In this uplifting and insightful episode, host Joe Fier sits down with Mitch Velez-Zumbrunn, a clinical apheresis nurse spearheading Therapeutic Plasma Exchange (TPE) treatments at MD Lifespan’s first clinic in Florida. Mitch shares an inside look at the patient journey, what makes TPE unique, and some of the transformative results he’s witnessed firsthand. The conversation ranges from practical details about the treatment process and overcoming patient anxieties, to the importance of toxin education and the supportive network driving MD Lifespan’s mission. Whether you’re curious about TPE protocols, intrigued by detoxification, or just want to hear how frontline care is evolving, this episode delivers the goods.

Topics Discussed

• Mitch’s Nursing Journey: From ER nursing and travel assignments to pediatric care and apheresis specialization, Mitch shares his career path and what led him to TPE.
• What is TPE? An accessible explanation likened to an “oil change for the body”—what it does, how it works, and how it differs from procedures like dialysis and blood donation.
• Patient Experience: Step-by-step walkthrough of a typical TPE session, addressing common patient concerns, preparation, and what to expect before, during, and after treatment.
• Results and Surprises: Real-life stories about patient improvements, from renewed senses to decreased inflammation and increased energy—plus the variety of responses TPE can produce.
• Toxins and Regional Trends: The types of toxins commonly seen in Florida, like pesticides and chemicals from plastics, and how environment and lifestyle impact toxin buildup.
• The Importance of Vascular Access Skills: Why advanced ultrasound IV skills are crucial for a successful and comfortable TPE experience.
• Overcoming Needle Anxiety: How Mitch helps patients relax—using cold sprays, supportive communication, and building confidence both in technology and technique.
• Post-TPE Follow-Up: Details on aftercare, including communication with patients, testing protocols (objective labs and subjective quality of life surveys), and what patients might feel in the days after treatment.
• Lifestyle and Education: Tips on reducing toxin exposure at home, plus how the MD Lifespan team educates and supports patients beyond the clinic visit.
• The Future of TPE: Mitch’s excitement about ongoing research, the growth of educational resources, and the promising direction of preventative care.

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• Contact: Visit our website for feedback, questions, and upcoming episode info!

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Disclaimer:

MDLifespan PlasmaXchange protocols are designed to support general health and wellness. They are not intended to diagnose, treat, cure, or prevent any disease. The information provided on this podcast is for educational purposes only and should not replace medical advice. Please consult with your healthcare provider before beginning any new health program, especially if you have a medical condition or are taking prescribed medications.

Today we're gonna go behind the scenes with Mitch, a clinical

apheresis nurse at MD Lifespan.

So he's leading the charge out in Florida where he's delivering firsthand the

cutting edge therapeutic plasma exchange treatments to a bunch of patients.

So he is gonna walk us through a real patient journey, like as if we were

gonna walk into the office and he is gonna step us through the process.

From the first session to the sessions that follow and share

some of the life changing results he's also seeing every single day.

So if you're curious, let's dive in.

All right, Mitch, we're doing this.

It's so glad I'm, I'm glad to have you here as someone who is running,

uh, the first clinic right for TPE in, um, in Florida for MD lifespan.

I, I'm super curious to hear your perspectives and insights and all

that, so thanks for joining me today.

No, definitely.

Thank you for having me, Joe.

I really appreciate it.

Yeah, man.

So what, I guess I always like, I'm always curious like, how did

you get into this whole field?

Like what was the, what was the turning point or maybe some aha

moment that you might've experienced.

Experienced?

Yeah, I mean, like most nurses started out as a baby nurse, uh,

worked in the ER for a few years.

Tried everything.

Education, management, um, precepted, some students.

Uh, that's actually where I learned while I'll get into a minute, is the ultrasound

IV skill, uh, was down here in Florida.

After I graduated, um, and that kind of followed me into travel

nursing, did a little bit of travel.

Nursing in the emergency department, really opened my eyes to different

types of populations, different types of individuals, the all different,

um, walks of life and everything.

Uh, and then from there.

Again, they wanted me for my ultrasound IV skills, so I would

go around, do ultrasounds there.

Um, got to a point to where I just wanted to focus on that.

Um, went to, uh, pediatric pick nursing, actually complete

departure from what I was before.

