Neuroma Pain Dramatically Improved with Shockwave and Electromagnetic Transduction Therapy

A 78 year-old female came in 2 weeks ago with a long history of a neuroma on the 4th MTP (metatarsal phalangeal) joint of her foot (ball of the foot) noting pain walking on the carpet or floor bare foot and shooting pains in that 4th toe and the top of her foot. There was some discussion of a possible surgical solution. She had also in the past taped her 3rd & 4th toes together. A type of toe guard was also tried.

Normally I do shockwave and/or EMTT treatments on a weekly basis for 6-8 treatments for a variety of conditions but in this case we decided to go twice weekly because she was leaving for Hawaii in 2 1/2 weeks, so we did twice a week treatments and got in five complete treatments before she left for vacation. 

Shockwave therapy (pulsed sound waves) can be uncomfortable but should not "hurt" enough that you can’t tolerate a treatment. You try and keep the discomfort under a 6 or 7 on a pain score. But everyone is different. This particular patient had very "sensitive" feet. During the first two treatments of focused and radial shockwave (15-20 minutes) followed by EMTT (pulsed electromagnetic fields; 10 minutes) she was so "jumpy" I thought we would never get a solid treatment session in. I was thinking it might take me a month to get to a full "strength" session completed. With the EMTT treatments patients usually do not feel anything, in fact many patients fall asleep. The EMTT treatments can take 10-20 minutes. She was given five thousand pulses of EMTT treatment directly after the shockwave treatments which was very well tolerated (remember the term “shockwave” does not mean electric shocks!).

The first two complete treatments of all three modalities over the first week did not result in any positive changes in her pain or painful tingling sensation in that left foot. She also did not calm down much with both applications so it was hard to feel like you were getting a complete treatment in. By the third treatment on week two she could tolerate the treatments a little better, but she was still very "squirmy" and there was not much pain reduction in the ball of her left foot. But I had told her at the beginning these treatments were best done on a weekly basis over 6-8 weeks. When she came in for the 4th treatment she very clearly said (after 3 full treatments) that she could walk barefoot and she had no pain in the ball of her left foot and the tingly pain on the top of her foot was significantly reduced. During that fourth treatment she was still very sensitive and fidgety when both the radial and focused shockwave treatments were applied. Usually, as one's symptoms improve you can increase the power of the treatment energy into the affected area. At her last treatment (5th) before leaving on her Hawaii vacation that weekend she noted she could walk barefoot on the floor or carpet pain-free and almost all the painful tingling sensations on the top of her foot was gone and that 4th toe was less tender and had more flexibility. Also! Finally! I could apply a little more power and lower the frequency of the treatment settings and she did not flinch hardly at all. In fact, we had a lively conversation while I was applying these treatments to her foot. So, you could tell she was definitely improving... and just in time for she and her husband's annual Hawaii vacation starting that weekend.

At the end of each treatment shockwave treatment, time permitting, I usually massage the treated area with a prescribed combination CBD cream (EB-C4; THC-Free Cannabidiol 3%; Myrcene 3%, Beta Caryophyllene 3%, Arnica 2%, MSM 2% in HRT Heavy Transdermal Cream - by prescription from EBM Medical, Chesterfield, MO). I was a massage therapist 30 years ago so there’s usually a couple of minute massage of the treated body part at the end of the shockwave treatment after applying this cream.

Again, shockwave therapy is not "electric shocks" being administered. These are pulsed sound waves delivered in a radial or focused fashion (two devices) and then in another room pulsed electromagnetic fields (EMTT) are applied to the area, in this case the feet.

Shockwave therapy stimulates a "healing response" to the "injured" or "damaged" tissues and improves growth factors and substances that build new blood vessels. If you improve blood flow (circulation) to an injured area healing will follow. Technically both types of shockwave therapies have been shown to stimulate:

1)     Neovascularization – the building of new blood vessels

2)     Release of growth factors such as eNOS (endothelial nitric oxide synthase)

3)     VEGF (vascular endothelial growth factor)

4)     PCNA (proliferating cell antinuclear antigen)

5)     An anti-inflammatory effect

6)     A breakdown of fibrous tissue

7)     Stimulation of stem cells

The EMTT (electromagnetic transduction therapy) I usually do after the two above treatments (or it can be done as a standalone treatment) in another room for 5-15 minutes.

This technology is an "upgrade" on PEMF (Pulsed Electromagnetic Fields) which are selected low-frequency electromagnetic fields without an ionizing or thermal effect. PEMF is effective and safe for the treatment of bone fractures and nonunions. EMTT has higher oscillations which allows it to go deeper and provides more magnetic field strength. Some of the physiologic effects of PEMP and EMTT are:

1) Up-regulating anti-inflammatory adenosine receptor A2A and A3.
2) Reducing PGE2 and pro-inflammatory cytokine IL-6 and IL-8 and inhibiting factor NF-kB
    transcription in human chondrocytes and osteoblasts.
3) Increased proliferation and enhanced osteogenic differentiation of mesenchymal stem cells
   (MSCs) isolated from human bone in several in vitro studies.
4) Stimulate activity and differentiation of specific cell cultures of the musculoskeletal system.
5) PEMF devices are approved by the FDA to fuse broken bones, reduce tissue and joint pain
    and support muscle function.
6) PEMP doesn’t have inadequate electromagnetic field power and is missing dynamic oscillations.
7) Electromagnetic transduction therapy (EMTT) is a promising new technology of a treatment
based on PEMF with magnetic field strength between 80 a nd 150 mT and oscillating frequencies
of 120 Hz of each impulse. EMTT acts via electromagnetic transduction. Impulses are emitted by
a high-speed generator to build up a voltage up to 30 kV which is released in nanoseconds and an
impulse release frequency of 3 Hz. The very short duration of each impulse ensures full
electrophysical reaction without any temperature increase in the tissue.
8) Electromagnetic impulses can stimulate osteoblast growth activity; neovasculogenesis; growth
factor release; improve blood supply to the treated area.
9) Studies have shown benefit of EMTT for low back pain, rotator cuff tendinopathy, osteitis pubis
(groin pain)
, bone stimulation therapy for scaphoid nonunions and Achilles tendinopathies.

In general there are very few tendon, ligament, muscle or joint problems where these technologies cannot be applied. While people can feel better immediately the full treatment is usually done over 6-8 weeks. Also, the healing response and release of these healing factors can continue for months. I remember at one conference listening to some very successful podiatrists that use these devices. They might do initial treatments of 4-8 weeks then tell the patient to go out and contact them 10 weeks later and the pain is gone. Sometimes the patient doesn’t even realize that all of a sudden there is no more pain. So patience is necessary for these therapies in the long-term. Usually there is enough pain relief or improved function in those first 4 to 8 weeks to get the person functional and get them through the whole treatment program. Point being the healing process that is started during the treatment phase continues for 2-3 months after the treatments end. 

I initially see patients for an hour to go over their medical history and do an examination to plan
their treatment. The treatment sessions are usually a half hour and cost ($175-200). If there is more than one area then there will be appropriate charges for the 45 or 60 minutes visits.

If you want to call the office and make a 15 minute FREE phone appointment with me we can discuss if you are a good candidate for these therapies to address your pain problem or personal situation. I am happy to do that. I want your treatment to be as successful as you do. Call 916-489-4400 and make an appointment to see me (1 hour) or for the 15 minute free phone consult.

Lastly, I always talk about diet with pain patients. Diet can lead directly to pain and inflammation. Being overweight not only puts added stress on your joints, tendons and muscles but fat tissue is releasing inflammatory compounds that are aggravating your pain. You can start very simply by eliminating all dairy products, wheat products and eggs for at least two weeks and also eliminate all processed foods. It would not be a bad idea to be off alcohol during the treatment period as well or the time you are trying to heal. You want to know if and how much diet effects your pain. It sometimes can be dramatic like 80-90% of the patient’s pain disappears with diet change.

People can sign up for my Health Letter Here.

If you are interested in shockwave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.

I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes, memory loss, aging and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

International Plant-Based Nutrition Health Care Conference Highlights and Comments, September 16-19, 2022

Thoughts and Highlights from 10th International Plant-Based Health Care Conference, September 16-19, 2022 that I took "virtually" from my cell phone (9/16-9/19/22). One good thing from the pandemic is more virtual learning. It’s hard to summarize a 3 day conference in brief so I’m just going to give some highlights and links. Take what resonates with you. Bottom line is a whole food plant-based diet can reverse, prevent or slow almost all the chronic diseases which account for over 80% of our health care budget and by reducing dramatically the co-morbidities (i.e. obesity, diabetes, heart disease and vascular disease, inflammation, etc.) would have dramatically reduced the susceptibility, hospitalizations and mortality to Covid 19 if universally applied.

