In this insightful episode of the TPE Blueprint, host Joe Fier welcomes Angela Howey, a passionate registered nurse at MD Lifespan’s Detroit clinic, to demystify the therapeutic plasma exchange (TPE) experience. Angela shares her journey into TPE after a diverse nursing career, opening up about the powerful potential of this procedure to transform preventive care and chronic illness management. The episode covers what patients can expect step-by-step, the big lessons Angela’s learned on the front lines, and practical lifestyle shifts for detoxification. Whether you’re considering TPE or just curious about proactive health measures, this episode offers both empathy and expert know-how.

Topics Discussed

• Angela Howey’s Nursing Background & Journey to TPE: From med-surg, hospice, and oncology to becoming a TPE specialist—Angela’s awakening to prevention-focused care.
• What is Therapeutic Plasma Exchange (TPE)?: The basics of the procedure, how it works, and why it’s compared to an “oil change” for your body.
• Patient Experience: Step-by-Step Walkthrough: What to expect before, during, and after a TPE session—preparation, sensations, recovery tips, and emotional factors.
• The Role of Toxins in Fatigue and Chronic Symptoms: How environmental toxins contribute to everyday fatigue and why personalized testing is key.
• Lifestyle Changes & Toxin Avoidance: Practical advice on reducing daily toxin exposure—food prep, water/air purification, and making sustainable shifts post-TPE.
• Empowering Preventive Medicine: Why TPE represents a shift from reactive to proactive care and Angela’s perspective on coaching patients for lasting results.
• Managing Needle Anxiety & Preparation Tips: Addressing common concerns and ways to make the procedure more comfortable.
• Personal Stories & Patient Transformations: Real-life examples highlighting the potential of TPE to change lives.
• Importance of Personalized Protocols: How individualized data guides each patient’s treatment and maintenance plans.

Connect with Us

• TPE Blueprint Podcast Website: https://mdlifespan.com/the-tpe-blueprint-podcasts/
• Website: https://mdlifespan.com/
• Guidebooks: https://mdlifespan.com/guidebooks/
• Follow on Instagram: https://instagram.com/mdlifespan 
• Subscribe and Listen: https://mdlifespan.com/the-tpe-blueprint-podcasts/

If you’re inspired by new possibilities in preventive healthcare, don’t miss future episodes! Hit subscribe on your favorite podcast platform, share this episode with someone curious about detox or longevity, and check out our resources to continue your journey to empowered health.

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.

Could a simple blood procedure be the most proactive health

decision you've ever made?

Today on this episode, we invited Angela Howey, a registered nurse that works

at one of the MD lifespan clinics.

She's gonna reveal and walk us through step-by-step what

it's really like to go through.

A therapeutic plasma exchange procedure, A-K-A-T-P-E, and why this procedure

is completely changing the way that we think about detox and disease prevention.

Let's dive in.

Angela, it's great to have you here.

How you doing today?

I am great, Joe.

It's great to be here.

Yeah, and I'm excited specifically to chat with you selfishly a little

bit because I'm going to be doing TPE Therapeutic Plasma Exchange pretty soon,

maybe at the Detroit office where you're at, but you're, you're a nurse that's

hands-on doing this stuff every day, so.

It's

Yes, yes, I am.

pretty.

Is it pretty exciting?

I mean like it's now, it's your daily thing, but like, I mean, this

is a kind of a newer thing Right.

For you as well.

Yeah, it is really new for me.

I, my background in nursing is, um, well, I've been a nurse for about 20

years, so I've done a lot of things and I have a background in vascular access,

which is pretty much just poking people.

Um, I.

though, right?

To get it right for this.

Is my Jedi skill.

I, you know, I'm a little, I'm a little good at it, but.

I actually found this position, it's a, was a little serendipitous.

I, uh, kind of stalk LinkedIn for, you know, future positions,

always looking for opportunity.

And I saw this position for apheresis specialists.

It called for all of my qualifications.

And I was like, well, let's do it.

And a whole new world opened me, uh, with.

Plasma exchange and functional medicine, precision medicine.

interesting.

So you didn't have the background in it, but obviously you have the skills

and what's absolutely necessary for.

Uh, the poke more or less, you know, to, to do it right.

'cause there's definitely obviously, uh, important there.

And we'll talk about that.

'cause like, like we were pre chatting.

Selfishly, I'll, I'll ask you some questions of someone who will

be going through TPE very soon.

Uh, but yeah, like, so, so you found, I guess, what, what is opened to your eyes?

Like what's, um.

And you can maybe tell a little bit of your background where it's relevant

here, but like what are some big ahas now that you've, you're doing these

therapeutic plasma exchanges, what Daily?

Mm-hmm.

So I, I went from, uh, just, you know, regular, a med surg nurse into hospice

and then, um, which was wonderful.

I mean, I really do still have a hospice heart.

Um, then my cousin actually was diagnosed with breast cancer and

we sat down, we went over all of her plan and I knew nothing.

I knew nothing about oncology, so I decided to become an

oncologist, uh, oncology nurse.