Uh, still seeing a lot of sick kids, um, and I world touch on this, but they

also seemed sicker than, you know, from before, even years before when I started.

Um.

And then from there I just wanted another change.

I really delve into my, uh, ultrasound IV skills and that's actually

what el me to for a job find.

And I got stumbled across MD Lifespan, stumbled across Dr. Savage.

Uh, from there I just went through the interview process, met Dr.

Savage, knew immediately like this was something I wanted to do.

He is so enthusiastic about toxins and fairly something I've never really

heard of or worked with, which is.

TPE Therapeutic plasma exchange.

And at first I was like, oh.

You know, it's probably just, you know, another procedure

or anything that's going on.

Uh, but as the kids say, he brought the receipts, so he showed me,

Hey, this is what it works with.

Um, and one of the things that really resonated with me coming from a physician,

um, a colleague, is I respect what you do.

Hmm.

And that's something that's really paramount, I think, for all nurses.

Um, but kind of starting the TPE journey, uh, going up to Chicago

learning, uh, the machines learning.

That it's taking out these toxins and doing my own research on the side,

figuring out we're surrounded by them.

I mean, there's toxins in almost every, everything that we have.

There's toxins in the shirt.

I'm wearing dry cleaning even.

Um, and going back into conventional, the conventional hospital and thinking

like, you know, they don't really talk about this, they don't talk about,

they don't talk about pesticides.

The more bigger, I guess, toxins that they think about.

But man, they don't talk about like pfas forever.

Chemicals.

They don't talk about, um, you know, reins, fennels, all these other things

that we're always in contact with that cause the inflammation and cause

the things that I've seen in the ER or cause the things that I've seen

putting in a pick in one of these children or one of these adults.

Uh, so really working with Dr. Savage, learning more about

it and coming up with this.

Procedure, this plasma exchange protocols that is all encompassing to help get

rid of those toxins and improve either longevity, immunity, and really just a

person as a whole and as a nurse, you know, that's what I signed up to do.

It's to help people and, uh, it's been a great journey so far, that

six months work with a great doctor down here that works with Dr.

Savage.

And, I mean, it's, it's been going strong.

I've been enjoying it

great.

It, it's so interesting to hear your background coming from a travel nurse, you

know, working in ER and all that stuff.

So you're seeing a lot of symptoms.

Right.

And then now you're almost like on the completely other

side of the spectrum where.

You're, you're at the root of the, the issues.

I mean, you're, you're trying to get that out with TPE, right?

Yeah.

And I'm glad you brought that up.

You know, in conventional medicine, um, it, we were treating a symptom.

Really?

You come in, I'm having an asthma exacerbation.

Okay, here's.

An inhaler and X, Y, and Z. Okay, cool.

It's fixed.

Goodbye.

Um, you know, there's other diseases that toxins do cause or

they can, uh, create more of a problem with and exacerbate more.

Alzheimer's being a big one.

I talked about, we talked about on the podcast, I'm sure a lot the am a

study which really pushed us forward.

Um, but, you know, other diseases, autoimmune diseases even, uh,

down to rheumatoid arthritis.

Um.

I even have people who have long-term COVID who are coming to see me.

And I have one patient I actually did this week who her,

their smell is getting better.

They haven't had smell since they had COVID.

So really seeing that we're treating the cause rather than just

a symptom is, is really telling.

Um, and as we continue to do research and as we continue to support these

patients, uh, seeing how well and better that they are getting, again, not just

as symptomatically, but as a whole,

Well, it's gonna be interesting to dive in with you here because

like I said, you're on the front lines, like, well, you always have.

But now with this different version here with TPE administering, how

would you, I guess, how would you describe it to someone if they're

first coming across TPE, this concept, how would you describe that to them?

So they kind of understand it, they get comfortable, and of course,

we'll, we'll dive in deeper.

Yeah.

Um, I mean, Dr. Savage coins it well.

It is an oil change for the body and the body's a machine

if we really think about it.

Um, and I guess another way that you can describe, it's like dialysis.

I think a lot of people kind of understand what that is or even just giving blood.

Uh, but what we do differently and what I like about it is the machine that

we use, the amicus, uh, the apheresis machine for these plasma exchanges is, is.

Basically like a fail safe.

