Episode 149: The Power of Hyperbaric Oxygen Therapy, Metabolomics and the Holobiont

Dr. Sherr believes that Hyperbaric Oxygen Therapy (HBOT) -- the administration of 100% oxygen at greater than atmospheric pressure -- is one of the most powerful ways to decreasing inflammation, accelerate wound healing, and optimise both physical and mental performance.

He is one of the few HBOT providers in the USA that creates personalised treatment plans for patients that include cutting edge & dynamic HBOT protocols, adjunctive technologies, laboratory testing, and nutritional interventions.

Dr. Sherr is the Director of Integrative Hyperbaric Medicine and Health Optimization at Hyperbaric Medical Solutions, in addition to operating his own independent hyperbaric consultation practice and performing in-person consultations in the San Francisco Bay Area (where he lives). Dr. Sherr aims to create access and educate all those who may benefit from HBOT through telemedicine consulting, advocacy, and education practice worldwide.

I wanted to share this second episode with Dr Sherr (he was on back in episode 77) to go even deeper into the little known facts about hyperbaric oxygen therapy like making epigenetic shifts, angiogenesis, stem cell production, lymph drainage and how it influences around 8000 genes in the body.   Hyperbaric oxygen  therapy was a major component in my mother, Isobel's rehabilitation after a devastating brain injury over 4 years ago.

Isobel was left with hardly any higher functioning, the brain damage was so severe she was unable to control her body in any meaningful fashion, had virtually no memory, no speech and was let in the . stage of a toddler at the age of 74.

But after three months in hospital and after months studying hyperbaric oxygen therapy and searching for somewhere to get her access to it I was lucky enough to find a chamber to use.  What followed was in my opinion nothing short of miraculous. and now after thousands of hours of training, combined with supplementation and diet changes and over 250 hyperbaric sessions later. Mum is completely normal again, can walk, read, write, do all her normal daily duties and is living a full life again, her doctor saying is a one in a million comeback story.

This is why I was so excited to get one of the worlds leading experts on this therapy to speak on my podcast and to explain much clearer  and better than I ever could, just what the mechanisms of HBOT are and the benefits, limitations and research going into this area of medicine.   My book "Relentless" which is out now on my website and everywhere good books are sold shares our journey with hyperbaric among other adjunctive therapies.  

We would like to thank our sponsors for this show:

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Lisa's third book has just been released. It's titled "Relentless - How A Mother And Daughter Defied The Odds"

Visit: https://relentlessbook.lisatamati.com/ for more Information

 

ABOUT THE BOOK:

When extreme endurance athlete, Lisa Tamati, was confronted with the hardest challenge of her life, she fought with everything she had. Her beloved mother, Isobel, had suffered a huge aneurysm and stroke and was left with massive brain damage; she was like a baby in a woman's body. The prognosis was dire. There was very little hope that she would ever have any quality of life again. But Lisa is a fighter and stubborn.

She absolutely refused to accept the words of the medical fraternity and instead decided that she was going to get her mother back or die trying.

This book tells of the horrors, despair, hope, love, and incredible experiences and insights of that journey. It shares the difficulties of going against a medical system that has major problems and limitations. Amongst the darkest times were moments of great laughter and joy.

Relentless will not only take the reader on a journey from despair to hope and joy, but it also provides information on the treatments used, expert advice and key principles to overcoming obstacles and winning in all of life's challenges. It will inspire and guide anyone who wants to achieve their goals in life, overcome massive obstacles or limiting beliefs. It's for those who are facing terrible odds, for those who can't see light at the end of the tunnel. It's about courage, self-belief, and mental toughness. And it's also about vulnerability... it's real, raw, and genuine.

This is not just a story about the love and dedication between a mother and a daughter. It is about beating the odds, never giving up hope, doing whatever it takes, and what it means to go 'all in'. Isobel's miraculous recovery is a true tale of what can be accomplished when love is the motivating factor and when being relentless is the only option.

 

Here's What NY Times Best Selling author and Nobel Prize Winner Author says of The Book:

"There is nothing more powerful than overcoming physical illness when doctors don't have answers and the odds are stacked against you. This is a fiercely inspiring journey of a mother and daughter that never give up. It's a powerful example for all of us."

—Dr. Bill Andrews, Nobel Prize Winner, author of Curing Aging and Telomere Lengthening.

 

"A hero is someone that refuses to let anything stand in her way, and Lisa Tamati is such an individual. Faced with the insurmountable challenge of bringing her ailing mother back to health, Lisa harnessed a deeper strength to overcome impossible odds. Her story is gritty, genuine and raw, but ultimately uplifting and endearing. If you want to harness the power of hope and conviction to overcome the obstacles in your life, Lisa's inspiring story will show you the path."

—Dean Karnazes, New York Times best selling author and Extreme Endurance Athlete.

  Transcript of the Podcast:   Speaker 1: (00:01)
Welcome to pushing the limits, the show that helps you reach your full potential with your host, Lisa [inaudible] brought to you by lisatamati.com.

Speaker 2: (00:12)
Well hi everyone. Fantastic to have you back again on pushing the limits today. I have a fantastic interview with Dr. Scott Scheer, who is a physician out of the United States. Now Scott, Dr. Scott has been on my podcast previously and it was one of the most popular episodes, so I'm really, really privileged to have him back on. Yeah, Dr. Scott is a pioneer in health optimization medicine and in this episode we really going and doing a deep dive into one of my favorite therapies, hyperbaric oxygen therapy, but we're also going to be talking about meta below mix in the hollow biome. Yeah, Dr. Scott is a position certified in the health optimization medicine and in hyperbaric same time and he uses both of these protocols and adjunctive technologies. Uh, he's a father of four and he's an incredible, uh, really outside of the box thinker and I love his approach to his work.

Speaker 2: (01:04)
So I'm hope you enjoy this episode with Dr. Scott shoe. Just a reminder, my book [inaudible] is now out. And, uh, my story with my mom was all, uh, one of the cornerstone therapies was hyperbaric oxygen therapy and I was, it was wonderful to connect with Dr. Scott about that previously and to learn all about hyperbaric. So I hope you enjoy this interview and if you want to grab the book while you're at it, he don't have it to my website, lisatamati.com and there was a lengthier under the shop for the books, so check them all out. Thanks for listening and we'll see you again soon. And now over to Dr. Scott. Well, hi everyone. Lisa Tamati here and very excited to have you on board again today for an exciting episode. I have Dr. Scott Scheer with me who is a hyperbaric specialist, uh, from the States and he is, uh, had been on my show before and he is now coming back on here. It was one of the most popular episodes on the whole show. So I'm really, really excited to have Dr. Scott Beck and he's actually sitting in his own hyperbaric chamber right now and doing the interview from inside his own hyperbaric. So Dr. Scott, how are you doing?

