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How artificial intelligence can help primary care doctorsand their … – Medical Economics

Two letters. Theyre enough to give your patients more anxiety than any treatment, test or injection. A recent survey by the Pew Research Center shows it: Sixty percent of Americans said they would be uncomfortable with their provider relying on artificial intelligence (AI) in their own health care. But when used responsibly, artificial intelligence can help primary care doctors expand their care while cutting costs in their practices. And patients will notice the difference tooeven if they dont realize the technology behind their improved experience is the result of those dreaded two letters.

Informed patients, informed doctors

What really scares patients is the idea of AI performing the skilled work of doctors. The fact is, however, we are a long way from AI replacing doctors. Nor will AI replace office staff. But we are now at a point where AI can start to address the communication issues doctors face in their practices.

Patients say they dont want AI making health care decisions for them based on its interpretation of their conditions, but AI can help patients navigate through the treatment process and get them information a lot faster. For example, doctors can use AI and chatbots in their patient engagement strategy to better understand their patients, send them personalized information that is tailored to their treatment journey, and create interactions that are relevant to their personal needs.

AI has numerous applications for primary care physicians who are looking to manage their patients health proactively, Jonathan Sachs, MBA, vice president and chief experience officer for Robert Wood Johnson University Hospital, told me. AI can unlock a physicians ability to understand a patients needs beyond their 15-minute office visit by helping that physician make sense of longitudinal data from multiple sources such as wearables, at-home biometric technology, and internet of things devices.

Interactive messaging

As Googles chief health officer Karen DeSalvo, M.D., MPH recently noted, the future of health is consumer-driven. AI can help doctors be ready for the shift by improving the way they and their staff communicate with their patients.

Many practices are adopting advanced communications platforms to help streamline their workflow and patient interactions. AI and machine learning will take these platforms beyond simple appointment reminders to create better patient experiences.

AI can send relevant content to the patient at the time they need it the most, which leads to patients who are better educated, more comfortable, more confident, and more engaged in meaningful conversations about their health. The result is better outcomes, and ultimately more patients and cases.

AI Is already working in health care

AI is already helping doctors do their jobs better and more efficiently. Patient diagnostics is one area where we see this already. AI can help doctors ensure that patients who need care most urgently are treated first. AI can also help staff keep track of patients in nursing homes by monitoring their conditions based on data, which takes some of the sting away from nursing shortages. It can also detect disease by analyzing data and advance treatment through machine learning.

In private practices, AI is ready to step in and help with eligibility checks, prior authorizations, insurance claims, referrals, and billing. The immediate benefit of the digital transformation to primary care doctors in their practices, however, is the technologys ability to boost patient engagement and adherence.

Also, imagine the day when the majority of your scheduling is done by a patient interacting with AI in your practice. Integrating AI technology with practice management systems will make that possible. Appointments will be made and changed all while your front office staff is checking in a patient. The result is a superior patient experience while doctors, nurses, and office staff get time back in their days for the tasks that are most important to them.

Easing patients concerns

AI is coming fast and furious, and that is undoubtedly why some of your patients will be apprehensive. The pace of change is exploding. The Wright Brothers first flight was in 1903, but commercial air travel didnt truly take off until decades later. The first human heart transplant was in 1967, while the internet revolutionized the world in a short period of time. And as my great friend Michael Longaker, M.D., co-director of the Stanford Institute for Stem Cell Biology & Regenerative Medicine recently said to me, The pace of change [in fields like] stem cell biology is rising exponentially each year.

Patients will get used to AI in their health care. It wasnt long ago that consumers were afraid to put their financial information online to complete a transaction. Now online shopping is so common that malls are half-empty even during the holiday season. Its going to take a little time until AI proves to be more effective, but in the present we can look for ways to help patients navigate information better. The right information at the right time makes a difference.

Jock Putney is the founder and CEO of WUWTA, an experience and engagement platform designed to help practices engage patients in their care and create better treatment outcomes.

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How artificial intelligence can help primary care doctorsand their ... - Medical Economics

Patients have renewed interest in STI exams after post-Covid spike – Medical Economics

Primary care physicians are being urged to encourage their patients to take a renewed interest in their sexual health after a report showed a spike in STI cases following Covid-19 lockdowns in 2022. According to experts, STI screenings were put off during the pandemic as patients prioritized other health care appointments.