Um, and I say that because when you talk about dialysis or you talk about

even donating blood, like red flags already kind of come up like, oh, how

am I really gonna feel after this?

Ooh, that seems like really excessive, pretty invasive.

Uh, but really what it is, is this two needles in the arms taking the blood

out, it spins it, and then unlike, for example, plasma donation or plasma or

um, blood donation, we're giving you back something so that it's not a full.

Draining you of 500 mls and hey, good luck on your own.

Here's some crackers.

Um, it's more of let's clean you out.

Let's replace it with something called albumin.

Um, and just kind of help with your, uh, blood volume there.

My machine, I always tell people when they come in, like it's loud,

it's going to yell at me, beep at me.

But really that's just either for me to change an albumin bottle or if you

just need to fold your arm out more.

there are.

Some, uh, things that may occur, but really it would be like

lightheadedness, feeling faint.

And that's just because, you know, we're pulling out some of the fluid.

But, you know, me and the other nurses, we do a great job preventing those really

like, kind of smaller level side effects, I guess is the best way to say it.

Um, some other things are.

It eats your blood sugar a little bit, but we always ensure, Hey, did you eat?

Let's check your sugar.

Uh, we'll give you just some sugar packets.

Hey, I know your arms are immobile, but here's a juice with a straw

to at least help with that.

Um, other things that we try to do is like, at least fill you up with fluid.

Um, get you a little bit of normal saline, just help you out a little

bit in terms of the fluid aspect.

Uh, but really it's, it's individualized.

It's not the same for every person.

And what I like to describe, at least your first TPE experience,

uh, would be more of, Hey, it is more of like a consultation and a

consultation with you and the machine.

I figure out which veins work best for you, which catheters

are gonna work best for you.

How do you react, um, while you're on the TPE, do you get lightheaded?

Okay, perfect.

If you get lightheaded, I know next time here's some blood sugar.

And normally if once I address those concerns, second,

third, fourth, fifth, TPEs.

Are running smoothly.

Um, and that's what I really like about it, and that's what to really

expect is especially on that first time, is I'm gonna talk to you.

I'm gonna be really assessing your arms.

I'm gonna be really assessing how you feel.

Um, and it's always great to come back, especially after that first TPE.

And here's somebody say, you wouldn't believe I have so much energy.

My brain bog is already going.

I can remember some things.

Let's just go onto the next.

keep harping on that first tb, but that's what people are genuinely, uh, anxious

about and afraid of, which rightfully so.

Uh, but just to kind of lay it out there, like we really take our time to make it

a comfortable experience for you and to meet the goals that you're trying to meet.

so Mitch, I'm curious, like after, you know, if someone understands

this, like, I'm curious what, what's like a surprise that you commonly see

that people have, like are there some pretty common experiences that, like

you mentioned, like the whole like, oh I feel like not lightheaded, or, or,

or a lot more clear minded, you know, are there other surprises I guess,

throughout the process that people kinda experience that you've seen?

Um, everyone's different.

Um, again, TPE know Dr. Savage and other physicians have talked about

this as well as on the podcast.

Um, it's not necessarily a cure for things, it works for

everybody in a different way.

Um, I had one surprise was somebody has something called a, um, a, um.

A geographic tongue, and it's kind of like where it almost looks like the tongue is

really dry and it looks a little cracked.

One day they just came up to me and were like, Hey.

Weird.

I don't know how, if this has anything to do with what we're doing.

He was like, but you know, it was for two weeks.

I didn't really have that geographical, uh, like tongue, uh, how it normally looks

like, like it kind of smoothed out a bit.

And I thought that was really interesting.

And I always like letting my doctors know like, Hey, this is happening over here.

This is happening over there.

Um, I've had people who, as we know, uh, rheumatoid arthritis,

like some of them, they come in for.

Like a brain protocol or let's say they come in for immunity protocol

and they'll be like, you know, my fingers have been moving a lot better.

Like, I have better dis uh, dexterity.

I was like, oh, well, you know, x, y and Z autoimmune conventionally past few decades

it's been used for autoimmune disease.

So that makes sense.

Again, let me let my doctors know.

Um, other surprises again, that surprise with the smell too.

You know, that's something that

everybody had when they had COVID was.

Their smell went away.