Speaker 3: (02:16)
I'm doing well. Can you hear me okay, Lisa?

Speaker 2: (02:18)
Yeah, it's not too bad. We might have to ramp up the volume when we're doing the either thing, but we'll give it a go. See, here we go. Okay,

Speaker 3: (02:26)
sounds good.

Speaker 2: (02:27)
I'm sorry.

Speaker 3: (02:31)
Yes, I'm in my own chamber. I, um, I have my own mild hyperbaric units. Mild hyperbaric therapy is defined as hyperbaric therapy, less than or 1.3 atmospheres or more superficial than that. Um, and so these chambers go to about 15 feet of seawater equivalent. Um, and these chambers are approved for home use. Um, and I use them for a lot of different reasons, but personally I use it for just overall health and wellness, cognitive capacity enhancements, muscle recovery, jet lag, and a couple of other other indications. The chamber is nice because it's a triangular type of chamber, which means that you can actually sit up in it and not have to lie down completely. And I've been using it a lot these days, given pandemics and all those kinds of things and doing my best to stay healthy along with everybody else. At least a lot of other people that are not eating junk food all the time.

Speaker 2: (03:32)
Yeah. And we'll get into that a little bit later that year. Um, no amount of boy hacking all out to a good dog bed diet. So we definitely need to focus on that. But, so Dr. Scott, so I have my own hyperbaric chamber. I go in and every pretty much, you know, three or four times a week at least my one goes up to 1.5 atmospheres. And, but you also have a clinic that goes, uh, has, um, hyperbaric chambers that go, uh, too high up precious. Can you explain a little bit difference between the mild hyperbaric and the medical grade, if you like hyperbaric sort of things?

Speaker 3: (04:09)
Yeah, sure. So hyperbaric therapy in the United States is approved for 14 different conditions and all of those conditions have been studied at two atmospheres or greater. And so all the medical conditions for hyperbaric therapy cannot be treated in mild hyperbaric units. They can only be treated in, in units that are more medical grade. The medical grade chambers go down. Uh, there's different types of medical grade chambers. The most common, it's called a motto place or a single unit occupancy chamber. That chamber goes down to somewhere between 2.4 to three atmospheres of pressure. Three atmospheres of pressure is the equivalent of 66 feet of seawater. What's interesting about 66 feet of sea water equivalent is that when they, that's actually where they've done studies showing that at that level you no longer need red blood cells in circulation to get enough oxygen diffused into the plasma where the liquid of your blood at that level and maintain your physiologic functions.

Speaker 3: (05:10)
So it's a, it's a significant amount of oxygen that we can get into circulation. And so, um, what we're doing in a chamber is obviously driving more oxygen into circulation. And that's kind of like the quick and dirty of what's happening. When you go in there. The heart chambers are typically going down to deeper pressures, um, two atmospheres or above. Mmm. And then the soft chambers, um, depending on the type of chamber you have, it could go down to 1.3. Some of them go to 1.5. It depends on the country and the location. Well, I think what's more important for people is not that type of chamber really. But because some soft chambers can actually go to very deep pressures and heart chamber go to any pressure, they can go to superficial chamber pressures and they can go to deep pressure. What's most important, I think is knowing is treated or what the difference in treatments is depending on the pressure.

Speaker 3: (06:03)
Mmm. We think of neurologic pressure. So brain and spinal cord related pressures being somewhere between 1.3 and 2.0 and we think of things outside the central nervous system, soft tissue, um, and sort of overall hello. Outside of the central nervous system. A 2.0 and greater in general. No. From a like detoxification, lymphatic perspective, you can get benefits at both at 1.3 to 2.0 along with a 2.0 or greater. And from a STEM cell release perspective, the further down you go, the deeper you go, the more STEM cells that are released. So the indications fall into those two basic categories of neurologic versus non neurologic conditions. Although you can modulate the salt chambers to help you with some non neurologic conditions as well. You are getting more oxygen in circulation, right? So you are getting the ability to enhance your flow of oxygen to tissues regardless of the chamber and regardless of the pressure actually, although some pressure is needed. Mmm. And then you are helping with detoxification as well, no matter what pressures you're using,

Speaker 2: (07:19)
but it's more optimal at the, at the higher pressures. So,

Speaker 3: (07:23)
okay.

Speaker 2: (07:24)
So for neuro separate brain injury, like um, you know, not my story with my mum, um, 1.5 was what, you know, we were recommended is an ideal, uh, pressure for, for brain injury. So, so you're saying the neurological, the problems that people have actually better at the lower or the a then this oppression. So I should say, and for things like, um, Mmm diabetic wounds or um, healing injuries, uh, boons, that type of thing at a higher pressure would be more beneficial, but, or hyperbaric will help with detoxification. And was the limps and speeding up the healing hearing properties, the STEM cell release, is that higher when it's deeper, uh, pressure or high pressure?

Speaker 3: (08:11)
Yes. Yeah. The deeper you go, the more STEM cells are released because it's related to how much oxygen is being infused. The more oxygen infused, the more STEM cells get released. It's a, it's kind of a, it's kind of, it's a direct relationship.

Speaker 2: (08:27)
So do you know the, um, so I remember from the last podcast you're saying, you know, up to 12 times the amount of oxygen can be taken up into the body. Um, it is sad. So it says three atmospheres, there'll be 12 times in it at one and a half atmospheres. That would be, I don't know, somewhere in that for some six, seven times the amount of Mmm. Uh, oxygen that's diffusing. Now, the difference with a hyperbaric is actually, you know, like people will say, well, you know, I put an SPO two of my little thing on my finger and it says I'm 98%. I'm saturated with oxygen, right? How do I get more oxygen in? So what is the different mechanism between normal barracks, uh, pressure and hyperbaric pressure?

