduction, long-term improvement in function and not just the quick pain relief that is seen or the alternative being a surgical intervention, you're not seeing that same sort of potential and healing in those spaces that you are with the regenerative techniques that we have.

Melanie Avalon
Actually, so hearing all that, that's really, you've really got me thinking because like with my injury experience, it was, it was probably a probably a year of the chronic, you know, flaring pain, and then doing the stem cell. And then, you know, six months later, it basically being gone, but also not knowing if it would have been gone either way.

But I actually just pulled up, I totally forgot about this, we did do a scan of my knee. And they saw because you when this was when you mentioned like the cartilage going away, they meant they saw that that was degenerating where the injury was. I just looked at my, I mentioned earlier the genetic, you know, tendency for arthritis, and it segments it into knee arthritis, hip arthritis and wrist arthritis, and knee arthritis is the one I have like a super high risk for. So I'm just thinking about it retroactively. And I feel like I got that injury, it looks like genetically, I'm very prone to knee arthritis, and I was definitely headed in that direction. And then I mean, if I don't experience it at all anymore, I should get a, well, I don't know what the radiation of that, I would be curious if the cartilage has changed or reversed.

Dr. Christopher Meadows
Yeah, that would be interesting and that's where things are really starting to get exciting from the regenerative medicine space because like I said, when we look at outcomes, a majority of the outcomes, the ones that we really care about is if I can improve your pain and improve your function, right? Because that allows you to live the life you want.

Now secondarily, there are studies out there that look at pre and post ultrasound or pre and post MRI, which is what you're referring to is like what would happen if I repeated the MRI? Would there be any significant change in the thickness of that cartilage that was noted earlier? And studies are showing that, that there's improvement in cartilage thickness and where there were cartilage lesions, they're resolved and that's where things are really exciting and that again shows you the potential, the power that these treatments have and again contrast that with a corticosteroid injection, which can actually be catabolic and actually worsen some of the cartilage that you have there.

So that would be interesting. If it's an MRI, it wouldn't be any significant radiation, actually zero radiation because it's just an MRI. So it's magnetic, it's not the radiation that you experience with the CT or X-rays. So if you wanted to do that, you should feel comfortable doing that.

Melanie Avalon
I wonder, because the initial scan I got, I got at the Urgent Care, would those type of places have an MRI machine?

Dr. Christopher Meadows
No, they're usually CT scanners or x-rays, yeah.

Melanie Avalon
Yeah, so I'm actually I'm very curious now. Okay.

And then for listeners, I will put a link in the show notes. I've done a few episodes entirely just on stem cells. And it's so fascinating the the healing potential with those. Do you do them like for yourself to yourself?

Dr. Christopher Meadows
Yes, I've had, oh my gosh, so I've had knee injuries, you know, these are the injuries that put me in the physical therapy office and that stimulated my medical career, but I've had MCL and meniscal injuries on both sides. I'm dealing with a meniscal injury on my left side that fortunately for me doesn't cause any significant pain or, you know, functional limitations.

So I'm fortunate on that front, but I am very active in trying to prevent that from giving me any problems in the future.

Melanie Avalon
Awesome, and do you find the patient success rate, does it work for most people? Some people, does it not?

Dr. Christopher Meadows
Yeah, we're getting good results. Our patients are regularly coming to us and saying how they've improved. So again, but it's not immediate. We have to give it time.

We have to invest into it. And you have to be proactive in supporting your stem cell therapy with all of the other additional factors. And so that's where we get the best outcomes. But it does take time. Patients usually don't experience anything in the first couple weeks. You're kind of thinking, okay, not seeing a whole lot, but just things gradually improve with time. And I have a unique approach to the way I deliver stem cells, partnering it with PRP and kind of leading up again to kind of improve the environment for which stem cells are introduced. But in looking back patients, we have a really good success rate with stem cell therapy across the board. We treat a lot of knees. You mentioned that knee osteoarthritis is probably the number one condition we see. And it responds very well to stem cell therapy.

Melanie Avalon
Wow, okay. And I'm looking at the recommendations for the knee arthritis in the in my genetic report and it's telling me not to wear high heels which are like my favorite thing.