The Zocdoc report, released ahead of CDC's STI Awareness Week, shows that patients have started to book more STI appointments in 2023. Zocdoc appointment booking data revealed that bookings in the first half of March 2023 were 26% higher than the same period in 2022.

The report also highlights a demographic divide, with men being more proactive about checking their sexual health than women. Millennials and Gen Z patients booked the most STI appointments, with patients in their 20s booking nearly twice as many appointments as those in their 30s. Meanwhile, seniors (65+) made up less than 1% of the bookings.

Genital warts caused by the Human Papilloma Virus (HPV) were the most common STI issue, accounting for 24% of all bookings. Genital herpes, HIV/AIDS, HPV, and hepatitis were also among the most commonly reported STIs.

Patients in Atlanta were found to be the most proactive about their sexual health, with the highest rate of STI bookings per patient. In contrast, patients in Boston, Charlotte, NC, San Francisco, and Nashville had some of the lowest booking rates.

Primary care physicians are encouraged to promote STI screenings and provide education on safe sex practices to help reduce the spread of STIs. CDC's STI Awareness Week runs through April 15th and provides a timely opportunity for health care providers to engage with their patients on this important issue.

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Patients have renewed interest in STI exams after post-Covid spike - Medical Economics

Woman diagnosed with incurable condition after eyes turned completely white – Yahoo News

Kerrys partner plans to walk the equivalent of a half marathon with Kerrys weight on his back to raise money for treatment abroad (Collect/PA Real Life)

A woman who lost her father to suicide and was diagnosed with a brain tumour in the space of six months, having seizures up to three times a month, has taught her 10-year-old son how to call 999 and says shes only still alive for (her) kids sake.

Kerry Warburton, 35, who lives in Gainsborough, Lincolnshire, with her partner, Craig Kirkham, 36, their son, Ethan, 10, and their daughter, Ellana, 10 months, landed her dream job as a teaching assistant in December 2019,but in April 2020 she began having seizures where her eyes would turn completely white and she could no longer work.

On top of this, in July 2020 Kerrys dad died by suicide, and in January 2021 doctors found a tumour in her brain, which was causing her seizures.

One month later, doctors tried to remove her tumour by performing an open craniotomy, which made her lose her speech, and while in hospital she contracted Covid and was quarantined for 12 days partnerCraig thought she was on deaths door and doctors wereseconds away from turning off her life support, but she recovered.

Things were beginning to look up Kerry fell pregnant with her second child, Ellana, but after resuming treatment, a follow-up MRI scan revealed that her brain tumour was at stage four.

Now, Craig is planning to walk the equivalent of a half marathon to raise money for stem cell therapy which could prolong Kerrys life by three to five years.

I was at an all-time low when receiving treatment, especially after losing my dad Im only still alive now for my kids sake, Kerry said.

In December 2019, Kerry finally landed her dream job, as a teaching assistant, after going back to college as a mature student.

But in April 2020, Kerry began to have seizures, which was the first warning sign for her terminal brain tumour.

Her partner Craig said: She was shaking like mad, and her eyes rolled back in her head, and I saw foam and blood come out of her mouth.

I didnt know what the hell was going on. I was so scared, and I thought she was dying.

Story continues

The whole bed was shaking, and I thought we were having an earthquake or something.

(PA Real Life)

I had no clue what to do I was trying to push her head back into the pillow to stop her shaking, and her eyes were completely white.

Craig quickly called an ambulance, and Kerry was taken into Lincoln Hospital for tests and an MRI scan.

But Kerry was not diagnosed with anything and continued to have seizures up to three times a week, while her father died by suicide in July 2020.

Kerry said: I hit rock bottom, they took me off my seizure meds because it can cause low moods, and my seizures got worse I was having them twice a week.

In January 2021, she received more devastating news she had a five-by-five-by-five centimetre tumour in her brain.

Just a few weeks later, in February, Kerry had an open craniotomy, and was told she had stage two brain cancer,which caused her to have aphasia when a person has difficulty with their language or speech.

She explained: I lost my speech completely, it was horrible.

It was so hard for me because I wanted to speak I could speak clearly in my mind, but I couldnt get it out.

(PA Real Life)

When in hospital, she contracted Covid-19 and was quarantined for 12 days.

Craig said: I thought she was on deaths door. It was so scary they were seconds away from putting her to sleep.

It was terrifying because you couldnt go and see her.