Pay attention to the pain management talk by Dr. Esser below. It was incredible. BLOOD FLOW OR TISSUE PERFUSION IS CRITICAL IN LOW BACK PAIN, OSTEOPOROSIS, KNEE, BACK AND HAND ARTHRITIS...His 4 week program I highly recommend or his other programs. Also Dr. Michael Greger’s weight loss tips from his book “How Not To Diet” at the very end of this post was excellent.

Plant-Based Health Care Conference
Agenda (scroll down the list and click on their names and a summary of their talk come up).
Speakers (bios on the speakers)

Lectures and Speakers - My "One Liners'

Health span: Adding Life to Lifespan, Scott Stoll, MD, FABPMR
We are expanding our lifespan...how long we live. But we want to be expanding our health span, how well we live, how disease free we live during those Golden years. And it is possible with exercise and a more WHOLE food plant-based diet.

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A Translational Research between Diet and Dementia, Ayesha Sherzai, MD Dean Sherzai, MD, PhD (neurologists)
There is lot's of evidence that memory and Alzheimer's disease can be prevented by diet and lifestyle. The most important things to prevent memory decline are: daily exercise, low glycemic or low sugar diets, sound sleep, good and engaging stress and challenges, avoidance of overwhelming stress. Community is important as well. Start these things early in life. Check for B12, vit D and essential omega 3 fatty acids. That is all the supplements the Sherzai’s would recommend. MAIN MESSAGE: MUCH BETTER TO PREVENT than treat Alzheimer and memory loss. It’s never too late so start now.

COMMENT: Their books are excellent. I am more aggressive in testing memory patients for vitamins, minerals, fatty acids, inflammation markers, gut health, environmental toxins such as heavy metals (i.e. lead, cadmium, mercury, etc.) and markers of mold illness (CIRS), and hormone levels and trying to integrate these findings on top of the basics - 1) a whole food, low glycemic mostly plant-based diet; 2) daily exercise - at least an hour per day which stimulates BDNF (brain derived neurotrophic factor) which triggers the growth of new brain cells in the hippocampus (neurogenesis). BDNF stimulates stem cells in the brain, providing the hippocampus with new healthy cells that enhance brain function. Vigorous exercise is best to stimulate BDNF…And it is free!; 3) Good sound sleep so the brain can consolidate memory and also “clean up” debris in the brain; 4) Avoid overwhelming stress and 5) Allow for challenging, creative and enjoyable good stress.
The Alzheimer' s Solution
The 30-Day Alzheimer's Solution

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The Role of Diet in Acne, Apple Bodemer, MD (dermatologist)
No question that diet plays a role in acne. Especially dairy products. AVOID ALL DAIRY PRODUCTS, ESPECIALLY CHEESE! Reduce or eliminate saturated fats (animal products, eggs as well), sugar and processed carbohydrates (which have trans fats and high omega 6 oils and lack fiber). She says cheese is a MAJOR offender. I AGREE! (Follow my basic elimination diet on page 2 of my 21 Day Healthy Living Program)

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Understanding Lipids, Monica Aggarwal, MD, FACC (cardiologist)
Animal products increase LDL cholesterol. LDL is a significant risk factor for heart disease.
non-HDL cholesterol is important to measure. Many believe non-HDL cholesterol is the most significant lipid number. She is a cardiologist who cured herself of severe rheumatoid arthritis buy switching to a whole food plant-based diet. She is also a busy mother of three, runner and a practicing cardiologist at the same time. She is the author of Body on Fire: How Inflammation Triggers Chronic Illness and the Tools We Have to Fight It.

__________

The Practice Management Side of Passionate, Purposeful and Profitable Plant-based Private Practices, Melissa Mondala, MD (family medicine). Has practiced Lifestyle Medicine successfully around the world.

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Nutrition and Non-Alcoholic Fatty Liver Disease, Hana Kahleova, MD, PhD, MBA (endocrinologist)
Whole food plant-based diets can reverse fatty liver disease. Animal fat and sugar restriction (and avoidance of PROCESSED carbohydrates) are important in reducing fatty livers as well as fat loss. She is an outstanding researcher at PCRM.org.
__________

The Year in Plants: The Most Important Studies You Might Have Missed in 2022, Andrew M. Freeman, MD (cardiologist)
Reviewed the research on the benefits of plant-based nutrition in a wide variety of conditions even though a cardiologist that specializes in heart failure for which a plant-base diet can be curative.

__________

Origins and Impact of Food Addiction, Eric Walsh, MD, DrPH (family medicine)

__________

A Carrot and a Stent - You Pick! Koushik R. Reddy, MD (cardiologist)
Interventional cardiologist at the V.A. who strongly recommends whole food plant-based diets for his veteran patients when they will do it. Any incorporation of more whole plant foods is better than none.

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Plant-based Nutrition for Optimal Performance in Master Athletes, Richard M. Rosenfeld, MD, MPH, MBA, DipABLM (ENT physician)
At any age you can increase the performance of your body. There are now many "Master Athletes" achieving amazing things at any age by just by going out and doing the activity. He strongly recommends not just aerobic exercise but by strength training as well. Start now! Walking and strength training can dramatically change your longevity and wellness.  (Video on Diabetes Reversal)

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Questioning Why We Think Protein Matters So Much, T. Colin Campbell, PhD (nutritional biochemistry)
Early studies showed that animal protein could turn ON cancer (casein) and plant proteins could turn OFF cancer (soy, wheat). Higher animal protein intakes increase the risk to cancer and heart disease. Dr. Campbell believes animal protein may be a carcinogen. Eating high amounts of plant protein won't cause cancer. Be careful of animal protein supplements, including whey. Eating whole unprocessed plant foods will provide all he protein you need.

Whole: Rethinking the Science of Nutrition

The Future of Nutrition: An Insider’s Look at the Science, Why We Keep Getting It Wrong, and How to Start Getting It Right

The China Study

__________

Train Them Up: Lifestyle Medicine in Children to Achieve Health Equity, David Bowman, MD (pediatrician)
"Be your child's parent not their friend." Tell them what to eat and have it available and not other processed foods. DON'T buy your kids processed or junk food. They will eat junk food if there is an option for them.
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The Breast Defense: How to Minimize Cancer Risk, Kristi Funk, MD, FACS (breast cancer surgeon)
12 Best Foods for the Breast

TOP 3 FOODS TO PREVENT BREAST CANCER
1) Whole organic soy foods REDUCE THE RISK OF BREAST CANCER AND WHOLE SOY CONSUMPTION LOWERS RECURRENCE of breast cancer.  Dr. Funk reviews multiple studies.
2) Cruciferous vegetables and leafy greens.
3) Flaxseeds containing lignans, sterols and omega 3 fatty acids.

Big Cancer Risk Factors For Breast Cancer
Diet/Nutrition - Don’t eat the SAD diet (Standard American Diet) and eat whole food plant-based foods
Alcohol - any!
Exercise - More is better
Obesity - Need to reduce

www.pinklotus.com/powerup - match up with breast cancer patients

BEST SELLING BOOK
Breasts: The Owner's Manual: Every Woman’s Guide to Reducing Cancer Risk, Making reatment Choices, and Optimizing Outcomes

IGF-1 which is stimulated by animal protein which increases the risk of cancer and diabetes.
IGF-1 deficient people don't get cancer or diabetes (Laron Syndrome).
Diet Goals
Lowering IGF-1
Low-fat (10-15%), high-fiber (30-40 gm per 1000 calories/day), whole food plant-based diet (WFPB), Daily exercise classes. RESULT: Lowered IGF-1 in 2 weeks. Breast cancer cells were destroyed in 2 weeks.

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A Unifying Theory of Lifestyle Medicine, Dean Ornish, MD (Preventive and Internal Medicine)

Dean Ornish shares his "unifying theory" of chronic disease which is the same biochemical abnormalities are seen in many differently named chronic diseases (heart disease, diabetes, Alzheimer’s, osteoarthritis, etc). So if you change your diet, you change your biochemistry and therefore one’s diet pattern (whole food plant-based) which can reverse or reduce the risk to many "different" chronic diseases.