So I went into oncology and.

I'm a nurse, so usually we have two jobs.

So I was doing, um, vascular access on the side and oncology full-time.

And I went back to school to become a nurse practitioner.

And the whole through line, through all of those is that we don't really do anything

to prevent people from getting ill.

We treat.

We treat people when they're already ill.

And the big thing that opened for me, like when I got into this position

with Exchange is that that we have an opportunity to help people before they

get ill to either delay their symptoms or prevent chronic illness altogether.

So.

I am actually re-energized in nurse practitioner school because

I'm like, instead of just writing prescriptions for people, because

with their chronic illness, we have a way to actually help them

because I mean, yeah, you as a nurse, you're in the front line

where not a lot of people are.

What?

Communicating with patients to the depth that you probably are right.

Yeah.

It's.

Primary care is like, the whole idea of primary care is to help people

like to, you know, to stay well, to have a relationship with them.

But our primary care practice is broken in our country.

It's very rare, like if you're a healthy individual, and I'm just saying healthy,

generally healthy, you go to see your primary care physician once a year,

maybe twice a year, you get your labs.

If they're good, that's fine.

Um.

It's hard to get back in to your primary care doctor.

If you just have a basic illness.

You, most people go to an urgent care because it's quicker.

And I feel like during the plasma exchange, obviously we have people like

we're captive for a couple of hours, so we can really talk about like their

symptoms and you know, what they're focusing on as far as toxin avoidance

yeah, it's interesting because this is a whole different aspect of care.

You know, it's this personalized medicine

Mm-hmm.

and, you, you mentioned prevention, so, and yeah, the healthcare

system definitely does not seem set up for preventing things.

It's more aiding or, um, what going after the symptoms after

something's already popped up.

Right.

That's correct.

I guess what, yeah, and you're re-energized.

So like what aspects are you seeing?

And maybe it's like with some patient stories, anything you can.

Like, are there some trends or things that are, you're seeing now

that you're kind of in the driver's seat, uh, that are different from

what you've seen in the past?

Well, I've seen people who, like my very first patient that I did here

in Detroit, uh, she was pretty much ready to retire and give up her career

because she's so fatigued and tired.

She's gone through all kinds of treatment with immunoglobulins, uh,

and she just really has like chronic inflammation and some autoimmune, um.

Disorders, but she's done three TPE sessions and she's said to me even

after the first one, she's like, I'm not really sure if I could

tell you that I have more energy.

But I can tell you that I've said yes to more things and I've

took on more projects, whereas she was before ready to retire.

And that's super, I mean, that's huge to me because it.

If a person can, you know, feel energized to keep going instead of

just hanging up, you know their hat.

I mean, that, that's huge.

that's, I mean, that's like a whole new re what refresh of someone who, 'cause I

mean, are there, are there trends like in the ages that you're seeing of, um, you

know, the type of people in there and, and maybe some of these turnarounds like that?

Well, it's interesting.

I've been to the Chicago clinic and the Detroit clinic.

I haven't been to the Orlando one, but I talk to the nurse Mitch

there all the time, and he seems to see like older populations.

I seem to see middle aged populations like myself, and there's some

younger patients in the Chicago.

The Chicago clinic.

So the younger set seem to be either they're having autoimmune, uh, symptoms

like inflammation symptoms, and they wanna get rid of them, or they want to prevent

that they've gotten their toxin test and they're like, no, we're just going to.

Go through this exchange and get rid of that, which actually

happens to be the boat I'm in.

'cause I had my toxin test and uh, I need to go have a plasma exchange.

That's what I.

Me too.

is that typically, and of course, you know, like we talked about the test and

Dr. Savage has been on here multiple times talking about know your own data.

Is that something that you walk people through?

Like are you, are you a part of that conversation at all with folks?

Not usually.

I am usually seeing the patients after they've already talked to

our physicians and they've settled on a plan and they're ready to go.

So then after they, um, I see them when they're in the chair, just,

you know, before we talk and have conversations about what to expect.

Yeah, that makes sense.

Well, how about like, on in terms of, 'cause now you're likely

getting, you know, prior to your, your, uh, in your nursing life,

you weren't thinking probably as much about toxins, but like now.

And I'm thinking of like what are, what are some of the most common

maybe illness trends or toxin related symptoms that you're seeing that

maybe folks listening or watching might be like, oh, interesting.

You know, like, sounds familiar.

think probably fatigue.

Yeah, looking back, um, I've had fatigue for a while myself, and

there's different things that you can do, but that's something I

think is more related to toxins in our body than I ever knew before.

So that's part of the eye-opening process for me.

And I, I feel that the patients I've seen that is the hugest, uh, or the

big, the biggest symptom that they have, sorry, is fatigue and they wanna

get rid of that so they can function and take care of their kids, grandkids.

I'm at 40 and I feel like, I don't know if that's the younger of the TPE group

or if that's the middle, I don't even know what I call myself, but, but like

I'm, I'm thinking of fatigue 'cause I'm like, yeah, I feel a little tired.

You know, I have two little ones at home, have my own business.