And it's just so great, like having people come up and be like, Hey,

like my smell's coming back again.

Everybody's different.

But just hearing like these, these small things, like I'll hear like the bad, like,

oh, I was really tired after it, which is normal after the first CPE, uh, we

take about 66% of those toxins and that fluid kind of shifts between

the vascular and the, and the um, out extracellular tissues and everything.

Shifts a lot.

Uh, but they're like, you know, for two weeks I was able to go to the gym and

I was at the gym for, you know, four times the amount I was there or, oh, my

husband, he's more alert, more awake.

We're able to talk, we're able to have a great conversation.

Um, so simple things like that.

And, um, I always have a cheer and a win for, because.

There's results that are happening there.

Um, I even had somebody say, oh, they're able to catch themselves now.

Like even if they trip or realize that they're kind of

slipping up when they're talking.

And those are just like really big things for me.

And I always ask my patients whenever they come in, what's good, what's bad?

What do I get fix?

That's a good question.

I use that for other things too, so,

right.

and I like that you're communicating back to the doctors as well, you

know, just because, so it's kinda like this feed look back loop, right?

So it's helping other folks in the future.

No, definitely that way they're also aware.

And, um, like I said, you know, Dr. Savage, it's, it, it's very,

it's it's very personable, you know, we're all in the same goal.

We're all in the same concept, and that's to provide.

The best care that we can to meet, have people meet their goals and create a

modality that is gonna be changing.

You know, it's gonna be ever changing, especially within the medicine world.

Um, so having that strong team and that strong teamwork.

And I don't know if you know, but like we're different centers.

Uh, so like, for example, I'm kind of like.

I'm here.

Another nurse is up here, another nurse is here.

Uh, we have a doctor maybe near this nurse, another doctor

that's working in this office.

But you would think that would, those would be barriers, but.

The communication has been really great.

Um, and just being able to get in touch with them.

And there's been times where I would call, let's say Dr. Ing, just on the

phone, Hey, this patient has a question.

Yeah, sure.

I have time.

Like, let's talk.

And, um, I think that really resonates with people and even me as a provider,

as a nurse, I'm like, I've never had that before and it's so refreshing.

And that helps.

I mean, that's the whole like kind of network of partners basically

with MD lifespan is communication, so everybody's learning together.

And, uh, yeah.

And that's why we're featuring folks, you know, on this podcast

to talk about their experience.

So

I'm, I'm curious of, uh, because one of the first things you started, uh, about

was your, your ultrasound IV skills, and I'm, I'm curious of, I guess, why that's

important just to talk about that, you know, with this whole procedure and Yeah.

Anything I guess we should know when it comes to that side of things.

like I said, a lot of people come in really anxious about it because.

That's the main part is the IVs and getting access.

Um, I know on one of the earlier podcasts, Dr. Savage kind of touched

on it a little bit, but, um, he really wanted nurses who are ultrasound IV

trained and even better if they could be what we call VABC certified, which

is Vascular Access Board certified.

So national certification, um, that's something actually I think.

All the nurses currently have.

Um, and what that is, is it kind of helps us dictate the proper veins to utilize.

It helps us dictate how can we assess and troubleshoot any issues that may come up.

Because during TPE, you know, we're pulling blood.

It's not like a normal infusion where we're just pushing.

Things in like, oh, you have a vein, there's a tube.

Like things can go through it.

Perfect.

Done.

Call it a day.

TPE is more of, okay, let's critically think which vein has the better diameter

and what we call a catheter vessel ratio.

Um, normally you want it at least 33%, not even half like you want it, 33%.

The reason why and why we take so much time with the ultrasound and ensuring that

that's the right vessel is to ensure that the diameter at least meets that 33% so

that there's also blood flow going around.

Because if we've just put in like the same size into the same vein, there's

no blood flow going around really.

You're just gonna be sucking at nothing actually.

and.

right?

Yeah, it's

Yeah.

like a vacuum, you know?

Uh, 'cause it's all negative pressure.

So having those ultrasound IV skills, um, also allows us to be like, Hey, like I,

let's say we're during the TPE, right?

Um, I talked about those alarms.

One of the things that those alarms could go off for, like a ding,

ding, to let us know is something called, there's a high pressure.