Presently Dean Ornish's group is doing an Alzheimer's disease study using the Ornish Program which includes his low fat plant-based diet. I don't know how much exercise, stress management and group therapy is included in the Alzheimer's study which all are components (diet, exercise, stress management, group therapy) included in the Ornish Program for heart disease reversal. I also don't know if he recommends omega-3 fatty acids as well. My guess is all the above are included in his study. I am looking forward to seeing the results. I believe they will be positive, the question is how much. He shared studies on plant-based diets reducing the severity of Covid 19 as well in his talk.

A “Third World Diet” is the healthiest way to eat (if eating whole natural foods which are mostly plant-based foods since people are poor and the individuals get enough calories).

The Heart Disease Reversal Program is now paid for by Medicare

U.S. News and Report #1 Diet for Heart Disease - Ornish Program Seven Years Straight.

Ornish Nutrition Program

Research Studies on Reversal of Aging, Cholesterol Lowering, Diabetes, Gene Expression, Heart Disease, Hypertension, Prostate Cancer, Weight loss

Loneliness and depression are key factors in increasing cardiovascular disease risk and can be helped by the Ornish Program

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Intersection of Food, Pain and Regeneration, Stephan Esser, MD (Physical Medicine and Rehabilitation) - Fourth generation physician.
Dr. Esser’s Program - Try his 4 Week Program Download
He sees 6000 physicians per year.  He applies whole food plant-based nutrition to pain management patients. Obesity causes pain and obesity increases knee and hip replacement 500%. 

He challenges everyone of his pain patients to go on his 4 week whole food plant-based program.  

1) Losing weight is critical for reducing pain and degeneration in joints - fat cells are factories for inflammation.
2) Inflammation goes down with whole food plant-based nutrition - obese people have the highest rate of hand osteoarthritis. Increased adipokines increase pain and inflammation. Losing weight decreases adipokines and reduces inflammation and pain. Make the program for the individual patient.
3) Perfusion and pain - you need more blood flow to reduce pain. With reduced circulation pain is increased.
Aortic calcification reduces blood flow to the vertebra and is a cause of back pain (can be see frequently on back, abdomen and chest xrays). Osteoporosis is correlated with reduced blood flow. Everyone who goes in for rotator cuff surgery (shoulder) should go on a whole food plant-based diet to increase blood flow to the tissues in the shoulder. He showed a picture of a PRP blood draw that was thick and cloudy with fat. Reducing blood flow to your heart also reduces blood to your bones, back, shoulders and knees. Increased blood pressure reduces blood flow to the chondrocytes and can trigger pain. He puts people on whole food plant-based programs which normalizes blood pressure which improves pain. .
4) The arachidonic acid cascade and pain - meat, egg and dairy fat (rich sources of arachidonic acid) increase inflammatory prostaglandins. NSAIDS block the production of these prostaglandins and can reduce pain but they wear the mucous lining off the gut wall which protects it from the acid. Eventually this can lead to increased intestinal permeability, more inflammation and more pain. The leading source of arachidonic acid is animal foods. Increased AA increases the risk to pain. And reducing it reduces pain.
5) Autoimmune inflammation - Fruit and vegetables reduce risk. Plant base diet reduces inflammation and risk to autoimmunity.
6) Low level increases in uric acid increase synovial inflammation and arthritic symptoms.
7) Neuropathic pain - diabetes is the number one cause of neuropathic pain (polyol pathway, AGEP's, Oxidative Damage) - enhance oxidative stress, decreases perfusion. (Story of a patient who brings his black beans to the local pizza parlor and pours them on his salads and then watches sports with the guys!)
8) Regenerate muscle, tendons and nerves (plant-based compounds can alter human stem cell function and rebuild tissue).

PAIN AND INFLAMMATION REDUCTION WITH PLANT-BASED DIET
1) Maximize nitrate foods, anthocyanidin rich foods foods
2) Reduce arachidonic acid exposure
3) Reduce circulating uric acid
4) Heal the gut - Gut - Joint - Bone Axis is real
5) Targeted intervention for 4 Weeks
6) There is a sense of URGENCY in changing your diet for pain reduction

Plant-based nutrition should be a primary intervention for musculoskeletal disorders
Why a Plant-Based Diet is Key for Joint Replacement (and Your Overall Health)
Plant-based Diet and Arthritis
Plant-Based Orthopedist Who Reversed His Own Heart Disease and Recommends Whole Food Plant-Based Diets for His Shoulder Patients

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Luminary Panel: A Historical and Visionary Perspective on Ten Years of Research with the Pioneers of WFPBN (Whole Food Plant-Based Nutrition)
Scott Stoll, MD, FABPMR - sports medicine and pain management physician and organizer of this conference and the Plantrician Project
Neal D. Barnard, MD, FACC, PCRM founder, author and leader in studies showing diabetes and heart disease reversal and almost stopping the use of animal experiment in medical schools
T. Colin Campbell, PhD - author of the China Study
Brenda Davis, RD pioneering whole food plant-based dietician, author and teacher who I went to the Marshall Islands to help with her diabetes reversal program
Hans Diehl, DrHSc, MPH, FACN - creator of the CHIPS Program
Caldwell Esselstyn, Jr. , MD, surgeon and author of Prevent and Reverse Heart Disease and studies showing heart disease reversal by a whole food plant-based diet
Michael Klaper, MD - Author, practicing clinician and medical school educator
Dean Ornish, MD - father of Lifestyle Medicine and did the landmark heart disease reversal study with a plant-based diet, exercise, stress management and social support

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The Science of Behavior Change: How to Influence People to Change Their DIETS! Ocean Robbins (Food Revolution Network)
Ocean Robbins is the son of the heir to Baskin Robbins John Robbins who gave up taking over the family business and eventually wrote Diet for a New America, The Food Revolution or the book that really changed my view on aging which was Healthy at 100. He starts with the story of his grandfather who ate the SAD Diet (Standard American Diet) including ice cream every day but was overweight, had diabetes and vascular issues. To his credit he eventually changed his life dramatically and ate mostly plant-based diet and reversed these diseases, while his great uncle who never changed his diet died an early death.

Trying to help people change in any lifestyle approach is difficult and is enhanced by people having support. People to do it with or just support you is very helpful and more effective. 

Ocean shared a case study of a blind (from diabetic retinopathy), diabetic and obese patient who taught herself to cook whole food plant-based and over time eventually not only lost a lot of weight, got rid of her diabetes and her eyesight came back.

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Getting It Right: Plant-based Nutrition from Birth Through the Senior Years, Brenda Davis, RD (registered dietician, author, speaker)
I know Brenda Davis. I joined her in the Marshall Islands in 2016 on her second trip there were she established a curriculum for teachers on the island to teach whole food nutrition, mostly plant-based to reduce the risk to diabetes and obesity which the Marshall Islands is know for.

Brenda Davis, RD Reviewed studies on the nutrient quality of vegan diets.
Vegan and vegetarian diets are sound when adequately planned.
Vitamin D and B12 have to be watched as well as getting adequate calories.
ALL diets that children are eating are generally inadequate.
Protein - the largest animals in the world get enough protein from plants humans can too.
Seniors need to eat more protein in general to maintain muscle mass from whole plant foods.
Soaking, sprouting, cooking, leavening increase protein absorption.
Real high fiber foods can inhibit protein intake.
Legumes and whole grains can reduce the protein absorbed.
Plant-based eaters get enough protein unless their diets are highly refined.
The 9 essential amino acids come from plants originally.
Have plant-based concentrated veggie protein rich foods at each meal with less fiber if needed.
Canada's Food Guide 1/2 fruit and vegetables, 1/4 protein rich foods, 1/4 good starches.
Consuming fortified non-dairy milks are reasonable to get adequate calcium intake.
Vitamin D is deficient in all types of diets and is very prevalent - should be supplemented no matter what diet chosen.
Vitamin B12 should be taken in vegans.
Omega-3s - sources are chia, flax, walnuts, microalgae, eggs.
ALA conversion is 5-7% to EPA/DHA. EPA/DHA from algae sources is recommended.
Severe iodine deficiency is the #1 cause of preventable mental retardation in the world.
A whole food plant-based diet is best for chronic disease prevention and reversal, being kind to animals and benefits to the environment.

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Evidence-Based Weight Loss Michael Greger, MD (nutritionfacts.org)
How Not How to Diet (book)

The Best Way to Lose Weight
Eating low calorie dense foods is key for weight loss diet.
(Example 250 calories from a cooked or raw carrots have two different effects on total daily food consumption).
Foods low in calorie density are almost impossible to overeat. With more fiber and low calorie foods
your stretch receptors in your stomach stretch and give you a sense of fullness with less calories.
People eat about 3 lbs. of food per day.

