00:05 – You’re missing a source of a pathogen in a partner who’s suffering
00:11 – and whose quality of life is impacted. Hi, welcome back to the channel. My name is Melissa. And today at Live UTI Free,
00:17 – we have part two of our follow up interview with Dr. Tim Hlavinka. In part one, we discussed hormonal imbalances,
00:23 – pre menopause and the possible link to UTI. Here in part two, we’re discussing how UTI causing organisms
00:30 – can pass between partners during sexual activity and what to do about it. If you haven’t seen our first interview with Dr. Tim Hlavinka
00:36 – on UTIs after sex, be sure to check it out. If you enjoy these videos, think they’re important, and want to support what we do,
00:42 – be sure to hit subscribe and tick the bell, so you’ll be notified of future content. Thanks again for joining us on this journey to making change in women’s
01:01 – and what you’re finding in terms of what organisms are being transferred between partners during sexual activity.
01:08 – So this has changed. And I must say one of the things that,
01:17 – and again, I’m going to plug the MicroGenDx, really the only effective, commercially reliable,
01:28 – next generation sequencing lab about there. They have been so instrumental in my being able to develop
01:37 – the experience that I have. And I would say expertise, but I’ll leave that up to you and your followers.
01:44 – But the experience has definitely been critical in determining
01:50 – whether or not there is an organism there.
01:56 – I’m going to speak both broadly as well as the cohort of patients that are “couples” infections.
02:04 – We’re now up to 96. We’re doing a research and looking at the data.
02:09 – On couples, we have 96. We do have four gay male couples
02:19 – and two gay female couples in there. So not a big database, but certainly something that I think is important
02:27 – because of partnering issues to get some science out there for everybody that might be suffering from this.
02:35 – And again, so many times I hear, well, that just doesn’t happen. Okay, well, you know, you can remain ignorant as long as you want
02:42 – but it does happen. And I give the analogy, maybe I said this last time, Melissa, but I tell providers and patients alike,
02:50 – well, you can get strep throat from kissing somebody. So why shouldn’t you get a UTI from any kind of sexual activity?
02:56 – And the first thing that we saw at the beginning of noticing this phenomenon
03:02 – was that there was a lot more oral organisms that were causing these chronic UTIs and beta strep.
03:09 – As I think I told you before, beta hemolytic strep was one that was very common. Typically, that’s just a few percent of UTIs in women,
03:17 – and it was 15% to 30%, depending on the risk factors and demographic
03:23 – pre or post menopausal patient population. So that was something that’s come.
03:30 – But as we treated patients more and kept them from just three or four years since we’ve talked,
03:37 – the microbes are smart. They’ve had that microbial drift, and it’s become different. So we are seeing some more unusual organisms.
03:45 – I’ll wait to publish the paper, but you’ll be the first to know what those data are.
03:50 – But we’re seeing microbial drift. And with a more treatment and keeping the patients chronically for several
03:56 – years now, now we’re seeing a completely new crop of organisms that’s showing up.
04:02 – The internal caucus continues to be an issue in refractory patients, resistant coliforms.
04:13 – But some newer organisms are emerging that are somewhat bothersome.
04:18 – And it’s obvious that the pressure on the microbial population
04:24 – from the chronic antibiotic use is what’s causing this to emerge.
04:30 – But I’ll update that when we have that. Do you have a timeline on when you might publish that data?
04:36 – Well, my research person, I need to hear from him pretty soon because I know the MicroGen people were bugging me
04:44 – to have something at least to present. Just an FYI, there’s like news.
04:53 – At these medical meetings, there’s news. If something’s really hot, you don’t have to have it published or anything like that.
04:59 – It was something really critical for patient information. And I was hoping to have that by next week when I go to the women’s health meeting.
05:08 – I might not have that. The researcher has had other things to do.
05:14 – And I think quite frankly, they get paid more by other people. What can I say?
05:21 – It’s women’s health, Melissa. It’s women’s health. I’m very familiar with that problem.
05:34 – when it shows up in either partner or in both partners.