I didnt sleep at all Id message her and check her WhatsApp constantly just to check she was alive.

Once out of hospital, Kerry found out she was pregnant and in June 2022 she gave birth to her second child, Ellana.

Just two months later, she had another MRI scan which concluded the brain tumour was terminal and stage four.

Craig said: It was scary as hell we were all happy, we had the baby, and then we were thrown back into the deep end again.

We had to travel for 55 miles for treatment again, for six weeks every single day.

Since October 2022, Kerry has been receiving radiotherapy and chemotherapy, which has caused her to lose her hair and put on over two stone.

She said: It affects my confidence I dont want to leave the house.

Kerry continues to have seizures, but they have gone down to three per month, and has even had to teach her 10-year-old son Ethan how to call an ambulance.

She said: Were scared to death that I might have a seizure when Craig is at work, so weve taught him how to call an ambulance.

Weve had to give him counselling at school to cope with me being so ill.

It was hard to teach him how to do it,I was petrified, and his school have helped.

I know it must be horrible for my son, I blame myself for him getting upset about it.

To raise money for stem cell therapy, which could extend Kerrys life by three to five years,Craig has set up a GoFundMe and plans to walk from Lincoln Castle to his house, which is the equivalent of a half marathon, with Kerrys weight, 12 stone, on his back.

Craig said: Gravity will be trying to pull me into the ground just like this tumour is trying to put her in the ground, but we are going to defy both.

Kerry added: It would just be wonderful to have the treatment, and to not worry my son anymore.

To find out more about Craigs fundraising, visit http://www.gofundme.com/f/kerry-the-white-knight.

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Woman diagnosed with incurable condition after eyes turned completely white - Yahoo News

Memphis Grizzlies provide details on why Steven Adams hasn’t been cleared for NBA playoffs – Yahoo Sports

The Steven Adams injury and timeline has left fans searching for answers.

A report from ESPN's Adrian Wojnarowski said that Adams is "unlikely to return" for the NBA playoffs. This came a week after Memphis Grizzlies coach Taylor Jenkins noted that Adams was beginning a reevaluation period where the team hoped he'd be able to return soon.

The Grizzlies practiced on Tuesday. Adams was at practice shooting free throws

"It's pretty confirmed he's most likely out for the playoffs," Jenkins said. "We don't have definitive words on what the next steps are. It's been an ongoing process the last couple of weeks. I think there's more dialogue still this week with doctors involved. We want to make sure Steven's in a good place."

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Adams initially sprained his right PCL in January. He was expected to return in early March, but he needed a stem-cell injection that sidelined him another four weeks.

That lined Adams up for a potential reevaluation at the end of the regular season. When the Grizzlies signed Kenneth Lofton Jr. to a standard contract, it felt like an indicator of Adams' playoff status and the lack of frontcourt depth, but the Grizzlies didn't issue an official update.

"We thought we were making headway with the process and all that, but each evaluation we had with the doctors kind of revealed it's not progressing like we need it to. ... No setbacks, no reinjuries, it was just not progressing to a level. Obviously some unfortunate news, but that's why we're going to try to do everything possible to try to get the best decision possible for him," Jenkins said.

Story continues

The Grizzlies haven't ruled out surgery as an option for Adams. Jenkins said that everything remains on the table.

Xavier Tillman Sr., Jaren Jackson Jr. and Santi Aldama are expected to get the bulk of minutes at power forward and center. Aldama didn't play in the final two regular season games due to left elbow soreness, but Jenkins called it precautionary.

Aldama was a full participant in practice on Tuesday and wore a compression sleeve on his left arm.

This article originally appeared on Memphis Commercial Appeal: Steven Adams: Memphis Grizzlies give injury report for NBA playoffs

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Memphis Grizzlies provide details on why Steven Adams hasn't been cleared for NBA playoffs - Yahoo Sports

Platelet-Rich Plasma Market Is Anticipated To Increase At A Steady CAGR of 12% by 2031 | Fact.MR – Yahoo Finance

FACT.MR

Fact.MRs latest report on platelet rich plasma market analyzes opportunities, trends, and threats affecting growth in the market. It offers an in-depth analysis of the market in terms of product type, application, and end users. The study also reveals interesting information about strategies adopted by market leaders.

Rockville , April 11, 2023 (GLOBE NEWSWIRE) -- The global platelet-rich plasma market reached US$ 400 million in 2020. From 2021 to 2031, global platelet-rich plasma demand will thrive at 12% CAGR. Total market valuation at the end of 2031 is likely to reach US$ 1.5 billion.

