Topics Discussed Include the Following...

*Transforming from ER Doctor to All-Cash, Specialty Practice. The personal story of how children do a "happy dance" because Dr-Mother gets to take better care of patients and sleep at home every night (with more money as a side-effect).
*What free strategies work better than expensive TV and Newspaper ads
*When to buy the machines (and when not).

Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips


Charles Runels: All right, guys! Let's get started. Should be a great meeting tonight. We have a couple of guests and good stuff happening. So before we jump into it, I think I'm going to just go ahead and introduce one of our guests tonight, Emily Porter. Let me unmute you, Emily ... there you are.

Emily Porter: I'm here.

Transforming from ER Doctor to All-Cash, Specialty Practice

Charles Runels: Beautiful! So, Emily, you had several things we wanted to talk about tonight. What's happened with you? You were in Vegas and met some people. You just went completely, no more insurance, no more ER, and you've got some things you've been doing with P-Shot®. So, talk to us. Share or pretend like someone just joined the group, because some of the people in the call have, and give them some advice and teach us some stuff. I don't even want to direct you tonight, just talk to us.

Emily Porter: Ah, okay! So, I'm board-certified ER. I did that for about eight years, eight or nine years, but I kind of always wanted to do aesthetics. I wanted to actually be a reconstructive plastic surgeon, because I really wanted to help people and change their lives. I had a lot of scars when I was a kid, a lot of surgeries, and it turns out I hate the OR. I want to help people, but I hate the OR and you just can't undo that, so I thought I'd do dermatology because I like that stuff and I had melanoma when I was 21 and it was so boring to me, so I ended up in the ER. It seemed to be the best fit for what I thought I wanted to do and then, I think probably just like everybody else.

Emily Porter: ER has a really high turnover. It's just difficult enough, patients are hard enough, they're hurting, they're upset, they don't like to wait. And now, you've got people that are upset about how much they're paying, their co-pay, patient satisfaction scores, and you've got corporations that are hiring Disney and the Ritz-Carlton and Toyota for [lean 00:02:12] management and patient satisfaction scores. They're basically telling you how to do your job. And it's not about your patient outcomes anymore, it's about whether you made people happy, and it's just hard to do that in the ER.

Emily Porter: So I got Botox® myself when I was 35 and got it a couple of times, and then I seriously thought, "Well, why am I paying somebody else to do this when I can do it myself?" So that's kind of how I started, I went and took a weekend class, and I just did it with the intention of I'm going to work my ER job, and I'm just gonna save some money on my Botox®. And I got on the plane to Arizona and did a little weekend thing with Botox® and filler and ... knew that I needed a lot more training. It was a horrible training, actually. But I basically told my mother who was my model that I was gonna open a med spa. And my mom is an entrepreneur, and she's very much like a tough love kind of person, and my mom goes, "I think that's a great idea!" And so I knew I should do it.

Charles Runels: Who? Who?

Emily Porter: My mom didn't put me down and tell me I'm crazy. She goes, "If you told me you were going to open a clothing boutique, I would tell you you're stupid! But I actually think that this is a good idea."

Emily Porter: So that was like May of 2016. By the end of September, I owned a laser, I owned a VISIA system, and I had a one room rented in a hair salon that I was running, it was like a 10 by 10 room with a three-week old baby. And I started my business.

Charles Runels: Cool.

Emily Porter: I started with a PRP. I took the training from Dr. Pete down in Houston, because I thought this was kind of new and trendy and I like the medicine. I like the science of it. There were a couple of people doing it, but not everybody. If somebody's starting out, you have to do Botox® and fillers because that's just what people expect of a med spa, and you have to be good at them. But I got some advice from somebody to get a laser. She wished she had gotten a laser sooner because you have to pay it every month, but you make thousands of dollars every time you turn it on, if you do a good job. It really is the thing that probably generates, time and time again, the most annual revenue for me.

Emily Porter: I have a Sciton [inaudible 00:04:36] and I'm very happy with it. Anybody can e-mail me; I'm happy to talk about my experience with them. One of the things that Sciton does is that they put you in contact with good and they want you to be successful. I don't work for Sciton; I don't get any kick backs for it or anything. They have this thing called the success builder program. I knew that I didn't know anything about business and I didn't know anything about marketing, so they sent me to see some consultants and to talk to some people.

Emily Porter: They're actually how I ended up doing my vampire training with Dr. Pete instead of with you, because Johnny helped with diVa. That's their vaginal laser, so he was closer than you were. I reached out to him, and then he told me about bioidentical hormones, so I kind of figured out what my menu was going to be and just sort of listened to the people around me that were smarter than I was or that had more experience than I did. Which is, I think, a problem for a lot of physicians, because we're all really smart people, but we don't know shit about owning our business.

Emily Porter: I mean, you don't learn any of that stuff when you're in medical school, so I hear over and over again that physicians are suckers, and we kind of are. They get sold a lot of stuff, and I fell prey to it a little bit, spending money that didn't get me money, spending a million dollars on your build out. It doesn't make you any money. You have to be nice, that it's not unsterile, but you don't need a $500,000 fish thank. It's not going to make you a dime.

Emily Porter: So, I see people that meet with these consultants that messaged me through this Facebook group that I run. They spent all this money on stupid stuff, and they could have had a SkinPen and some PRP tubes, trained with you or with me and be making money sooner. Instead, their businesses fail because they waste all this money on the wrong stuff, and I don't know how to emphasize that enough, other than you have to be smart about where you're spending your money, and don't get oversold on every little thing.

Escape the ER<--

Emily Porter: So, I thought I'll do [Vampire Facial® 00:06:37] stuff. I didn't do a whole lot of the facelifts, just because Dr. Pete didn't actually teach those, but I did a few O-Shot®'s and I did some P-Shot®'s, and I did some BBL photo facials. I had one esthetician who worked there for me the 40 hours a week that we were open and I was still working in the ER. And then when I'd have days off, if we had an appointment, I would come in. And if we didn't have an appointment, then I paid her $18 an hour to answer my phone and do laser treatments on clients that I already seen.

Emily Porter: Then I started doing the build out of 2,000 square foot place. Now that I had a clientele of a few hundred people, I don't know, 300 or 400 I think after six months just with word of mouth marketing. I was in a hair salon, so the people that had the hairstylists, I gave them free stuff or I gave it to them at cost. And then they've got people that are prey to them talking for an hour, so [inaudible 00:07:35] would say, "Well, what is she doing in there?" And somebody goes, "I hear she's making the orgasms better!"

Emily Porter: Right? I've got a bed; I can do an O-shot® in a bed. [inaudible 00:07:45] my room had blinder shades and stuff, so it was real private, but I did P-Shots® and O-Shots® in a 10 by 10 room and did a little bit of Botox®, and fillers, and a little bit of laser treatment. And then I built out my space, about 2,000 square feet. Every time you grow, there's always growing pains, because I had to hire more staff now. That's the thing that I found to be the hardest is so much staff turnover. I respect the way that you talk to your staff. I've seen your staff, and I know it's hard. They can't read your mind, but sometimes it's hard to have people that can keep up with you and can understand what you want from them.

Emily Porter: People are lazy [inaudible 00:08:24] on a post it note. She literally quit on a post it note like two and a half months into her job, because she thought that it was too hard. She was sitting at the front desk making crazy money. I gave them all free treatments, too. And she quit on a post it note. If there's been a lot of turnover, that's hard on staff, and it costs a lot of money to train people, so I learned slow to hire, quick to fire. That was one of the things that I learned. You give people 90 days and if you're not a good fit, then you just move them on along and find the next person.

Emily Porter: Get a good manager up front. Tracy's probably one of the main reason why my business has really exploded the last say six months, because I hired her in May. She had management experience, and she can hire people and she knows who she can direct and who she can't. She knows how to run a tight ship. I think doctors, I don't know, a lot of us are really anti-conflict. I hated that in the ER. I hated fighting with people. I hated worrying about whether they were going to shoot me because I didn't give them hydrocodone or that they were going to egg my house or whatever because I didn't give them the Z-Pack they wanted. So I have a manager that can kick ass and take names and people respect her. That allows me to not have to worry about the day to day stuff. I say I'm only one person's boss, and that's my manager. She's everyone else's boss, so that's helped a lot.

Emily Porter: And then I just started listening to you honestly, about some of your marketing stuff. We do an open house every year. We did our grand opening. We publicized it pretty well, but I made some mistakes. I mean, I spent way too much money on newspaper marketing. The one newspaper that everybody reads, I spent probably $60,000 my first year and I think I got two patients. You have to be able to track where your people come from, your leads. You have to know where they come from or you can't ever know whether that was a good return on your investment.

Charles Runels: Okay, let me stop you right there. I want to stop you right there before you get further about the newspaper. I'm not saying don't do newspapers, but I've heard that over and over again. One of the top people in our group who just sold a bunch of clinics, that he built very quickly out, and sold them out, he came to one of my workshops. When I talked about how your advertising does not need to be real expensive, he said, "We built the whole thing." He was up to, I think, six clinics when he just recently sold out. But the whole thing on Botox® parties and the other things that I talk about, he found that the ads didn't bring any return. Newspaper ads brought him nothing.

Charles Runels: I've had a few people who have done well or had some return on television ads put in the right place, but it has to be in the right order. If you throw the ball, somebody has to be there to catch it. Here's the thing about a newspaper ad or a TV ad. It could be if you go back now and we do those same things, it may work. Because what happens is you can't really sell someone on the idea of having their blood drawn and a needle into their genitals with the space in a newspaper or a TV ad. All you can really do is create curiosity enough for them to then find out more, so if you create the curiosity and then they try to find you on your website and that's not thought out properly, or whoever answers the phone has to sit there and try to explain what an O-shot® is, which takes too long to do. Then it's ... You just pay, you made a $60,000 pass as you just said, and thereby there was nothing to catch the ball.