05:39 – We are all subjected to our own biases, there’s confirmation bias.
05:44 – If you’re a human, you have confirmation bias. I think it’s part of being human. And as providers, we suffer from the same thing.
05:53 – And I don’t think it’s because the first patient, the index patient for me,
05:58 – for whom the next generation sequencing solved a very refractory tenacious problem,
06:04 – for whom this patient had seen lots of providers and was suffering a great deal.
06:10 – I did an exam, I did a urethral massage, which is now fine because she had a little bit of discharge, which is now my kind of
06:19 – protocol. And I saw the discharge, I swapped it with a microgen and she had ureaplasma.
06:24 – I gave her two weeks of doxycycline and she thinks I’m a hero. So that’s the kind of thing that transforms into your thinking.
06:33 – But I really do suspect that ureaplasma because of its potential to stay as a harbor in periurethral glands in both men and women,
06:42 – in the prostate in men. I treat it. And even if one partner has it, for instance, I saw a patient just yesterday,
06:49 – and she had ureaplasma, and her partner had never had it. But I said if you’ve had it twice, that means he’s got it
06:56 – and he’s given it back to you. And she indeed had it twice. So I pretty much treat ureaplasma as one of the most universally,
07:05 – potentially, is infecting the other partner and needs to be treated.
07:18 – is that a good indication that partner may be transferring UTI causing organisms?
07:24 – Those circumstances are too easy for us now. We know to test that partner right away.
07:30 – That’s an easy one. And even as, I think I’ve mentioned before, but I’ll get into it more detail.
07:36 – Even if they’re using a condom, we have found that sometimes it’s going into the inguinal hole.
07:44 – It can be bacteria that can live there. About 10% of our patients will continue to get UTIs with condom use.
07:51 – And we are much more aggressive in swabbing areas and looking for potential sources of the pathogens.
07:59 – And I also no longer, again, when I was first starting to treat couples for this,
08:07 – it was mandatory that the couple had the same organism.
08:13 – And I treated them accordingly. As I saw, no, they can have two or three,
08:21 – and only two of them be the same or one the same. And then I saw that sometimes none of them were the same,
08:27 – but pretty much still was necessary. So I think there’s something pro inflammatory about, say for instance,
08:35 – the semen or the genital tissues, and let’s just say for instance,
08:40 – the male partner who may be asymptomatic and be the carrier of these pathogens.
08:45 – So even if they have different organisms, they have pathogens, I treat them all,
08:51 – because I have found that they will continue to produce the same UTI organisms in their partners even if they’re different organisms.
08:59 – And that is something that I really can’t get any my colleagues to understand but it’s just so paramount in my evaluation now.
09:08 – It’s a pro inflammatory state. If you’re having sexual activity related infections,
09:15 – it’s caused by the act of sexual activity. Gotta look for what you can treat.
09:21 – And sometimes those can be disparate microorganisms in the two members of the couple,
09:27 – and no longer do they need to have parallel organisms for me to treat. No way. I would miss so many infections if I did that.
09:35 – That’s very interesting. It kind of complicates it, though, to change the way that things are done.
09:41 – That just kind of means we have to be very suspicious about partners and test them and be willing to treat them if we want to help
09:48 – women get over these infections. And I will say just to backup my guys a little bit.
09:54 – The guys have been very good. It’s very, very rare that a guy has been reluctant to test
10:00 – because, I mean, they want to be able to continue to have sexual activity.
10:06 – And they certainly understand that if their partners are suffering that that’s just not in the cards.
10:15 – And if not, pick up the phone and give him a piece of my mind, guy to guy.
10:21 – So I’ve done that many times. You mentioned oral sex briefly.
10:34 – Even if you’re making out, driving on a country road and you get to the backseat and start making out and groping.
10:42 – And that’s why see some of the young teenagers come in where their parents saying, there’s no way they could be getting these from each other’s.
10:49 – Well, yeah, they can. And yeah, I mean, even just from manual contact, because we have seen that,
10:57 – that somebody says, well, we didn’t even have sex that time. We were just sort of fooling around, and they got the infection.