Negative Calorie Pre-Loading
A salad before a pasta meal reduced the total intake of calories compared to eating pasta alone.
Just eating a raw salad (no creamy dressing or high oil dressing) or fruit before the main course causes a reduction in total food intake. An example is eating an apple and pre-meal vegetable soup resulted in reduced total calories consumed at the meal. Drinking two cups of water before eating a meal resulted in 44% quicker weight loss.

Increasing AMPK
Vinegar increases AMPK - 1-2 teaspoons of apple cider vinegar with each meal which increased weight loss.
Garlic 1/4-1/2 teaspoons per day increases weight loss.
Black Cumin seed 1/4 tsp per day (Nigella Sativa) increases weight loss (can also drop cholesterol).
Cumin 1/2 tsp per day.
Ginger 1/4 tsp per day.

FAT BLOCKING FOODS -  THYLAKOIDS

Cooked greens - 1/2 cup twice daily
Gut flora can digest fiber even though we can't.
Eat MACs - microbiotic accessible carbohydrates - fiber.
Meat consumption is associated with weight gain. Poultry is the worse.
Most food studies are compared against junk food not against whole plant foods.
Meat - plant-based meats - whole plant foods (transition).
Animal protein increases insulin release like sugar.
Plant proteins are lower in branch chain aminos which decrease insulin resistance.
Decreased consumption of branch chain amino reduces insulin resistance.
Drugs that block branch chain amino acids have been suggested to reduce diabetes risk.

Wall Off Your Calories! - His most important diet recommendation
Fiber in plant foods “wall off” the calories from being absorbed while animal foods calories are not walled off.  Eat the whole grain versus refined grains with reduced walled off calories.

The best study showing weight loss (> 20lbs weight loss) over one year without limiting calories.
The BROAD study: A randomized controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes.

Conclusions:

This program led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise. Many patients are interested in making dietary changes, and the WFPB diet can be offered as a safe and effective option for losing weight and obtaining some reduction in cholesterol, without necessarily increasing exercise. The main advantage is in eating to satiation without restricting the amount of food eaten. This small study also showed several improvements with chronic disease risk factors and quality of life, which were largely maintained to 12 months. Future research could identify participants who are currently likely to succeed with a diet change, which could reduce dropout rates and increase effectiveness. Given the low cost of this intervention and the relative benefits of this dietary approach, this could be offered by policy makers and practitioners as promoting weight loss, and suitable for consumption in hospitals.

Eating more whole plant-based foods - burns more calories even with you are not exercising.

Keto-genic diets reduce muscle mass even with successful weight loss

Low Carb Diets increase overall mortality

People can sign up for my Health Letter Here. |

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.

I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

What Do Sexual Headaches and Knee and Back Pain Have in Common?...It's The Food!

A 33 year old male who is a big man 6'7" 267.6 lbs. (BP 148/94, P 67) came in with a major complaint of aching in the back of his head every time he approached orgasm. After his orgasm the headache pulsed and went away in about 15 minutes. He took no sexual enhancing medications.  He was in a wonderful relationship with his partner. In fact, she had become pregnant. But both were concerned if there was any underlying health issue with this onset of sexually induced headaches. This phenomenon started only about a week before I saw them. He plays volleyball competitively 4-5 times a week. That activity never triggered a headache. But he does take Advil 800 mg (4 pills) 3-4 times per week for his back, hip and knee pain which he stated was from playing competitive volleyball. Otherwise, he took no other medication.  Aside from splitting his forehead before the age of 10 and occasionally getting concussions from fighting in his teenage years his health issues were minimal except for the knee and back pain and occasional shoulder pain which he attributed to playing volleyball so much and getting a little older.

The only other problem he had was alopecia areata (hair loss) in his beard which is an autoimmune disease of unknown origin. But it was mild in its manifestation. He had no known allergies. He was owner of an IT company.

His diet was poor eating a fair amount of junk food, but he was trying to clean it up recently with a smoothie in the morning of mixed berries, water, dragon fruit, jack fruit, almonds, and a green powder. He did have one 160 mg caffeine drink daily. Lunch was many times fast foods like burgers and fries. He was trying to have a more vegetarian dinner. He drank rarely.

PLAN
I told him to eat off my BED Food List for 2 weeks (off essentially all dairy products, wheat and eggs, page 2).
He was eating dairy products regularly. He also stopped the daily highly caffeinated energy drink. He took the following supplements focusing on basics and vascular prevention.

SUPPLEMENTS
Affirm 2/d (nitric oxide booster, dilates blood vessels)
Algal 2/d (omega 3 fatty acids DHA/EPA from sea algae, anti-inflammatory)
Magnesium 400-500 mg/d (dilates blood vessels, relaxes smooth muscle)
Metabolic Synergy 2 2 x day a high potency broad spectrum multivitamin and mineral (covers the basics)
Vitamin C 2000 mg twice daily (immune function, vascular protection, supports adrenal function)
Vitamin D 5000-10,000 IU/d (immune function)

He came in 3 weeks later and his headaches were gone! Pre – and post orgasm. He had cut his Advil down from 4-5 days per week at 800 mg per dose to 800 mg every 2-3 weeks. He cut out his daily energy drink. He pretty much cut out dairy. He kept his coffee. Being off dairy and energy drinks were his two biggest changes. His neck and back pain improved considerably even cutting his Advil dramatically. He cut down his volleyball from 4-5 days per week to 3.

LABS REVIEWED FROM 8/18/22
HgbA1C 5.7 (pre-diabetic-ish!, insulin 15 - hyperinsulinemic-ish!)
His LDLp 1794 and LDLs 857 were elevated. He was Vit D deficient at 25.1 ng/ml. His plaque was "growing" with his LpPla2 being mildly elevated at 150 and he had some inflammation with a hsCRP of 2.8 and oxidation was increased with an OxLDL of 70. His Omega Check (omega 3 fatty acids) was 4.0 which is reasonable. His PULS cardiac score was 1.82 which is very low (good) and his complete blood count and metabolic panels were normal.

MY CONTINUATION PLAN

He needed to lose 20lbs at least... goal 1 lb. per week. Needs to lower his blood pressure (weight loss, food elimination, exercise, nutrients). He is too young to have elevated blood pressure.

EAT OFF KIRK’S BED LIST, page 2 - work on Whole Food Diet; Eliminate dairy products still; Just eat whole grain bread if consumed; Stay off processed carbohydrates (EAT: whole grains, beans, lentils peas, sweet potatoes, potatoes, yams, squash in their whole state); animal food 1 serving per day; 2-3 whole fruits per day; 1-2 palm full of raw nuts or seeds daily; Half his food intake at least should be vegetables. Avoid energy drinks. Could have 1 cup tea or coffee daily.

CONTINUE WITH SAME SUPPLEMENTS
Affirm 2/d (nitric oxide booster, dilates blood vessels)
Algal 2/d (omega 3 fatty acids DHA/EPA from sea algae, anti-inflammatory)
Magnesium 400-500 mg/d (dilates blood vessels, relaxes smooth muscle)
Metabolic synergy 2 2 x day a high potency broad spectrum multivitamin and mineral (cover the basics)
Vitamin C 2000 mg twice daily (immune function, vascular protection, supports adrenal function)
Vitamin D 5000-10,000 IU/d (immune function)

Keep exercising as he is doing.

Prolon (fasting mimicking diet) monthly x 3 months, bimonthly x 6 months – 3-4 times per year thereafter (Prolonfmd.com)
Repeat in 3 months Cleveland Heart Inflammation Panel (recheck specifically oxLDL, LpPla2, CRP, LDLp, sLDL)
GOALS: vitamin D >50 ng/ml and hsCPR <1, A1C <5.6, Insulin <10 preferably < 6, oxLDL gone, LDLp <1000, sLDL < 500)

DISCUSSION

Truthfully, I had never heard of sexually induced headaches.  Asking "Dr. Google" described the headaches as not uncommon but as something that is more annoying than a significant health risk.

While this initial treatment was very successfully in getting rid of his two major complaints - sex-induced headaches and back, knee and shoulder pain which I think was mostly related to his high caffeine energy drink and dairy consumption, his long-term issues are reducing his borderline high blood sugar and hyperinsulinism, plaque (artery) growth, and his borderline hypertension. He is too young to have any of these at significant levels. He could reverse these problems within 3 months if he works at them. We will see.