Speaker 3: (09:16)
Yeah, it's a question I get a lot, Lisa, and I'm sure you get it a lot too. So a pulse oximeter, it's something you put it on your finger and that measures the arterial oxygen saturation of your red blood cells. So you, red blood cells are what typically carry oxygen from your lungs. When you take a deep breath [inaudible] after going out of your lungs, as they go through the rest of your body and they to release oxygen so that you can make energy without oxygen, you cannot make ATP, which is the energy, energy currency of, of our body. And so you're right, our red blood cell carrying capacity for oxygen at sea level, he's actually quite good. That's when you put a pulsox machine on your finger. You get 97 to a hundred percent if you have normal lungs. So hyperbaric therapy is going to saturate any more sites on the red blood cells where they can carry oxygen.

Speaker 3: (10:08)
If there is like 97% sites, I already occupied those extra 3% will be occupied. But what's actually happening and the power of hyperbaric oxygen therapy in its ability to change this gaseous form of oxygen into a liquid form that actually diffuses directly into the plasma or the liquid of our blood and the liquid of our blood has very little oxygen in it at sea level. And we can diffuse up to 12 times or actually even more than that, a deeper pressures than three ATA, oxygen in circulation. And it's that extra oxygen you cannot get without having also been under pressure at the same time as getting more oxygen as well.

Speaker 2: (10:49)
So then this is really powerful when it comes to say injuries where uh, there's been a blockage to the blood supply to a certain area so that whether that's from a heart attack or a stroke or you know, Mmm. Or even as I presume with crush injuries and certain things like this we are not able to get, Lisa was a blocked in some way that you can actually perfuse the area around the injury with oxygen despite it not going through the blood vessels. Is that, is there a correct way of explaining it or

Speaker 3: (11:25)
know? The way I like to think about it is that you have all this oxygen that's now in circulation and it's kind of like oxygen, just like osmosis. We'll go to the area where there's less of it, so the more oxygen you have in a blood vessel, the more of that oxygen is going to get into the tissue around the blood vessel so you don't have to have as much vascular density potentially to get oxygen to that tissue because we've found a few, so much oxygen inside of that tissue bed itself that it could potentially factor as a way of saving tissue in the acute setting. So like you said, like the acute ischemia is the acute hypoxia is or low oxygen safe that happened with a heart attack. Well you have a lack of a blood flow in a coronary artery or a stroke.

Speaker 3: (12:09)
We have lack of blood flow, an artery in the brain or a spinal cord injury. When you have arteries that are actually broken you can actually get more oxygen to that tissue because you can diffuse more into the tissue bed around the injured blood vessel. It was also good is that when you have an acute injury there's also going to be a lot of swelling and actually injury too. The vessels that are going to cause leakage of that fluid and swelling. And actually in the chamber you actually constrict down blood vessels a little bit and that constriction actually helps you and prevents some of that fluid from releasing. And for some of that swelling to happen, even though you have this constriction of the blood vessel, you've also net had a significant delivery of oxygen to that tissue regardless because we've had all of that oxygen diffuse into the plasma. So Mmm, oxygen carrying capacity in normal settings without pressure is only dependent on how many red blood cells you have. But in a chamber we're pressurizing your body, pressurizing your breath or your whole body really. But when you take a deep breath, that pressurized oxygen is driven into the plasma or your liquid of the blood and that liquid of your, of your blood, it can go much further and diffuse much further into tissues outside of blood vessels as well.

Speaker 2: (13:26)
So for an example was, um, you know, my mom's story with the aneurysm. If I had managed, and of course at this stage I didn't know anything about Harbor about when this first happened, but if I'd been able to get her into a chamber immediately after the event occurred, uh, the cause the inflammation obviously with a broad love and Brian tissue mixing causes inflammation in the skull. Yeah. Um, that would have been hugely beneficial if I've managed to get her in a few times immediately after the event. So after she was stable, yes. Obviously, yeah,

Speaker 3: (14:03)
being stable. So I have some people, I just like to be very clear, you should go to a hospital. Did you have a stroke or you will have a heart attack and don't go to your local hyperbaric provider once you're stabilized. Yes. Um, there are some indications that the sooner that you can get treated in a chamber, the more oxygen you can get to your brain to a certain degree. I mean, not huge amounts. You don't want to go down to three atmospheres because that could be dangerous for your brain, but oxygen to your brain, oxygen to your heart after an acute event is going to save tissue in your brain and save tissue in your heart. [inaudible] they've even done studies looking at people that are getting bypass procedures, coronary bypass procedures. And if they're doing this, they get into a hyperbaric chamber right before, um, they save tissue in their heart so they, they have more harder to function, have better neurologic function after a coronary artery bypass grafting procedure.

Speaker 2: (14:56)
Wow. So, so Dr. Scott, like why is there any place in the world where this is offered in the ICU? You know, in the acute setting where people are coming in with major injuries or strokes or heart attacks or this type of thing where it's actually used as a part of the syrupy and if not, why not? Why is it not everywhere?

Speaker 3: (15:17)
Well to do acute care, hyperbaric therapy, it takes very specialized capability because if you're going to be in there with attendance or you have IVs going and you have others drugs you need to give, it's, it's definitely a specialized service. Um, in Japan, China and Russia, it's used much more in the acute setting than it is in the United States. The U S it has, and it still is used for acute trauma. So if you have like a traumatic ischemia, like we have a traumatic injury to one of your soft tissue areas, for example, it can be used. Um, but in general, um, it's not used as often in the trauma setting in the, in the U S as it is in other countries, especially China, Russia and Japan.

Speaker 2: (16:05)
Right. Okay. And it's not, it's not used here either and it's not even approved. Is it on the, in America, is it an approved treatment for, um, neurological events?

Speaker 3: (16:18)
There's no neurologic indication that's covered right now in the United States. Wow. Yeah.

Speaker 2: (16:23)
Even though it is right,

Speaker 3: (16:24)
I'm going to change that. And I mean the one that has the had the most, I think research behind it in the most interest is traumatic brain injury and concussion. There is definitely some good studies from across the world. M a U S showing how hyperbaric therapy can help people recover from concussion and traumatic brain injuries, which is another name for concussion really either in the short term and like from an acute concussion or even from hello term symptoms that may not go away.

Speaker 2: (16:53)
Yeah, absolutely. So we were talking about like there's different things here that are going on. You've got, it's detecting the inflammation is producing more STEM cells. It's a, it's Oh, sorry. Knocking off senescent cells isn't it? Which are your old cells that are not doing much of anything.