Increasing prevalence of sports injuries incidence and chronic orthopedic conditions is a key factor driving the platelet-rich plasma market. Similarly, rising number of cosmetic and surgical procedures performed globally will elevate demand.

A concentrate of platelet-rich plasma protein obtained from whole blood is called platelet-rich plasma or PRP. It is also referred to as autologous conditioned plasma. It contains different growth factors and cytokines that can trigger healing of joints and soft tissues.

For Critical Insights on this Market, Get A Free Sample Report:https://www.factmr.com/connectus/sample?flag=S&rep_id=170

In recent years there has been a significant increase in the demand for platelet-rich plasma. This is due to its use in applications such as tissue regeneration, scar revision, wound healing, alopecia, etc. PRP is also showing promising results in the treatment of conditions such as osteoarthritis.

Hence, increasing cases of sports injuries, orthopedic diseases, and musculoskeletal disorders will fuel PRP demand through 2031. For regenerative medicine, PRP is a significant source of personalized products for each patient that support wound healing and the repair cascade.

PRP has become a magical potion for flawless skin and hair. It is gaining immense traction in cosmetic surgery and hair loss treatments. PRP injections are being increasingly used to treat hair loss conditions such as alopecia.

Story continues

In 2020, PRP use in cosmetics increased by around 25% over the past four years, according to the American College of Plastic Surgeons report. Rising usage in cosmetics will therefore continue to boost PRP sales revenues through 2031.

Several studies are presently being conducted to assess the effectiveness of PRP in therapeutic areas such as disc herniation and hair loss. It is believed that PRP therapy can rejuvenate skin and reduce wrinkles.

Although this therapy cannot replace certain critical conventional treatments, it can reduce the economic cost of standard medical procedures.

In hair transplantation, PRP binds to growth factors and increases the proliferation of human dermal papilla cells, resulting in hair follicle formation and maintenance.

Platelet-rich plasma has also gained wider popularity in plastic surgery. Properties such as ease of use, inexpensive manufacturing using patient cells, and little or no risk of side effects are the main reasons for the increasing adoption of PRP in therapy.

Based on product type, pure platelet-rich plasma kits segment dominates the global market. This is due to various advantages of pure-PRP kits which include enhanced wound healing and tissue repair.

Regionally, North America will continue to lead the global PRP market. This is due to increasing cases of sports injuries and orthopedic disorders. Similarly, development of PRP-based therapies, rising interest in personalized medicine, and high sourcing from end-users such as hospitals and clinics will boost North America market.

Key Takeaways from the Market Report:

Global platelet-rich plasma sales revenue will increase at 12% CAGR during the forecast period.

Based on product type, pure platelet-rich plasma kits segment held around 50% revenue share in 2020.

Based on end user, hospitals segment is set to thrive at 10% through 2031.

India platelet-rich plasma market will exhibit a CAGR of 8% from 2021 to 2031.

In the United Kingdom, platelet-rich plasma demand is likely to surge at 8% CAGR.

The United States market will experience a 9% CAGR throughout the projection period.

Growth Drivers:

The rising incidence of orthopedic and sports injuries coupled with increasing acceptance of PRP as an effective treatment option will drive the market.

Rise in surgical and cosmetic procedures will generate high demand for PRP treatments.

Increasing awareness about PRP and its potential advantages will boost sales revenue

Technological advancements in the PRP devices supported by new product launches will foster market development

Growing popularity of plasma-rich protein therapies for treating various conditions will create new growth prospects

Restraints:

High cost of PRP procedures and various side effects associated with PRPs are limiting market expansion.

Low awareness about PRP in several regions of the world might restrain market development.

Get Customization on this Report for Specific Research Solutions:https://www.factmr.com/connectus/sample?flag=RC&rep_id=170

Competitive Landscape:

Key players are focusing on implementing various strategies to expand their product offerings and strengthen their geographic footprints. They are spending large amounts on research and development.

For instance,

In February 2020, all assets of Cellmedix Holdings LLC which includes the Centrepid Platelet Concentration System were acquired by EmCyteCo. This expanded the business's product portfolio.

In September 2021, Royal Biologics Maxx-PRP Concentration System received FDA 510K approval.

Key Companies Profiled by Fact. MR

Arthrex, Inc.