Things like this.

Managing things.

Obviously this podcast is part of it too.

Like are there common, I guess, signs of fatigue that you would.

Rank as like, oh, that's, maybe that's something worth

exploring a little further.

Yeah, there's a normal fatigue that you have like running after little

ones, being busy with your career, you know, you wanna stay healthy, but

if you're finding yourself just like.

At the end of the day, or four o'clock, five o'clock, just,

I can't function anymore.

I need to just take a nap.

Like a, you're literally hitting a door and you, you can't even

move or you aren't able to like get up and take care of yourself.

Those are like serious, like signs of fatigue.

That isn't the normal.

I'm tired.

I've been running all day.

Yeah.

Yeah, that's true.

It is a different feeling.

I think people should pay attention to those signs more.

It isn't really, I, I think, I thought for myself, like, I'm

just getting older, you know?

This is just a part of getting older and I think it's just a part

of being overloaded with toxins.

Like we don't know how good we actually can feel because we're so used to kind of

feeling like crap the whole for a while

I think that's, that's a pretty common thing that I, I see here in these chats.

But also just, I mean, just chatting with my own friends and family is.

Yeah, everybody has their own thing or different lifestyles, but

we're all exposed to toxins, right?

So,

Yeah.

and until we really know, you know, do the test for ourself and understand our data,

like I know I have a bunch of mold in me.

I'm like, didn't know that before.

And I'm like, didn't think I would be I in hot place.

But, um, you don't know until you, you actually see your own data, right?

Then you can kind of map a little bit more of that to maybe a symptom you're feeling.

you can say there's so many toxins to avoid in the whole world.

And when you start looking into it like, like I have in the past

year, it, it can be overwhelming.

And that's what I try to talk to patients about is just making small changes.

You know, every day just pick one area to make a change in.

And then once you have that down, like make another change.

like, and when you get your toxin test, you can see what you

really actually need to focus on.

Like, I have a really high level of BPA in my blood.

So I was not even thinking of BPA as being a, like I thought that would

not be what would be in my system.

So now I'm really gonna hone in and focus on how do I not expose myself

to BPA and plastics in the future.

Which it's so hard, right?

With the world of like literally everything seems to

be wrapped in plastic and it's

like, why does that even need to be there?

Like, why are you wrapping an apple and plastic for Stop that.

Right.

But it's, it's, yeah, but we, lifestyle choice is a even, you know, after

TPE of course is very important.

Um.

I guess, yeah.

What are your thoughts on that too?

Because like, of course you can clear the slate through TPE and get rid of

a ton of toxins, but there's still the changes after, after the fact.

Yeah, we ki I kind of, I think in analogies, so I kind of think of it like

you, your toxin load is like a bucket.

So once you go through TPE, then your bucket is pretty empty of toxins.

So then you wanna just kind of.

Keep it as low as possible, but every now and then you're gonna have a

rainfall of toxins and then the things that you can do to like scoop out,

uh, so your bucket's not full, the biggest thing is just to avoid them.

So, um.

Well, I'm ridiculous.

I didn't even wash my vegetables until I got this position.

I mean, I rinsed them, but I wasn't like, I'm just like a little dirt never hurt.

Like I'm like a, a typical nurse.

Well, you're either a germaphobe as a nurse or you're just like, whatever.

I'm not dying, and I was the whatever.

I'm not dying kind of a nurse now I'm like using vinegar and

soaking my vegetables and fruit.

Alright.

That's what I was gonna ask, like what's your protocol?

So it's vinegar and so like literally walk me through, like you get a

bunch of vegetables from the store.

Yeah, you get like your vegetables.

I definitely peel, uh, like peel my cucumbers.

I used to leave some of it on for the.

Nutrients, but now I peel them, uh, grapes.

I kind of used to just rinse under the water and not soak them.

So now I soak them in like vinegar and water.

Um, and like lettuce, I have like a vinegar water spray that I spray

and then rinse and the pat dry.

Hey, you laugh, but it's like these are all things that are

like, I'm like, I'm not doing that.

I know.

So.

Yeah, that, that was me.

I mean, I would probably eat even some dirty grapes like, 'cause

I just thought it was dirt.

But I've read studies even about like spinach and all of the heavy metals

that are like just on a spinach leaf.

And I'm like, oh man, I'm so dumb.

Yeah, I mean, well you're not dumb, but it's, uh, but I mean, I think all of us

can be, like, can probably say guilty, you

Yeah.

Very guilty.

Yeah.

and you don't know what you're, like if you're going eating out, I

guess you're hoping for the best.

Um,

Yeah,

I'm not gonna bring a little spray bottle with you everywhere, but

yeah, yeah.

I, I think, I don't drink out of plastic containers anymore.

I, I love coffee and I really struggle with not using my Keurig, so.

Because it's so fast, but it's so bad.

So I have

plastic cups, right?

yeah.

What do you what Do you go for coffee then instead?

well, if I was real good, I would do the pour over and grind my own

beans, but I'm not that great.