Speaker 3: (17:15)
Yeah, they're called the zombie cells. Right. So, um, can we, I like to think about hyperbaric therapy is, is relatively simply, there's four things that we do in the chamber. The first thing we do is we reverse hypoxia. We've been already talking about that. We reverse low oxygen States by getting more oxygen into circulation and over the longterm a protocol of hyperbaric therapy, create new blood vessels in those areas that have been injured. We're going to play games and then maintain the ability to get blood flow to that tissue over the long term. That's the first thing, reversing hypoxia. The second thing is decreasing inflammation. It does that immediately by constructing down the blood vessels like we talked about, but also over the longterm. It has the ability to shift our epigenetics, change how our body, our DNA expresses certain proteins that are responsible for inflammation.

Speaker 3: (18:07)
Things like TNF alpha, I'll one L six I'll eight and others. The third thing it does is releases a massive number of STEM cells. Those STEM cells all released throughout the body and they hone or they go to areas where there is more inflammation or there's more need for STEM cells to go to those areas and regenerate them. The next thing that happens is that there is, especially in higher oxygen environments, we have the ability to kill bugs, kill bacteria, fungus, and potentially even viruses. A deeper pressures in the chamber. So senescence cell populations look like they do get decreased or they do go down. We're not exactly sure how that's happening. We don't know if that's happening because those cells are being regenerated or if those cells are being killed off and either way is good for the body really. Because when they stick around and they're not replicating, and there we have a high association with cancer, with degenerative disease. Yeah. With aging overall. So senescent cells aren't cool in general. So we want those to go away. Uh, we don't know if that's because new STEM cells are coming and just the other ones are dying or if we're now getting more oxygen to the tissue. And so those cells are getting enough oxygen to regenerate their mitochondria and start making energy more effectively, which is where we make energy in ourselves. We're not sure.

Speaker 2: (19:39)
So the senescent cells are basically cells that have had past their use by date really. And they're not doing much of anything except causing trouble in the body, causing inflammation, causing changes, perhaps even, uh, in closing cancers and so on. Um, so it's really good to be getting rid of those. You mentioned the, um, I was six. Yeah. I are six from memory as one of the ones that they talking about in the Cobra, uh, scenario a that that's so interleukin six is, can you explain, um, I mean obviously we don't know whether it's good for coven Mmm. But is this potentially something that if someone has the Corona virus that they can potentially look at doing to stop the cytokine storm that's actually killing the people?

Speaker 3: (20:30)
Well, we're actually looking into it now. I have several colleagues around the United States that are starting with clinical studies to look at how hyperbaric therapy I can work on two fronts. It can work as a way to get more oxygen to the system as we've been describing it, because one of the things that's happening in covert is that they're getting very, very hypoxic. They're getting very low oxygen levels and we think this has something to do with destruction of the red blood cells or the inability of red blood cells to carry oxygen as effectively. So again, we can bypass that by being in a chamber like I am right now and pressurizing around you. And then as a result of that pressurization, I'm getting more oxygen in circulation regardless of how many red blood cells I have working or not, how many hemoglobin molecules I have working or not.

Speaker 3: (21:16)
So that's one area that we're looking at is how hyperbaric therapy can work. The other area that we're looking at is as, as as an anti-inflammatory. So it does have the ability to downregulate those inflammatory cytokines, one of them being IO six. So maybe helping with that cytokine storm at the same time. We also know for other studies over the years that hyperbaric therapy is and immuno modulator, it helps the immune system function better. Um, so we think in the early part of the process, maybe if coven 19 we don't know yet for sure, but it may help to support the immune system and allow it to sort of weather the storm better as opposed to not weathering it as well. So it's a lot of conjecture right now, Lisa, you know, we don't know for sure how it works or if it's going to work, but there are definitely some of my colleagues around the U S and around the world that are looking at how hyperbaric therapy might be a helpful adjunct to conventional care.

Speaker 3: (22:16)
Maybe prevent people from getting intubated or being on ventilators, which would be a great thing. And so they're looking at that as another having you, and they're also looking at pressurizing the hoods, the hoods that you were in a hyperbaric chamber as a way to get more oxygen into the system without being an hyperbaric chamber as well. So yeah, I've posted a little bit about this on my Instagram because I just find these really intriguing. There is actually one company that's looking to retrofit airplanes. Airplanes are usually pressurized at 8,000 feet above sea level, so they're actually hypoxic environments. There's lower oxygen on and off on an airplane. That's your breathing as opposed to being at sea level. Wow. But what they can do is that they can reverse their pressurization and actually pressurize it. Like a hyperbaric environment. No, you couldn't fly with a plane like this because it would be too heavy, but you can keep it on the ground and and make it a hyperbaric chamber. And you know those oxygen masks that come from the ceiling already, right? So they could use those oxygen masks as a way to get more oxygen into circulation. So this is just one of those sort of crazy ideas. But it's a really interesting idea where you can actually retrofit airplanes to be hyperbaric chambers. Wow.

Speaker 2: (23:31)
Because that's one of the reasons we get jet lag, isn't it? Because we're, we're, we're at this, um, you know, equivalent of 8,000 feet or 2,500 meters. Mmm. Right? So we're just, we were actually coming out with a bit of an altitude situation where you've actually not got enough oxygen and that's adding to the fact that you've been traveling for how many hours and sitting still and not oxygenating. Anyway,

Speaker 3: (23:55)
there's the circadian rhythm piece of it, but you are at low oxygen levels and you are at higher risk for jet lag and infection too, so that's why you have a higher risk for infection when you fly. Not so much because of the sanitation on the plane. Although yeah, the air itself on a plane isn't the cleanest. Yeah, and I'm hoping that one of the things that happens with this whole covert thing is that the air on planes becomes cleaner than it is now. That more is coming from the outside of the plane and be less being research related, but in in in essence the low oxygen environment is, is definitely not helping from your health perspective and like the Dreamliners. Some of the newer planes are pressurized to 6,000 feet above. See instead of the 8,000 you said it helps with jet lag and you add on circadian rhythm changes or helping urge on your circadian rhythms to be in the, the times when you're going on it's going to help significantly and that's what new plans are trying to do and that's a new health. Your hotel rooms are also trying to do as well, new hotel rooms with new lighting and things like that that are happening, which is super cool. But in essence, yes, the airplane itself is a hypo H Y P O Barrick environments. And we can make it and retrofit it to be a hyperbaric environment as well, which, so if you have any extra seven 30 sevens hanging around, let me know and we can work on it.