Charles Runels: On the other hand, if you flip it, and we have people who sometimes are excited. They do somebody's class, usually not mine, but someone else's class or something, and then they immediately want to go buy ads. My advice is always stop, first do the basics, which I think are a video on a webpage where that webpage is nothing but devoted to that one procedure. The whole plan is laid out right here. I'll show you where it lives. Once you get this in place, now when you arouse curiosity with your newspaper, TV, or radio ad, now there's place for them to land and find out whatever else they need to see. With some people, it's going to be they want to read the science. Some only want to see that six celebrities had it done. Others want to see ... Whatever it is.

Charles Runels: All these websites are made the same way. So if you go to the dashboard and click on the marketing part and then if you do the basics and then keep doing them ... So, if you do the basics and then you get six patients. Well, repeat! The basic plan is right here. It tells you everything that you need to know to get this thing going. And I think that's what you're saying [crosstalk 00:13:35] What's that?

Emily Porter: I'm not seeing your screen, so I don't know if other people are seeing it.

Charles Runels: Hold on a minute.

Emily Porter: Oh, now I see it. Okay.

Charles Runels: Okay. Alright, yeah. So, this is all sitting here and now, if you went back and did those same ads, they may work. I think my understanding is you don't really need them anymore; it's working well without them. But at least now, if you did something like that, you have a place for them to land and figure out. In my opinion, without that in place, a video preferably with the provider that's at that location talking about it, it's difficult.

Emily Porter: Yeah, I think [crosstalk 00:14:22] spend some money on marketing on marketing and creating a brand awareness, but their sunk costs ... I mean, Dr. Sheila Nazarian, I know her. I want to say she spent like a million dollars or something crazy her first year on marketing her business. She's a plastic surgeon out in Beverly Hills. Her husband's a neurosurgeon, so they had some money in their bank account, so it's not possible for everybody to do that. But she really, really marketed herself a lot. Everybody tries to sell you advertising all the time, and my-

Charles Runels: Let me just stop you there just a second, because what you said ... It is true that you have to spend something. It has to be something, but I want to make real plain, for example, and this is not unusual, one of our people spent $100 that he gave to a 12 year old who made, you've heard me tell this story before, but there are others like it. 12 year old sit there and filmed the doctor talking about the procedures. The 12 year old made the YouTube channel, and then the guy made $20,000 the first month after doing my class. But he was following these plans about how to make the videos.

Charles Runels: So, I'm not saying you can do it for free, but I'm just saying that if it takes a million dollars to create brand awareness ... You know my analogy, that sex and marketing are the same. If you've got to spend a lot at it to get good sex, you're not very good at it. So yeah, you can do it, but you don't have to do it if you know what you're doing. And over and over again, I've seen people make easily ... And again, these are not plastic surgery procedures. These are not procedures we're getting paid $20,000 or $30,000 to do them. But over and over again, I've seen people follow this plan and spend in the neighborhood of hundreds of dollars per month, not even thousands, and the thing goes crazy.

Next Workshops with Live Models<---

Charles Runels: I built the whole business on hundreds of dollars per month. Just know that it's not necessary if you know how to do it. Your main work horses are e-mails to your people. That's the other misconception, I think, that you don't have now that many people have in the beginning. You are not marketing to the masses. You're marketing to your people, and then the masses will listen, so-

Emily Porter: Yeah, but you have to know about the lists. So that's where it starts to snowball. You're starting from an ER doctor who has zero clients, zero customers, so you have to be patient with that.

Charles Runels: Yes. That's good. That is a good point. [crosstalk 00:17:05]

Emily Porter: ... I gave everybody I knew a $50 or $100 gift card. I had these fancy, little cards made. They're like little plastic credit cards. And it was $50 off any full price procedure, and it had this little [inaudible 00:17:18] made for them with my address and the procedures that I offered and the conditions that I treated.

Charles Runels: Okay, good! Now, let me stop there, because I want you to finish that, but I want you to understand, I want everybody to understand what you're saying. That is really not costing anything. Because if you're doing procedures that make you $1000 profit or even a couple hundred dollars profit because it's Botox® or something, and you are giving $50 off, it's still not costing you. You're making less profit, but you're not taking money out of your bank account to make money and then hoping money comes back.

Emily Porter: It costs me like a buck-fifty.

Charles Runels: To make the card, but then it didn't cost you anything ... I mean, that was to make the initial card, but in the end it didn't cost you anything, because when they brought it back ... You get the point.

Emily Porter: Yeah. I mean, I'll do something for five dollars. If somebody came to me, $50 or $100, and said, "Oh, you've never tried Botox®? Go to this place," and I gave them to happy people. So I didn't hand them out at the Wal-Mart parking lot, okay? I gave them any time somebody said, "Oh, I love the way my Botox® looks." I said, "You got a couple friends, here. Give them a couple of these."

Charles Runels: Okay, stop again, because you're laying down a lot real fast and I want to dissect it. So, we're talking about two different things. The first is building the people who know you and trust you, and the second is marketing to those same people. Marketing as to have them come back for either more of the same or for something different. People start into the cosmetic or the sexual medicine business through two different arenas. One arena is where you came from. Part of the reason I'm interested in hearing what you're saying, and I'm learning from you too, as well as the others, is you started with no lists because you were an emergency room doctor.

Charles Runels: So, you're starting with no patients, just the desire to take care of people in a different way and profit in such a way you can still take care of your family, too. So, no lists. Then there are many on the [inaudible 00:19:25] who already have a huge list of people because they're family doctors or gynecologists or something. So they've already got that part whipped, but yet even having that part, and this part you may not have seen happen because you've seen what's happened with you and some of the people you've taught.

Charles Runels: So you may not have seen this happen, but it does. You'll have someone with a big list. They've got 3000 or so charts in their office or more. Or let's say it's 1000 charts because they're new to practice. They have no reason to go take out some big TV ad. All they need is to market to those people who already know, love, and trust them, and let market, as in educate them in the way I just described, which is explaining through what you can help, what you cannot do, and then let them know about in very effective but extremely inexpensive ways.

Charles Runels: Then, you go do the thing. And I'm going along exactly what you're saying. The sixty grand didn't do so well to bring you new people, but the personally asking the people marketing to your people, even if it was your people being, in this case, maybe the bank teller who already knows you or the person who just cut your hair or changed the tire on your car. Marketing to people who already know you and see you and trust you, and then making them happy, and then empowering them in a simple way to bring you more people. That's how you win in this game. That is you do it.

Charles Runels: Then, those same tools that you're making though, to educate those people, as I'm describing in this page that you're looking at, which is on the marketing page of all the procedures, will start to bring you other people, which is, I think, what you're seeing now. Keep telling them your story, Emily, because you're right on the target. I'm just adding to it.

Emily Porter: Yeah, so I gave out a lot of those cards. They're cheap to have made. Every time somebody was happy, I would ask them for a review, because you have to ask them. The unhappy people will yelp, but happy people, they don't take the time because we're busy people. They'll tell you how much they love you, but they're not going to go put it out there. So I just ask people. And you know, I have maybe 80 Google reviews and I probably could have thousands. I don't push it as much as I should.

Emily Porter: Another thing I found is ... I think I sent you another Priapus Shot® review that I got today. He put one on Google as well. The men are more likely to review, in my experience. If I ask a man to review, I've got about a 50-75% chance that he'll actually go review me. If I ask a woman to review, I've got a 5% or 10% chance that she'll actually go and review me. So I started asking the men to review me on and I've probably got, I don't know, half a dozen in the last two months including one today. Yeah, there you are, Jason, right there.

Charles Runels: So just so you guys know, for some reason I'll bet you less than a dozen doctors have taken me up on this, but if you Google ... I'll just show you. If you Google Priapus Shot® and you go buy Google click ads for Priapus Shot® ... By the way, the price is still reasonably low because, since we own the [domain, 00:22:52] not ... Oh, I didn't Google it. I typed it in. A lot of people, they can't use it. I've even threatened to sue Groupon. If someone tries to do an advertisement, whether it's through Google click ad or Groupon or whatever and they're not in our group, I make them take it down. So that's our main website. But look at what the second one is. That's the same website on reviews, and all you have to do to be there is answer a couple questions from somebody. Or as you just said, Emily, if you have a happy patient, have them go say something honest about what happened. And now, the phone starts to ring.

Emily Porter: Yeah, so my experience has been that the women trust the word of mouth reviews. That's 100% what they're going to go on. They go to my website, and I'm not going to lie, I spent forty grand on my website. I'll throw that out there. It was the best money I've ever spent. The guys are geniuses. I'm happy to refer anybody there. No kickbacks or anything. They're really, really great. And they know some marketing and they have a thing on there that's like a virtual consult. It's brilliant, because it makes people think that they're getting a consult, but what they're really getting is just a suggestion of what procedures might work for what they have.

Emily Porter: So for example, there's a body on there, and you click female. And then you click on the woman's vaginal area and you can click the symptoms that you have. So, it'll say vaginal dryness or decreased orgasm or pain with intercourse, and when they click that and they click submit, it requires them to put in a phone number and an e-mail. So I was able to grow my e-mail database that way a lot. I don't even need your name; I just want your e-mail. Then it'll say, like "We recommend an O-Shot® for you," and they'll get just a little information about an O-shot®. It tells what it does. Then, we get an e-mail immediately that says, you know, "Tina Smith was interested in an O-Shot®. Here's her name and e-mail."