11:03 – Well, yeah, that can be sort of an oral manual type transformation.
11:18 – that UTIs are not sexually transmitted? How is it different from trichomoniasis, HPV or any other STI?
11:25 – How’s it different from strep throat or viral upper respiratory illnesses?
11:30 – I don’t know, Melissa. One of the frustrations with my colleagues not being able to see what I
11:36 – see so obviously. I don’t even think it you have to do next generation sequencing. I think you just have to be a astute clinician and realize that if a mode of
11:47 – transmissibility is probable, and it’s likely.
11:59 – And now there’s questions around whether STI testing has the same problem. Is it as unreliable?
12:07 – Well, I will say for the PCR component. Again, PCR technology, everybody’s familiar with that after COVID
12:14 – — PCR testing. But the bottom line is, it’s definitely an upgrade from traditional cultures.
12:20 – No doubt about that. But all of these panels are limited. They’re set up economically, because you want to get the most probable
12:32 – agents that are causing the potential disease, infection, symptoms,
12:37 – whatever you’re looking for. And so to do that, you have to set these up
12:42 – because the FDA here in the US won’t approve tests unless it’s got bonafide research behind it.
12:49 – So getting these combinations through the FDA is very difficult at the beginning.
12:55 – So it behooves the manufacturers, producers, and distributors to the limit that.
13:02 – That doesn’t behoove the patient or the provider because then you’re narrowing the spectrum.
13:07 – Over time, now after 6000 microgens and 3000 patients are false negative
13:15 – for the PCR component of the microgen, which is just that there’s the PCR loan,
13:21 – is still hovering at 35% to 45%. And the false negative for the next generation is about 8%
13:33 – when you wait for the next generation sequencing to come out. So no, I don’t trust PCRs.
13:46 – I think it’s the type of contact that’s important. If it’s a monogamous partner
13:52 – and there has not been any sort of variants and partners, you can just do UTI testing.
13:58 – If there has been any potential for that, then it’s probably more prudent to do STI testing.
14:04 – Okay. Another question about testing in these scenarios. You’re saying that the organisms could be transferred from anywhere on the body.
14:21 – So I used to be more broad, and honestly, this was in order to get the paper published where I knew I had
14:27 – to swab. the groins of men and women, do a vaginal, deep and superficial vaginal
14:34 – and males in the semen and urine, and groin swab in the guys.
14:40 – So in order to get my first paper published, the 35 patients, I knew I needed to do that.
14:46 – But pretty much even before I accumulated that data, I knew that the 10%, as I said before,
14:54 – and those are typically the ones that still get them after condom use, where you need to look for other sources.
15:00 – Now, do I swab the mouth? No, because I’m not really capable of ordinaries or something.
15:07 – I stick to the below stuff because I really don’t know how to interpret if I do a mouth swab.
15:15 – Now if it’s a typical oral organism, well, yeah, then we’ll maybe do that to see if there’s a harbor.
15:20 – And quite honestly, see if they could gargled and get rid of that pathogen.
15:26 – I have a lot of patients, I tell them a gargle three times a day, and it’s taking care of the beta hemolytic strep that they’ve been
15:33 – causing their partner to have an infection with. So I tend to kind of be more specific about those
15:42 – and see if I can prove that there’s a traditional source cause of infection.
15:58 – it is getting more and more traction among women’s health providers. A lot of the functional medicine doc, a lot of gynecologist,
16:06 – particularly those that treat chronic pansinusitis are on board, it does so much more.
16:13 – You get a next generation sequencing of the vaginal biome, both pathogens and normal.
16:20 – And you also get many, many more chemical parameters studied
16:28 – that can be important. If it goes well beyond pH, I think they measure the pH. So 0.01 as opposed to what you typically, with the dipsticks, can get.
16:39 – There is a vaginal health index that they do from that, which sort of looks for a given hormonal environment in a woman,
16:50 – what’s happening with the that’s not the feeling which is critical. So the Evvy test has been very helpful and my patients know what’s there.