I, I'm still opting for a little bit of speed, so I have a single

use coffee maker that I just.

Have my pre ground, ground beans and go, but it's like an aluminum

or stainless steel basket, so

That's better.

Yeah, I, I do something similar with the espresso machine, but like,

yeah, pour overs are great, but like, what do you always have 15

minutes in the morning or whatever?

It's to

I do not,

Yeah.

Most people don't, but, well, no cool insights.

And that was a little diversion from what I was thinking about.

That's good.

That's all good.

Uh, what, what do you think, like now that you're, you're in this

whole, the, I mean, you're working with MD Lifespan and you're.

You're literally getting patients coming to you because they

know they're toxic, you know?

And there's toxics and toxins in 'em.

Is there any like misinterpretation of detoxing or like is there a

different frame that you give people or an understanding of, I guess,

what that means and how to do it?

'cause TPE is part of it, of course.

a lot of people that I've seen so far are really knowledgeable

about toxins and they want.

You know, to detox and they're serious about the lifestyle

modifications that they'll need to do to keep their toxin low, uh, down.

I think if I've seen anything, it would be that you can just do plasma exchange

and you're good to go and then you can go back to your lifestyle and you'll be fine.

But I haven't seen that too much.

Really what I've seen are people who understand that.

Detox isn't just like a liver cleanse or something that you can drink

or it, it really is modifying your lifestyle to avoid toxins, uh, your

toxin exposure, knowing that you're not gonna avoid toxins altogether.

Yeah, it's, they're not going in away, going away at all in the

world.

Seems like there's a lot more popping up, so.

We've had a lot of episodes.

We probably won't go into it in depth here 'cause I have some other ideas, but

yeah, definitely for listeners watchers, go watch some previous episodes with Dr.

Savage and I mean, almost everybody else talking about like how, what,

what things to avoid, you know, air, water, um, just inside the house,

like cleaners and things like that.

Right?

Yeah.

Yeah.

Dr. Savage has some great recommendations for air filter.

That was also another thing that I did once I got this job is.

Got an air filter from my home and water filter.

I was just drinking the dirty Detroit water from the city, not filtering it.

Risky.

I mean, you know, I live on the wild side.

but that's most people, right?

Like you just don't know.

And.

Um, yeah, I know there's places, there's ways to actually look up your area code

or your zip code and see like the kind of stuff that's floating around in your city.

Water, county water, and it's pretty eye-opening.

We have someone coming on pretty soon to talk more about that,

Oh, that's great.

Yeah, it really is eye-opening to start.

Pay attention to that.

Yeah.

Yeah.

So when it comes to TPE, because I wanna walk through kind of like some of the.

I guess the experience that someone has when they go through a procedure.

Of course, selfishly, I want to kind of know what I'm in for

too,

but like before that, if someone's listening, watching and they're, they're

just kind of understanding what TPE is like, could you, I guess, describe

it in a way that would, that's almost empowering, because I know some of it

could be a little bit overwhelming or a big commitment, you know, but like, I

guess, how would you frame it to someone who's just kinda learning about it?

From a nurse who's literally doing it daily for, uh, for patients,

I think of the concept and Dr. Savage just says like an oil change.

I really think it's empowering because.

This is how I talk to, to people.

It, it, it is a procedure.

It's not a, it's not a small proce.

It is, you are not going in for surgery, but it is a procedure and

some people are quite concerned about it, like rightfully so.

I think if you come into having a plasma exchange knowing that

it is a procedure and you have to take it seriously, that's great.

It's not just.

Like going to a med spot and getting hooked up to an iv.

That's, that's not it, but it is an empowering thing that you can

do to proactively change your life.

Like you might not feel the effects from it.

You might not feel any different even after three or five like,

uh, exchanges, but you will be rid of all of those toxins.

And depending if you have no symptoms, then you're then.

If that might happen, you might not feel any different.

Most people feel a little bit different, like they have more energy or less

fatigue, but you're doing something proactively that you might not

even know for the next five years.

Like you might have these toxins in your body and you might not feel any symptoms

for five years or so, but by the time you have a symptom and you go to your doctor

to treat the symptom, like damage is already done, it might not be reversible.

You just have to take.

A medication for that, for whatever chronic disease you have.

Got it.

So basically going to the source early,

right?

yeah,

that's how I really, I think of it.

And if you do have symptoms and you already have like an autoimmune disorder

or some other kind of, uh, chronic inflammatory disease, you, this is one

of the best things that you can do.

Outside of just taking treatment for whatever it is like to change your

WIC because you're actually like resetting your immune system so your

immune system can function properly.

Like our bodies are, you know, diseases.

Of aging, like my age, um, happened because of chronic inflammation,

and it just creeps up on you.

You don't even really see it.

And this is just kind of a way to reset your body to do the things

that it's normally supposed to do.

Like our bodies are amazing.

They're wonderful.

I mean, we all have superpower of healing within us.

We're just overloaded, you know.

Like, kind of like a, our immune systems are kind of like a crane

that has too much weight on it.

It just function.

It can't function and it breaks down.