Typically what happens is if, if you have a, a catheter, let's say it's my

pinky and you have a, a vessel and it's.

So, you know, if the negative pressure is too much, the vessel

vein can collapse and kind of like squeeze, almost like a Capri sun.

We just wanna make sure that a Capri sun stays filled.

Uh, so whether we need to, let's say, slow down how fast it's pulling those,

um, the blood out, whether it's, we need to reposition the arms, so like

some of the muscles around the veins aren't constricting it too much.

Maybe it's, Hey, we just need another tourniquet on.

You have.

Vascularity there.

If we put on another tourniquet, maybe it could pool with blood a little bit more.

So we're actually also able to assess during the procedure

and see what could be going on.

Um, live time without being like, oh, oh, oh, well that doesn't work.

Let's poke you again.

Um, something that I actually learned from my pick nursing days from an

amazing team that I have here in Orlando I used to work with was the

more times that you stick somebody, the body kind of remembers that and it's

gonna be even harder to do the next.

IV

So is it every, every time do you have to switch locations

for each, uh, TPE session?

naturally no.

Like if you go pretty well, uh, through it, after that first

stick, you can use the same vein.

Like I normally say, Hey, that vein works for you.

That's what I'm gonna use.

Because in all reality, that intake is only in your arm for about two hours.

So it's not causing a lot of damage.

Uh, for example, if it was in, let's say, during a hospital stay, uh, so nine

times outta 10, you're able just to.

Use the same vein each time, and that way the patient also kind of knows,

Hey, this is the vein that you used.

You did great last time.

Like it worked well.

Didn't really feel a thing.

Um, and that was another thing too.

You know, like in the pre-assessments, uh, we really do like our vein

choices, see what works best.

We can see valves, we can see, uh, what we call bifurcations, where vein split.

Um, I even try to assess and see if I need to use a regular catheter or

if I need to use the actual apheresis steel needle, because that can also

play a different type of a change.

Um, so really I feel as if.

That confidence within that machine and that technology kind of calms people down.

And I also like pointing like, Hey, this is what I'm looking at

as, as people aren't squeamish,

uh, and being like, Hey, like this is what I'm looking at.

This is what I'm going for.

Feel free to watch.

I'm confident within it, and I can see where it's going.

I can see how it's gonna last, et cetera.

And I think once they understand that as a patient, kind of all other

anxieties go away, especially after.

The two, uh, needle sticks there.

And from there it's just playing around with the machine.

What speed should I do you at?

Um, you know, how do I need to give you a glucose tablet?

Do I need to give you a Tums to help with calcium?

Uh, but the ultrasound IV skills is definitely something that is a game

changer in this, um, form of work and in this procedure because if

you don't have a good line or if you don't have, you know, a good IV or.

Your vein choice is poor.

You're not gonna have a good procedure or a successful one.

yeah, I respect you.

And anyone in that position of even drawing blood or, because yeah, I've de.

Had some, some, some misses.

I think we all have.

And

that leads to, well you said like the squeamish type of folks and,

'cause I know a lot of people who are in that boat, like how do you,

how do you calm those folks down?

Maybe pre-procedure as you're getting into it?

again, everybody's different.

Um, I like if I know that they're a little bit more anxious about the actual

poke, and they'll tell me too, like, oh, like I don't like being stuck.

Like, you either tell me 1, 2, 3.

Some people tell me, don't even count at all.

Um, we also have something called, uh, like a pain ease.

It's almost like a little spray that we can use to help with a little bit of a

initial pinch.

It's like a cold spray, so it kind of tricks your mind.

Um, but really just any nurse's discretion like that, like, Hey, let's talk about it.

This is where I'm going.

This is what it's, I have confidence in it.

We'll try it out.

At least gimme one shot if I can at least prove my skills, show that I hit it.

Yeah.

Then nine times outta 10, they'll be like, okay, yeah, this

isn't as bad as what I thought.

Um, I have had patients that say, oh, just don't go here.

Don't go there.

Okay.

Like, I'll have a look.

And that's why I also like showing them the screen.

Like, Hey, I see it.

I, I'm not feeling like I, I visually see it.

It's a video game, like I'll just say it.

We'll treat it like that.

Um, and even using that terminology like I just used, Hey, it's a video game.