I love seeing simple lifestyle changes (food manipulation and exercise) getting rid of immediate problems and then also prevent the chronic diseases that plague much of the industrialized world - heart disease, hypertension, high blood sugar/type 2 diabetes and weight issues.

Anyone can make an appointment with me for any of those issues (and more) by calling 916-489-4400.
_____________________________

People can sign up for my Health Letter Here. |

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.

I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Be Well,

Kirk

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Sudden Knee Pain, Torn Mensicus Responds Quickly to Shock Wave and Quad Strengthening

A 75 year-old male mildly overweight with type 2 diabetes step out of bed on June 28, 2022
and felt a sharp pain on the inside of his left knee when his left foot turned inward.  He came
to me 2 weeks later on July 14, 2022 limping into the office with a cane asking for help. I took
a history, examined him and said it could be a ligament strain or a torn cartilage or both because
of the pain on the inside (medial) aspect of the left knee. I told him whether this ends up with a
surgical solution or not it is important to be on an anti-inflammatory diet; strengthen his quads
and calves to stabilize the knee, improve his range of motion of the knee and enhance the natural
healing process with shock wave (radial and focused) and some EMTT therapy (electromagnetotransduction therapy). Shock waves are pulsed sound waves not electrical shocks, while EMTT is high oscillating pulsed electromagnetic fields. Both promote healing.

TREATMENT APPROACH

Exercise daily - just walking

Strengthen Quads, Hamstrings and Calves
(yellow highlights are what the patient did)

Wall Sit - 10 seconds to a minute 2-4 x day
Quad sets
Straight leg raise
Short Arc Quads
Bridges
Sidelying Hip Abduction
Knee to Chest Exercises
Calf Raises flexing quads (can hold on to something)
"Sink" Squats - hold onto the sink - go down to 90% if no pain then return - eventually if no pain can do full squat - again not if there is pain (or clicking or locking of the knee).

Xray and MRIs of the knee on 7/14 and 7/23/22 respectively showed left knee osteoarthritis,
chondrocalcinosis of the menisci and upon MRI he had complexed tears of the medial meniscus and horizontal tears of the lateral meniscus.

Shock Wave (radial and focused) and EMTT Treatments

After two combined treatments 1 week apart of 4000 (1.2-2.0 bar.15 Hz) radial pulses ("shocks") and 2000 (.03-.07 mJ/mm2) focused pulses and EMTT treatments 5000-6000 oscillations (8/8Hz) there was a mild-to-moderate improvement though he was still using his cane. I then saw the MRI and referred him to an orthopedist which was scheduled for September 6, 2022 over a month away. I wasn't sure about the focused and radial shock wave improving actual cartilage tears (there is some suggestion of a positive effect on cartilage; see references below) but I believed these therapies along with exercise would have him optimally prepared for a great surgical outcome if that is what was to happen. So to keep expenses down until he had his surgical evaluation we decided to just do the EMTT therapy (high oscillation pulsed electromagnetic fields) on the left knee that only takes 15-20 minutes weekly until his orthopedist appointment on September 6, then decide if he wanted more shock wave treatments. He continued to do the weekly leg strengthening exercises (below). EMTT only sessions were continued at 8000-9000 pulses (8/8Hz) for sessions 3, 4 and 5. Coming into the 4th session (8/2/22) before the treatment he said he hadn't had any pain in his left knee since July 26 even though recently he had walked up and down 12 flights of stairs. He was still doing his Quad exercises religiously (and staying off all dairy products and processed wheat products; and his HgA1C was creeping down from 6.9 to 6.6 showing his diet was improving slowly). When he came in for his #5 EMTT session he said his left knee pain was almost completely gone and he hadn't used his cane at all for the last week.

He will be traveling to visit a lifelong friend who is seriously ill for the next 2-3 weeks. So we will see how long his good progress lasts. I may be able to see him for an EMTT treatment or two before his September 6, orthopedist visit. I will be curious to see what happens.

Even though traveling and away from home he can still do his Quad/knee exercises daily and eat well. The unique thing about using shock wave therapy is that there is an immediate effect many times but then there is a physiological effect that continues releasing healing substances for 10-12 weeks after the last treatment.

There is no perfect protocol with shock wave therapy and EMTT. There are guidelines then there is individual experience and "feel" and getting feedback from the patient. I used to be a certified massage therapist many years ago and putting my hands on people in a healing fashion is a natural for me. Many times I feel like I am "feeling" through the shock wave hand pieces, like extensions of my hands. These technologies and tools are very powerful because they stimulate your body to heal itself with minimal, if any side effects.  I also can't emphasize enough the importance of an anti-inflammatory diet, taking some nutrients, selective exercises and muscle strengthening playing a big role in healing a chronic problem and then staying well.

Call me between 8-9 a.m. at 916-489-4400 if you have questions. Right now you can schedule a FREE 15 minute phone appointment with me to see if you are a good candidate for shock wave and EMTT therapy. If you are ready to go make an initial 1 hour appointment for me to obtain a good history, do an exam and then have a treatment session please schedule a new patient appointment. Call the office for our initial office visit charges.

Shock wave treatment sessions are $175-200 for a half hour (1 body part); $250 for 45 min (2 parts) and $300 for 60 min (3-4 parts). EMTT alone is $80 per 15 minutes session. Treatments are paid for at the time of service.

I look forward to working with you and sharing more cases with you. Shock wave works not only for musculoskeletal problems but for erectile dysfunction as well. You can do a 15 minute free appointment to discuss ED if you are interested. Some groups also use shock wave treatments for aesthetic medicine related health issues.

REFERENCES

Extracorporeal shockwave therapy improves pain and function in subjects with knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. Int J Surg. 2020 Oct;82:64-75.

Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism. Biosci Rep. 2020 Nov 27;40(11):BSR20200926.

The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion. Medicine (Baltimore). 2019 May;98(20):e15523.

Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee: A pilot randomized controlled trial. J Back Musculoskelet Rehabil. 2017 Sep 22;30(5):1121-1128.

__________________

People can sign up for my Health Letter Here.

FEEL FREE TO FORWARD THIS HEATLH LETTER TO FRIEND OR FAMILY....

If people would like to make an appointment with me in person or on the phone regarding all matters Covid 19 - Prevention, Early Treatment, Long Hauler's Syndrome , Post Vaccine Syndrome or recovering from possible vaccine side effects and hospitalization please make an appointment by phone or in office with me by calling 916-489-4400.

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.

I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Be Well,

Kirk

Kirk Hamilton PA-C
Prescription 2000, Inc.
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Overactive Bladder and Shock Wave Therapy with EMTT

Frequent urination or an overactive bladder can be a very aggravating situation. While diet is important like cutting out caffeine, alcohol for a while, avoiding milk products, eliminating sugars and processed carbohydrates, losing abdominal fat, hormone replacement and doing core and/or Kegel exercises it would be nice to have a non-invasive therapy which actually "rejuvenates" the tissues in the bladder. Shock wave therapy (not a real electrical shock) which are types of sound waves create a healing response that has been shown to significantly improve bladder symptoms. Click on full study - Scroll down to Figure 4. This is a very simple treatment that I have done and can be done along with an EMTT therapy session in about a half hour $175-200.

In this study they did it on 8 weekly treatments. I always like to emphasize to my shock wave patients for any medical syndrome being treated - DO DIET ADJUSTMENT at the same time. You will save time and money!

Low-Intensity Extracorporeal Shock Wave Therapy Ameliorates the Overactive Bladder: A Prospective Pilot Study.
Objective.
In the present clinical trial, we evaluated the therapeutic effects of low-intensity extracorporeal shockwave therapy (LiESWT) on overactive bladder (OAB). Methods. Female subjects with ages of 20-75 years and who have been clinically diagnosed with OAB were included in the study. The LiESWT (DUOLITH SD1 T-TOP, AG) applicator was placed on the suprapubic skin area and applied with an intensity of 0.25 mJ/mm2, 3000 pulses, and 3 pulses/second. To assess the therapeutic efficacy, all subjects were required to complete the validated OAB symptoms and life bothersome questionnaires, 3-day urinary diary, uroflowmetry, and post-voided residual urine (PVR) measurement at 4 weeks of LiESWT (W4), 8 weeks of LiESWT (W8), 1-month follow-up (F1), and 3-month follow-up (F3) after LiESWT. Result. 82 subjects with the mean age of were enrolled. The questionnaire scores were significantly improved at W4, W8, F1, and F3 as compared to baseline data (W0). At W8, the mean values of functional bladder capacity were meaningfully increased. According to the 3-day urinary diary, daytime frequency, urgency, and nocturia were significantly decreased. The uroflowmetry results showed that the mean voided urine volume and the maximal flow rate were noticeably increased. PVR volume was also significantly decreased. Conclusions. The data demonstrated that 8-week LiESWT ameliorated the OAB symptoms, promoted the uroflow parameters, and improved the quality of life (QoL) in OAB patients, suggesting that LiESWT might serve as an alternative noninvasive therapy for OAB.
Lee YC, Chuang SM, Lin KL, Chen WC, Lu JH, Chueh KS, Shen MC, Liu LW, Long CY, Juan YS. Biomed Res Int. 2020 Jul 6;2020:9175676. doi: 10.1155/2020/9175676. PMID: 32724817; PMCID: PMC7364200.

