278. Dr. Jason Snibbe: On Why Meniscus Surgery Backfires, Prehab, Peptides, & Robotic Joint Surgery

20:13Oh, my God.

20:14Gary Brecka:And this was an issue because there was this little loophole where one of the rehabilitation specialists could come in, and if my mom denied therapy, they would get paid for the therapy and they would just leave. So I found out that this young therapist was coming in on the days she was supposed to see my mom and if she said, okay, you ready to go, Mrs. Brecker? And she goes, oh, I think I need to go to the bathroom. She goes, oh, patient denied therapy. And by noting the denial of therapy, they didn't have to do the rehab. So it set her back tremendously. and then she had the knee replacement and she was starting so far behind the eight ball.

20:57The muscle loss just from that. The muscle loss was incredible.

21:00Gary Brecka:And she's working her way out of it now. I have a rehabilitative specialist, comes to the house, what, three, four days, four days a week. Dr. Evan, big shout out to you. And does the post-surgical rehab and gait analysis and things like that. And it's helping a lot. So I help my father with his gait. but i i wish we had um known about the prehab yes um so for for someone like my mother what would uh you know where where we've decided yeah it needs to be a bilateral knees and you do them both at the same time right sometimes yeah in the right patient yeah um and um with this robotic surgery what would that prehab timeline look like and and what kind of biomarkers if any are you looking at before.

21:43I mean, we like, I mean, we obviously work with professionals that do the labs and we like to look at, you know, A1C. We like, you know, we like to look at all the inflammatory markers. C-reactive protein. C-reactive protein. All these inflammatory markers, sedimentation rate, different things to look at what people's inflammation is and also to look at all other aspects of their health, you know, and whatever they need as many biomarkers as they can check, you know, to just make sure that like even heavy metals and all those kinds of things to just get them detox from all these things. Because I just think that more optimized you are.

22:20But like I said, I like to get to people as early as possible. Most of the time we have about three months, you know, to get them going. And so getting them in prehab and getting them through that process where they're getting stronger, but we also empower the patients. We say, you're getting up day one and you're getting up immediately. And that's your job. And we walking the day of surgery. Our goal is to walk within an hour of the surgery. Oh my God.

22:46Gary Brecka:The nurses always say, if you have Snivy do your surgery, you're up and walking day one. So there's enormous amount of data showing that if you get up and walk on your joint replacement and immediately your confidence goes through the roof of trusting the joint. And I tell this to patients all the time. I'm like, your joint replacement is like a delicate egg. It's not gonna break. It's so strong. This is metal and plastic. It's really strong. So we get them immediately up. And then when they have that confidence, they realize, oh wait, I'm okay. I can put my weight on my leg. I'm not gonna collapse.

23:22I'm not gonna fall and break something. I can actually put pressure on it immediately. And that's one of the reasons, it's a good segue, it's one of the reasons for us, for me, my big passion is controlling the episode of care for these patients. Is how do we get the right people to touch our patients and have access to our patients through that process? Because in the medical system now, it's hard. Because in a hospital, some therapists buy into the system, they don't. Some internists buy into the system, some don't. And so I have spent my whole life, my whole career, trying to control that episode of care, to get the best physical therapist, the best person to check all those markers, the best person to give them the right medication, the right treatment to get them through that process.

24:13And we're starting to evolve into that, where it's all about like all the things that you do that I love. I was very flattered that you invited me in

24:22Gary Brecka:to be a part of your rehabilitation facility. and bring some of my biohacking tools there and maybe even take advice on how we could do, you know, better recovery through different biohacking. Absolutely, yeah, and that's what we want. We want a whole system. Because I think like it's almost like, yeah, you have to have a surgery and it's a process, but you can save that person's life. You know, if you do this whole analysis on them and you realize, hey, you need to lose some weight. You need to get your inflammation markers better. you can make their entire life better. Yeah. You know, the level of activity, their level of resilience and strength, you can change their life completely.