So plasma exchange is like getting rid of that load so your body can go in,

fix your immune system, and then you're good to go and you can carry the regular

immune load that you're supposed to carry,

that's a good analogy with the crane too, because like yeah, we are taking on so

much, even without knowing, but like.

Like we talked about just the toxin load and burden that we're all carrying

already, but then just our lifestyles.

Right.

Like and, and stress, inflammation.

I mean, like you said, that's the source of basically everything, right?

Like all the disease?

it really does boil down to that, you know, the.

Chronic inflammation of our life.

Yeah.

Yeah.

And, and getting to the cell cellular level where you can clean that out

and actually have that function properly again, um, from the ground up.

Well, how about, let's walk.

So let's, um, I'm your patient.

Let's, let's just, let's just do this because, um, and maybe,

maybe you'll actually help me.

I don't know if I'll go to Detroit or not for my TPE, but.

Um, you know, I'm, I'm thinking, it's almost like my brain logically is like,

okay, what do I gotta know before I go, you know, I'm signed up, you know,

I know my, I've done my toxin test.

If anybody's curious, you can go see it.

We did a whole episode on it.

So that's where I'm at right now.

So like, what's the stuff beforehand I should be kind of preparing myself for?

Um, and then, and then want to get into like the during

and then kind of the after.

For me.

For me, I have five sessions that Dr. Savage recommended.

I heard it's what, three to five typically for folks?

Right.

Correct.

It's typically three to five.

Number one, you can go to any of our locations and our

nurses are gonna be amazing.

So though you will be taken care of.

So beforehand, you really, uh, just have to prepare yourself for the day.

So if you're gonna fly into one of the locations, just prepare yourself

that you're gonna be tired like that night of probably the next day.

If you're, you should.

Probably not drive like I have patients that drive to me.

So I typically like at recommend, don't drive until

you know how you're gonna feel.

Some people feel great and they can drive afterwards, but the first

one, we really want you to just take care of yourself and not drive,

because you could be really fatigued afterwards and I would expect that.

I would tell you you're gonna be real tired, kind of like you have

the flu achy, so don't plan to.

Do anything su like, don't run a marathon the next day.

That's what I would tell you.

Yeah.

Yeah.

So plan it out like you're gonna need a day or two to recover.

And are you seeing most people traveling in for the procedures?

It's like half and half.

Yeah.

and half.

Yeah.

So this, I mean, this is applicable to most people for me especially,

but, 'cause I, I'd be flying in and essentially flying back out

Yeah.

fairly quickly, but I wouldn't be driving, so that's good.

is, is there any prep, like let's say before I hop on the plane or like, you

know, is it like a week before or just days before, uh, going to an office?

like the day before.

We don't want you to eat anything real fatty because if you have

like lipids in your blood system, it could affect the exchange.

Just there's sensors on there that can, if you have like a fatty meal

the day before or the morning of like it'll affect the exchange.

So we really just want you to like eat a normal healthy meal that meals the

day before, but the morning of, which is really hard for a lot of people.

'cause there's people who are fasting or just don't eat breakfast the morning of.

We want you to eat a good meal.

Good protein, like some carbs.

And when I think of a hardy meal, I don't know why, but potatoes always like pop up.

So yeah, eat a good, a good meal the morning of that just helps

prevent like high, uh, like low blood sugar during the process, uh,

with hypotension, uh, afterwards.

Yeah.

And I've, I've, I've read that as well as like, just go in full, right?

So you're not fast during this whole thing.

You said n not a lot of fatty stuff, but get, get protein, some carbs.

And yeah, it's essentially satiate yourself in a way where you're

not gonna, you know, because it's gonna be a procedure, right.

For a handful of hours,

so,

Yeah.

Now, the other thing is we don't want you to hydrate the morning of, like,

don't get up and drink a ton of water.

We want you to stop drinking an hour before you come into your, uh, procedure

because we, you're in the chair for a couple of hours, so having to get up

and go to the bathroom is not an option.

Ah, yeah, I've heard of that.

Where, um, I think it was Dr. Lee, ed Lee was telling, he was telling

me about one of his patients, and yeah, they had to cut it short because

one, one of the patients had to.

Restroom, so

we could.

We do have urinals and bedpans, but nobody wants to do that.

Right, right, right, right point is just, yeah.

Cut off the hydration hour-ish before.

Okay.

That's fair.

Well, how about this?

So like, Angela, I walk through the office, I, I greet you or you greet me.

Like, I guess, what does that look like?

What's the, what's the day look like once I get there?

Well, once you get here, I'll ask you if you have to go to the

bathroom, then get your height and weight and your vital signs.

Let you get comfortable.

Uh, people usually bring a phone or your, you know, your, um, like earphones.

You can talk to me the whole time.

I'm totally fine with that.

Some people don't like to converse, so they just listen to podcasts

or anything like the book on tape.

So then I will scan your arms with an ultrasound to look at your veins.

I want like the best vein, uh, possible.

So we'll start two IVs, one in each arm.

So one is the return iv and that's like a smaller iv.