Call 916-489-4400 to make an initial hour appointment with me so a history and physical exam and come out with a game plan and we can do a treatment probably that visit as well for bladder issues or any condition below.

Conditions Treated by Shock Wave and EMTT Therapies

Achilles Tendinitis
Avascular Necrosis (hip)
Benign Prostatic Hypertrophy (BPH)
Bicep Tendinitis
Bursitis Hip
Calcium Deposits
Carpal Tunnel Syndrome
Erectile Dysfunction
Fracture Healing
Greater Trochanteric Syndrome (hip pain)
Knee Pain
Low Back Pain
Lymphedema
Muscle Strains
Overactive Bladder
Neck Pain (stiff neck)
Neuroma’s (feet)
Neuropathies (feet)
Nocturia (nighttime urination)
Osteoarthritis
Patellar Tendinitis
Plantar Fasciitis
Rotator Cuff Partial Tears
Shin Splints
Shoulder Pain
Sprains & Strains
TMJ Pain
Tennis & Golfer's Elbow
Trapezius Pain
Urinary frequency
Wound Healing
__________________

People can sign up for my Health Letter Here.
FEEL FREE TO FORWARD THIS HEALTH LETTER TO FRIEND OR FAMILY....

If people would like to make an appointment with me in person or on the phone regarding Long Hauler's Syndrome please make an appointment by phone or in office with me by calling 916-489-4400.

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.

I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Be Well,

Kirk

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Role of Sound Waves = Pressure Waves = Acoustic Waves = "Shock Waves" in Healing and Pain Relief

The reason I gave this title to this health letter is because this past weekend I was in Chicago at the Institute for Tissue Regeneration and Repair workshop put on by Curamedix who distributes the radial pressure wave and focused shock wave devices (EPAT/ESWT) which I have been using in the clinical for more than two years along with their newer EMTT device (Extracorporeal Magnetotransduction Therapy) which I have been using in the clinic for more than 6 months for almost every kind of pain syndrome. These devices promote healing and tissue regeneration literally from "head to toe."

I generally have been using these devices in combination because they are synergistic in  triggering the body to heal itself with pulsed sound or pressure waves and high oscillating pulsed electromagnetic fields. But each device can be used individually as well. The EMTT device especially can be used painlessly by itself with one’s clothes on for not just pain relief but to promote healing almost anywhere in the body.

These devices not only reduce pain but non-invasively promote healing in virtually any part of the body that has pain or that needs to heal (including wounds and bones). This is called "Regenerative Medicine" when you use techniques or compounds that stimulate the body's own mechanisms to promote healing. I was with practicing physicians from all over the country (actually the world - Germany and the United Kingdom) including an orthopedic surgeon (Instructor, Ludger Gerdesmeyer, MD, PhD, FIPP), an anesthesiologist, many podiatrists, chiropractors and a brilliant physiotherapist from the United Kingdom who was one of the keynote speakers (Paul Hobrough).

One of the hardest things is to explain what radial and focused shock wave therapies produce to promote healing. You can call them pressure waves, sound waves, acoustic waves or "shock waves" (but there is no electrical shock created by these two devices). The radial shock wave device creates a mechanical pressure by compressed air pushing a "pellet" up and down a tube that moves a tip up and down hitting your skin creating a "pressure wave" that goes out in a circular fashion but doesn't go deep into the tissue. In the focused shockwave device a magnetic coil creates a pressure or acoustic wave that goes through your body tissues with it's maximum energy deep in the tissue and hence starts the wave process deeper (i.e. focused shock wave therapy).  The radial device works better in conditions closer to the surface while the focus device works on injuries and pain deeper in the tissues.

The pulsed "sound wave or acoustic" creates in body tissues a release of biochemicals that promote healing:

1)      Neovascularization – the building of new blood vessels

2)      Release of growth factors such as eNOS (endothelial nitric oxide synthase)

3)      VEGF (vascular endothelial growth factor)

4)      PCNA (proliferating cell antinuclear antigen)

5)      An anti-inflammatory effect

6)      A breakdown of fibrous tissue

7)      Stimulation of stem cells

Electromagnetic transduction therapy (EMTT) is a promising new technology of treatment based on PEMF (pulse electromagnetic fields) with magnetic field strength between 80 and 150 mT and oscillating frequencies of 120 Hz with each impulse. EMTT acts via electromagnetic transduction. This treatment is also classified as soft tissue engineering therapy. Impulses are emitted by a high-speed generator to build up a voltage up to 30 kV which is released in nanoseconds at an impulse release frequency of 3 Hz. The very short duration of each impulse ensures full electrophysical reaction without any temperature increase in the tissue.

The EMTT device promotes healing by creating high oscillating pulsed electromagnetic fields which allow for deeper tissue penetration and a stronger electromagnetic effect compared to traditional PEMF (pulse electromagnetic fields) which has shown benefit in bone fracture and non-union healing.

Conditions Which Respond to Radial and/or Focused-ESWT and EMTT Therapy
[5-6 Weekly Treatments with all three modalities - $200 (20-30 min/ 1 body area); $250 (30-45 min/ 2 body areas) $300 (45-60 min/ 3 body areas) and/or EMTT alone 15 min 1-2 x week ($80)]

Achilles Tendinitis
Ankle Sprains
Avascular Necrosis (hip)
Benign Prostatic Hypertrophy (BPH)
Bicep Tendinitis
Bursitis Hip
Calcium Deposits
Carpal Tunnel Syndrome
Erectile Dysfunction (10-20) weekly or twice weekly treatments, $200/session)
Fracture Healing
Greater Trochanteric Syndrome (hip pain)
Hamstring injuries
Low Back Pain
Lymphedema (8-12 weekly)
Muscle Strains
Overactive Bladder
Neck Pain (stiff neck)
Neuroma’s (feet)
Neuropathies (feet)
Nocturia (nighttime urination)
Patellar Tendinitis
Plantar Fasciitis
Rotator Cuff Partial Tears
Shin Splints
Shoulder Pain
Tennis Elbow (outside)
Trapezius Pain
Urinary frequency
Wound Healing
...and More

***We don't offer treatment packages. You pay for the visits as you go at each visit.

If You Have Pain Ask Yourself These Questions...Because I Will Ask You Them in Our Visit...

1) What are the 3 things you cannot do as a result of your pain?
2) What are your three goals when pain-free?
3) What will it mean to you if you achieve these goals?

Watch This Webinar of a Family Physician who treats a wide range of conditions like I do with EPAT/EMTT. Start at 10 minutes - turn up speed to 1.25-1.50 if you want to get through the video faster.
Treating from Head to Toe Using Shock Wave, EMTT and More... David Cunningham, MD – Webinar

You can make a FREE 15 minute phone appointment with me to discuss your particular situation
to see if this is an approach you may want. Or, if you are sure you want to try this technology you can make an initial one hour appointment to allow me to take a good medical history of your problem, a physical examination of the area and your pain and give an initial treatment. Call NOW 916-489-4400 to schedule an EPAT or EMTT appointment.

I recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reducing pain along with EPAT and EMTT therapies. You will have a better outcome if you reduce the inflammation in your diet.

I also have a special interest in reversing heart disease, diabetes, overweight and memory loss . If you have concerns about CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness these are also areas of significant interest and study for me.

People can sign up for my Health Letter Here.

Be Well,

Kirk

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Fasting Your Problems Away - 30lb Weight Loss in 10 Weeks - 10 Complaints BETTER!

A 58 year old female who had finished her first Prolon (www. prolonFMD.com), or what is called the "5 Day Fasting Mimicking Diet", added a 2 day water fast ending on 5/17/22. She noted she had a negative colonoscopy on 5/24/22 which on a previous exam showed excess inflammation in the colon. She also had a normal endometrial biopsy (inner lining of the uterus) on 6/27/22 after a previous ultrasound had shown excessive thickness of the endometrium.