It's a, that's just my target.

Sometimes it'll.

They'll calm down from it.

They'll see it more as like a kind of fun experience rather than a

Yeah.

We'll make that the, uh, the image of this, uh, podcast.

No.

No, but like the way you're describing it does take the mystery out of it.

And I think that's what I'm trying to do here is, you know, take, take the mystery

out of, from the, from the patient's perspective, it's, yeah, there's a target.

It's very logical.

Uh, you have great tools and awesome training, you know, and,

and, and everybody's helping each other as well in this process.

And the cool thing is what there's a series of, of, um, of these

sessions that are happening, was it between three and five typically?

I think.

Typically three and five.

Um, I like to say on average you'll see more of the five range.

Um, and that's kind of like what we like to keep.

Um, I know on an earlier podcast as well, we talked about, oh, 66% in the

first TPE, then another percentage in the second, third, and fourth and fifth.

But again, it's individualized.

It's, it's per the, uh, per the patient.

Um, whether they just want the TP itself, that's also an option.

Do

you want an IV bag after?

That's another option.

Um, and our team does a really good job of saying, Hey, this is what

we think will work best for you.

We'll work around it and we'll make it feasible for you and your own goals again.

Um, but normally three to five, um, I rare, I think I only had like one,

um, at least in my line of work, one.

Just regular TPE to try it out.

But then they continue on to do further TPEs just 'cause they wanted to try it.

And I guess they had a great experience

That's a good sign.

Yeah.

Well, I'm curious with, uh, being in Florida, like, do you, and you know,

you haven't done this in other states, but I'm curious if there are like

regional toxins that you're seeing or any kind of trends maybe from others

that you talk about or talk with?

I, I'm just curious if there's like a, a regional like consistency of trends

or, you know, from the patients that you see when it comes to, um, I guess what,

what's getting taken out or even the, uh, the, the feeling afterwards, you

know, the, the different effects of TPE

Um, in terms of toxins, you know, Florida is, we're a bed full of golf courses,

so pesticides is definitely one of 'em.

Um, any toxins that deal with pesticides, uh, anything that comes

from aerosol cans, think sunscreen, um, I mean, we have sun basically

year round, um, you know, everything from what's in our water, et cetera.

That can definitely play a part.

Um, in terms of how people actually react to the TPE, I think

is again, dependent on person.

Um, you can have somebody who comes from Massachusetts or even

let's say Denmark for example.

Like if somebody comes from Denmark,

uh, they have clean water, they have different like filters.

Uh, systems, et cetera.

But if they're still around, like a different type of specific chemical,

like they could have higher toxins than me, like whether I have, you know,

four to five or six on the little, um, on the, the, the blood test or

the urine test, the toxin test to, you know, figure out what I exactly have.

Uh, but region does play a role.

Mm-hmm.

like I said, pesticides is definitely one of 'em.

Uh, but really it's all about getting tested and seeing what

you have, what you're around.

Um, you'll be surprised.

Um, and one of the things too, I actually have, um, a, uh, one of the headquarters

for some of the containers, uh, that we buy, like the plastic contain.

So I'm sure there's some plastics, you know, even in the, in the air.

Um, and we also have a paper mill kind of down the road a little

bit, so I'm sure that's in the air.

Uh, so there's definitely a bunch of different environmental factors there.

But again, it's what we do.

What do you do in your home as well?

What is your lifestyle like?

Because you're always gonna have toxins everywhere.

Uh, so one of the things that we did, yeah, like you can't escape it, um, but.

Well, you know, we got rid of all of our plastic, uh, containers.

We have glass containers now.

Like simple things like that.

Yeah.

It's not taking everything, it's not the TPE, but it's at least

keeping your toxin levels down.

Uh, like for example, there's certain chemicals or certain toxins that

only last 21 hours in your body.

If you can get rid of where those are coming from and change that,

then you won't have that specific chem, uh, chemical or toxin going

throughout your body as well.

And that's what we really also try to.

Learn and teach and educate our patients, uh, with our different protocols.

And our plasma exchange is, Hey, get rid of this, you know, skillet,

here's a concept here, or all the rage or the Stanley Cups, you

know, like at first I was like, oh, Stanley Cups another fad.

But then when I started this job I was like, oh yeah, no.