And then the other one is a little bit larger gauge of an IV because

that's the one we're gonna pull the blood from that will go into the

machine and, uh, separate your plasma.

Gotcha.

Okay.

So basically lounged out in a chair, two arms out.

Yeah, I, two different IVs.

And I like the ultrasound concept

Yeah.

it helps you, but also helps you know the patient not to do a miss or so.

that it, it really is helpful because we wanna make sure that we're not putting

the IV access up against a valve.

We wanna make sure that we're far enough away from any bifurcations in your veins.

We just wanna make it the best, uh, stick possible.

So how about, so, uh, what's the duration?

And I guess, uh, like what would people be.

Yeah, everybody experiences differently and obviously everybody has different

relationship with needles too.

Um, I guess what's your best practices like for someone to hang out?

Like I guess what is that experience once they're hooked up?

so once you're hooked up, then.

You have a job to do, you're not done.

You have to squeeze a ball to keep that vein open.

It can be really tiring to like just squeeze a ball for two hours.

Um, most people, it's about a average to, um, two hours

actually hooked up to the machine.

It could be a little bit longer depending on how much plasma we're gonna remove.

Um, so we test, when we start the iv, we will test your blood to,

uh, for your hematocrit level.

So that really, um.

The hematocrit and your height and weight kind of, uh, help us figure out

how much we're gonna pull off of you, how much plasma we're gonna exchange.

What's the hematocrit level?

What's, what does that,

the hematocrit is how many, uh, packed red blood cells you

have in your, in your blood.

So,

Got it.

Okay.

So the what, the more you have, would it be a little,

uh, I guess how, yeah, how, how

the lower your hematocrit, the more plasma you have essentially.

Got it.

Okay.

So you might take more out from someone if that's the case.

yes.

Yeah.

If, if they have a real low hematocrit, we don't, we don't take out like as

much because that is, you know, could be dangerous, but, or not, I shouldn't

say dangerous, but we don't wanna have anybody like have low blood pressure, so.

Got it.

Yeah.

So once you're hooked up to the machine, um, and you're pumping your arm, you'll

start to notice like right away that the, uh, plasma separates from the blood

and you can see your plasma like fill up a little, uh, little bag and, um,

and then your blood starts circulating back into your system with the other iv.

Um, and then we, as we.

As they separate, we're also giving you a replacement fluid, uh, 5%

human albumin, which is a similar color to your actual plasma.

But, every couple of minutes we load another, like vial of the albumin.

And if everything goes great, that's fine, but usually we have

problems with some alarms because the pressure in your intake is.

Uh, down, so I'm monitoring the pressure of your va, uh, your,

the veins and the intake, and then your job is just to keep pumping.

It's a little, it's a little harder than it sounds because if you're watching

something or you're talking to me, you can, you can get distracted and not pump.

Right.

Yeah.

It's, it's your, it's literally a team sport right now,

it

right?

You gotta work together.

yeah.

Yeah.

So, yeah, that's two hours.

So you're kind of Yeah, I'm sure.

Hopefully getting in the zone, you know, and, and maybe people need

to do, uh, those, I forget those, um, yeah, group strength, uh,

exercises before they end up going.

Maybe that's a prep.

Yeah, you could do that as prep.

You could start getting yourself a little squeeze ball, so

get your forearm used to it.

Group strength.

I, I heard it's good for your long or, you know, it's a determinant.

I dunno how true that is, but

I just heard that as well, so I. On my drive to work,

I have a little Griffin Grip

Do.

There you go.

See, maybe it's, I, I don't know the research behind it,

but I've heard it quite a bit,

I don't think it could hurt, you

yeah.

Yeah.

Well, can't, yeah, I can't hurt you.

So, so during, during the fact, so it's about two plus hours in the chair.

Um, anything else going on that, I guess it's that process, right?

The, the whole time it sounds like.

Okay.

Until you're complete.

Yeah, and it, it seems like a lot, sometimes it goes faster than

others, depending on, you know, how fast we can run the machine, which

really is determined by a person's vein and where we can get access.

So that's what we monitor.

Um, we monitor the pressure on the machine and then also we're monitoring

you to make sure that you're doing okay.

Typical symptoms that we see, um, thing that we use, we use calcium citrate

to prevent clotting in the machine.

You, most of it is taken out with the plasma, but some of it gets back

into your blood and then binds with your calcium in your bloodstream.

So we can see signs of hypocalcemia, which is really just like tingling

around your like nose or your mouth.

It's this real funny light feeling.

We do replace calcium proactively.

Most of our patients don't have any symptoms whatsoever.

If they do, we give 'em a little extra calcium, uh, with the albumin.

Or a Tums if they need it.

But most people do fine.

Uh, some people get a little hypoglycemic and we know that because they start

yawning, like mid, mid exchange.

They just start these big yawns and then they're like, no, no, I'm fine.

And we're like, drink this juice.

Yeah, you, I would trust you.

You've seen a lot of folks.

well that's great.

And that's, that's, I think it's, it's good to know for everybody here in me, um,

you know, the nurse, you're in good hands.