Coincidental improvements? Maybe... Or the "fasting" and the weight loss helped! 

She did a second "fast" starting on June 29, 2022 for 5 days - She ate 1 Prolon bar (200-210 cal) and some green olives (5-6 green olives in the afternoon), coffee and herbal teas for 5 days. When she saw me she had done an additional 2 days of water only and then wanted to add 7 more days of a water fasting but made only 3 more because she got Covid. On July, 10 she broke the fast weighing 158 lbs. When I saw her on July 6, she weighed 163.2. She originally was 188 lbs. on May 2, 2022.  That is a 30lb difference in less than 10 weeks. Most of the symptoms she originally came in with are gone.

PROBLEMS (before the two modified fast - and after)
Acid reflux - gone
Anxiety - much better
Fatigue - gone
GERD - acid reflux - gone
Hip pain – left hip - almost completely gone after second "fast"
Heel pain, prickly sensation bilaterally - gone
Mental fogginess - gone
Overweight – 30 lbs. weight loss
Prediabetic - no more
Rosacea x 10 years - improved dramatically

My Clinical Experience with Food Elimination

"Food Elimination is the Most Powerful Medicine"

The first practice I eve r worked in as a physician’s assistant was in Marina Del Rey, CA in 1983. Yep 39 years ago. Every patient that came into this practice was put on a green vegetable puree, psyllium seed husks and a few vitamins for two weeks. In that two week period I saw every complaint improve. From Migraine Headaches to Inflammatory Bowel Disease to Rheumatoid Arthritis to Dramatic Weight Loss and More...

So in all my 39 years of practice I have used different tools and "diets" to get people off what they eat normally to see if they feel better. It is an amazingly simple concept...BUT VERY POWERFUL!
So, I have used:

My basic elimination diet or BED Diet (or variations thereof, page 2); the Inflamx medical food as a meal replacement with just vegetables and minimal fruit; Prolon or the Fasting Mimicking Diet; or even water fasting as mentioned above. When I do pain management work with the shock wave devices and EMTT device mentioned below I always try and get the patient to go on some type of elimination diet first because many times their pain will be reduced 30-80% just by changing their food intake.

"FOOD CAN CAUSE ANY SYMPTOM...ESPECIALLY PAIN!"

If you want to talk to me about a tailored food elimination diet for you just make an appointment (CALL 916-489-4400), let me take a real detailed history and you might be pleasantly surprised what symptoms go away with some type of food elimination diet tailored to what you normally eat.

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well (916-489-4400). I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes, overweight and memory loss issues. If you have concerns about CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

People can sign up for my Health Letter Here.

Be Well,

Kirk

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Knee Pain in Runner from Multiple Injuries and Surgeries Responds to Shockwave Therapy

Case Study of Knee Pain Improved with Shock Wave and Electromagnetic Therapy

This is a case study of a 58 year old female runner who had fallen and over the years had 4 surgeries on her left knee including two meniscus repairs, a ligament release and surgery to clean up debris in her knee. Surgeons say she has a lot of "wear" in her left knee. She has tried other modalities such as cupping, acupuncture, ultrasound and more and nothing has helped. She was interested in prolotherapy initially which our clinic doesn't provide any more.  I explained to her the possibility of her being a good candidate for low frequency shockwave therapy (radial (superficial) and focused (deeper) shockwave) and EMTT (Extracorporeal Magneto Transduction Therapy) which are high oscillating electromagnetic pulses.

Treatment Length and Results

She received 7 weekly combined (RSWT/FSWT) of 5000 pulses (not actual shocks) along with 6000 EMTT pulses in a half hour appointment. After the first treatment (1 week) there was immediate improvement in pain and swelling. The second treatment had minimal effect. After the third treatment (3rd week) she noticed a definite improvement again even though she had gotten an upper respiratory infection so overall she didn't feel well. By the fifth treatment she noticed definite reduced swelling in the medial and inferior aspect of the left knee which was her definite area of most intense discomfort at the beginning of the treatment and she wasn't noticing the treatment being as "painful". I noticed her not flinching as much or none at all over painful areas like in the first one to two treatments. This is a pattern you start to see as the patient heels. Also, by the sixth and seventh weekly treatment she was not having pain going up and down stairs which was a hallmark of her original complaints.

I felt the patient could stop treatments after the 6th or 7th treatment and let the healing biochemicals triggered by the shockwave therapy and EMTT continue which they will for 8-10 weeks. The patient wanted to do just the EMTT treatment (15 minutes only) for another 4 weeks which there is no problem doing.Also, as part of my total treatment plan I put every patient on an anti-inflammatory diet...if they will do it!
Diet Options are:
1) Eat off my BED Diet list (whole food, a palmful or less of animal food per day; no dairy products, no eggs or wheat products ; page 2) for atleast a week (preferrably during the whole treatment period (3-7 weeks).
2) Inflamx 2 scoops in ice water 2-4 x daily with all the vegetables you want cooked anyway except fried or raw and 2-3 pieces of whole fruit daily.
3) The Prolon, the Fasting Mimicking Diet for 5 days
4) Or a water fast for 4-5 days.

If you do an anti-inflammatory diet you will get faster, better and more long lasting results from the treatment. Also appropriate exercise and stretching helps.

FREE PHONE APPOINTMENT: If interested in shockwave and EMTT Therapy for your "painful" body part (s) you can make a FREE 15 minute phone appointment with me whether you are a patient or not and I will let you know if you are a candidate for these therapies. If you are sure you want to try this therapy I need a one hour first time visit at our normal office visit prices to do a history, exam and first treatment. After that treatments are $175 for a half hour (usually 1 body part), $250 for 45 minutes (2-3 body parts) and if needed 60 minutes ($300 for 3-4 body parts). CALL 916-489-4400 TO SET UP AN APPOINTMENT.

The Benefits of Low Intensity Radial and Focused Extracorporeal Shock Wave Therapy (ESWT/EPAT) and EMTT (Extracorporeal Magneto Transduction Technology)

Extracorporeal Shockwave Therapy (ESWT) was first introduced into clinical practice in 1980 as a treatment for non-invasive lithotripsy (destruction of kidney stones with “high energy” SWT) (1). In the last two decades SWT has been commonly used as a treatment for musculoskeletal disorders and the stimulation of bone growth (2) (medium to low frequency SWT). Common orthopedic conditions treated successfully treated include plantar fasciitis (heel), Achilles’ tendinopathies, patellar (kneecap) tendinitis, shoulder and elbow tendon issues, femoral head necrosis, patellar knee pain, osteochondritis and calcified shoulder tendonitis (3-6). Shock wave therapy has also been used to treat recalcitrant angina pectoris (chest pain) possibly due to its ability to stimulate angiogenesis (new blood vessel formation). (7-8) For more than 10 years low intensity shock waves have been used to treat erectile dysfunction (and prostate issues) by improving blood flow and breaking down fibrous tissue (9-11).  EMTT (Extracorporeal Magneto Transduction Therapy) is usually added to the above ESWT modalities but can be used as a stand-alone weekly treatment as well. EMTT’s high oscillation frequency between 100-130 kHz allows these pulsed electromagnetic fields deeper penetration into body tissues. (13-17).

Shockwave treatment is a non-invasive therapeutic intervention without the risks of surgery and postoperative pain that has been used medically for 20-30 years. EMTT is a new technology that has been used in a variety of inflammatory disorders for the last 5 or so years.

Focused and radial shockwaves and EMTT all promote:

1)      Neovascularization – the building of new blood vessels

2)      Release of growth factors such as eNOS (endothelial nitric oxide synthase)

3)      VEGF (vascular endothelial growth factor)

4)      PCNA (proliferating cell antinuclear antigen).

5)      An anti-inflammatory effect

6)      A breakdown of fibrous tissue

7)      Stimulation of stem cells

These all lead to the improvement of the blood supply and to an increase in cell proliferation and ultimately tissue regeneration for tissue repair (12).