25:01Gary Brecka:Yeah, I love that. I also like that you're outside the box and you have a very progressive attitude towards things like PRP, exosomes, stem cells, and fascinatingly and very exciting, you know, peptides. Yes. You said that you're not only on peptides yourself, which is a good sign. But talking about peptides specifically for a moment, what peptides have you found in your surgical practice and your rehabilitation of patients post-surgery have been the most effective? Like what are your go-to? So my go-tos are BPC-157, TB-500, and ipamoralin, which is a stimulation of your own growth hormone. Those are the main ones that we use and those are the ones that we tend to see great results with.

25:51and the peptides have been a game changer because we're putting people on these peptides and a lot of them are getting better without anything. Like I had a guy in the office the other day who had rotator cuff tendonitis. We put him on BPC-157-TB500. He texted me a month later, he goes, I'm 80 % better. So it's incredible. And then I have my own story about peptides. So I had all these patients on peptides. I had this horrendous Achilles tendonitis. It was so bad. my patients are like, hey doc, why are you limping around?

26:24Gary Brecka:Yeah, it's not good to be limping as an orthopedic surgeon, dude. It's not a good look. It's not a good look. It's like being a skinny chef. Exactly. It's not a good look. Exactly. So I had this, and so I had a few patients, actually a couple of patients from Vegas, and they were all on peptides. And I'm like, you know what? I just got to put myself, I put myself on it. Six weeks cured. Really? I had it for two years. Yeah. It was gone. Like if someone hit my Achilles, I'd like go through the roof. It was so painful. And so it literally just healed it. And so I'm a huge believer in it. I also think for me, I'm a surgeon, but my single, the principle that I've lived my life by is how do we avoid surgery?

27:05When people come to me, and a lot of people come to me in LA and from all over the country, because they say, go to Snibby, because if you don't need the surgery, he will tell you.

27:15Gary Brecka:Really? Because I always say, I'm more popular from the people I didn't operate on than the ones I did. Really? Because I like to look at things and look at their, and I ask the questions. I always tell patients, I don't operate on your MRI. I operate on how you feel. I love that. Yeah, I saw that in your record. You could have a meniscus tear, a little arthritis, and you say, well, I can play golf five days a week, and I'm exercising, working out. So I'm like, well, what's the problem? Just go keep doing it. And then the other thing is all these injections. These injections help continue the process of healing and promote healing into the joints, increase blood flow, lower inflammation.

27:54And all of these injections that we do, whether it's PRP, whether it's exosomes, are gonna keep evolving. I mean, you're on top of this data so much. No question. We're just at the tip of the iceberg of this thing where we're gonna be able to modulate these things based on what you have. So they say, okay, you have arthritis, this is what we use. You have meniscus, this is what we use. Rotator contendinitis, this is what we use. and I think that that's the key for me is that I'm always asking the question, how does this affect your life? How is it? What's the impact? I'm like, and I always tell them, you can always have surgery.

28:30Right. You can have surgery tomorrow. You can have surgery three years from now. I can always operate on you and if I do it, I'll do a good job. Right. But right now, you don't need it. Go get your biomarkers better. Go get your nutrition better. Lose a little bit of weight. Get your diet organized and let's see what happens.

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29:27Gary Brecka:That's A-I-O-N-G-E-A-R.com. And you can use code ULTIMATE for 10 % off and start training smarter today. Now let's get back to the Ultimate Human Podcast. you know you and i have a friend in common uh ram dandalia yes uh is it ram or rom rom rom okay rom dandalia yeah um every every other uh indian doctor i know is named uh patel so he's like exactly i think you almost have to be a patel if you're indian and you're a doctor it's like i think so there's a lot of them it's like smith in india yeah so um but but he and i connected over uh dana white's journey he was his uh cardiac uh doctor and uh he's out at at seniors where where you are yes what i really find fascinating is um what you guys are doing with this um more than 100 million dollar center that you're building for um not just surgery but pre and post-surgical rehab yes bringing biohacking modalities like red light and uh hyperbaric you know, chambers and things like that to the table to really help patients accelerate their healing process, but at the same time just improve their cellular biology.