Johnson & Johnson

Zimmer Biomet Holdings, Inc.

Exactexh, Inc.

Stryker Corporation

Terumo Medical Corporation

Biotest Aktiengesellschaft

CSL Ltd.

More Valuable Insights on Platelet-Rich Plasma Market

In the report, significant growth approaches such as acquisitions and mergers, cooperation, and partnerships are operated. The reports provide an in-depth report of the opportunities and growth drivers anticipated to boost the expansion of the platelet-rich plasma market through segmentation as follows:

Product Type:

Platelet-Rich Plasma Instruments

Pure Platelet-Rich Plasma Kits

Leucocyte- Rich Platelet-Rich Plasma Kits

Platelet-Rich Fibrin Kits

Pure Platelet-Rich Fibrin Kits

Application:

Orthopedic Surgery

Cosmetic Surgery

General Surgery

Neurosurgery

Other Surgeries

End User:

Hospitals

Orthopedic Clinics

Dermatology Clinics

Others

Region:

North America

Latin America

Europe

South Asia

East Asia

Oceania

Middle East & Africa

Buythis Premium Research Report (170Pages, 241 Tables & 87 Figures)https://www.factmr.com/checkout/170

Key Questions Covered in the Platelet-Rich Plasma Market Report

What will be the demand outlook for the platelet-rich plasma market during the forecast period?

Which are the challenges faced in the platelet-rich plasma market?

Which application will lead the growth in the platelet-rich plasma market from 2021 to 2031?

What is the projected market valuation of the platelet-rich plasma market in 2031?

Which are the factors driving the platelet-rich plasma market from 2021 to 2031?

Which end user will generate maximum revenue in the platelet-rich plasma market?

Explore Fact. Mrs Coverage in the Healthcare Domain

Plasma Fractionation Market: The global plasma fractionation market is set to reach a valuation of US$ 65 billion by 2032. Total demand for plasma fractionation will rise at 7.3% CAGR over the next ten years. Rising prevalence of chronic disease and widening usage of immunoglobulins for treating several conditions are driving the market forward.

Plasmapheresis Market: As per Fact.MR, global demand for plasmapheresis is set to increase at 7.4% CAGR through 2032. Total market valuation at the end of 2032 will reach US$ 2.6 billion. Increasing incidence of autoimmune diseases and growing health awareness are key factors driving the plasmapheresis market.

Mycoplasma Detection Systems Market: The global mycoplasma detection systems market size reached US$ 560 million in 2021. Over the next ten years, global mycoplasma detection systems sales will surge at 9.6% CAGR. By the end of 2032, the total market valuation will cross US$ 1.5 billion. Rising emphasis on mycoplasma testing by research and pharmaceutical companies will elevate mycoplasma detection system demand.

About Fact.MR

We are a trusted research partner of 80% of fortune 1000 companies across the globe. We are consistently growing in the field of market research with more than 1000 reports published every year. The dedicated team of 400-plus analysts and consultants is committed to achieving the utmost level of our clients satisfaction.

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Platelet-Rich Plasma Market Is Anticipated To Increase At A Steady CAGR of 12% by 2031 | Fact.MR - Yahoo Finance

When Blood Is a New Alternative Medicine for Pain Relief at Chula … – PR Newswire

BANGKOK, April 11, 2023 /PRNewswire/ --Chula Medicine researchers have successfully published an article on the injection of patient's own platelets rich plasma into the shoulder ligaments resulting in painreduction, heal torn ligaments and restore torn muscles as an alternative to surgery while reducing the side effects of prolonged use of pain medications.

"Pain"is a condition that no one wishes to experience. And when it occurs, people want to heal as soon as possible. This can be achieved through taking painkillers or alternative medical approaches such as acupuncture, massage, using heat compression, etc. But today,Chula Pain Clinic, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society has a new proven treatment for pain derived from the person's own "platelets" to offer.

"Platelet-Rich Plasma (PRP) injectionfor shoulder ligament injuries or "rotator cuff tears" is one of the treatments we have been doing for over 5 years." ExplainsAssistant Professor Marvin Thepsoparn, MD, an anesthesiologist and pain management specialist at the Pain Clinic, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society. "This approach helps to reduce the side effects of painkillers and is very safe because the patient's own platelets and plasma are used to inject back into patient's injury site to stimulate self-repair," Dr. Thepsoparn is discussing how to relieve pain with platelets.