Get those bottles out of here.

I even go to Duncan sometimes.

I'm like, no, get that out of here before it,

you know, it starts warming up.

I had a whole, uh, podcast with what Dr. Fine, um, who it'll, it'll be

released, uh, somewhere in the future, but yeah, she was talking about just

how much, how much stuff is leached from these coffee cups, plastic bottles.

It's just ridiculous.

And we all

And then you add heat to it, you know, and

everywhere.

So.

Mitch, I'm curious of like what, uh, what happens post TPE?

Like is there testing or like follow ups that happen that, that you

guys do or that you're aware of?

And I guess anything that you kind of see in that phase after procedures?

after every TPEI try to at least reach out, um, especially if

you had something interesting.

Go on.

Um, uh, whether interesting, like a lightheadedness or anything.

I always try to reach out to them within 24, 48 hours.

Hey, how are you feeling?

Let me know if you need anything.

I'm just a serbo, which is our charting system.

Just a message away on there.

Um, I'll reach back out to you within 24 hours, um, and.

Specifically in terms of testing, like you said, we normally wait at

least six weeks after your last CPE.

And what this does is I talked about the mobilization of toxins as well.

That's about the amount of time that it would take for your body to kind of like

relax and let things settle where they are so that we can get a good idea of

where your toxins are after the fact.

Um, so really what you have to look forward to after the TPE in terms

of communication is you'll hear from one of us nurses, Hey, how are you

doing, um, even before your next TPE.

Yeah, we'll send you an email, um, or some form of reminder and just to let us know

that we're available, uh, for any calls.

Um, I've had patients message me the good, Hey, I'm feeling really tired.

Um, oh, you know, that's normal after the first TPE and we can talk about it.

Um, but again, testing is more, um, after the fact and we do.

Subjective and objective testing.

And what I mean by that is you have objective testing, which is like your

lab work, your urine, your blood.

Those are things that give you those results.

Um, just flat out, these are

the facts.

Uh, subjective testing is more of like surveys.

So we do do questionnaires at the beginning, um, and at the end, uh,

some of them include like a quality of life questionnaire, uh, fatigue scale.

Um, and what we're trying to do as well is see is your quality

of life also getting better?

Based off of the TPE, do you feel you have more energy?

Is your fatigue gone?

Um, how is your mood?

Uh, so that's something else that will, um, also repeat at

the beginning and at the end,

uh, from there.

And that's what makes that plasma exchange so great and also makes our,

um, our research behind it well is, oh, like looking at the full person, not

just the physical attributes, but how is your, you know, your sense of self.

How's your mental, um, how's your, uh, holistic, your spiritual, um, and

like, how are you doing as a person?

Uh, so that's also something that you can see after in terms of, uh, signs.

Symptoms.

Um, what you might feel, uh, during the TPE, like I said, you

might feel a little lightheaded.

A lot of times that's just, here's a glucose tablet.

It could be your sugar.

Um, you might get tingling in your face.

That just lets us know you just need a little bit of calcium, whether we

give you Tums or we put, put it in the, um, albumin bottle before we hang it.

Um, that way it goes back into

your system.

Um, but definitely after first, second, third, you'll feel

at least a little fatigued.

Um, after it.

Um.

It's okay.

You take a nap.

I mean your body literally went through a whole cleansing.

Right.

Um,

and especially with that fluid shift and that mobilization of the toxins

out of the tissues to prepare for the next one, uh, you might feel

a little groggy and that's normal.

Um, so I like to let people know that as well.

Like you will feel tired, especially at the first one.

'cause we're taking these toxins, whether they've been in you for hours, days,

weeks, years, and we're actually getting rid of 'em Now your body's like, oh.

Well, now I have to kind of reset,

figure out if there's things I can actually focus on, um, as we

decrease your inflammation and as we decrease your oxidate, decrease

your, uh, oxidative stress.

I mean that's, there's so many, there's so many shifts happening all at once and.

A short period of time, but I know it's spaced out.

What about a month between procedures?

Right?

Um, so gives a little, little time for the body to circulate and, and yeah,

and like I said, you know, you'll normally see those changes, I

would like to say 48 hours after.