30:42Gary Brecka:Absolutely. How is it that you're, you know, such a classically trained allopathic physician and surgeon, but you're willing to consider and you're open to some of these biohacking modalities and therapies that I would call non-mainstream, like red light. and hyperbarics. I think that when, like we said earlier, I think that it's like you're an artist, right? And you have a canvas. You want that canvas to be good quality canvas and that you can paint on. You make that beautiful picture. So if the canvas or the patient is not quality, they don't have good tissue or good metabolism and good health, no matter how great of a painting you draw, no matter how great of a surgery you do, you're gonna have a bad outcome.

31:27You're gonna increase your infection rate. You're gonna have wound healing problems. You're gonna have muscle wasting and muscle loss. And sometimes they can never gain it back. And so, like I said earlier, how do we control the episode of care? Because it's not a transactional thing. We're like, okay, you come in here, you have a knee replacement, goodbye, I'll see you later. It's now a process where we can take them through and try to control some of these things and also mitigate risk and try to make sure that they don't have, they have a lower chance of, given the best chance for the wound to heal, put them in a hyperbaric oxygen chamber, put them in red light to increase blood flow so their wound healing is better.

32:09So they get better blood flow to their muscles and their microvasculature. All of that stuff is just such a huge part of it. And I think that for me, I've always thought, that's why I embrace robotic technology. Because I said, this is where we're going. This is where the technology needs to be. and I don't want to be in the back seat. I want to be driving this. But then by building this beautiful hospital that will be done at the end of this year, you'll come see it.

32:35Gary Brecka:Yeah. You're literally building a hospital. Building a hospital, 70 ,000 square foot hospital. When you say building, ground up? Ground up, from ground up. Just a beautiful, gorgeous hospital that we can control all these aspects. So we can put hyperbaric red light inside of it. Because when you work in a hospital system, there's so much regulatory issues that restrict you from doing the things that you really wanna do. And so I said to myself, I said, how can I make the experience on all levels amazing? But it's also, like we said earlier, the non-surgical patient. You have a meniscus tear and you're gonna get an exosome in your knee.

33:12I love that. I want you doing all this stuff too. I want you doing the red light and the hyperbaric and the peptides and the aminos. I want you on all this stuff to optimize your recovery.

33:25Gary Brecka:surgical or non-surgical yeah i love that i mean and i think the i think that the future of medicine in general is this whole patient approach absolutely i i think you know for for so many decades we've we've only treated the one little narrow symptom that's presented like you know uh you know the joint has degraded let's replace the joint right and and we just focus on that event, not this pre-habilitation and post-habilitation. You know, I had an orthopedic surgeon named Dr. Alex DeSimone, and I'm grateful to that man to this day because in 2009, I had an ACL, an MCL, and I actually clacked the lateral half of my tibial plateau in a bad knee injury.

34:13Gary Brecka:I wish I had a great story. The story is terrible. I'm going to make something up so it It sounds like heroic. But the truth is I'd had a few cocktails and decided that the one jiu-jitsu class that I took at the YMCA qualified me to wrestle a D1 wrestler that was my business development director. Oh, my God. And it was like this short little spark plug. And we got to chatting at the bar at an insurance conference. And I was like, hey, let's just go up to the room and figure it out. Oh, yeah. I'll hip toss you all over this place. And I was like, you know, it's like one of those like, you know, like the guy that's taking two boxing classes.

34:52Gary Brecka:And I'm like, no, don't grab me like this. Grab me like this. Don't stand there. Stand over here. Put this like here. And then I'm going to like throw you across. He's like, we're going to wrestle. We're going to wrestle. And he handedly whipped my ass. And in the process, you know, broke my knee. Dislocated my knee. And, but I remember what he said to me after surgery was, and he said, I need you to hear these words because it's the most important thing you're going to hear for the rest of your life. And this will determine the use, your pain level, your functionality for the rest of your life.