Speaker 2: (25:14)
There you go. We can got Richard put them together. That sounds really good because flying is one of a really big danger to our health and we've, we've seen the effects of covert going through airplanes, you know, all that sort of, um, um, I just wanted to, to touch on a couple of years, NGO Genesis. Can you explain what angiogenesis is and what is actually happening there in regards to Hochberg?

Speaker 3: (25:42)
Yeah. So angiogenesis is the creation of new blood vessels. And in a hyperbaric chamber, that acute infusion of, of oxygen, it's going to flood the body with more oxygen, but it's not going to create new blood vessels. What happens after a protocol call of hyperbaric therapy is that we have these epigenetic shifts, we have these shifts and expression of DNA and that DNA expression is shifted in a way that more blood vessels are created because of some of the various factors that are released under pressure and under a high oxygen conditions. Those are things like VEGF, which is a very common blood vascular growth factor and others. And we have these new blood vessels that form and they tend to form in areas where there is hypoxic tissue or there is low oxygen in tissue. They tend to form an areas where there have been injuries in the past. And so these new blood vessels which are created allow the sustainability of the results on the effects of hyperbaric therapy to be a longer term play.

Speaker 2: (26:43)
So if you have a heart problem, so you have to ha, you know, you've got a blockage in one of your, your arteries. Um, is this a possible way to get around that blockage without surgery in conjunction with surgery over the longer term enough stations here.

Speaker 3: (27:01)
So we're talking about collateralization of blood vessels, which which would, what I mean by that is that that's the medical term of you basically create collaterals around blockages and that's what a bypass is, right? A bypass procedure is creating ways to go around blockages. It's like, it's like going off the on ramp and taking the service road like around traffic, uh, that stopped and then going back on the service road back onto the freeway after the traffic is over kind of deal. That's a good way to describe it. What a collateral would be like a collateral road. And so hyperbaric therapy can help you create those. And we don't know about the heart specifically though because we haven't done the studies to know. But we do know from the studies that have been done that there is an increase in vascular density in the heart. There's an increase in vascular density in the brain after a protocol of therapy. And so as a result of that, you will have the ability to get more oxygen to tissue because you have more density of blood vessels. No, we haven't done the study looking at people with blocked blood vessels to see what happens under hyperbaric conditions. It just hasn't happened. But the conjecture that we have is that it would potentially help without collateralization. It goes off roads, service road kinds of ideas.

Speaker 2: (28:18)
Yeah. Going around, I heard, um, that DHEA is an interesting one for the main, at the uh, uh, erectile dysfunction can be helped with hyperbaric oxygen therapy, creating new new blood PA angiogenesis for that sort of a problem. Is that correct?

Speaker 3: (28:35)
Yeah, it's the same deal. I mean the, the physiology of hyperbaric therapy, it goes everywhere. Your, your full body is oxygenated. So decreasing inflammation, reversing hypoxia, the STEM cell release and killing bugs happens anywhere and that includes regenerating blood vessels in, in a penis or and uh, in areas around the heart or in areas that have degenerated otherwise. And so they did a study looking at erectile dysfunction in males that were relatively healthy and their erectile function improved after, I think it was 6,600 hyperbaric chamber treatments. And so that's new blood vessels that are getting created, a new blood vessel, low vascular flow and the penis. And so we have indications that happens in women as well with, with vaginal flow. But we don't have the studies to show that. Right. Often we'll get the, uh, the feedback from women and men that sex life is better in, in hyperbaric. There's people that have gotten hyperbaric therapy.

Speaker 2: (29:38)
That's a good reason.

Speaker 3: (29:40)
Yeah.

Speaker 3: (29:41)
Well, yeah, there are some studies on infertility already, uh, in helping with fertility because it helps getting it a deeper pressure helped, helps with the uterine lining. The uterine lining itself will, um, we'll get thicker under hyperbaric conditions we think. And then as a result of that, there's a higher chance for the embryo, the embryo to be implanted. And so if you have a thinner uterine lining, you can pick it up potentially in the chamber. So this is used already in Russia and in China as a fertility treatments actually quite commonly in the West and the U S it's not very common.

Speaker 2: (30:19)
No, I haven't come across the same one. You know, you the troubles with fertility for years. [inaudible] um, I'm going to get in there even more often now. That's not the reason.

Speaker 3: (30:31)
Just to be clear though, this is at the deeper pressures.

Speaker 2: (30:34)
Oh yeah.

Speaker 3: (30:34)
It's shown effect. So this is at like two atmospheres, 2.4.

Speaker 2: (30:38)
The 1.5 why won't quite cut it so that, that sort of a problem. It probably can't hurt Kenneth.

Speaker 3: (30:44)
I don't think it would hurt. No. I mean, but there are certain things that I don't recommend going at less pressure. Uh, and that I'm pretty emphatic about. So the things that I don't feel are likely well-treated at 1.3 are any open wounds. Any open wounds really need to be treated at deeper pressures. If you have any ongoing infections. I don't, I feel for the most part, that 1.3 atmosphere is enough. Really. I see a significant benefit unless it's an it, a bug that does not like oxygen environments. And then in that case maybe, but the deeper pressures would likely still be better. Yeah. If you have any chemical sensitivities, these chambers can sometimes make them worse because they're made out of a plastic material. And that plastic material, uh, does off gas to some degree. And I do find that some of my patients that are highly sensitive, so plastics and to chemicals, uh, will not feel good in these kinds of chambers either.

Speaker 3: (31:46)
If you have any of the FDA approved conditions in my country, I don't recommend using a soft chamber either. Those should be done in deep pressures. The only approved indication for these chambers, assault chambers, that's insurance coverage in the U S is acute mountain sickness. So you go up a mountain too fast, you get signs of altitude sickness, you can get into one of these chambers and you can feel better pretty quickly. And that's, you know, one of the reasons why I have some interests in, Oh, there has been interested in coven 19 specifically because they're thinking that some of the physiology is similar. Yeah. Altitude tickets, how people are, how responding to the virus.

Speaker 2: (32:30)
So, so, so most of those, um, so since only the only thing that, uh, Molotov America is approved for is mountain, even though there are, but, um, from, from, yep. Okay.

Speaker 3: (32:45)
There are studies to show that these pressures can be beneficial for brain related conditions. Yes, yes.