Dr. Christopher Meadows
That's a challenge.

Melanie Avalon
I know. Do you work with a lot of women, men, like the population? Yeah, both, both. Do you tell the women not to wear high heels?

Dr. Christopher Meadows
You know, unfortunately, that is a challenging one. Sometimes it's knee and sometimes it's ankle foot, you know, they can really start to cause some discomfort of the foot. Obviously, footwear is important. You know, we have to choose our battles and we all have our, you know, vices.

So, you know, it's not that I'm trying to change anybody's appearance or try to change people's lifestyle, you know, you're doing the best you can. And we have to make there's a give and take there, you know, so I try to meet patients where they're at and say, you know, if this is what you want, we just have to acknowledge that these are the potential. Consequences of that and, you know, patients are reasonable and they say, you know, okay, I can expect them. I can accept that this is might not be the best thing for me, but I'm willing to make that sacrifice and address, you know, deal with the consequences after that. And that's fair.

Melanie Avalon
Yeah, I feel like my approach, you know, if I was in a position where I was wearing them every single day, I think I would definitely want to rethink that. I typically just go out like once a week though.

So I feel like the happiness that I get from wearing the high heels, you know, brings some benefit to my life. So.

Dr. Christopher Meadows
Yeah, absolutely. Yeah, and those are the exactly those are the give and take that we give so that's that's that's okay

Melanie Avalon
Also, another question, actually, no, really quickly, so the PRP, what layer does that add to it?

Dr. Christopher Meadows
So, the thing about, let's take knee osteoarthritis, for example, this is a great example of a space that is a chronic inflammatory state. If you sample the synovium of arthritic knees, the pH is low, so it's an acidic environment. It has a lot of cytokines that are pro-inflammatory, so these are signaling molecules that are continuing to stimulate that inflammatory response that we talked about, right? This low-grade inflammation that's persistent, it's not getting better, it's not going away.

Things like interferon gamma and TNF alpha, and these things are pro-inflammatory, and they're immediately toxic to stem cells. And so, when I think about treating a patient and I want to do a stem cell injection, if I want to get the maximal benefit from those stem cells, I don't want to put them in an environment to be interfered with from an inflammatory and low pH environment that's going to, you know, they have enough to deal with, I don't want to make an, I don't want to introduce them to an environment that makes their job difficult and can actually be toxic to them. And so, by prepping the joint, by utilizing PRP in a series of injections, I can actually reduce the inflammation in that joint because we know that PRP, which stands for platelet skin, and reduce some of that inflammation and improve the pH, reduce some of those inflammatory cytokines, and that helps to prepare the joint to receive a stem cell injection so that the stem cells can go to the area to regenerate tissue, right? And so, I utilize this regularly with my patients where we'll do a series of one, two, sometimes three PRP injections until we feel like we were able to calm the joint down. We can reduce some of the swelling, the swelling that may have been recurrent previously is now calmed down, and now we can introduce a stem cell to allow them to go to the sites of injury, to the sites of damage, and just focus all of their efforts into that space rather than having to overcome a toxic environment. So, that's how I use PRP and or PRF, you know, platelet-rich plasma versus platelet-rich fibrin, those are things that I use in advance of a stem cell therapy to really maximize the potential benefit of a stem cell injection.

Melanie Avalon
Okay, so is it basically getting rid of the distracting inflammatory signaling that might occur and then just going to the inflammatory signaling that needs to be addressed?

Dr. Christopher Meadows
Yeah, exactly. So the stem cells can go to areas of damaged tissue, and it's not just the inflammation that signals, but it's the damage, the sites of the areas that are exposed that should not be exposed, and the stem cells can see that, and they can go to those areas to stimulate the regenerative process. But if it's an inflammatory state that's just widespread and throughout, again, that is just directly toxic to the stem cells. So if you get X number of stem cells injected, you can reduce that by 50% almost immediately because of the toxic environment that you've been introduced into.

So your army is not as big, and the potential is not as great.

Melanie Avalon
Gotcha, that completely makes sense because I guess, ironically, you wouldn't want to get rid of all the inflammation because then the stem cells, you know, wouldn't necessarily go anywhere potentially. So, okay, very, very cool.