35:29Gary Brecka:He said, surgery is 30 % of your journey and your surgery went exceptionally well. I did a great job. You got great tissue in there. Joints very healthy. he said 70 % is going to be how dedicated you are to your post-operative rehab. And at some point you're going to feel like you're tearing pages out of a phone book, meaning like your progress is going to be so minimal. You know, for the first few weeks, it's like big progress. Yeah. You know? Absolutely. And I never forgot that. And I just, I hardcore dedicated six months of my life to just rehabbing that joint. and you know a few years later i was age group champion for the state of florida and medium distance triathlons i was you know and to this day god bless him i have zero pain no loss of range of motion that's great um you know knock on wood yeah but he was you know i i think a lot of patients think okay surgery's over i'm going back to normal life and they don't think about how much care do i need to give to this so that it doesn't i'm just not not buying myself a problem in 10 years.

36:34Gary Brecka:Absolutely, yeah. And I tell patients all the time, like, I take care of professional athletes. Yeah, I mean, your roster, not to interrupt you, the LA Clippers, the Lakers, the Sparks, the Kings, and the Angels, an assistant team physician ties to the Dodgers, Galaxy, and others. I mean, you're a monolithic mega giant. He's being very humble, guys. Thank you. You know, with his career in professional sports. And I was going to say, like, when you take care of a professional athlete, they're back playing sometimes at six months, but then you have a conversation with them and you say, when did you feel, if you ask the question, when do you feel like you were back?

37:10Like, when did you feel like you were explosive as you were before you got injured? And a lot of them say a year. Many of them say a year because it takes that long for those fast twitch fibers in your muscles and the explosiveness of your body to be able to do that. It's also really important for us as orthopedic surgeons to look at the whole body. Like someone comes in with knee pain you gotta do a good back exam. You gotta do a good hip exam. You really have to check other parts of the body. For example, I had a patient the other day who I did a knee replacement on. He goes, my knee replacement's hurting.

37:44I'm having trouble. And I examined him and his medial collateral ligament was on fire. Like I just touched it. He went through the roof. And I examined him and I examined his hip. His hip was arthritic. He'd worn out his hip. And I'm like, because your hip's arthritic, you're cranking on your knee too much. So guess what? We replaced his hip and now he's great. No problem. So it's by looking, not being so hyper-focused on that one joint, is really looking at the whole person. What other surgeries have you had recently? Have you had an abdominal surgery? Have you had a back surgery? How is your life right now?

38:19Are you under a lot of stress? What's your work-life balance like? Thinking about the whole person is very important to understand what makes them tick, but also how to organize and customize their recovery and we're planning for their surgery.

38:35Gary Brecka:Yeah. So you're building a hospital. You also launched your own shoe brand. I did. Which I think is so awesome. It's so fascinating. It's great, actually. It's a fun project. Yeah. I mean, specifically designed around, it sounds like you did it out of need because designed around people that are on their feet for longer periods of time, which anyone that's in a hospital. And those are concrete or hard tile floors. Absolutely. You know, and standing on all that. I mean, I just noticed it walking around my own place because we've got tile in here. If I walk around barefoot for too many hours, just being in here, I - It's a lot of stress on your body.

39:09Gary Brecka:Yeah, it's a lot of stress. Yeah, so I spent about four years. My partner is a chef and I'm a surgeon. And so the two of us looked at each other - Chef and a surgeon got together and made a shoe. Made a shoe. Okay, good. And so we said, our shoes are so bad. You know, we have these clogs that you can barely walk in or people just wear like a pair of Nikes or Asics to the hospital and the fluid gets through it and the padding in it wears out after like, let's say two, three months. And so we said, we spent four years designing a shoe, working with materials and testing them. And I would go in the OR with them and spend days working with them.

39:49He would work with them as a chef. And we put them on our friends and family and said, Okay, how does this feel to you? And finally, we developed a company called Snibs. It's a parody on my name called Snibs, S-N-I-B-B-S. And we created this amazing shoe. And then we also now have multiple levels of shoes. We have shoes that are waterproof and slip-proof. Most of them are slip-proof. We have a work boot. We have a clog. We have all different kinds of shoes for different environments. And it's really not just a doctor-chef thing. It's for anybody. anyone that works on their feet anyone that's out working and walking people people wear them to work out people wear them for long walks and people like we have people wear them on movie sets when they're working those 12-hour days all kinds of environments but it's to basically take the stress of your body away and we always say i would say about the shoes is like i want you not to think about your feet at the end of your day yeah i want you to come home and think about okay how am i going to enjoy my night i'm going to have dinner with my wife i'm going to go do something relaxing.