Emily Porter: And then we nurture those leads. We're not as good about it as calling them back several times, but we get them all called back pretty quickly the first time. Then we have that chance to talk to them about the thing, because we know they're already interested, and then we find out if they've been marketed to and send them to your website. The women want a personal referral generally. Just like when you get your haircut, I don't care if some place has five stars; I want to know, "Where do you, Sally, get your hair cut? I like your hair." And that's your hair you're talking about, not your vagina or your Botox® or whatever.

Emily Porter: Men, they don't talk to each other about this stuff, so they're going to go one of two ways. One is, they're up late at night at 3:00 in the morning researching about how their penis doesn't work the way it used to, and they find GAINSWave or Priapus Shot® or whatever and they find you that way. Or two, wherever their wife tells them to go. So I market internally to my couples, so if I'm doing a Priapus Shot® of a man, I have your book any time sitting on the table next to him and I've got the how to activate the female orgasm sitting right on top. And I'll be damned if every single time, I don't walk in there they're not reading that book. Every time. And there's a little sign there that says "Take home with you." And then their wives come in, so I get lot of men that way, too.

Charles Runels: So you're saying the men take home the O-Shot® book and bring back the women. Is that what you're saying?

Emily Porter: Yeah. I hate the fact that this is true, because as you know, this isn't the case in my house. A lot of women have to ask their husbands how they can spend their money, but men will gladly spend $1200 on an O-Shot® for their wife if they love her, and they all do. Whereas if you talk to a woman about ... I don't know what it is about women. You sneeze and you wet your parents. And you jump on a trampoline, and you wet your pants. And I tell you I can fix it for you, and you have to go home and ask your husband.

Emily Porter: But the men don't think twice about it. They'll drop money in a heartbeat, so I find that you have to convince women and plant the seed and kind of almost give them ... permission for something even though it's an actual medical ... We're not talking about how your vagina looks or whatever. I'm talking about you wetting your pants. You can make it very medical for them and they still, I don't know if they feel bad or maybe they don't work and they feel like they've got a relationship where they need to ask their husband before they buy a new TV or a couple pairs of shoes or whatever. So I feel like you have to talk to women several more times. And the men, I find, come in ... They've already been marketed to. They call up, we just need to answer a couple questions, and they're ready to do it. They're ready to go. And they want whatever procedure done that day.

Emily Porter: I know you tell everyone to prepay. We actually haven't had to do that. I've got my pulse on that. Our most cancellations that we have are flaky ass women who want some Botox® and they've never met me before, and they have to have a consultation with my esthetician that I'm present at to do a medical history. And I do the Botox® and those women have a no show rate probably 10% or 20% of the time if they've never met us. But the men, they always show up in my arena. And maybe it's because we tell we book three weeks out, which we do, and they don't want to lose the appointment, but I haven't had any men no show. Not a single one without them having to prepay.

Charles Runels: You're better than I am, but maybe there is ... I'm not doubting it. That's cool that you're pulling that off. So, don't go away. I wanted to see if anybody has questions and then I want to talk a little bit about the research, because we need some more participants in our research. We got a double blind going that's stagnant because we don't have enough people in it, so I was going to see if you guys would help me fill it. Anybody have any questions they want to bring up or they want to contribute to, I know we've got some experienced people, other teachers on the phone, about getting started with some of the new people? Looking for hands to go up.

Charles Runels: Of course the fun conclusion to your story, which is wonderful, you've got to tell them about your daughter's happy dance, and then I'm going to pull up some research. You got to tell this; it's just too good.

Emily Porter: Okay. I quit my ER job on Sunday after a little over two years of doing this. I wasn't going to quit; I thought I would just still work two shifts, three shifts, or whatever. They just quit valuing me, and I realized that the time that I was spending there was taken away from me being able to build my business on Mondays when my clinic is closed. Because that's, usually when I worked in the ER was Sunday night into Monday. I did 24 hour shifts.

Emily Porter: Anyway, so I came home and I told my daughter, who's six, my oldest daughter, that I quit my ER job. She just squealed with joy, and she jumped up and down, and she says, "Now that means that you're not going to have to sleep at the hospital!" She was just so excited, and she goes, "That means you're going to be home more." I'm like, "Yes, baby," and she goes, "Hey, Alexa! Play Girls by the Beastie Boys." And she starts co-opting and she wanted me to dance with her. It was like, wow, I did the right thing, you know? I was so afraid all that time my bank account didn't have enough money or that any time, I might not be recession proof or whatever. I did it and I don't regret. I'm not looking back.

Charles Runels: Beautiful. I just love that story about your daughter being happier because you made some changes. You can say, you know ... We talked about this yesterday when you were telling me the news or day before, whenever. But you could say, "Well, the world lost this really smart ER doctor." But the thing is, they got a really depth of understanding hardcore doctor, who trained as an ER doctor, who now can take that experience to a different level with what you're doing now.

Charles Runels: There was a piece of your story though that I would like to ... Correct me if I'm wrong, but you just didn't willy-nilly suddenly decide, "Okay, now the time is to quit." Your income caught up to where it was costing you to be in the ER because you could be in your office making more than you would be if you were at the ER, did I-

Emily Porter: Absolutely. And even if I have the day that I ... I mean, I might open my clinic on Monday. Right now, I work Tuesday through Saturday, and I'm not there every minute of every hour of every day, because I still travel and go to conferences and stuff. I'm there most of the time, and I see patients before hours and after hours. But it got to where it's like, Okay, I need either A, to see more patients and I hired a medical assistant, which was the other thing I did [inaudible 00:33:05].

Emily Porter: She started last week, so now instead of having 30 minute Botox® appointments, where I got to [consent 00:33:12] them and numb them or you know, sorry ... Cleanse their face and take their pictures and whatever. They're making those like 15 minutes on my schedule. And then all my laser appointments that would be an hour long, well I only need them for half an hour. So, they're putting that other half hour on my medical assistant's schedule. And I did a wing lift tonight at 5:00 and a modified O-Shot® because the lady was worried about her urinary retention that she had after surgery, so we just did her ... It's real sad, actually. Her husband has severe ED; I think he's Parkinson's. But she enjoys oral sex with her husband very much, and she's on testosterone. She's crying in my office at 5:00.

Emily Porter: I've only met her one other time. She came to me because she's getting hormone pellets somewhere else and started getting hair removal from us and then she signed up for a wing lift. And my front desk person, because she's gotten those things. That's the other thing you always say, have your own staff market for you. And they're not pushy about it at all, but if somebody asks them if they've got the O-Shot® and when they smile and their eyes light up, that's genuine. My front desk person tells everyone that the Vampire Facelift® she got last month in my training was her favorite thing that she's had done, and she's had everything done. So, they sold this lady a wing lift so her labia would be more plump, because she enjoys oral sex. We did a diVa on her actually and then just did the clitoral part of the O-Shot®. Anyway, she's happy, but she's crying in my office.

Emily Porter: So, I got to where even if I just have that Monday off, where I can have a little bit of a minute to catch up on my charting, because I'm notoriously bad. I don't have time to catch up on my charting. It's all fun and games until the medical board comes after you and you're six months behind on your charts. Just to have a little bit of time to sit down and think about strategizing, like who would I want to talk to next? Do I want to go talk to some oncologist and talk to them about the O-Shot®? Well, you've got to have time Monday through Friday to be able to do that, right?

Charles Runels: Mm-hmm (affirmative)

Emily Porter: And Tuesday through Friday, I was always in the clinic, so Monday now could be my day that I'm going to make an appointment and go market to an oncologist, or I'm going to go do those sorts of things to help grow my business. Anyway, I just decided that that time was going to make more money. So, if I worked a 12 hour ER shift and I made, I don't know, $1500 or $1800 or whatever ... What if I just spent three hours with the right person making those videos that I don't have on my site or three hours that I'm going to go talk to a couple people or hand out some of my little cards or whatever? But I didn't ever have that time, and so now I have that time. And I just have to put it on my calendar and do it, because you can't just have the time and then fill it up with other crap. You have to actually apply it.

Charles Runels: Okay, so let me jump in there one more time and then I want to cover some research, but don't go away. So, I think you guys just heard now why I really wanted Dr. Porter to talk tonight, because that jump from this is really, really important ... I think, when it comes to marketing, that jump from giving up your insurance job to now, I'm out there, I have no more pimp to tell patients to come in. It's just me with no marketing in my skillset. That takes some courage, and you did it. There's a difference between positive thinking or even praying and a strategy.

Charles Runels: I don't know if it's true or not, but supposedly, there's a story that someone told Mohammed that they were going to untie their camel and trust God to take care of the camel. At least I was told this story by my dad; he might have made the whole thing up. But Mohammed said, "Nope. Tie your camel and then trust God to take care of your camel." So that was always a running joke for us that we would say our prayers, but we'd also get our camel tied. So here's the tying camel part of your story that I want to tease out. You took your class. How long ago did you do O-Shot®?

Emily Porter: September 2016.

Charles Runels: Okay, and when did you come to my marketing class the first time?

Emily Porter: August of this year, so two years later.

Charles Runels: Yes. Now, the class you did was amazing. Dr. Pete, he's a luminary; he's so brilliant and personable and teaches the procedure [crazy. 00:37:42] Sometimes, it's just time to do the next thing and it may or may not have been what you learned in my class. But when you came here, the next thing became doing some things with your marketing. Now the cash is flowing even more, because you've done a lot of things the right way, and you've laid some stuff, and cash is already flowing. Now cash is flowing even more, but that happened not by just saying prayers or having a goal to quit the ER.