1.  Lancet. 1980;2(8207):1265–1268.
2.  Sports Med. 2002;32(13):851–865.
3.  JAMA. 2003;290(19):2573–2580.
4.  Am J Sports Med. 2006;34(4):592–596.
5.  Br Med Bull. 2015;116:115–138.
6.  Mater Sociomed. 2018;30(2):131-146.
7.  Clin Cardiol. 2010;33(11):693-9.
8.  Japan. Heart Vessels. 2019;104-113.
9.  Am J Mens Health. 2019;13(2):557988319846749
10. European Urology, 58(2), 243–248.
11. European Urology, 71(2);223–233.
12. Chang Gung Med J. 2003;26:220-232 
13. Krath, A. et al J Orthop.2017;14(3):410-415.
14. Kluter, T. et al., Electromagn Biol Med. 2018;37(4);175-183.
15. Kluter, T. et al., J Orthop Ther. 2018: JORT-1113.
16. Gerdesmeyer, L. et al., J Foot Ankle Surg. 2017; 56(5):964-967.
17. Knobloch K. Handchir Mikrochir Plast Chir. 2021 Feb;53(1):82-86. German. REV 3/20/22

People can sign up for my Health Letter Here.

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well. I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweigh t issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Be Well,

Kirk

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Beans are a Super Food! Great for Your Heart, Blood Sugar and Brain Health....and Cheap!

I just rinse the beans; throw them dry in my InstaPot; pour in 4-5 parts or more of water
(water to beans, etc. 1 cup dry beans to 4-5 cups water); shake in every herb I have within
arms' reach!; seal the lid; press the 'pressure' cook button; select the time of 25-28 minutes.
Let it go overnight and the beans are ready and soft in the morning or when you come back
from work if done in the morning. There should be 3-4 parts or more of "herbal bean broth"
in the pot with cooked beans. You can directly from there add some vegetables and more
herbs and heat up an excellent bean and vegetable soup quickly. Or, use a strainer spoon
to just get the beans and use them for dips, over rice, etc. And you can freeze them for use
at a later date. Simple and time efficient! I don't follow the directions on the InstaPot. Just
use my past experience. I have under-cooked a few batches of beans by not using enough
water and cooking time - i.e. like one cup of water and not enough cooking time, like 10 minutes....
More water (4-5:1) and more cooking time (25 + minutes) makes it easy and the warming or
slow cooking overnight, or, cooking while you are at work makes this SOOOOO easy to prepare...
in literally 5 minutes. Try it!

Watch Neurologist Dr. Ayesha Sherzai talk of the health benefits of beans
https://www.youtube.com/shorts/jd01oyW7cQQ

Please share if you feel so inclined.

People can sign up for my Health Letter Here.

FEEL FREE TO FORWARD THIS POST TO A FRIEND OR FAMILY....

If people would like to make an appointment with me in person or on the phone regarding
Covid 19 - Prevention, Early Treatment, Long Hauler's Syndrome or recovering from possible
vaccine side effects please make an appointment by phone or in office with me by calling 916-489-4400.

If you are interested in shock wave (EPAT/ESWT pulsed sound waves) or EMTT (pulsed magnetic fields) for pain management, stimulating healing and/or for erectile dysfunctions make an appointment as well.

I still recommend variations of "Kirk's 21 Day Program" and different fasting regimens (Prolon and Inflamx) for reversal of heart disease, diabetes and overweight issues. If you have concerns about memory, CIRS (Chronic Inflammatory Response Syndrome), and/or mold illness those are also areas of significant interest and study for me.

Be Well,

Kirk

Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 716-2295 (m) / (916) 489-4400 (w)
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com

Got Pain? Try Shock Wave!

I have been applying low dose shock wave technology for multiple health conditions since May of 2020.

First the focus was erectile dysfunction of which there is definite benefit with these pulsed sound waves (sometimes marketed as acoustic waves), especially when used in conjunction with lifestyle (heart healthy diet and exercise), certain nutraceuticals that enhance nitric oxide release (available here Affirm or at our office), testosterone therapy if needed by prescription (or enhancement also available at Health Associates) and low dose Cialis (cost between $10-20 cash per month). And you have to have a good relationship for sexual relations! Make a Free 15 minute appointment by phone or in person with me to discuss if you are a good candidate (916-489-4400) for shock wave therapy and this combined approach for ED.

Shock Wave For Pain. A Non-Invasive Treatment That Stimulates Tissue Healing and Regeneration. A Saturday Morning Well Spent!

This past weekend (7/24/21) I spent a morning in Littleton, Colorado with Dr. Hani Saeed owner of the Red Rock Ankle and Foot Center who is a pioneer in using shock wave therapy in treating chronic and acute pain as well as injuries. It is the second time I have gone to Colorado and train/observed a “Master” at his craft reducing pain and enhance healing utilizing low dose shock wave therapy with the same radial and focused shock wave devices that I have been using at Health Associates since May, 2020 which are manufactured by Storz Medical.

On a busy Saturday morning we saw fourteen or so very appreciative patients for 20-30 to minute treatments of a wide variety of acute and chronic joint, muscle, tendon and chronic pain issues as well as difficult neuropathy patients. Almost everyone had immediate improvement and would walk, stand or move better and with less pain right after the treatment. Patients came from all over Colorado and a few out of state patients were seen. Aside from his unique technique in applying shock wave therapy Dr. Saeed is incredibly positive, patient focused, caring and it’s obvious his patients love him and have tremendous confidence that he will help them heal.

Since I have been doing this since May of 2020 and having success with patients with all kinds of chronic pain in issues (feet, ankles, calves, knees, hips, groins, shoulders, hands, wrists, backs, necks, TMJ, lymph edema…just about any body part that hurts) it made it much easier to pick up the little things from a “Master” to make my treatments more effective and efficient. While there is a lot of evidenced based research on shock wave therapy for a wide variety of conditions it is also and art form to administer it.

Shock wave therapy is NOT an electric shock, but pulsed sound waves. The radial device we call the “little jack hammer” works by compressed air pushing a pellet up and down a tube, pushing a tip up and down to create the shock wave on the surface of your skin. This device disperses it’s maximum energy on the surface of the skin. This device is sometimes called a radial pressure wave device. The focused shock wave device uses a magnetic coil to create the shock wave (sound wave) whose maximum strength goes centimeters into the tissue which allows for healing deeper in tissues, even to bone.

Shock wave therapy has been shown to promote (See Shock Wave Benefits and Function):

1) Neovascularizatioin –the building of new blood vessels
2) Release of growth factors such as eNOS (endothelial nitric oxide synthase)
3) VEGF (vascular endothelial growth factor)
4) PCNA (proliferating cell antinuclear antigen).
5) An anti-inflammatory effect
6) A breakdown of fibrous tissue
7) Stimulation of stem cells

If you improve blood flow to any area healing occurs much more rapidly and completely. This technology has even been used to treat resistant angina pectoris (chest pain) because it can improve blood flow in the heart. Stem cell enhancement is a long-term healing component of this technology as well. So there is usually a relatively immediate effect in a lot of cases but a long-term healing effect occurs after the treatment is stopped.

Try this experiment just Google “Pub Med - Shock Wave Therapy - and your pain condition” and see what pops up in the National Library of Medicine. You will be surprised how much supportive data there is on this non-invasive technology using sound waves. If interested you can make a FREE 15 minute appoint (by phone or in office) to tell me your issue and I will tell you if I think I can help you (Call the office 916-489-4400 and ask for a free 15 Minute Phone EPAT visit with Kirk).

If we decide that shock wave is a good approach for your condition the first time I meet with you is a 60-75 minute office visit in which I include the treatment in that initial visit. I have to know your medical history, medications, diet and do a focused exam on that body part. After that most treatments are 20-30 minutes for 1 or sometimes 2 body areas and cost $150. The treatments are done 5-7 days a part for 3-5 treatments. This is not a one treatment and your are “cured” therapy. Each treatment builds off the prior session.

At that initial visit I will talk to you about an anti-inflammatory and healing diet as well. Food makes a '‘HUGE” difference in pain reduction and healing. So I use the BED Diet (pg 2), modified fasting types of diets with meals replacements (Inflamx) and/or Prolon to reduce your pain quickly, speed healing and give you more “bang for your buck!”. One to three nutraceuticals that help with pain will usually be recommended.

I also was introduced to an excellent CBD cream for almost immediate pain relief by Dr. Saeed that I have begun using post treatment as well. It has to be ordered by a licensed health professional. If you come in for a treatment I will apply this cream usually after the treatment and many times you will feel an immediate pain relieving effect.

Call 916-489-4400 for the 15 minute FREE visit or to set up a 60-75 minute initial visit with the first treatment.

Be Well,

Kirk Hamilton PA-C
Health Associates Medical Group
Prescription 2000, Inc.
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 716-2295 (m) / (916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com