40:54I don't want you to say, oh my gosh, my feet are killing me. And we realized by making great shoe wear, you take stress off your knees, off your hips, off your back. And that makes you perform better as a person. It makes you feel better as a person. And we're also realizing that we're minimizing injury. And so we've done a couple of projects. Actually, one of them was at Caesars Palace in Vegas. We gave two, 300 people shoes, and none of them had a slip and fall over the course of about a six-month period. And so we're realizing that we can actually have the potential to minimize injury.

41:35Gary Brecka:Is this because of the floor grip, the anti-slip? Exactly, the anti-slip and also the fact that the shoe really captures your foot. And we also designed the shoe to allow for swelling. As your foot swells over the course of the day, it accepts that. And so those were realizing that we can actually even benefit the patients and also the employees by not having injury, which can take them out of their life and cause horrible problems for themselves. And what's unique about the padding? Is there something? The padding is a special kind of padding. it's a special rubber material that we proprietary designed that basically has resilience and cushioning but it doesn't wear out in three months it's not the same stuff that like if you have a running shoe like a hoka running shoe yeah the hoka running shoe is very cushy and bouncy bouncy it's great for about three months right but after miles i think is what my son says he replaces them after exactly so after that it goes but our shoe we're not obviously running in them but they have much more resilient.

42:39So they last a year, year and a half of that cushioning. It's much more resilient.

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43:25Gary Brecka:Visit drinkh2tab.com. That's drinkh2tab.com, and upgrade your hydration today. Now let's get back to the Ultimate Human Podcast. Okay. So for you, you know, as an orthopedic surgeon, being in this minimally invasive category of robotic surgery, which I'm an enormous fan of, where do you see the future of orthopedic surgery going? Like what's like really exciting for you on the horizon? Is it faster healing through things like stem cells and peptides and exosomes and different biohacking modalities? or is there new technology on the horizon that you've got your eye on that you think is gonna revolutionize orthopedic surgery?

44:12Gary Brecka:Or do you consider what you're doing right now to be the absolute most cutting edge thing available? I think that, I don't think that, I think we're always changing and moving and learning and things are just being, and they're going faster than they ever have been. I think the future of orthopedic surgery will be even less invasive than what we do now. I think that we have the ability with the robot at some point to have what they call automation, where you basically, you know, you open up, you make even smaller incisions that we make now where the robot can go in and prepare the joint or prepare things for us with cutting even less tissue and even less materials.

44:53You have to still make an incision to get the implant in there, but even less trauma to the soft tissues than we do right now. And so I think that's really important. I think that we already are using AI. When we get the CT scan, AI kind of prepares a 3D model of the joint for us. So we use AI already, but there's going to be even more AI on data. So what is going to happen is that in the future, it's going to be like, okay, I think this person should have a hip that looks like this. and they're going to say, well, of the last 5 ,000 hips that were done in the United States that have hip just like this, this is the decisions that they made.

45:34They use this implant, this sizing, this positioning, and those patients had 98 % satisfaction. So we'll be able to use outcome data to correlate live during surgery to make sure that like, we want to make sure that this person has the best result. So that's a big part of it. There's also some, you may you know more probably about this than me i do but there's there are also some data about muscle mass he's special mris now looking at muscle mass oh yeah i am pernovo yeah and all and all these and looking at the quality of your muscle so part of that prehab is that how do we quantify muscle mass like how do we know we don't know like if someone comes to me and they have a bad hip they've lost a lot of muscle mass in their glute did they lose 50 percent did they lose 20 We don't know.

46:23So understanding the value, a quantitative value of like how much muscle mass you've lost and this is how much you need to gain. And we can check them post-surgically to say, you've gained back 80, 90 % of your muscle mass now. And so those are some things, but I also think the biggest part of this in my life will be all of these biological things that we can do to patients without having surgery. And how do we treat joints? It's like, for example, when you tore your ACL, right? Like, is it important? Should you have gotten like 10 injections of exosomes over the course of a year into your knee to protect you from post-traumatic arthritis?