Charles Runels: You had a strategy, and the strategies were, "Okay, it takes too long to explain this and so here's what I'm going to go do. I'm going to make sure that I've got a video, a webpage, that everybody that talks to patients has had these procedures so that I'm not having to spend as much time explaining things. I can do more of the doing," and on and on. A lot of what I'm saying is your strategies have now paid off, and you're implementing even more strategies to leverage.

Charles Runels: The other thing ... So, first thing is you had strategy, and you actually did it. You didn't try to invent a new strategy. You said, "Okay, here's the guy that thought this thing up. Here's what he's saying that people are doing that are profiting from it. I'm going to go do some of these things." And you can say a lot about Emily Porter, but what you cannot say is that you don't do stuff. You went home and you just did some stuff, and it wasn't a $60,000 ad. You went home and you did some stuff that was strategically thought out, and then you were able to have your four year old child do a happy dance because Mama followed the strategy that worked. That's the way you were able to make the jump.

Charles Runels: And I just wanted to make that point that you guys don't have to make up a new strategy; I know what works, and I didn't figure it out. I experimented, and I watched what our other doctors did, and I'm not saying you don't do other things, but we got a strategy that works and if you're phone's not ringing, I've got people that are paid to answer the phone and look at what you're doing and help you with it, as can some of the people in this call who've been very successful and are teaching classes. There's several people on the call that do classes and they're doing well and can also answer those same questions if you just go look at our list of teachers.

Emily Porter: The other thing that happened after August is ... I never had my [sure start 00:40:08] call. I didn't until August, because I kept putting it off and I didn't do it. They made me sign up for it in your class, and so when I teach my classes, I make the people sign up in the class, and I tell them, "This is a huge regret that I had that I didn't actually ever do this call." Every time I was in the ER and I didn't have patients and I couldn't sleep, I went onto your sites and just watched all the videos.

Emily Porter: And I took notes on them. I have like 20 pages of notes on your videos. You saw I wrote down pretty much every single thing that you said, and then I watched- [crosstalk 00:40:44]

Charles Runels: I'm going to jump in there again. What I've seen is the people that are making a half a million or more just from our procedures, without exception, always, they've called us more than once and they've done what you just said. They'll watch ... Because I can see how many times they've been logged on. They will have logged onto our websites 40, 50 times the first couple of months after coming to our class. And for those of you guys who haven't done it, some of them may not even know what you're referring to.

Next Workshops with Live Models<---

Charles Runels: I just put it in the chat box. That's where you can schedule the sure start, which is basically, you call my office, one of my business consultants, and they're business people that have been talking, were in business before I hired them, and they take their experience with that, prior to working with me, with their experience, having seen what people are doing making things work. And then they look to see where you are. And especially like an intern is trying to diagnose you, only they're business people trying to diagnose where you are to tell you the next thing to do. And the people who do well, they'll call us sometimes 5, 6, 7 times, and we like that because we know that it's rare they don't just kill it. Then they're off to the races and they're ready to teach somebody else or just put the money in the bank. So I just put that link in the thing. I want to come back to that shortly, but I've also put in there some research that's come off of this for a second ... Oh, I pulled it up. Let me let you look at it.

Charles Runels: So this is what it looks like when you get to that link. And if you go right here, if you've never done this before, you click this one and it'll schedule a time for us to make sure you just know where everything is and you're able to log in. Some people just never log in. Everybody that drops out of our group, almost without exception, just never even logged in or implemented anything. Then after you've been in it for a while, some of you guys may have been in for six months, a year or more, it's still not happening with you, you go here and we'll give you a more detailed consult.

Charles Runels: Let's swap off of this for a second and let me just show you ... I just put it in the box, if you want to open it up. It's some research that came out this month about hair that is worth looking at. I'll pull it up so we can look at it very quickly together. Let's see here ... Yeah, there it is. You guys can download this really beautiful study where they didn't just take pictures. They really did microscopy and they documented that PRP works for hair. Interestingly, they did more injections than that's normally done. Most protocols is two or threw shots six weeks apart. They went every three weeks for three months, so I guess that's four injections, I guess depending on how you count it, four or five injections. But a really beautiful response to that, so just know that this science is not the first study like this. This science is growing.

Charles Runels: We've had some other people on these calls talking about hair. I think it's important to show people what success looks like. You could use pictures from this study if you wanted, talking to smart people, to show them the science that ... A success is this, it's not your 18 year old mop back, but it's thicker hair. And the response, really following out for three months or 12 weeks is not full effect. Full effect is probably six months to a year out.

Charles Runels: Anyway, I want you guys to have that, to know the research is growing. We might shut this thing down in second. There was a question about how did you make the virtual consultation on your website. I want to comment on that. That consultation is very elegant, and Dr. Porter's website is very beautiful. I don't want you to think, if you're new, that you have to come out, if you don't have 40 grand to pop in from the start to a website, that it's not going to work for you. Yeah, it's great if you do.

Charles Runels: But the biggest point of what she told you was you do need a way to get that e-mail address from every patient you're seeing. One way is to have the consult, which she does have a gorgeous website. What's your domain, Emily?

Emily Porter: Https://

Charles Runels: Hold on a second.

Emily Porter: I'll type it in for you.

Charles Runels: [inaudible 00:45:31]

Emily Porter: I put it in the comments there under questions. And I have a new one that I'm launching, too. But it's the same thing; it's just a landing page for Austin Love Doctor, but it has a way to collect information from people. It's like, "Am I a candidate?" And then they click on the different symptoms that they have. Erectile dysfunction or low libido or vaginal dryness or inverted nipples or whatever. Then it collects the information. You don't have to put a name.

Emily Porter: Here's a pointer for you. My web guys told me that if people have to put a name in there, you're going to get about at least less than half of what you'll get if they just have to put an e-mail in. If people like they have to put a name in, you don't get as many ... I put it in the questions right there under questions, so click on it there.

Charles Runels: Okay, yeah. Okay.

Emily Porter: If you just ask for an e-mail and a phone number, people will generally give you an accurate phone number and they'll give you an e-mail, and then you can put it in there. The virtual consult is usually at the bottom. There you go. Click on that, say virtual consultation, and you can just [inaudible 00:46:53] where you have to put your information in.

Charles Runels: Uh-huh. So let me add to this the-

Emily Porter: My first website cost $500, so I didn't start out with this.

Charles Runels: ... I agree completely. If you ask for full name, you're not going to get much. You do need to get an e-mail. If you're going to ask for ... I think they'll usually give you a first name, but I would never ask for first and last name for someone just to do something on my website. Here's the process that takes place, and this is why this is critical for a website. Let's say that sister Sue talks to her sister Jane and says, "Jane, you got to go see Dr. Porter. She's going to make you have amazing sex. Your marriage is going to get better. It's just wonderful. And you'll be more beautiful and happy and live forever." Now Jane is working on her computer and goes to this website, but the phone's ringing because she's a busy, smart woman or she's ... Wherever. She's busy. Everybody's busy these days. So she doesn't make the call and tomorrow, she's not even thinking about this. It's off her plate.

Charles Runels: If you have something to offer for free, it can be a consult, it can be a news letter, it can be a download of a PDF file, but there should be something for free on your website in exchange for an e-mail address plus either, I like to get a first name, but it could be an e-mail address and a phone number. Something so that you can now follow up with them, and then they get an e-mail every two weeks or so. If you do that, you will wind up capturing somewhere between another 30-60% of the people of those sister Janes who show up, and they may wind up coming in next week, next month, next year, but that's how you build the list for people that know your patients much more easily than if you don't do that.

Charles Runels: My first website, which is still out there, is just my last name. And there's a little form that offers something free for their first name and e-mail address. I call it my weight loss secret; it's basically all the benefits of walking. It's an audio file for walking. So whether you ask for the ... You give them a free consult or you give them a free download, either way, they wind up on your news letter and that becomes a way that you engage them and keep telling them about your stuff. And of course, that e-mail has a whole strategy of its own, some of which is covered right there on the website that I just showed you.

Emily Porter: You do have to have a website. You can't just have a Facebook page. I want to throw that out there. Even if you have a $500 website, you need a domain name, because otherwise people are like, "What, you don't even have domain?" And the other thing I didn't do was I didn't early on have my e-mail at It was still a Gmail account. I don't know about you, but if you're still using a Gmail account, I think you look like you're a freshman, and I don't want a freshman in my vagina. I want a senior, you know? So I changed, it costs five dollars a month to have Google Suite, G Suite or whatever ... It's still Gmail, but manage your website, but give your e-mail at your domain name. So now we have and and all my estheticians and my nurse, everybody has a business card that I got cheap on Vista Print.

Emily Porter: And I've noticed, Dr. Runels, that you give out your business cards like candy, too. Whenever you send a book to somebody, you send them like three business cards. They float out there and even though we're in a very virtual age where everyone shares contacts and puts things on their phone, people still take business cards and they look at them, and they give them to people.

Charles Runels: So, mentioning that ... This guy right here, Joe Girard ... Did I put that in there right? Joe Girard, spelled it wrong ... This guy, last I checked, still has the world record for the most car sales ever. He's got one called How to Sell Yourself. This is an old one; it's probably out of print now. He talks about cards and how most people don't give out enough of them. He would literally just ... Like if it was a football game or something and somebody did something, he would throw them out like confetti at parades and give them out stacks at a time. Most people completely, totally under utilize their card.

Charles Runels: The thing about it is though, with our procedures, you're exactly right. Those cards need to be going out. The other thing that you're doing right though is that for something that's difficult to understand ... The more difficult to understand and the more expensive, the more information they need. So if you're just handing out a card, it just has to bring them back to a website where you have a video where they can absorb a lot of information instead of having to read it. Or it needs to be one of the books, as you said, because they have a lot information. It's a hard thing to understand, drawing your blood and getting a shot in the genitals, for the layperson and it's not cheap.