'cause 24 hours, um, after typically your plasma will regenerate itself,

whether from, you know, hydration and the electrolytes, uh, which can

help, uh, your plasma regenerate, which we do give, uh, vitamin bags

as well at the end of the session.

So you're not as like.

Depleted, I guess, or as tired, um, for lack of a better term, uh, because

the tpe e does take out some of those electrolytes, but we would like to

replace them, um, and then help with what we call performance IV and even

give you some of those good amino acids, give you some of those, uh, good zinc

and those immunity, um, uh, raising, uh, vitamins like vitamin C we give and

it really helps out people's immunity.

I actually had a patient who told me she was like.

You know, like, uh, I think it was second or third TPE, she said,

everybody in my family is kind of sick.

She's like, I never got anything.

And I was like, oh, wow.

I was like, I mean, it could be, um, because of the extra electrolytes, it

could be because we're rebooting and helping your immune system, getting rid

of those inflammatory markers and those oxidative stress to help out.

So like, you know, hearing those things is really great.

like going back to your question, it's normally like just mainly like a fatigue.

You'll feel after it.

Um, some people might, they might not even have it.

I have one guy that goes out and runs or goes to the gym right after, which I

don't, I don't suggest doing, but he does.

He's like, yeah, I felt great.

I just went.

I said, okay, cool.

Um, but just let me know.

Yeah.

Yeah.

That's what I've heard from everyone else who I've chatted about

with or, or folks administering.

Yeah.

And that's pretty common.

But, um, I guess just to wrap it up, like what, um, I guess what, what

excites you for what's to come with TPE?

'cause it is so new, you're only six months in.

Um, yeah, I don't know anything top of mind because, you know, the more that.

And I like to ask this because I feel like at the end of these

conversations, typically it's like, whoa, there's a lot of toxins everywhere.

What the heck do I do about all this?

But like, there's gotta be some hope to it.

Some, some, you know?

And, and obviously you're talking about the actual way to cleanse,

so I felt like it's, it's a very hopeful conversation, but where do

Yeah, definitely.

You know, TPE, uh, I guess just.

That's the exciting part about it.

We're utilizing it in a way to get rid of these forever chemicals and these toxins

that have been in our bodies for so long.

And, uh, Dr. Savage said it well, like, we need to be educated on toxins.

Um, TPE itself, it, it is fairly new and it's, it's not for everyone, um, in

terms of, you know, whatever that may be.

Uh, but there's still ways that.

You know, we can, you can help and you can help your yourself and keep

away from these toxins just to create a healthier, um, environment and,

and a healthier life for yourself.

Um, a lot of that is what you consume, what you do.

You know, you visit our website, we have a bunch of learning

tools and education materials.

Go ahead and do a consultation.

Uh, talk about it.

Who don't mind, like I talk to me.

So I do some of the consultations sometimes.

Talk to the Dr. Ing, Dr. Savage, all of our amazing team.

Um, and it's just a quick phone call away just to discuss, Hey, I

have this one question, or, Hey, I was, uh, uh, subjected to a mold,

like how can I help with that?

Um, and really that's just what excites me about is the education,

the, the research that they're putting into it, and just being a part of

a company that everybody's excited

for.

Um, and the prospects, and of course, you know, the, um, the, the, just

what I've been seeing on my end and what patients have told me how

they feel, um, a lot of that is just, that's really exciting for me.

And just to continue pushing forward and seeing really, in a sense, results rather

than just, Hey, try it out.

No, it didn't work.

You know, so that's what really excites me about it.

Yeah.

Well, you're doing, you're doing great things, man.

And, and I'm happy, uh, yeah, you've seen from the er side of things and, and

that's, you were helping folks there, but now this is like a whole new, new

way, and I know you're not, there's gonna be many others that are like

yourself who are helping others as well.

So we'll keep doing the education on our side of the podcast and that you are too.

So

there go.

Yeah.

Which has been great

because been doing great with it, so

Thank you.

Well, thank you Mitch.

And um, yeah, maybe I, maybe I'll go join you for a, for a TPE session.

It's a little

Yeah.

Come on down.

Come on down.

You know, world of the Mouse

There you

go.

I love it.

I bring the kids for that one though.

Yeah.

There you go.

All right, man.

Well have a good one.

Thank you,

Thank you.

You do the same, Joe.

Have a good one.