47:03Like, what are the things that we can do to prevent these things from happening? And also we're seeing people get arthritis and damage in their joints just from wear and tear, but also from metabolically, right? They're like women, they're post-menopausal, they lose their estrogen, they all of a sudden they wear out their joints from lack of estrogen. And so how do we understand that better? How do we understand why you have so much inflammation in your body because your diet is horrible that your knee wears out? And so it's understanding these things on a higher level, I think is gonna be the most incredible thing where people will, all the things that you do that are so incredible, that everyone will have access to that.

47:45Gary Brecka:I love that. I mean, what's an example of somebody that had, let's say, arthritic knees and you use some other intervention besides surgery? Absolutely. What ways have you intervened? So one of the simple things is meniscus tear. So classically, if you tear your meniscus in your knee, an orthopedic surgeon like me would say, oh, we're going to go in there and nibble away that meniscus. Well, guess what? 30 % of those patients, which is a big number, end up within three to six months with a knee replacement. Really? Because by just mucking around in the knee. Going in and cleaning it up. Going in and cleaning out.

48:19Just that little clean out, it's trauma. You know, surgery's trauma. So you're creating trauma inside the joint, which makes the knee deteriorate. So those patients, the simple injection would be platelet-rich plasma. You draw some platelet-rich plasma, you spin it down, you inject it into the knee. Sometimes if they have a little bit of arthritis, I'll put hyaluronic acid with it. But that simple injection, many patients get 70 to 80 % better from one injection.

48:46Gary Brecka:Really? Absolutely. PRP or hyaluronic acid or exosomes. A combo of that. Or sometimes we'll do exosomes. But the thing is, we get patients better with that simple meniscus injury. And I tell patients all the time, I'm 53 years old. If I tore my meniscus, I wouldn't let anybody touch it because I see so many problems with this meniscus surgery. And so I treat them with exosomes, with PRP, a good physical therapy supplements and then they get through it and they're they're back they're back on the tennis court they're back playing golf they're back exercising and they're fine some of it takes a couple injections to get them across the finish line i mean a couple of injections versus a full you know joint replacement is or surgery and then a joint replacement absolutely you know is is is a much easier road much easier and that's something that is is in my in my Unfortunately, it's not the mainstay in all practices, but in my practice, that's what we do every time.

49:41And that's why a lot of people come to me, people think like, oh, they come to Dr. Sin because he's gonna operate on you. They come to me all the time, they can say, I heard you do this PRP in the hip and to get me better. And they're like, that's why I'm here. Like I saw three surgeons, they all wanna operate on me. And we do PRP and they're like, I got better and I can't believe I was gonna have a surgery and you just fixed me with a simple little shot.

50:02Gary Brecka:Yeah, and even in arthritic patients, these exosomes, the platelet-rich plasma, highly erotic acid, you see improvements in those arthritic knees that may not have traumatic anatomical issues, but pain. Absolutely. And then obviously every patient is different. I mean, we analyze the MRIs carefully. We look at the deformity of the knee, how much disease they have, how much they don't have. And I would say when you come to me, it's like a picture. I'm taking a picture of your knee in this one moment. in 2026. And things can change and move. And sometimes it doesn't change, but we try to optimize that joint and get that joint happy as it can be right now.

50:45Gary Brecka:You know, it seems like I have a lot of friends for some reason right now that are having total shoulders. Yes. And not a single one of them has not told me that it was the most brutal thing they've ever been through. Like, even though they prepared for it before surgery, like coming out of it, the length of time getting back to full mobility for them. TJ Dillashaw is one of my buddies, UFC fighters getting ready to have one. But I have a number of friends that have had them for some reason. And I wonder if there's, you know, in your case, do you do? Yes, I do. And are there minimally invasive, you know, robotic procedures that lessen that kind of recovery time?