Emily Porter: Yeah, and another thing I do is I send everyone a handwritten thank you card. I don't care if they didn't spend any money with me or not. If they came in and gave me 30 minutes or an hour of their time, I thank them, and I send them all a handwritten thank you card with my clinic's address on it, with my clinic name on it, I write them, I sign them, my estheticians send their own cards, and we stamp them. Like last night, I was up until 3:00 in the morning, I sent 63 Christmas gifts to ... Harry & David® pears, right? So I sent $30 boxes of pears to anyone who spent more than several thousand dollars with me.

Emily Porter: Nobody does that. I want to be the Nordstrom. I don't want to be the Wal-Mart. And that shit matters. It matters. We went down to Hall's Chophouse for our wedding anniversary in Charleston. I'd never been to Charleston ... and talked to them. It was our anniversary and they made us feel really nice, and the guy made me feel really ... Like he knew me, right? Yeah, we went there for lunch and for dinner. We probably dropped $600 or $700 on the two meals, but it was worth every penny. A month later, our waiter had sent us a handwritten thank you card saying, "It was so great meeting you. I love Austin. Thanks for celebrating your anniversary with us."

Emily Porter: You don't think that the next time that I go back to Charleston, or every single time somebody tells me that they're going to Charleston, that I don't tell them to go to Hall's Chophouse? Of course I do! And that stuff matters, because nobody does it anymore, and it takes no time.

Charles Runels: Okay, so we need to shut this thing down. Someone asked me for a link. I moved that into a Dropbox and put the link, you can also download it if you can click the right button on the little ... Click on the little orange flower, and then it should open a little sidebar where you can actually download the PDF file. Also, I put a link in the chat box where you can download that research about the hair. And I put a link to this book about Girard, where he talks about how he used his cards to sell 3000 and something cars in one year. That's belly to belly. That's without people helping him. So if anybody knows how to use a business card, it'd be this guy.

Charles Runels: Emily, we all want to see our babies doing happy dances, so thank you for sharing your story. I know you motivate a lot of people. Dr. Porter does a wonderful class. You'll see her classes posted at the [ACC and A 00:54:58] website, and so here's the ... Things are coming up, looks like January 12th. Is that one full?

Emily Porter: I've go one or two spots left.

Charles Runels: Okay. Alright, cool. If that's still in your schedule, I'm putting the link right there. She teaches GAINSWave as well all the PRP procedures, so I highly recommend her class. And you guys have a wonderful night! Thank you for tuning in. I hope this was helpful. Have a goodnight. Goodbye.

Relevant Links

Escape the ER<--

Altar™--A Vampire Skin Therapy™



Vampire Amnion<--


Cellular Medicine Association



Topics Discussed Include the Following...

*Soldier regrows his penis after war injury
*Vampire Facial® on the cover of New Beauty
*O-Shot® [Orgasm Shot®] in Glamour magazine
*What to expect after an O-Shot® [Orgasm Shot®]
*Please make your own version of "What happens after an O-Shot®"
*Lichen Sclerosus & Clitoral Hood Phimosis (when & how to treat)
*Combining Electro-magnetic chair therapy with the O-Shot® procedure

Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips


Soldier regrows his penis after a war injury

Journal Club & Pearls & Marketing (JCPM) 2018May16

Charles Runels: So this was a wonderful month, actually an amazing month for our marketing. So Dr. Shirin Lakhani over in London just killed it again with this amazing story...

Click to read about soldier regrowing penis<--

This solider had an injury in active duty and because of the trauma to his penis, lost some size and function. And then after treatment you can see he's a happy man and back with his lover, and regained some of the size that was lost due to trauma. So I think we can all be proud.

There's doctor Shirin over there in London who's been very successful as a teacher and a provider of our procedures. And this man is lucky to have met her.

In case you think this is outrageous...
PubMed. Wound Healing with PRP<--
PubMed. Penis regeneration with PRP<--

Anyway, so this is a great one to put out to our people. Obviously this amount of growth is not something that we see often, but because it was repairing an injury and he had multiple treatments, we do see it even in people without injury and the fact that he might have regained some tissue that was damaged actually makes sense.

I pulled up for us here, just so you can see, if you look at just wound healing fairly ... And you go to PubMed and look at wound healing & platelet rich plasma, right at 1700, there's 1,689 papers. And of course they keep doing papers because it works. And it's quit being about "does it help with injury." It's become about "what's the best way to have it help with injury." Whether it's diabetic wounds, or old tissue injury to the solider.

So I highly recommend that you let this be out. Take a link from this or a screen shot, I'll put the thing right now in the chat box so that you'll have it easily available,

Copy, paste the following link to an email, tweet, or facebook post....

but I'll also shoot out an email so that you guys will know. And when you put that out, just don't over promise. I think I would downplay it by saying this guy achieved some size increase because he was repairing an injury and this is not the usual result.

But there are a lot of men who've had injury to their penis. Usually it's either a bike accident/injury, or what's common is women in top sexual position and when the woman comes down it can be a loud "pop", then injury of the penis, which sometimes leads to Peyronie's and sometimes not--can just lead to loss of sensation and erectile dysfunction. So things happen and most of the guys who've had something happen, they've been told there's nothing to do.

One guy that emailed me today said that as a child he had something, I can't remember what. For some reason he had some rash and they were putting cortisone in his penis and one of the corpus cavernosi didn't develop to the same extent as the other. So palpable difference in size so he asked is this is something that would work. The answer is I do not know. But it's his best chance of repair, is to do that. Or to use our platelet rich plasma to encourage some recovery.

And most of us that have done this for any length of time have treated people that have old injuries that recover years afterwards. Years afterwards. So that's one thing.

Vampire Facial® on the cover of New Beauty

The other thing. I'll let you look at this. I'm proud of this. Let's see if I can pull it up for you again, hopefully I didn't lose it. Oh I don't see it. Anyway. We made the cover of New Beauty this month.







And it's the spring summer edition, so it will be out on the newsstands for a couple, three months at least. And right in the title it says Vampire Facial™, right on the title. And it's interesting because when you finally get to the article the movie star they interviewed, all she has to say is that she's afraid to try it because she's afraid it will hurt. And for that comment they put it on the cover of New Beauty. Which just goes to tell you that even when it's a stretch people love our name because it does sell magazines.

O-Shot® [Orgasm Shot®] in Glamour magazine







Another one of our people had an episode on the local news about the Vampire Facial® and in that one they, the newscaster, I don't know why they always feel inclined to say this, but said there's no research to back it up. So I want to show you ... I put another link to make it very easy to find. If you go to I had some individual links, but just to make it easy ... I don't know where the doctors get that there's no research. I mean I could understand maybe there's not enough research to convince me yet, or something to that effect. But to say there is no research to back it up is just not true. Anyway. So here are, for the vampire facial different very strong papers. And this just takes you to a collection of papers about microneedling combined with PRP and the results were positive. And we even make compare of vitamin C or saline, it's positive.

The only one that wins out over PRP is interesting, is one study that compared PRP with microneedling and PRP with TCA immediately following for acne scaring. And the TCA, they both worked, but the TCA beat out the PRP for [inaudible 00:06:33]. So we're thinking maybe some rotation of those two.

So I'm getting to a question, let's see who's on the call because ... Yeah. Yeah. So I see Dr. Singer's on the call.

Dr. Stephanie Singer

That's good because this one has to do with lichen sclerosus and I want one of the gynecologists to answer it. Let's see, what else. In the ... Yeah. So in the marketing department, here's kind of an outline of where we're going. Let me pull this up for you guys so you can look at it.

So we have the sign about the P-Shot, all within the past 30 days or so. The vampire facial is in New Beauty. And it's a little bit old now, but in the April issue of Glamour there's a big half a page quote from one of our doctors talking about how wonderful the O-Shot works for orgasm. So all this is out on the stands right now at the same time which is just amazing to me.

So I've had several people this week ask for a very specific thing about what to expect after the O-Shot. And I think it would be helpful to take this part of it and maybe make a video about this. And I'm happy to do it, but it would be nice I think, if some of our multiple people did this. I'm going to do my version of it. And what I think would work wonderful is if ... Let's see Dr. DeLucia is on the call,

Carolyn DeLucia, MD

Dr. Carolyn DeLucia

we have some really nice people on the call. I'm not even going to name everybody. There's just a bunch of really smart people on this call.

And so if you guys do a version of what to expect and I'm going to give you my version, but if you will do your version of it, I will put it on the main website. I will put it places where it will be seen, it will be helpful, both before and after. Because we don't want to obviously over promise people and then on the backside it's much needed. I used to have one. I can't remember why I took it down. There was something about it I didn't like so I took it down.

But we desperately need a what to expect video, or videos. So I'm going to do this and I would implore you guys to do your version of it and then shoot me a link to it and I will put it out there everywhere. And thousands of people will see it, it will help your practice and will help patients.

So here we go.

What to expect after an O-Shot® procedure

Very rarely, and usually I don't even mention this or I try not to stress this, because sometimes people will think it's not working if they don't experience it. But rarely, probably 1 in 100 women in their twenties or thirties will experience, and sometimes older, hypersexuality. I mean really to the point that it would qualify as persistent genital arousal disorder where there's just no getting relief. Constant need to masturbate to the point [and multiple powerful orgasms that offer no relief] where it can be a nuisance if you're trying to work or something like that. Although it might be fun for a day or two if you're with your lover. It could be an absolutely nuisance.