Not only are they, you know, you're looking at the machines, but you're

looking at the person too, and just checking in throughout the whole thing.

Good.

So I guess what happens, uh, unless there's anything I'm missing enduring,

but like, let's say right after, like when it's wrapping up, you know, that

first session, or maybe it's the third session even, uh, what's, what's gonna go,

Depending on your hematocrit, sometimes there's like only ever 160

milliliters of blood out at a time.

So it's not like we're a bunch of vampires and we're draining all of

your blood and putting it back in.

So even if something were to happen, uh, and we had to like turn the

machine down like some, I can't even think of what would happen,

but just if there was an emergency.

We, there's only 150 or 160 milliliters of your blood out, which is not that much.

So depending on your hematocrit, if you have a high hematocrit, we're not gonna

give you that 160 milliliters back.

If it's under like 45%, we'll give it back to you.

That takes a few minutes.

But we can take that large IV out at that time, and then you just have one IV in.

And then depending on your protocol that you're getting, we'll, we'll

give you IV infusions afterwards.

Gotcha.

So then you're just kind of hanging out with the iv.

You can move your arm, you can get up and go to the bathroom, uh,

eat, you know, anything like that.

So,

Nice.

Okay.

So, and, and yeah, everyone has a different protocol and you know,

there's a lot of information on MD lifespan about this as well.

You know,

different guidebooks to go check

out.

Um, but, so that sounds like that that would be like a separate, I

don't know, is that infusion typically or is it a mixture of other things?

Yeah.

There's different, there are different infusions.

and that's, that's the awesome things.

'cause you know, the physician's gonna talk to you about that

and based off of who you are.

So it's, it's legitimately personalized too, whatever your goals are.

Right.

Yes.

Yeah.

I like that part.

It's not a one size fits all kind of thing.

Right.

Yeah, it is.

It's pretty incredible, actually, but I, yeah.

So what happens when, so you might be fatigued afterwards.

Someone goes, you know, you go home, however you, you get there.

Um, ideally not driving.

What's happening?

What, there's like a month gap, right?

Between sessions and.

Yeah.

So right afterwards you will probably feel tired.

Sometimes people kind of have a reaction, uh, depending on how many toxins and how

many, uh, bad autoimmune complexes they have in their body, they might have.

What we call a her hercs like reaction where they're kind of tired and achy,

almost flu-like for a day afterwards.

So like that day or two, depending on the person you, you know, you

might have like aches and pains, like you feel like you have the flu.

but most people like really like the second day after,

like the day after, real tired.

The second day after they're, they're better.

So.

a lot of people during that four weeks just go back to their normal self.

Some people I've heard, like, um, they feel real great and then

they notice when the toxins start coming back in because you're.

Blood.

Your blood, your circulatory system is kind of like a roller coaster.

And so we like the toxins are just kind of lined up, ready to get on board.

And so we do the exchange and they go through and they go off, and

then there's more ready to come on.

So around that like.

Three, four week, your, the toxins are kind of back in your

blood, your circulatory system.

So some people have said, they start feeling like, oh yeah, I need, you

know, the second one because I'm really starting to feel fatigued again,

I mean, that goes back to Dr. Savage's analogy of the oil change, right?

It's like, yeah, you do the oil change like to an old car and you drive it

around for a while, and then it's bringing out the gunk again, right?

And.

Yeah.

Time to clear it out.

So, and you said anything else between the sessions that you recommend folks to do?

Well, most people, uh, have a. Sign on for a plasma exchange protocol.

And with that comes our, uh, MDL clean supplement.

And that actually has a lot of the nutrients that is gonna help your

body, like rebuild all of the good things for your immune system.

So we really recommend everybody, uh, doing that consistently every day.

Some people, uh, can only do a little bit and every, some people do it a lot, but

the more consistent you are with it, like.

Seven days a week.

The, the healthier you're gonna feel, the better you're gonna feel and the

more your body's gonna be able to regenerate those, uh, good things

that your immune system can do.

Nice.

Okay, cool.

Yeah, and I know those are all dependent on, um, yeah, the protocol.

You'll have, uh, different things.

Yeah.

And I usually have, I talk to, uh, people and find out what.

Obviously they're focused on, because usually everybody has something

specific they're focused on.

Like for you it would be molds.

So I would talk to you about like, you know, where do you think the molds are

coming from and like in your house, your, like I have coffee molds that

are found in coffee and I'm like, oh that's right on board for me.

'cause I drink a lot of coffee.

But

I mean, that might be me too.

I have a cup next to me, so I haven't finished it, but Yeah.

And I've heard, yeah, molds can be in a lot of coffees too.

That's an issue.

So.

Yeah.

Yeah.

So that's where your toxin test will really kind of tell you

like what you need to focus on.

So I just discuss it with each person and then we kind of pick something to

focus on, like in their like life just to, uh, modify their life to avoid those

toxins or help reduce exposure to it.

Yeah.

I mean, you can't totally prevent it, like you said these days, unfortunately.

But.