51:29Absolutely. So in a shoulder, a shoulder is a unique joint because it's like I call it like a golf ball and a golf tee. The socket is a tiny little bone. It's called the glenor. It's tiny. It's like some of them are like a quarter, maybe a little bit big. It's like it's a tiny little bone. The ball is big. But to put an implant on that little bone, that little golf tee, the socket, is very difficult because you have to fire a pin down the bone that's in the perfect alignment. And so the robot, which is incredible, I was on the development team for the robotic shoulder. The ability to get that pin in the perfect position every single time with the robot is like as accurate as it can be.

52:13It's incredible. And so that makes a big difference because now you're putting the implant in the right spot, but also you're minimizing bone loss. So remember we talked about haptic technology. The robot prevents you from taking too much bone or causing too much trauma around the joint. And so the robotic technology will make a big difference. It is making a big difference in the way people recover from those surgeries and the way they respond from those surgeries. Because sometimes the preparation of the bone and all the tissue causes a lot of trauma around the joint.

52:46Gary Brecka:Yeah, just getting in there, you gotta do a lot of damage getting in. But also the issue with the shoulder too is like we talked about muscle mass. A lot of these people have these very arthritic shoulders that don't move, and so they have a lot of muscle wasting. So it takes them a very long time, sometimes a year, to gain all that muscle back. But again, by doing things like perfect amino, by taking certain things in your body to help maintain your muscle mass and build your muscle mass, because sometimes just you on your own eating fish and vegetables is not enough. Right, right. You know what I mean?

53:23and so it just fix your shoulder exactly so you need supplements that will help build those things yeah

53:28Gary Brecka:Dr. Snubi this has been amazing I know my audience is going to be so excited to listen to this podcast and tear through this information I love thought leaders like yourself that are really patient centric and thinking about what is the best possible outcome for this patient to get back to full life and forget that this surgery ever ever even happened and the focus on prehabilitation, post-habilitation, minimally invasive surgery, and the use of things like peptides and stem cells and exosomes and platelet-rich plasma and all of the biohacking modalities, you know, tells me that you're really focused on the whole patient journey.

54:10Gary Brecka:And I really applaud you for that. I wish more of allopathic medicine would take this whole patient approach. It's really exciting. But so for my audience that wants to find out more about you, Where can they find you? Are you on social media? I'm on social media at Dr. Snibby, Dr. Jason Snibby on my Instagram, on Facebook. I have a website, Dr. Jason Snibby. Okay. So they can find me all over. Okay, I'll put links to both of those in the show notes so people can find it. And I'll put links to your new, when is this new hospital going to open? DOS will be done being built in December. Oh, dude, you guys are well underway.

54:47And then we'll probably do our first cases like January, February.

54:50Gary Brecka:Okay, and is this all outpatient? No, inpatient. You can stay overnight. Wow. So we'll have physical therapy in the place. They'll stay a few nights, you know, and then they'll go home. But we'll have all of that there. And then we're building out this whole thing. So we want to do this whole longevity kind of thing. Well, I'm going to do it with you. Yeah, I love it. I would love that. It would be a dream. Yeah, yeah. So I'll come out and see you next month. And we'll talk about how we build the most impactful rehabilitation center for these post-surgical patients that the world's ever seen. I would love it.

55:19Gary Brecka:So I wind down all of my podcasts by asking all my guests the same question. There's no right or wrong answer to this question. Sure. But what does it mean to you to be an ultimate human? To be an ultimate human is to be a person that, for me, to be, to help people. To really, really help people in what they, their struggles in their life. And obviously for me, orthopedically. and to be an ultimate human, I wanna do whatever I can on every level of their life to make them move and perform and go through life comfortable and happy and strong. And to me, that is the ultimate, for me being, that is what I would say is the ultimate human for me.

56:06Gary Brecka:That's awesome, man. Well, I think you're an ultimate human, so. Thank you so much. For me, that means a lot. Yeah, Dr. Stevie, Thank you for coming on the Ultimate Human Podcast. We're going to head over to my VIP room now. I've got some VIPs waiting for you to ask questions. They knew you were coming on the show, and they asked us questions. So we'll go in and speak to those guys. And until next time, guys, that's just science.