Actually, so another question, just looking more at your bio because you, so you currently do training with Olympic lifting and racing triathlons?

Dr. Christopher Meadows
Yeah, I try. As I mentioned, I try to maintain my identity as an athlete. My focus has shifted from being in college where it was all about performance on the field and trying to be fast, jump high and explosive and that sort of deal. Now it's been to the whole health and wellness side where I'm focusing on what are the metrics that are going to help me be healthy and live long. There's a period of time where I was freshly out of college and the only workouts I knew how to do were the ones that I had been doing in college for the last four years. I didn't really have a focus. It's like, what is my purpose of trying to rep 225 pounds? Yes, there's a strength component and a muscular endurance component, but it wasn't until later that I started to realize that there are markers of longevity and there are objective measures and things that I should really focus in on. It was great for me because now I had a framework to work with. I knew what the new metrics were that I can hone in after to support my health and longevity. That's my focus of training now.

That does overlap a bit. I do some power training still because I want to maintain explosiveness and type 2 fiber, density. Those are the things that I continue to implement in my workout regimen, but also recognizing I was never a long distance athlete at all ever in my life. Football plays are measured in seconds. Thinking about doing a 5K or 10K or triathlon was never really on my radar, but I recognize that there's health benefits from that, from doing sustained long endurance training. I got into doing some triathlons and I've done a couple marathons in my life. I've learned the importance and recognized the importance of implementing that into my exercise regimen, so I try to cover both ends of those spectrums. Again, just thinking about longevity and just overall health.

Melanie Avalon
Awesome. Well, I'm the same in that I lean more towards power, not endurance.

And actually, my genetic test also said that I was on the power side of things. So doing all with all this training, because you mentioned earlier that you personally practice intermittent fasting, what type of fasting window do you do?

Dr. Christopher Meadows
Yeah, so I do once a week I do a 24 hour fast and then quarterly I do a 72 hour fast water only.

Melanie Avalon
Okay, with that once a week, 24 hour fast, is there any specific rules or how do you time it around your athletic endeavors?

Dr. Christopher Meadows
Yeah, so it's on my day off. I usually do my last meal Friday night and then won't eat again until Saturday night and I don't typically work out on Saturday. So that's what I do.

Sometimes I will change, because breakfast is my favorite meal, I will change to eat breakfast on Saturday morning and then not eat again until Sunday morning. And again, I'm usually not training or doing much around that. If I do train, I try to focus only on a long endurance, usually like a zone two type of exercise because I'm getting into that ketosis and I'm trying to stimulate fatty acid oxidation. And so I pair those up to try to enhance my ability to mobilize fatty acids and to utilize the fatty acid oxidation aspect. So I don't do a whole lot of high intensity strength training or power training in those realms when I'm doing my fast.

Melanie Avalon
Okay and then major question for you because we get this all the time. So when you are doing the type of training to build muscle, how soon do you need to eat protein after working out?

Dr. Christopher Meadows
Yeah, so that depends on how long you've been working out and how long you've been taken in your high protein meals because your body can adapt. When you're newly into exercise regimens and newly into paying attention to your nutritional side of that, the impact is greater by consuming your protein closer to the workout.

But your ability to consume and absorb and utilize the amino acids that you consume in your diet are improved with a more regular exercise regimen. So the more you work out, the more consistent you are in your exercise regimen, your ability to utilize and absorb protein is improved for longer periods of time. So it's not as important to take in within the first hour or first two hours. I still try to do that because I work out in the morning and then I'm going to get a big breakfast before I head out to work. So that's my rhythm and how I do it. But it's not as important, the more trained you are, but if you're early on to the exercise world and you're starting a new exercise regimen, then taking in a good slug of protein shortly after within that first hour is going to be ideal.

Melanie Avalon
Awesome, yes, we get that question all the time. Awesome, well, is there anything else?

And for listeners, this is so exciting. You can actually get 50% off a consult with Dr. Meadows at his practice. If you go to ifpodcast.com slash clinic5c, so that's ifpodcast.com slash clinic, the number five, the letter C. So thank you so much. What is the purpose of these consults? So is this for what type of people should come to you for this? Like what type of issues?