And people with persistent genital arousal disorder that goes on for years actually have a higher instance of suicide than do people with chronic pain. It's a real problem. But for a few days it could be fun and it can happen in someone who gets the O-Shot® who is already experiencing normal sexuality and they're just kind of doing it to tune up.

I think it has to do more with the increase blood flow, the cytokines, and the increased rubor and calor that come with just things that happen with the process/cascade involved with wound healing. And it's not a permanent effect. We have not seen it last more than a few days in any of our people. So that's on the consent form. I talk about it. I'm talking about it first here, but I usually downplay it because if you tell everybody about it, which I started off doing, and you stress it too much then people think it's not working if they don't experience it.

The usual experience for the first two to three weeks is the rule of threes, is nothing, absolutely nothing [happens for the first 3 weeks]. Maybe a little tenderness from the injection site. Maybe a little bruising. Maybe a little spotting in their panties, that's why we keep panty-liners and baby wipes in the office. But otherwise nothing. And the analogy here is if you watch your seeds if you have a garden, like we did when I was a child, and you put seeds of corn in the ground and you watch for them, it's going to be a few days before you see the sprouts come up. So in the same way the PRP is just the, as the guys know this is way I'm explaining to patients, it recruits the pluripotent stem cells to the area, activates them and then it has to develop.

3 Days-the PRP is gone (3-14 days)
3 Weeks-the effects of new cell growth START (3-6 weeks)
3 Months-full effect of the procedure and new cell growth (2-4 months)

So although you may have blood flow and sensations that go on with that from the cytokines and growth factors that are in the platelet rich plasma or the platelets, that's not the permanent effect. And that's usually minimal and it can be all over the map what people experience. So it can be dysuria, urinary frequency, hypersexuality, decrease sexuality because you create a basically a hematoma, so they may have a time when there's decreased arousal because it kind of feels numb. Just like you have a hematoma on your hand. You might feel sort of boggy and not as much sensation. On the other end it might feel more sensation.

So that part lasts for around three days. It could last longer but three makes it easy to remember. Because it starts the effect, no longer than a week. Then the effects start to kick in at about three weeks, from the new growth, the new blood flow. That's when if they have pain it start to go away. That's when they have decreased orgasmic intensity. It might improve. Things get better.

So, with full effect at three months, two to three months. Although we'll repeat it at eight weeks if people are having no results. Just to keep them from having to wait the three months. Full effect with orthopedic procedures are six months to a year. But with soft tissue and wound healing it's usually about eight to 12 weeks or three months.

So then as far as what happens or who gets success. I hear people say "Well, it didn't work." As in that means it doesn't work for anybody anytime. So analogy there is one in five people who have pneumonia in the hospital, hospital acquired pneumonia, die from it. But we don't say antibiotics don't work. They work 80 percent of the time and that's a good effect for hospital acquired critical care pneumonia. It's not what we would like, but that's about the best we get. And in the same way the 65, 85. When I just survey our providers for every problem the easy to get well and the difficult. It's 65 percent of our patients love it the first time around, 85 percent of them love it after the second time around.

But these are hard to treat people. If they were easy to treat they would have gotten well with their insurance with their regular doctor. These are people with dyspareunia, incontinence that won't go away with kegels, but they don't want to have surgery. Try another ... These are difficult problems. Or Lichen sclerosus. So 65, 85.

Now if it's an easy to treat problem it would be 85 first time around 95 or more second time a round. For example stress incontinence in a younger woman, or even an older woman that has good pelvic floor integrity. But if it's a woman who's never had an orgasm in her life and she's trying to have her first orgasm it's probably more like 35, 55. Still one in three is wonderful for a woman who's gone for years without an orgasm. And now she's able to achieve orgasm. Either because she's never had one in her life, or she's trying to have an orgasm with penis in the vagina sex for the time in her life. So those are my best stats from surveying our people, surveying our patients.

And so you might think "Well, why not just have everybody do two." Because ... And many of our people do that. But the reason I don't do that is that I'm thinking, well, if you required that then you have over half of the people who would be getting that second one, perhaps even though they didn't need it. On the other hand if we're to require ... If we only give people one and we make them think that's all they're likely to need, then we're going to have somewhere around 35, 40 percent of them are not happy.

So the way I usually do it, there's enough profit built into this that you can give them the second one for free if nothing happens with the first one. If they have enough effect with the first one that they're happy then I'll charge for a second and third if they're just trying to get things even better. But if they think the first one did nothing I'll give them the second one free. And then you still get a nice profit because the second one doesn't take much time since you've already done your interview.

Then if they have no effect after the second one. Just give them their money back. You have enough profit that you're going to be fine and still profit on the next patient. Don't keep their money or they will be angry at you. So those are the stats.

You'll repeat it based on the etiology. If the etiology is still present they'll probably need another one in about a year. For example, if it's a woman that has dyspareunia and dryness because she has breast cancer and she still doesn't want to take hormones of any kind. She will usually get results, that's an easy win for us. But because she still can not take hormones and she's post menopausal she will probably need a repeat in nine months to a year and a half. The same with Lichen sclerosus, whatever the inciting etiologies was, she'll probably still ... It will probably still be there and she'll need another procedure done in somewhere around nine months to a year and a half.

On the other hand if you're treating a scar for an episiotomy, if she doesn't have another big baby and need another episiotomy, I have people that are seven years out still without pain. So etiology's still present. She'll need to repeat it nine months to a year and a half. Etiology gone, it could be permanent but I'd still hedge my bet and tell them about a year.

So the decreased orgasm, they'll probably see some improvement hopefully in about three months, excuse me, three weeks to eight weeks. But this one is the most difficult, excuse me, no orgasm is the most difficult. They almost always are going to need a therapist and testosterone to go with it. Decreased orgasm likely to get better and probably better in about three weeks.

Incontinence often gets better, stress incontinence, the day you do it. Just because the platelet fiber matrix is creating a sling basically where you put it. And then as that matrix gets replaced with new tissue their incontinence stays gone so as far as the patient's concerned it goes away the day you do it. But to hedge my bet I usually tell them it starts in three weeks, full effect two to three months because that's what I usually see but again you will often see it go away the day of the procedure. If it's not better at eight weeks, I'll repeat it.

Dyspareunia, difficult problem but for us for some reason we have a really very high success rate, much higher than placebo, but this one will get worse the first week and then start to improve starting the second or third week with full effect at eight weeks to three months. I would also recommend you use little vibrators here, about the size of your little finger and gradually going up to a vibrator the size of their lover about once every week or two. I prefer that over dilators because I think the vibration helps with the pain, helps with the physical therapy of it and probably encourages the woman to practice having an orgasm as well.

Lichen sclerosus you plan on them coming back at six weeks and treating whatever still bothers them. The full effect at eight to twelve weeks and out so I'd space these two treatments six weeks apart with full effect six weeks after the second treatment or about twelve weeks in or three months and then they're usually good for about a year.

Decreased libido, there's so many things involved here. It often improves for us but this idea of sexuality being arousal, plateau, orgasm, and then a recovery time is really not how it works for most women. It's really more of this circular, either spiral up or spiral down. So let's talk about the spiral down, then let's talk about the spiral up, then I will be through explaining what I think your patient should understand post O-shot.

Let's say the woman has decreased libido but she's got an element of dryness or pain so she has arousal and she starts to spiral up. Then she has sex but it hurts and she's disappointed and her lover is disappointed so she comes back down. Now it's going to take more to encourage her the next time to have sex because she has a negative association with sexuality. So two or three rounds of that, let's say she does attempt sex again, she spirals down another notch. So it becomes more and more difficult to interest her in sex because every time she has it, she has pain or perhaps it's not pain but a lover with premature ejaculation or that leaves her frustrated instead of satisfied. So whatever reason, if it's not a satisfying response, there's a spiral down and every time that spirals down it becomes more difficult for her to be interested in sex the next time around.

So if we take something to break that cycle, if we do something to increase orgasm a little bit or pain goes away mostly, for some reason she's able to now when she has an encounter that it's satisfying. Now there's a positive association and the next time she has an opportunity to have sex it's more easy for her to become aroused and there becomes a spiral up into, I think, a nirvana that actually becomes a spiritual awakening for her and her lover. But it doesn't happen immediately, it's a climbing effect that happens over time.

The cause, or back to our O-shot. If you can break that cycle by doing something, even if it's not the ultimate cure for every part of her relationship, if you can start the cycle to circling up instead of down, you've done an amazing thing for that woman and her lover.

Please make your own version of "What happens after an O-Shot®"

Hopefully that helps and hopefully you guys will take that and do a better version of it. I think it would be wonderful if it comes from especially some of the women in our group. I love it when women are talking to women and so I would love it if you guys...I'll put the recording out. But you guys know it. Just do your version of it and I'll put that video everywhere.

Lichen Sclerosus & Clitoral Hood Phimosis (when & how to treat)

The next one is a question and then I'm going to open it up after I read this question for you guys to give me an answer. So here's...let me see if I can pull up...let's see, I think I can show that...Anyway so lichen sclerosus question...So here we go...and then I need to be quiet, let you guys talk some...So please find attached two photos of a patient referred to me by her local gynecologist for treatment of her biopsy proving lichen sclerosus. She's been managed off and on with Clobetasol for four years, it...Clobetasol four years ago had PRP injection...that's good! a California dermatologist that was very painful...huh...she is a menopausal 65-year-old woman who tells me that her primary symptomatology is painful inflammation of the introitus and vulvular skin (pictured), stress incontinence, is sexually active without severe dyspareunia although she feels her clitoral area is quite insensitive. She rarely has an orgasm. Her clitoral area is completely closed. She says it happened a couple of years ago. She says she has considered the idea of clitoral surgery and I would refer her out for this if it became necessary. She wishes to try the O-shot and one of...and a vaginal laser treatments first.