Speaker 2: (32:52)
Yep. Mmm. That's interesting. So, so oxygen oxidative stress was the next thing I wanted to touch on. So, so w when we think of oxidative stress, we think that that's a negative thing. Generally. You know, we should, we need to get rid of the oxidants in our body and we need antioxidants and we need to detox and so on. So why isn't this case oxidative stress? Not a bad thing. What is it [inaudible] is it an oxidative stress?

Speaker 3: (33:19)
Well, there's a lot of things in life that are good for us that are oxidative stress. One of the most common, hopefully his exercise exercise creates inflammation and oxidative stress. Body responds with the ability to produce antioxidants. And then as a result of those anti-oxidants being released, the body has a way of compensating and then growing stronger. And that's what's happening inside a hyperbaric chamber. Every single thing that's happening almost in a hyperbaric environment is because of oxidative stress. The only thing that's not as a result of oxidative stress is purely the oxygen infusion that's getting more oxygen to the cells and that's allowing more energy to be produced, but everything else, of course, that's very important, but everything else, the oxidative stress causes those epigenetic changes that are happening on the DNA. It causes is that STEM cell release, it causes that inflammatory downregulation.

Speaker 3: (34:17)
It causes those that vasoconstriction, that constriction of blood vessels that could be injured during an acute event, so it's oxidative stress that initially spurs the system to have a cataclysmic cataclysmic. Yup. Okay. That sounds almost like like a catastrophe. I mean, yeah. Yeah. Basically, you know, it's a huge catalyst for change. Cataclysmic and catalysts are not the same word, but I had a huge catalyst for change. But what happens is that the body, just like with exercise, has a significant ability to have a reactive antioxidant search and that antioxidant surge, it happens and equates or balances out all that oxidative stress or the oxidative stress that we gave the body initially. So it's important for me when I'm thinking about hyperbaric protocols, I think about the person in front of me, I think is this person, somebody that has the ability to have a re the reactive antioxidant surge to balance out that oxidative stress. Because if you're not healthy, if you are sick, if you're inflamed, if you have lots of chronic conditions you made, do be depleted in various things that could make it difficult for you to do this. And that's why I'm very emphatic when I can and when there's time to consider a foundational of cellular health, looking at vitamins, minerals, nutrients, antioxidant levels, looking at signs of gut dysbiosis and immune system function to understand how well somebody is going to do in the chamber before they get in.

Speaker 2: (35:54)
So that, that's a perfect segue because I wanted to go into, um, the whole foundational health, uh, and, and, and also adjunctive therapies too. Hyperbaric. Um, so it started with a couple of things like Mmm. You know, like taking things like vitamin C infusions before going into hyperbaric, uh, doing the keto diet or exogenous ketones in combination with hyperbaric. Mmm. And then looking as the next step and the conversation into the foundational things which really need to be addressed as well. Um, so they start with it junked of therapies that will benefit from a hyperbaric in combination.

Speaker 3: (36:40)
Sure. So yeah, that's a good segue I feel before getting into adjunctive, it's important I think to describe that I jumped in. Therapies can definitely synergize together, but it's really important I feel to have a good sense of your own foundational biology before you start stacking therapies on top of each other. Because synergistic tools that are both potentially oxydative, IB, vitamin C, and I can direct therapy, it can be very helpful. However, if you don't have the capacity to physiologically benefit from it or potentially have side effects as a result of the too much oxidative stress, it could be detrimental. So when I think about stacking therapies, I often try to take it a step back and say, okay, let's look at that foundation assessment first. Like your vitamins, your minerals, your nutrients, you're announcing the levels. That's the reprogram that I have that I, that I work with called health optimization medicine, which was founded by a colleague of mine named dr Ted Archer, COSO.

Speaker 3: (37:43)
And I work as the C Oh of our nonprofit that's educating doctors on how to do this. And I also have my own clinic concierge virtual clinic, really in the Bay area in San Francisco, working with clients across the U S across the world. So once I've done that, once I've looked at that foundational biology, then I think about therapies that can stack on top of hyperbarics or with it. One of the things that I think about is a low level light there. There'll be a low level light technologies because lights have the ability to get more oxygen to tissue by dilating the blood vessels in that area. And so if you're dilating various blood vessels in an area, you can then get more oxygen to that area. So that's one way for some specific spectrums of light to help. Um, infrared light is also really good for detoxification.

Speaker 3: (38:33)
So I often combine hyperbaric therapy with detox publication strategies and one of them being infrared light, I think about post electromagnetic field technologies. Wow. Those are micro circulatory pulses of electromagnetic fields that can help with circulation. And then increasing circulation is going to help you benefit in a hyperbaric chamber as well because you're getting more tissue oxygenated because there's more tissue that's dilated in blood vessels. And so we can help there. I also think about using various technologies inside of a hyperbaric chamber. If you're in a software like this one because then now you can bring in things that are portable and then you can do brain training like neurofeedback for example. And you can do other types of brain training and using computers or iPads or whatever, doing certain things to sort of work on your multitasking capabilities and, and the like. And you can do a lot of other different things. But those are some of the things that come to mind.

Speaker 2: (39:31)
Wow. This is what really getting into the whole, you know, optimizing in, in high performance and being able to, to stack the different biohacks if you like. And the different things on top of each other. I'm very interested in the infrared light therapy and um, have some of the products from vital light. Um, again, something that I've used in conjunction with, uh, for mums rehab. Mmm. And uh, very interested in the PME if I haven't had a chance to, to go down that route, but very keen cost prohibitive to have that at home unfortunately. Um, so there are so many amazing things in the biohacking world if you like, where we can actually, uh, sat to look with relatively low risk, um, the lights therapy. Um, it's an interesting one. Also the detrimental effects of blue light coming from our computer screens, stuff like that.

Speaker 2: (40:28)
Um, yeah and that's um, you know, probably a topic for another day. But what I did want to go into is as you work with dr Ted COSO who I would love to get on the show as well. He's amazing. Um, so dr Ted, uh, is from the Philippines and he has a um, uh, he has health optimization, Madison and so you are the CEO of that company. Can you tell us, well dr tin has created his own own hole. What would you call it, system of looking at so meter below mix the hollow biome. Can you explain what the heck those are? Cause I'm sure nobody listening to this podcast would have come across those terms yet. Sure, no problem.