17:08 – Absolutely, 100%. And there are a few patients that can’t ejaculate
17:14 – in order to product a semen specimen. Typically they’ve had prostate surgery or they are on medications
17:20 – that make ejaculation problematic. And those patients will all do a prostate massage
17:29 – and have them put in a cup and sent out. Some providers think that’s just as good. No, it’s not. Guaranteed it’s not.
17:35 – So the best thing is a semen specimen, a urine specimen, and a groin specimen. That gives me the most information.
17:42 – But I seen enough. About 30% of the time, the urine has a pathogen that the semen doesn’t.
17:50 – And that’s why I insist on both and the guys. If I only can get one, I prefer a semen, but you can always get a urine.
17:57 – It’s getting the semen that’s the problem. How do you address a chronic prostate infection given treatments don’t tend to penetrate that organ very well?
18:17 – And if she’s getting really sick and quality of life is impacted, then he needs to get full blown aggressive, chronic prostatitis treatment,
18:26 – like he came in with a really acute episode. Well, that would be acute prostatitis,
18:32 – but we know where he’s really got a bad episode that needs to be treated with six weeks of antibiotic.
18:38 – That’s what we’re gonna have to do to give any chance. So she’s really getting volatile symptoms from sexual activity,
18:45 – and there are clear pathogens in the male, I treat more aggressively. But most of the time, I try to do an appropriate course of antibiotics.
18:52 – And by the way, nobody should be given you these 1-day, 3-day, 5-day 7-day. If you have refractory UTIs, please, please, please,
18:59 – please tell your providers that’s not enough. I need more or at least give me a refill. So I don’t start, and again, I’m seeing a very specialized population,
19:08 – but I don’t give anybody less than 10 days. And most of the time, it’s two weeks of therapy.
19:14 – And guys, if they’re totally symptomatic and it’s like an easy to eradicate pathogen
19:19 – and she’s got that pathogen, I may give them 10 days just because I don’t want the antibiotic side effects
19:27 – to occur in somebody who’s asymptomatic. I will tell you, that’s the reason why a lot of my colleagues have not adopted this,
19:33 – but, you know, too bad. You’re missing a source of a pathogen in a partner who’s suffering
19:41 – and whose quality of life is impacted. So you got to go and say, “Hey, you got that organism. You need to be treated.”
19:49 – And again, she’s more virulent, the male partner is treated more aggressively. When it comes to finishing a long-term course of antibiotics,
20:08 – I think it depends on the patient and what their course has been.
20:14 – Those that get really sick really quick, as I say, they’re reluctant
20:20 – and you have to be much more cautious about doing that. We try to boost everything, the immune system,
20:27 – make sure the immune system boosters, prebiotics, probiotics, try to make sure that the normal flow has been raised to help us as much as possible.
20:35 – And then we slowly wean off. If they’re on daily antibiotics, let’s go three times a week, then twice a week,
20:42 – then once a week and stop. Others just switch to something like Hiprex as they come off the antibiotics,
20:48 – and then wean off with Hiprex if they can. Those are typically the way that way when patients sell clinic antibiotics.
20:56 – But again, if they get really sick right away, you’re gonna have to be much more cautious in that time courses are long.
21:04 – I would say probably about three months in the most severe cases, you can do it in a few weeks and patients for whom
21:10 – the infections have been infrequent but severe.
21:23 – Yes, because I want to give hope out there when hope can be given. False hope is not good, but true hope is good.
21:31 – It leads to determination. When we know that there’s hope, we become more determined. And that’s when I will tell you that yes, most patients can be.
21:40 – Again, I’m seeing a patient population for whom that’s not the case. They’re just again and again and again. But I have to feel like I made a difference in their lives
21:49 – after doing this for seven years.
21:54 – And sometimes I think you only remember the failures. And I think it’s important for us to recognize that
22:00 – if I can improve, I try to focus on quality of life.
22:06 – And for all intents and purposes, that’s an individual decision of a woman to tell me.