Dr. Christopher Meadows
Yes, great. Thank you for that.

A consult with me in the regenerative medicine space can be anything from an orthopedic-related condition, it could be autoimmune conditions, it could be any questions you might have surrounding the potential utilization of regenerative technology, stem cells, PRP, et cetera, to support the healing process of whatever you may be dealing with. And so a predominant, a good portion of my practice is in the orthopedic space, but we're recognizing how impactful these tools are being across the board of different diagnoses, neuronal health, cognitive impairment, that's what we started off with. Again, autoimmune processes, which I think is going to be the next big area in which stem cells are going to be beneficial for because of their immune modulating capacity.

So it could be across any of those. And again, I can kind of help patients guide them in the direction of what potential therapies there are out there. And again, we talked about some of the protocols, both pre and post-operative. So anything amongst those different avenues, I'm certainly here to available help.

Melanie Avalon
Amazing. And are those consults done virtually? Can they be done virtually?

Dr. Christopher Meadows
They can be virtually or if you're in the area in person, we offer both.

Melanie Avalon
And if people want to work with you, is any of that virtual or are they going to need to come in person?

Dr. Christopher Meadows
If there's any treatment that's recommended that we offer, of course, that's going to be in person, I certainly can offer the insight that I have into lifestyle management or adjustment treatment ideas that I would have. But if there's any sort of, of course, we talked about diagnostic ultrasound and ultrasound guided procedures, if any of that is recommended, I can certainly point you in the right direction if you're not able to travel up here.

But otherwise, if you're interested in me personally doing any of that, then of course, we'd have to do a little bit of traveling, but hopefully not too bad.

Melanie Avalon
And anything else? Thank you so much, Dr. Meadows. This has been so amazing, just so enlightening.

Is there anything else you wanted to touch on from your practice or especially, you know, with you what you were saying earlier in the show about how important education is to you? Just anything that you would like to educate our audience on?

Dr. Christopher Meadows
Well, I'm just excited to be here. I am thankful that I have the platform to continue to talk about stem cell therapies and regenerative medicine. I think it's a growing area of interest and a growing area of science, and I'm excited that I have the opportunity to share that with your audience here, and I'm grateful to have the opportunity to chat with you.

We've covered a lot of ground. There's still so much that we can chat about, but I think we talked about a lot of stuff here, and I'm grateful to have had the opportunity.

Melanie Avalon
Yeah, no, this was so, so wonderful. I'm just so, so grateful for everything that you're doing because like I was saying throughout the show, it's, it's really hard to, it can be hard for people to find, you know, sources where they can actually, you know, make change and what they're experiencing, especially when it comes to pain in their body and your approach is just incredible. It's fantastic. Thank you for everything that you're doing.

And yes, so again, so listeners, these show notes for today's show will be at ifpodcast.com slash episode 438. And those show notes will have a transcript. They'll have links to everything that we talked about. And again, you can get 50% off a consultation with Dr. Meadows and check out his clinic's website when you go to ifpodcast.com slash clinic5c. All right. Well, thank you, Dr. Meadows. Are there any other links you want to put out there?

Dr. Christopher Meadows
Yeah, so you can go to our website clinic5c.com. I am also on Instagram, meadows.md, so you can follow me there as well.

And so you can also connect with me. I'm on there pretty regularly. I chat with patients and answer questions there as well. So there's a couple areas that you can get some more information.

Melanie Avalon
Awesome, awesome. Well, we will put that on the show notes. Thank you so much for your time and we will talk again in the future.

Dr. Christopher Meadows
Look forward to it. Thank you.

Melanie Avalon
Thank you so much for listening to the Intermittent Fasting Podcast. Please remember, everything we discussed on this show does not constitute medical advice, and no patient-doctor relationship is formed.

If you enjoyed the show, please consider writing a review on iTunes. We couldn't do this without our amazing team. Editing by podcast doctors, show notes and artwork by Brianna Joyner, and original theme composed by Leland Cox and re-composed by Steve Saunders. See you next week!