Speaker 3: (41:16)
Yeah. So dr ten's an anti-aging doctor. He, uh, we specialize in antiaging medicine and then created his own practice that looks right. Two, I think take the best of conventional medicine. And then the best of what was under the radar in conventional medicine, which is called metabolomics, which is the field of study that we look at real time cellular metabolites. So the real time factors that are making ourselves work. And we can measure all of this. This is something that I didn't know when I was in medical school that you can actually do, but you can actually measure all of these various factors and understand how the body is making energy, how the body is processing your various foods into like from macronutrients all the way down to micronutrients, understanding how we can measure antioxidant levels. And so you can do all this. And so what Ted developed was a way to do this sort of like in the 80 20 framework, which is 80% of the benefit for 20% of the testing and focusing that testing on health and not focusing on any specific disease or condition and setting that aside for the moment and, and just doing, Mmm.

Speaker 3: (42:25)
More testing related to health and health focus. And so the program itself has seven pillars, but they all comprise what's called the hollow biomes. H, O, L, O, B, I, O, N, T. And this is the idea that we are not just an individual in a population, but we're actually up population of organisms or individuals together in ourselves, in it of ourselves. So we are made up of fungus, virus, bacteria, human. And then we're also made up of the, the metabolites or the production, the toxins and the other things that are in environment. That's all happening all on our cellular level that we can see. So the idea is to create a program for people that uses all of that data that we can measure and understanding where it's coming from and then how to optimize and balance. So the first pillar is metabolomics, which is looking at the cellular data.

Speaker 3: (43:25)
Another one is epigenetics or looking at how our environment and how are exposures overall change how our epigenetics are or express or how our DNA is expressed through epigenetics, looking at chronobiology or circadian rhythms and how light especially affects our circadian rhythms, looking at the gut immune system. So that's our gut microbiota and in detail how our gut is a very significant indicator of our overall health and our immune health and neurologic and psychologic health are all related to our gut, just on some level looking at evolutionary biology. So the idea is that we have trade offs in our evolution that some certain traits will help us when we're younger, but actually be a detriment to us when we're older. And also how our evolutionary biology is related to our ancestry. So where our ancestry as well also indicate where we should potentially best focus our diet and our and how we change it depending on seasons, et cetera. And there's also the bioenergetics pillar, which is related to energy production, other cellular level. And that's mostly our mitochondria as well, where we're making energy and exposomics, which is the study of toxins, the toxins in our environment. But in essence, this is what we call our whole bio. And we can use about 500 or so data, measure measures to look at measures of all of these things and then create programs for our clients using those metrics and these pillars. [inaudible] really optimize health over the longterm. That's the idea.

Speaker 2: (45:09)
Wow. So that's just, this is, this is unsigned and something that I'm hoping to study in that in the future. Once I get through the next lot of study, it's just seems to be one

Speaker 3: (45:19)
the chamber you can study.

Speaker 2: (45:21)
I do. I was yesterday sitting in there listening to all your lectures and preparing for today's podcast. It's a brilliant way to do it and it just seems so much to learn. Mmm. And I'm very interested in dr Tibbs work and um, you know, coming to grips with it. Um, you know, we, we, we do something in our company, you know, if the genetic testing was that dr Alberto Gralise work and we're finding that absolutely. Yeah. Fascinating. Now, adding in the functional genomics into that with document's or Mohammed's work, uh, it just gives another lens at another lens to be able to look through. And the microbiome is an, is an area anyways, you know, um, you can't have one without the other. I just wish there was more hours on a day to day to deep misinformation.

Speaker 3: (46:08)
It's a network, Lisa. I think that's what you're going at, right? It's a network effect. Our body doesn't work in silos. You don't just have a heart, you just don't have a brain. You don't just have a gut. They all work together. It's this beautiful symphony. Mmm. Bacteria, virus cells, humans, human cells, mitochondria, which can be classified potentially as bacteria cells as well. Probably back in the day became or came from bacteria that combined with another type of cell that didn't have oxygen capabilities. And that's our, so we have all these things working together. We have hormones working together. We have chemical factories called cytokines working together, um, from a distance. Nothing has to be right next to each other to get there. We have blood vessels, we have lymphatics, we have nerves and other different types of channels to get things. So where they need to go with neurotransmitters.

Speaker 3: (47:00)
And so it's very difficult to just boil it down. So just a couple of things. I think where the future is going, there's a great article that I loved. It was actually, I think published about six months ago. It was at, it was actually published at Stanford, they called it the narcissism like narcissistic, right? The idea that you'll know everything about yourself, you're no your jeans, you'll know you're genomics, your proteomics, which are the proteins get from genes, you'll know your epigenomics, you'll know you're metabolomics and you will be able to use all this data to create a personalized understanding of you, your risk factors, but also what's actually happening to you right now and getting ideas of what you need to do now so that you can optimize over the longterm. The problem with just looking at genomics is that yeah, it gives you risks of what you may have, but it doesn't tell you actually what's happening.

Speaker 3: (47:56)
That's what metabolomics does. And so the narcissism is the idea that you have access to all this information and access to the data that's being, I studied as a result of this information too. So anyway, I think we're all gonna have those in our pocket books at some point in the next two years. It's a fascinating to be able to have all of that and to be able to look through these different lenses and to look at the person as a whole. And I think that's where, um, you know, allopathic medicine has had its limitations and that every specialty is very siloed in, in not necessarily communicating with. Right. Hmm. It's still too siloed and the brain does a work independently of the knee and the, you know, whatever the case might be. Mmm. Is it interconnected, focused on, in the past I'm saying would that would be a fear?

Speaker 3: (48:52)
Well, because as human beings, we try to simplify things as much as possible. There's very good reasons for that. Um, and I'm not, I'm going to be against it, but I think it's important that you have certain people that specialized in organs and do the work that they do and be very, very good at it. But it's like not having a primary care doctor, I'm just going to see a specialist. If you're just in the conventional world, what's going to happen is that you just get opinions in the very singular lens of that particular organ system. So it doesn't look at the big picture. And then you look outside the conventional system and you have to think about this larger, this larger understanding to really get a good holistic, comprehensive plan I feel of of how to maintain your health over the longterm. Cause if you're just looking at, I want to optimize my heart function, I want optimize my, my brains function.