22:11 – I don’t get to say whether or not the quality of life has been improved. EDTA is often touted as a biofilm buster along with other ingredients.
22:25 – That has evolved, certainly a lot since we’ve been last talking.
22:32 – The whole notion of embedded infections being a controversy is absurd.
22:37 – It just has to go out the window. If you have an allergen and you treat it appropriately
22:43 – based on all the therapeutic data that you have,
22:48 – and I would say without a microget, you haven’t quite honestly. But if you’ve done that and if the pathogen re-emerges
22:57 – or a second path of pathogen emerges because of treating that one, then you’ve got an embedded infection.
23:04 – I’m convinced that these are microscopic because I did endoscopies and cystoscopies
23:10 – on many of the first patients that came in to me, but I realized that that was just punitive to them because it didn’t matter.
23:18 – It was very rare that I saw seeing, a lot of ICU patients did have an ulcer
23:24 – or lesions that I biopsied. And half of them I found a biofilm, but another half I didn’t, but they acted like they did.
23:31 – So I quit doing that. I thought that was horribly invasive, but it’s what happens to us when we’re doing something new
23:40 – that we feel like we got to get it right. But very quickly, I realized how overly invasive that was.
23:46 – It was horrible to suggest to a patient that’s what I was going to have to do. Because obviously, when you get a biopsy,
23:53 – you’re gonna burn it with the laser, it’s gonna make you miserable and subject you to lower infection threshold because you’ve altered the tissue.
24:03 – So but biofilms are there. I treat every patient who becomes refractory. If I treat with two or three courses of antibiotics
24:13 – and they don’t respond with either the same or newer pathogens, then I treat them as having biofilm
24:20 – and I treat them accordingly. Our approach to biofilm is got a EDTA antibiotic.
24:30 – There are several antibiotics that have been shown to penetrate the biofilm. However, they need to be taking high dose and long-term.
24:39 – Azithromycin is one, erythromycin is another, doxycycline, trimethoprim/sulfamethoxazole.
24:46 – Those are one. Most of the time, I like to stay with the simplest agent and that’s azithromycin given 500 milligrams.
24:55 – And I typically give that for two weeks before I start the others, ust to give Antibiotics little time to penetrate.
25:02 – So even though these are really lousy UTI antibiotics,
25:07 – typically, azithromycin are not good for UTIs, doxycycline and bactrim, of course, can be,
25:13 – but they do penetrate biofilms very well. So a couple of weeks then,
25:19 – then a combination of you need enzymatic degradation, you need to have the enzymes that are going to go.
25:26 – You need EDTA and enzymatic degradation for the biofilm. You need something that are proteases and things like that.
25:34 – Proteolysis is what they’re actually called because that means break up the protein. So you need both.
25:40 – And the reason why they’ve been ineffective is that there haven’t been formulations that have been able
25:45 – to get into the bladder in high enough concentrations, because they’re not absorbed through the gut.
25:52 – So the liposomal, and again, the medicine doctors are so good about this, the liposomal formulations of those are much better
26:00 – because then you’ve got a concoction of the EDTA and the enzymes that are not going to be chewed up
26:06 – by your stomach acids. They’re going to get into the bloodstream and into your bladder for deconcentrations to work.
26:12 – So you can get that at least started. So two weeks of azithromycin and start that.
26:19 – I tell patients, if they’re not willing to do all of this for three months, then don’t start it because it’s not going to help.
26:24 – In many patients, it’s six months, a year, and many patients they have to stay on it. So that’s why giving more antibiotics up front
26:32 – more often, more courses, what are you going to commit to? Taking three things for six months,
26:39 – or one thing for a couple of weeks at a time? So we do the math and look at each indication that way.
26:49 – But that’s kind of how I do biofilm disruption now. Is there a particular biofilm disruptor that you use?