I am one of the O-shot providers and a Board Certified Plastic Surgeon, and while I perform labioplasty and clitoral hood reduction, I don't perform vaginoplasty or clitoral surgery such as this patient might require. In addition, and to the benefit of my own patients suffering with LS, I do clinical research for various device manufacturers...that's impressive...and published...okay, so wonderful, she talks for a lot of people...Can you give me your thoughts on this patient prior to my O-shot procedure in about a month? Is she likely to need corrective surgery to open the clitoris?...

and let's! Oh there you are, you're on the call! Let me unmute you so you can tell us about this patient...Dr. Samuels...I'm waiting...I think your microphone should come live here in a second...[silence]

Dr. Julene Samuels: Okay, It just opened up! This is Dr. Samuels, Julene Samuels.

About A Womans Touch MD

Dr. Samuels: Thank you for featuring my question

Charles Runels: Thank you very much for the fascinating patient. So tell us about the patient. I'm going to try...while you're talking I'm going to try to get a better view of your photographs for everybody to talk about. Tell whatever I left out.

Dr. Samuels: No that's very good. This patient has actually...she came to me primarily because she was definitely in search of the O-shot and but she also had done a significant amount of research on other options that she thought would be of help to her because she has suffered with lichen sclerosus for over twenty years. So the...her...the reason that she kind of narrowed her search down to me was because I have some of the devices that I show here and in particular the CO2RE Intima Laser was one that she had personally researched and she lives part of the time in California, part of the time in Kentucky and part of the time in Florida so she does have access to several of our O-shot providers if that becomes necessary and also to some of the gynecologists that I know join you on your webinar.

And I actually have treated quite a few patients with our fractional CO2 laser, and although the study that I'm publishing in the Plastic Surgery Journal, the Aesthetic Surgery Journal, does not deal with lichen sclerosus patients, it deals with forty menopausal women who also have components of not just dryness, itching and dyspareunia, but stress incontinence so she would like treatment for the stress incontinence as well and we've talked to her about an electromagnetic therapy chair that we have as well as the CO2RE Intima. The spotty treatment with Clabetasol was really more, I think, a noncompliance issue. She has no problems with insertion of a laser handpiece. She thinks her introitus will accommodate that because she is sexually active and it's, as I said in my question, is she's not experiencing a lot of dyspareunia but she has had complete phimosis and closure of the clitoral area.

I can just barely, not when she's stretched like she is in this photo, I can see where the...attachments to the labia minora used to can barely make that out so I was envisioning being able to do a nice clitoral block and the first portion of the injection, I think I can tell where to put that but the clitoral opening is completely obscured so the primary symptom she's having, as you can see in the photo, are the inflammatory changes in the vulvar skin near the introitus. Intra vaginally, it's a completely normal exam. She's actually quite lubricated and I suppose that's from her hormone replacement therapy and the estradiol cream that she uses. She uses that more faithfully than she does the Clabetasol. But she, in my talking to her today, she wants to proceed with the O-shot and the CO2RE Intima treatments and I think both would help her, but I don't know if this is...

I've probably done a dozen O-shots now. I just joined you guys earlier this spring. All of my patients have experienced incredible results and I will say some even amazing so I have no failures at this point but I'm sort of been very attentive to the videos. The technique videos are awesome and learning curve, I'm probably still experiencing yet, but my patients are doing well.

I'm wondering, first of all, is this a case I should tackle? She desperately wants me to do it and if you have some advice and then beyond that what should I tell her to expect? She kind of would like to know am I still facing clitoral surgery? And I need help with those expectations.

Charles Runels: So just so you guys know I have unmuted Carolyn DeLucia and Stephanie Singer, who are both gynecologists on the call that have treated lichen as well so I'll tell you my two cents worth and then they can chime in.

Usually...Kathleen's on the call as well but she's not on tonight...So first of all I saw a very interesting study done by a gynecologist presented at one of the meetings of the International Society for the Study of Vulvovaginal Disease where she took women who had lichen sclerosus to this degree and she just did a ultrasound and the whole purpose of the study was just to prove to these women and to us that the clitoris is always spared--that down there somewhere there's a happy, normal clitoris that's feeling neglected and so...I think along those same lines it's always sad to me. I've seen two women now, one in a teaching environment where the chief complaint was anorgasmia and with a history of frequent UTIs and she was young and the woman had had lichen sclerosus and her poor husband didn't know the difference and neither did she and she'd spent her whole life, both of these women with their clitoral hood phimosed but it was never active enough and somehow went dormant and they just didn't know so the point I guess I'm making is that I think she will benefit from someone going there and retrieving it and with your skill set I would love for you to hook up with one of the people in our group who does this on that level, if it's something that you're not quite ready to tackle.

Obviously, with your skill set you can tackle anything. It's like see it, then you're going to do it but if this is something you want to see someone do there's several people in our group that are very good at it and so I would recommend that if you're not seeing her for a month, that you go visit one of these people and offer her that. .

Dr. Samuels: An opening of the clitoral area, just to clarify, Dr. Runels, are you talking about to open the scarring and then do the O-shot after that has healed?

Charles Runels: It can actually be...the exact timing of that could be debated but most of the people I talk to are doing it all at the same time. For example...I was looking for a picture is why I sound distracted...but I'll look for it in a second. Usually it's all done, so do the regular O-shot, inject the area, dissect the clitoris out, inject the clitoris and then bring them back six weeks later and then inject wherever you still see active disease. And because of the injection around the time of surgery we have a better success rate of keeping things looking pretty.

Dr. Samuels: Okay.

Charles Runels: Did that answer your question?

Dr. Samuels: Yes.

Charles Runels: And I know...I know Red Alinsod, Kathleen Posey, Oscar Aguirre, Michael Goodman, & Alex Bader, there are others in the group. Those come to mind who both teach and who are doing this quite a bit and if you wanted to touch base with one of those people.

Dr. Samuels: Actually, I'm going to see Dr. Alinsod this weekend. We're presenting at a summit conference for BTL, both of us and a couple other presenters in Orlando so that's a very good suggestion. I'll take these pictures to them.

Charles Runels: Beautiful, beautiful. Well we appreciate...

Carolyn: I'll be there too. I'll be there too. This is Carolyn Deluccia. I'll be there even though I don't know what it's about.

Dr. Samuels: Oh that's awesome! Awesome! That will be great!

Carolyn: Yeah.

Charles Runels: So Carolyn has been teaching for us for how many years now Carolyn?

Carolyn: Over three years!

Charles Runels: Well thanks for chiming in. Have you had the opportunity to treat someone like this? Can you add to...I know you have something to say about this case...

Carolyn: Well yes I have and I also... I'm just going to throw this in there as something I've started even more recently is before they get to this extent of complete scarring if there's just a little bit of scarring I will do the O-shot and treat all the lichen around the clitoral hood and if you push back you can see the little tip of the clitoris beginning to come out. I'm instructing the patient to, as long as it's not too painful, to do that in between her visits with me, is just kind of pull back and gently stretch the tissue open and as it's healing from having been injected with the PRP, it's separating on its own without even having to do the cutting. So...

Charles Runels: Interesting.

Carolyn: Not completely.

Dr. Samuels: I don't want to interrupt you but where you see me really stretching the clitoral area, she barely felt me starting to touch up there and she just about had a mental breakdown because she just had so much pain associated with that spot and I was just barely separating things but as you mentioned, not having quite this degree of lichens sclerosus before, I did start to see the clitoral head.

Carolyn: Mmm-hmm. Correct, correct.

Charles Runels: Interesting...

Dr. Runels: See the clitoral head.

Stephanie S: Mm-hmm (affirmative). Correct, correct.

Dr. DeLucia: Interesting.

Stephanie S: Yes.

Dr. Samuels: And I can still see the corpus spongiosum when I put it on stretch I can see where it is still. It's barely distinguishable because it is so scarred down, but that's why I wondered if maybe the O shot if I should try that first or if I should even do that. Should I even send her, possibly to somebody who could do a corrective procedure if it didn't work? But I then also thought-

Stephanie S: I do. [crosstalk 00:36:32] I inject the PRP first.

Dr. Reynolds: Okay.

Dr Runels: Yes. So let me jump in and add to that as well. So you guys can now see this case where I saw this person first and I could put my thumb maybe to the fingernail. That was all that would go into her introitus. Had not had sex with her husband for seven years. Most of you heard me talk about this case but I think it's very instructive. Kathleen now has an atlas of about 60, 6-0 patients that she's done like this. I'm encouraging her hopefully to publish it.

But to answer your question, I went ahead and injected the area even though I couldn't obviously get to her clitoris. I inject in the interior vaginal wall. I infiltrated the area and with the idea that when she got to Kathleen a few weeks later and had this procedure done, the tissue might be healthier. And then of course Kathleen re-injected it and dissected it out in the office. This is eight weeks later. This woman now, I think she's pushing three years out.

She's been treated one more time in between about a year, year and a half out. So the possibilities are pretty remarkable. But to answer your question, whether it helped or not I don't know, but my imagining was that somehow the tissue would be healthier when she did have the surgery. And if I were a surgeon, which I'm not, I might consider doing it that way just to kind of prep the tissue. I don't know that it's necessary, but it makes sense that it wouldn't hurt anything.

Dr. Samuels: Yeah I kind of was thinking that too.