Speaker 3: (49:48)
It's like, well what about your gut? You know, what about your antioxidant levels? What about your, see, what about you're motion in your feet and how that's affecting your back. And there's all these other aspects of things that are important. So I tend to work with people that look at more of a holistic view of movement and holistic view of health with whatever capacity. And I do my best to help people across the world in not only hyperbaric therapy, but helping them understand the best ways to approach their goals from a holistic perspective. And so I do, I think you remember, I do virtual consultations, education, advocacy for hyperbaric across the world. And I love new challenges and ways to people. I mean, I often get the thing, it's the same things over and over again, but I love when new things kind of pop up and I go, Oh, that's super interesting. And then I get to harness the network that I've created across the world to really help people. And a lot of these things, things can be done remotely now, which is great, which is even even better given that most of us are stuck in our homes. No, anyway, at the moment, given the whole pandemic thing, I was talking to my hyperbaric chamber for a little while longer, which I'm not too sad about that.

Speaker 2: (50:58)
And, and you know, I find this just such a refreshing approach that you, you know, as a doctor, as a medical doctor, an internal doctor who's looked outside of the box you had on your website somewhere or some somewhere I read, you know, the box was broken a long ago. Um, you don't all to confine yourself to one way of thinking or one.

Speaker 3: (51:18)
There was never a box

Speaker 2: (51:20)
for me, Lisa.

Speaker 3: (51:23)
It was actually, I created a box after not having a box and then I broke it open again. I grew up because I'm the son of a chiropractor who didn't have a box. There was no such thing. And so aye created some sides of that box and some, you know, some stingy walls and pretty thin walls when I went to medical school. So I could learn what I needed to learn and then now use that information and work within that framework when necessary in the conventional framework, but also knowing that they're clumsy and that it's easy to get outside of those walls and we should, especially if there's time, if there's time to work unconventionally than work on unconventionally. If there isn't a time work eventually, but also do unconventional things if you can and you could do them side by side. And that's one of the things I specialize in too is understanding that most things in life are not mutually exclusive and you don't always have time to wait for one or the other. And sometimes you just kind of have to throw the bus at it in a very methodical way to help it. I know that's what you did with your mom.

Speaker 2: (52:31)
Yeah. By Sigma. Yeah. A multifaceted Chuck everything. It started them out at the wall and I'd hope some of it sticks. [inaudible] it has,

Speaker 3: (52:41)
yeah. Throw shit at the wall is like is the nice way of saying it for maybe the nonsense nice way of saying

Speaker 2: (52:46)
and, and

Speaker 3: (52:47)
you do that in a methodical way and that's the important, the thing that I try to emphasize is that there has to be a physiologic reason and they have to be done, at least if it's, yeah. If it's a recommendation for me, it's have to be done in a methodical way that you kind of understand what's happening. And w the factors that are playing and not just throwing shit at the wall without a plan of what shit is going at the wall. At what time

Speaker 2: (53:10)
and looking at the risk reward. Yeah. And then making sure that you're not, um, and you know, for someone like, so, you know, if my nature is, is very much a dive in and just have a crack and, um, you know, sometimes they have to pull myself back and go hang a minute. The risks too high here or yeah.

Speaker 3: (53:29)
Words. So

Speaker 2: (53:31)
yeah, it's really, it's, you know, it's one thing to do it on yourself. It's another thing with other people in being able to,

Speaker 3: (53:40)
yeah. What I was saying is that as a new Zealander, you're, you're known for your risk taking. So sometimes you gotta you gotta you gotta bring it back in a notch there.

Speaker 2: (53:48)
Exactly. Yup. Too much adrenaline. You can say it in my epigenetics, my ring finger is longer than my index finger. I've got too much to drink. Nice. Um, but you know, like doctor dr Cher, you know, we'll wrap up in a second, but I just wanted to thank you so much because the advocacy that you're doing, the work, the connections that you're boating, the network, you really are the worlds having age of, of, of Oh this new, whatever the says that sets happening with us as personalized health, uh, this new paradigm shifts. And um, I'm excited to get your message out there. So if any of the lessons sitting out there, we'd like to talk to Dr. Scott because obviously he's a super expert in everything from a hyperbaric right through to metabolomics and the holiday BYOD. Um, if you would like a bitch or a consultation with doctors, dr shear, where can they go doctor?

Speaker 3: (54:43)
So for my consultation work, my education and advocate, you can see work, I do it all through my, my website. It's integrative HBO t.com

Speaker 2: (54:52)
integrated kioti.com.

Speaker 3: (54:54)
Yeah. And then if you could also disconnect with me on Instagram to add Dr. Scott [inaudible], S C O T T S H E R R. And I also, we can set some things up through that as well if people have interest. I've been looking to post more and get more out there for people. And I know I've been doing podcasts for awhile but I feel like smaller little bits of information are helpful too given the attention deficits of our current state of affairs. So I have this like funny airplane pillow around my neck there. That's better. Okay. Um, so it was nice when I was in the other position. Um, but so those are the two major places that I do my education, advocacy and consultation. I also have a new Facebook group actually just set up called optimize H optimize HBO T with Dr. Scott Cher.

Speaker 3: (55:43)
And this is a really fun one. I'm looking to have a location where we all can kind of get along in the hyperbaric community. They have like the heart chamber advocates and the salt chamber advocates and you have to be able to know a lot about having barrier therapy in that, you know, very little. And my hope is to create a platform where we can kind of all come together and I'm going to be creating content and curating content with a team of people to hopefully bring, I think I hope the community together a little bit more and bring more information out there. So that's a new, that's a new one that I've just come out with.

Speaker 2: (56:16)
I'm definitely count me in, count me in. I'm definitely an advocate for all of us. And um, want to share, you know, um, I've just sent you actually a copy of my book. I don't know if it'll get through when the covert situation, but I really want the story to get out.

Speaker 3: (56:32)
Yeah. For sure.

Speaker 2: (56:33)
Yeah,

Speaker 3: (56:34)
we'll hear that story.

Speaker 2: (56:35)
Yeah. And that's like 250 and counting hyperbaric sessions so far.

Speaker 3: (56:41)
That's amazing what you and your mom has done. It's really beautiful.

Speaker 2: (56:44)
That is really beautiful. So Dr. Scott, thank you so much. I'll put all those links for everybody in the show notes today. I really appreciate your time. Um, it's very, very precious to me and I really, really grateful for you doing all this work. So thank you very much. Okay,

Speaker 3: (57:00)
and you, Lisa. Thanks for all your hard work and your advocacy and it's been my pleasure to be on your podcast, my first one in the hyperbaric chamber.

Speaker 1: (57:09)
That's it this week for pushing the limits. Be sure to write, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com.