27:01 – Again, most of the time, it’s probably a better idea to go to a functional medicine doc
27:06 – and see who their suppliers because they do have the liposomal ones. Those can be expensive, but quite honestly,
27:13 – it’s completely different efficacy with patients that I’ve seen. And after all of this treatment, is it possible to restore
27:26 – In so much is that we’re looking at what the normal vaginal and bladder microbiome is
27:33 – and I think that that data should be published by MicroGen pretty soon. I’ve talked to the CEO.
27:42 – I think they’ve submitted it, and it’s being looked at by journal right now.
27:48 – So I don’t want to be premature about disclosing that. But the bottom line is that is being looked at
27:53 – and see what the normal is first. I will say that it’s a struggle for many patients that we send these nuclear
28:03 – bombs into your intestine and your vagina and create these horrific changes
28:10 – in the ecosystem. That is a finely tuned human body.
28:15 – When one I was listening to one functional medicine lecture the other day, and I didn’t realize it, but
28:21 – there’s over a trillion microorganisms in our intestine. So when I give you 20 billion twice a day to prevent your as a probiotic,
28:30 – Well, I mean, come on, look at what I’m doing from the standpoint of impacting that. The vagina doesn’t have that much.
28:39 – But still, the bottom line is, these are profound alterations in a very well balanced ecosystem, that have multiple parameters in terms of pH,
28:52 – flora, epithelial changes, and pro inflammatory agents.
28:58 – Most of what we do just sits a nuclear bomb off in a woman’s vagina. And so it’s very critical to be proactive about that.
29:06 – I try to do that as much as possible. Most of my patients now I’m seeing now, Melissa, quite honestly,
29:12 – they had so much treatment for so long, it’s going to be very difficult. It’ll be very refractory to restoring that and can take months and months
29:20 – may never happen. But typically I do the prebiotics, probiotics. I do hyaluronic acid,
29:29 – the commercially available products over-the-counter, like refresh and recleanse. I think the more you can do to kind of recreate the
29:36 – ecosystem like it should be, the faster that patients are going to respond. But without hormones, it can be next to impossible.
29:50 – Most patients are able to tolerate that very well. Typically it’s in the form of a suppository.
29:55 – There are several commercial… Raveree I think is one that produces it.
30:00 – Very, very effective product. You can get combinations with other agents
30:07 – with the hyaluronic acid. Many of these are sort of concoctions that tend to have sort of
30:13 – emoluments or hypoallergenic cream to kind of diminish the inflammatory response.
30:19 – So that’s typically what I recommend. But again, then you start getting a thing where you’re
30:24 – putting five things here every day, just to be able to have a quality of life.
30:33 – As a male, I tend to let my patients teach me what is the right thing for them.
30:40 – About how much they’re willing to do. Do you think using these types of products, the hyaluronic acid, DHEA, vaginal probiotics,
30:53 – Yes, I do. In so much is that’s what God gave us from the normal ecosystem.
31:00 – The more it makes sense, the more you can recreate that or recover that, the more likely you will have those protective phenomenon.
31:07 – I don’t have a lot of studies on that or something. It’s just one of those that it makes sense.
31:19 – I think the issue is that hygienic. And my patients, everybody’s first thing they do is be better with our hygiene.
31:29 – That doesn’t really seem to help because these are the patients that are already doing the simple things. They’re avoiding before and after.
31:36 – They’re making sure that they don’t have prolonged time between a shower and having intercourse or something like that.
31:44 – Many times, they’re showering before and after. The kind of basic hygiene is already done in almost all my patients.
31:53 – And they’re not really doing anything that’s bothersome. You know, it’s hard to tell people to give up oral sex
32:00 – because that’s just so much fun. I do say that even with a condom,
32:06 – anal penetrative sex is probably not a good idea just because it spreads so many more potential pathogens
32:13 – from the rectum onto the perineum. And that that’s kind of the main things I say for prevention.
32:33 – I have not seen so. With good hygiene I have not seen so. Are you saying that someone with sort of large labia
32:41 – there might be issues with predisposing to infections? Is that the question?
32:46 – I think either way. The question was neutral. Okay.