That's, I mean, it's good that now you know the data from before and yeah,

you can, can kind of work through your goals and what you can kind

of control and then, uh, what, then you get into round two, round three.

And is it kind of more of the same or are there any differences in feelings

or expectations in the future session?

Usually people tolerate the subsequent sessions better because the first one

you're, you're getting six rid of like 60% plus of the toxins that are in your

body, so you're gonna feel more tired.

That first one.

Usually people tolerate that second and third, um, one better.

So, and they have more energy and then, and then.

From a nursing perspective and like lifestyle modifications, we just

talk about how they've been doing, what they've been doing differently,

and, um, what they wanna focus on.

Yeah.

And then the, and of course the different protocols, depending on your protocol.

We do different, um, infusions after each one.

So, um, that could be different, like depending on what protocol you have

and which, um, infusions we're giving.

so I, it really comes, and that's why I love about this, is know your data.

You sync up with the per, uh, with the, uh, physician and.

Really, you get like, you get so much more of an understanding of what's

happening in your body, but also like what you can do about it now and then.

I think that's the big change, right?

it really is empowering because you're.

Essentially preventing yourself or doing the best that you can outside

of like diet and exercise, right?

Like those are things that we know and it's also, you know, a

lot of people we're not great at.

But it gives you more incentive because exercise actually like,

helps you also detox your body

For

and, and the food you eat can help you detox your body.

So those are wonderful things to like help focus on.

Nice.

Yeah.

Well, I think, is there anything that maybe I should have asked you

with the, you know, as a patient trying to get my, my head around the

experience and you know, what to expect.

I think we went over most of everything.

The, the poking it.

Some people really have an issue with the needles.

We try to do the best that we can to make it as painless as possible.

Of course, when you're getting poked with a needle, it's.

Gonna hurt a little, but we have, uh, some pain relief measures that we try

and we really focus on, like breathing and try to like, have some distraction.

Uh, so, but if a patient does have real fo needle phobias, like letting us know

that so we can prepare for that and help 'em through that is really key.

And I know everyone's different, but, um, yeah, like I, I love breathwork,

so that's definitely what I'll employ is, you know, maybe load up some tracks

from YouTube or some apps, you know.

And,

um, any, have you heard of any recommended, uh,

soundtracks that people like

Oh my gosh.

I actually, we just had a patient in Chicago and she told us we need to come

up with our own, like TPE, like playlist.

So I think that we're taking suggestions, but she had like,

you know, the Rocky song.

Um,

yeah, there was a couple of those, uh, empowering songs

like that she recommended.

That's good.

Yes.

I mean that's a hundred percent like come prepared with a playlist or

whatever it is that makes you feel great.

Right.

Well this, this is awesome.

I mean, Angela, this is, it's helped me honestly be a little bit

more comfortable going into it.

Um, and.

Yeah, I mean this is like the deepest dive I've experienced with the,

well, the actual experience so far.

Of course, I'll report when I do mine, but yeah.

What were you gonna say?

Oh, I was just gonna say yeah, because you have the idea of the plasma

exchange and you, and you have all those intellectual like things about it, you

know, it's good, but then to actually do the actual procedure, it's uh.

A different thing.

And actually when I got this position, I actually went and donated plasma because

I wanted to see what it was like being hooked up to the machine and even just

donating plasma, I was a little nervous about it because it's a big needle.

It, it's a little bit scary because they talk about, you know.

The different, you know, things that could happen and it, I actually think it helps

me be a better nurse because I know what it's like to be hooked up to the machine.

Now, plasma donation is not an exchange.

I was not hooked up for two hours, But

But

similar needles and

uh,

yeah.

That's good to know.

I mean, for people who have donated plasma and you know, it's just to

kind of frame that timing differently, you know, like the duration, but,

got it.

Okay.

Cool.

Well, I mean, this is, yeah, this has helped me a ton and I, I, I hope I

go visit you in Detroit, so I gotta

Well, I told you it's the nicest one.

But to your point though, you know, the nurses MD lifespan, I know

there's like some really cool training that, that, that keeps everybody,

uh, looped in on the latest, right?

Like,

We're all vascular access trained nurses, so we, uh, know how to use the

ultrasound and start IVs and we are really big nerds about your veins, so

just be warned if you have good veins, we might nerd out about it a little bit.

But, um, I think all of our nurses are great and wonderful humans.

Very caring.

I've definitely had some bad ones where you're just like, Ooh, I don't

know if you should be around needles doing that, so, but I know, yeah.

MD Lifespan, I mean, everybody on the team is like super particular

and um, you know, very knowledgeable,

so.

That's good.

Well, Angela, this has been super helpful for me.

I hope it helps everybody else too, kind

of just getting more of a

too.

Yeah.

So, um, go check out MD lifespan of course, and, and

you know, check out a location.

But I, I would urge you to check out those guidebooks too 'cause there's

a lot of cool information there

on the protocols and, and really understanding a little bit more

and they get that toxin test too.

Yes, the toxin test is amazing.

Yeah.

All right, Angela, well appreciate your time.

Thanks, Joe.