Dr. Runels: Then they can go have the procedure done then follow up with you if she's back in your town and you repeat the PRP maybe six or eight weeks after the procedure and hope she's good for a year or more.

Dr. Samuels: 'Cause I have joined you guys before and seen some of these pictures that are treated only with the PRP and they're quite amazing.

Dr. Runels: Mm-hmm (affirmative).

Dr. Samuels: And I'm happy that her introitus is only inflamed and not scarred and closed.

Dr. Runels: Mm-hmm (affirmative).

Dr. Singer: If I may interject a bit, Doctor Reynolds. This is Stephanie Singer here. Did you say this patient is refusing Estradiol vaginally or she's been using it?

Dr.Samuels: She's been using it. She's not terribly compliant with the Clobetasol.

Stephanie S: Well the Clobetasol I don't think is the greatest idea. I definitely think that she needs estrogen as well.

Dr. Samuels: Yeah I have not treated her with those topicals. She's been under someone else's care for that for years and I just met her today.

Stephanie S: I just see these kind of cases and I think the PRP plus the Estradiol is really the key and then they will clearly, unless it's been so phimos that it's permanent scarring which is really unusual which you were saying earlier, that these patients really all do respond. Just like Doctor Posey is seeing in her reviews.

Dr. Runels: You know the other thing is Kathleen's a big fan of testosterone cream. I know that's old school but she's a big believer that following and keeping them on testosterone cream post procedure is also helpful. I don't think the studies-

Go ahead.

Stephanie S: Yeah I'm a fan of intramuscular testosterone for most menopausal women. But that's another [inaudible 00:39:56].

Dr. Runels: Yeah before I had a no shot and I was just treating women with hormones. I did have really good result with testosterone creams for dyspareunia. And my thinking on it was that, and I'm also a big fan of intramuscular testosterone, but my imagining was that by applying it topically I can get really high doses at the site of disease. Higher than I could by doing an injection and then wanting the parental testosterone to be as high locally.

So start it off and do some of both. Some low dose testosterone at the site of the dyspareunia since the vagina does have testosterone receptors like the penis. Plus minus something parentarally, or IM injection or pellet. So Doctor Singer's also a gynecologist who's had some great success, I think, with our O shot.

Anything else anybody wants to say? This is a great case and I appreciate you being brave enough to bring it up and listen to what people have to say. We'll be curious to how things go.

Dr. Samuels: Thank you.

Dr. Runels: And talk to us about, I know people are starting to talk some about the electromagnetic chair and it's not really why we're doing the call but it sounds like you're going to speak about it. You're having nice results combining that with the O shot.

Dr. Samuels: Yes. So I was asked by BTL to be chair the committee in the US to gather some data on its use. And so Red Allenside, Nathan Garrett and myself and two dermatologists and Brian Kenny, another plastic surgeon have been working about the last six to eight months pooling our data. Doctor Garrett and I presented 150 patients. Our own pooled data at ASLMS in Dallas a couple weeks ago. It was really BTL's launch of the chair. And it works upon the mechanism of action is electromagnetic high fem, high intensity electromagnetic field therapy.

And it works on the muscle where as all of our other vaginal devices and devices [inaudible 00:42:35] externally in the vulvar areas as well, work on the soft tissue. So this is the first device with the mechanism of action directed to the muscles. And our pilot study had really incredible results. We took all types of urinary incontinence, but they were all menopausal women.

We didn't have any men in the study, however there are some indications, forthcoming, to use the chair for male nocturia anuria and post prostatic urinary leakage. So the results were very good. In summary, they kind of went like this. What we did was we measured, we had patient surveys and after treatments, which involved a package of six treatments, two per week. It's a 28 minute treatment.

The patient sits on a chair with, basically sits on this magnet, like sitting on an MRI. And the muscle is stimulated through pulsed electromagnetic fields which are creating super maximal contractions, much stronger than a kegel. So in many of these patients with pelvic floor weakness and pelvic floor muscle weakness and pelvic organ prolapse can't really even do a kegel. And one could argue that those are not effective anyway.

And so its super maximal contractions sustained for three or four seconds. And the machine pulses and the patients are slowly increased from 50% of max power to 100%. And the results showed 75% improvement, clinically significant improvement, which was measured through patient diaries and follow up questions on their follow up visits. But we measured the number of pads that they were using in a day and 65% of patients either reduced the number of pads they were using in a day to a minimum of one to three, even when they started out using eight to 10 in a day. Or completely stayed dry.

So we didn't weight the pads. We didn't do any urine dynamic testing or anything like that, but it was just a pilot study that we planned to follow up on with a larger patient sample. Perhaps comparisons with electrostimulation, Botox, medication, PT, non-surgical measures. But Nathan Garrett, Red Allenside and myself and the others that I mentioned were very impressed. And those that do the pelvic floor reconstructions, I'm not one of those, I'm a plastic surgeon. But they have really reduced the number of pelvic floor reconstructions they've had to offer patients.

And I don't know if any of you say 60 Minutes this Sunday, but they really, really hit hard. The source of the mesh that's used in the United States for pelvic floor reconstructions and the mesh that is sold here in the US, a large portion of it comes from China. Which is not the same therapeutic product. And I think that the market, especially since stress incontinence, stress urinary incontinence, mixed urinary incontinence, and urged urinary incontinence were the ones that had the best results that it will be technology that you'll hear some more about.

We've actually treated some patients with interstitial cystitis, intrinsic sphincter dysfunction, and even rectal and fecal incontinence that have had pretty nice results and prolapse as well. Different grades of prolapse.

Dr. Runels: So have you combined it with the O shot?

Dr. Samuels: I have. So I usually will sit with a patient. Try to figure out what the degree of symptomatology that have is. Is it mostly vaginal? Dryness? Itching? Dyspareunia or is it mostly incontinence? And how much of a quality of life decrease or the incontinence is and either start them with the chair as a stand alone therapy or I might combine that with some of the vaginal devices.

For the electromagnietic chair discussed. 
Call David Carraway 1-770-316-1647
or email here (be sure to let him know you're in the O-Shot® provider group for special pricing)...

And Red Alinsod has a lot of patients who are in combination treatments. I've incorporated the O shot with probably about a third of them if not a half of them. But I haven't been offering the O shot as long as the other things and that does seem to make everything better as well. This patient, the one that you presented tonight, she's going to start with the CO2RE Intima treatments and the O shot. And if the stress incontinence is not improved enough then she plans to proceed with the chair treatments.

Dr. Runels: Mm-hmm (affirmative). So from a business standpoint I spoke with one of our providers today who is doing extremely well. She's doing quite a bit of O shots and the way she structures it is she'll give half price on the ThermiVa if they get an O shot. So she'll do an O shot a few weeks later, two or three weeks later with ThermiVa. A second ThermiVa. A third ThermiVa. And then two weeks after that an O shot.

And she says the results are pretty spectacular, so I can see some protocol like that being worked out. Of course with all these devices. And what's left to be decided, we have all these tools now, what's the best algorithm? 'Cause we know each one of thems working to some degree, so if you want the Lamborghini treatment for stress incontinence, when do you do what and how far apart? And so hopefully you guys can help us figure all that out. But that's what one of our providers is doing.

Dr. Samuels: I think there has been a little bit of talk also with some of our patients. And I have a patient who's in my office today doing it on more of a proactive basis. I think she sort of hears what's coming and before her pelvic floor falls to pieces, she's kind of doing a couple things in tandem. And Gwyneth Paltrow actually has had a blog recently where she was promoting the chair in a fairly proactive way. And it's not expensive.

Most of the early users now are settling somewhere between 250 and 300 dollars per treatment. And if it means that a woman doesn't have to change her PJ's two or three times at night and can leave the house without a pad they think that's a pretty good alternative. And I think following the 60 Minutes segment, more women will want to do non-surgical things.

Dr. Runels: Just a quick idea about how when to do what. I get this question sometimes. Of course if you're using energy of any type, it's probably better to do the O shot afterwards, but it could be done immediately afterwards. For example, [inaudible 00:50:08] or IGF1, all those small proteins, growth hormone, all those small amino acid chains are fragile.

You can't even shake Genotropin in the bottle or it tears the chains apart. So we're either frying the egg with laser or we are breaking up the amino acids with our shock wave treatment if we do the PRP first. But there's not reason not to do the O shot immediately afterwards. Same visit.

Any of these procedures, or any of these devices where it's laser or radio frequency or shock wave or electromagnetic treatments. If you go back to the literature, there's actually a time when PRP was banned from being used by athletes. It is no longer banned. But there is a small, but measurable increase, in IGF1 systemically. And some of the basic research even talks about systemic done regulating of the autoimmune response with PRP systemically.

So to the point to like where I said for a while it was banned. But if you think about if what you're trying to do is build muscle then from that standpoint alone, it could be that there's a nice energy there. Not to mention the fact you're creating a possible [inaudible 00:51:34] sling. And so I would think they would work well together.

But working out when or how or how you structure it, I don't know. I just mentioned one possibility. I think that's enough unless you guys have anything else. That's right at an hour and there are no other questions on the blog. So thank you guys for coming. I'll get this up on a recording with a transcript and thank you very, very much Doctor Samuels for that interesting case and keep us posted. You guys have a good night. Bye bye.

Dr. Samuels: Thank you.

Dr DeLucia: Thank you.

Next Workshops with Live Models<---

Relevant Links

Vampire Skin Therapy™
For the electromagnietic chair discussed.
Call David Carraway 1-770-316-1647
or email here (be sure to let him know you're in the O-Shot® provider group for special pricing)...

Soldier Regrows Penis<--

International Society for the Study of Vulvovaginal Disease<--


Cellular Medicine Association