32:52 – I’ve seen quality of health of the labia. In other words, if a large labia
32:58 – for which there’s estrogen deficiency and a small retracted labia with estrogen deficiency, I’ve seen that.
33:06 – Mainly because there’s a mechanical issue. So with both ways, with intercourse, it’s very hard to get enough lubrication
33:13 – to not irritate those areas during intercourse. Okay. And another question about whether vaginal discharge can cause UTIs.
33:28 – Vaginal discharge. So some vaginal discharge is normal, particularly if you’re on a therapy,
33:28 – an estrogen based therapy or DHEA, anything that you’re going to be doing,
33:33 – a lot of the things we just talked about, that are potentially pro hygienic
33:40 – and promote restoring the normal ecosystem, there’s going to be some discharge.
33:46 – If the discharge is copious and bothersome, then that becomes an issue. I tell the patients, if I’ve got to have you put
33:54 – up with one sort of side effect or symptom, and things are working very well and your quality of life you’re happy with,
34:01 – that may be the one that I have to ask you to put up with just because it can be a side benefit.
34:08 – I mean, there’s a sign of a special treatment. If it’s excessive, then most of the time I have to withdraw a therapy to diminish it.
34:17 – They’re not necessarily willing to do that. Okay, can you provide any advice on how to clean the urethral opening and anus
34:31 – There are works is a manufacturer. It’s a healthcare company that produces things like
34:39 – mainly orthopedic sports medicine, where there’s like pain patches for injuries, you’ll see these
34:47 – shoulder things if you’ve hurt your shoulder and things like that. But they do have a genital urinary division that produces a product called U-Pak.
34:57 – Like urology in a package. And U-Pak by Theraworx is,
35:05 – and you can get it on Amazon. It’s got colloidal silver and a natural antiseptic.
35:12 – It is a great product. It’s something I was not using I don’t think at all.
35:18 – Last time we spoke, I couldn’t go so far as to say game-changing,
35:24 – but critical addition to my treatment protocols.
35:30 – And it’s very safe. Again, there’s no antibiotic in it, there’s nothing that’s sort of a chemical,
35:36 – either than colloidal silver and natural antiseptic, right?
35:41 – It is so safe that it is used in newborn intensive care units for newborn pinkeye,
35:48 – conjunctivitis. When the rep comes into the office to sell it to you, he will squirt it in his eye and show you how safe it is.
35:57 – So that was safe enough for me to ask my patients to put it in their perineum in their vagina.
36:03 – And it comes in just like a little spray pump bottle, which is a foam liquid
36:10 – and then it comes to these wipes. The wipes are done in perineum, buttock, whatever you need to do that.
36:18 – And then the pump, instead of using that like to wash an area,
36:23 – although if there’s obvious contamination that might be good, I’m having women soak a tampon
36:29 – and put that in their vagina for a couple of hours a day. And for most vaginitis, be it anything, and backing up a little bit,
36:40 – those two agents, not in group. But it’s also not very toxic, it’s very well tolerated.
36:46 – And I have found that it just does not disrupt the microbiome nearly as much as like boric acid or new interventional therapies,
36:55 – or, you know, certainly than any systemic therapy. They see a woman seems to regain the vaginal microbiome,
37:02 – the vaginal ecosystem faster after using this. So that’s the therapy I use.
37:08 – Another thing I think is critical, and I have to criticize one of my colleagues
37:13 – here in the US who is also a refractor UTI specialist,
37:18 – but he has told patients, and again, I’m going to be blunt about what I’ve seen, it’s just not working, it’s not to criticize a provider.
37:26 – As I said at the outset, we all have different approaches to this. Our confirmation bias are different.
37:33 – But this provider doesn’t even look at the vagina, doesn’t swab the vagina, doesn’t treat anything,
37:41 – only what’s in the bladder is treated, well, that’s just not going to work. I have many patients who have a vaginal source of the pathogen.
37:51 – And I treat with two weeks of this interventional therapy with this thorough work.
37:56 – And it gets rid of the UTIs. Even though they’re not having the vaginal symptoms, I find the harbor with next generation sequencing.
38:04 – And I treat it and that has been critical in terms of altering the disease process.
38:12 – And it makes sense if you can get rid of it in the vagina, that’s where it’s coming from. But treat that instead of taking a pill or goodness god awful stuff in there,
38:20 – that’s gonna nuke everything. So that’s kind of what I would say is that,
38:27 – listen to what makes sense to you. And if the provider is telling you that it doesn’t .. If whatever they’re saying to you doesn’t make sense to you,
38:34 – then it doesn’t make sense. So find somebody who’s willing to look wider.
38:53 – And we tend to have somewhat different ways of doing it. I’m not going to pat myself on the back from the
38:58 – standpoint of just telling you that what I have spoken to you, it’s extensive experience.
39:04 – And the experience has been, quite honestly, to be blunt, failure. In other words, most of what I’ve learned, and what I’m telling you
39:11 – is extensively backed up by experience that has been negative, and I’ve had to find something else or I’ve had patients
39:19 – for whom I haven’t been able to help or have actually made worse. And so when I tell you something, there’s a lot of data behind it, a lot of patient experience and outcome
39:29 – that make my recommendations as they are. And I don’t know everything. I learn something every day.
39:34 – I learn something from you right now. I’m not going to be so arrogant. I’m much more humble than I was four years ago when we
39:42 – interviewed because I thought this microgen is great. I’m gonna have next generation sequencing. I’m gonna whip their butts,
39:47 – bacteria, you know, and fungus and yeah, well, the microbes have made me very humble from that standpoint.
39:56 – But that’s critical to keep an open mind about new things. New ways of looking at things, new protocols.
40:02 – I know a lot of providers across the world that are we’re seeing the same patients,
40:09 – I’m anxious to share their experiences. One of the things I’ve told the CEO of MicroGen is that
40:15 – you really need to get a panel of experts and be promotional about this, you’re the common link, as our view, Melissa and others to getting us
40:24 – professionals together to start talking. I’ve tried individually to talk to some of them.
40:30 – And it’s been frustrating in that we haven’t really been able to reach much common ground,
40:35 – because I would really like to share that information with you. But I would say, your website and the MicroGen website,
40:43 – and the other sort of Facebook pages and things, that’s the way to find it, because then you’re going to find out what the patient experience has been
40:51 – from somebody for whom it counts. Here’s the other thing to kind of circle back about finding a provider.
40:57 – You need a team. Patients want an advocate.
41:03 – They know we don’t know it all. Obviously, we don’t know it all, because you’talking to us, because you’ve had all these issues.
41:08 – So the bottom line is if that provider does not have a pelvic floor physical therapist,
41:15 – potentially a pain management person, they need a network and a functional medicine doc
41:22 – typically or natural path. If you don’t have that basic team,
41:28 – you’re not going to be able to treat these conditions effectively. Probably a good time to mention that we also can share information
41:34 – about clinicians with patients. So we do have a network of clinicians who have been recommended by
41:39 – patients in the community and sometimes by other clinicians. If there are clinicians out there that would like to find out more about that,
41:45 – they can get in touch with us. And patients who would like information about clinicians in the area, we’ll always do our best to provide that information.
41:52 – You’re on that list, of course. I’m glad. It’s been wonderful.
41:57 – I really wanted to thank you for joining us again today and answering questions Of course. Anytime.
42:02 – It’s always a delight to spend time with you. And again, in the beginning, in the end, I’m going to absolutely tell you how important you
42:11 – are to all of us in the community. Critical you’ve been to be able to make people’s lives better.
42:18 – We thank you for that. Thanks so much. Thanks again for watching. I hope you found part two of this follow up interview helpful.
42:24 – Pay particular attention to the section about UTIs as sexually transmitted infections, particularly if you’ve experienced UTIs after sex.
42:32 – Of course, if you like what we’re doing on this channel and want to support what we do, be sure to hit subscribe and tick the bell so you’ll be notified of future videos.
42:38 – Thanks so much for watching. And until next time, keep asking questions and pushing for better solutions.