This research was conducted in collaboration with the Orthopaedic Sports Unit of King Chulalongkorn Memorial Hospital to study pain care for people who have suffered injuries from work, sports, and abnormal body movements. These are the causes of muscle injuries and torn ligaments, which can lead to lifelongchronic pain.

"In this study, we compared the efficiency of treatments by performing an MRI of the shoulder of patients who had already received platelet injection for 6 months, and those who did not use this method to treat torn shoulder ligaments. We found that injecting of the concentration of platelets into the shoulder ligaments significantly reduced pain within 1 2 months and also helped repair the tear, resulting in better healing of the ligaments and a reduction in size of the tear. As a result, patients did not have to suffer from chronic pain, avoided surgery, and eliminate the risk of continuously taking painkillers for an extended period."

The concentration of platelets a new option for pain relief

Dr. Marvin explains the two commonnon surgicalapproaches to pain treatment today: medication and non-drug treatment.

1. Pain treatment with standard analgesic drugs that are commonly used include:

2. Pain Management without medication can be divided into two groups:pain intervention procedures such as radiofrequency ablation of nerves, steroid injection and PRP injection. Secondly, physical therapy by Rehabilitation Medicine which can be done in various ways, including shock wave therapy, ultrasound therapy, warm compress, massage, cold compress, acupuncture and music therapy, etc.

"PRP Injection for body regeneration is considered an alternative medicine that has been practiced abroad for over 10 years. Platelets have various substances that the body produces for self-repair. Therefore, platelet injection has been studied both for cosmetics purposes and for pain management in the knees, shoulders, and other organs in the body," explained Dr. Marvin. He added that many hospitals in Thailand now use this approach as an anti-aging medicine.

Blood quality: efficiency for pain relief

Because this method uses the patient's own platelets, the effectiveness of treatment varies depending on the patient's physical condition, age, lifestyle, habits, andblood quality of the individual patient.

"If the patient is strong, exercises enough, or is an athlete, the blood quality will be good, and so is the body repair effect."

Dr. Marvin cited a foreign study of platelet injections which indicated that the effectiveness of platelet injections in body repair would be very effective for patients under the age of 55.

"This method is very safe because it uses the patient's own blood for treatment, so there are no side effects like using conventional painkillers. Often, patients over 60 years old come to seek treatment using this method, and the doctor agreed to do it, but informs the patient that the effects may not be as good as those who are under 55 years old."

"The treatment is done by taking about 15-30 ml of venous blood and then running it through a centrifuge to concentrate the platelets and splitting the plasma and red blood cells. Then take the plasma with platelets to be used for immediate treatment."

Who is PRP not suitable for?

Though very effective, PRP injection is not suitable for all patients, especially the following two groups:

Shoulder ligament problems trending ailments in urbanites

Until recently,Chula Pain Clinichas taken care of many patients suffering from chronic pain caused by shoulder ligament problems.

"We found that shoulder ligament problems are mostly the result of heavy lifting, work related injuries, and sports injuries. These injuries often take a long time to heal and recover from. PRP injections are therefore beneficial for athletes, office workers, and anyone wanting to recover from injuries in a shorter time so that they can get back to work, compete in sports and live a high-quality life as soon as possible," explained Dr. Marvin briefly.

"We atChula Pain Clinichave a comprehensive approach to patient care, where doctors including surgeons, orthopedic specialists in shoulder surgery, and rehabilitation doctors work together to restore the shoulder function." Dr. Marvin explained

"The doctors begin by selecting the appropriate treatment for the best results that can improve the patients' quality of life. If an ultrasound or MRI shows shoulder ligament injury or frozen shoulder and the team diagnoses that surgery is not required nor suitable, exercise would not help alleviated the pain, an PRP injections should be administered. The patient will be referred to receive PRP injections.Most Patients will receive one or at most two injections, and the pain should have expected to decrease by 80 percent. The remaining 20 percent of the pain will go away with time and rehabilitation exercises.

Dr. Marvin further added, "the cost of treatment is around 9,000 baht per session (procedure)."

The Future of Research on Pain Management with Patients' Own Blood

Dr. Marvin explained the progress of clinical research "in medicine, we do not stop researching to help relieve patients from pain and suffering. This research has also been extended to other organs, such asthe study of PRP injections to suppress pain in fused vertebrae (Ankylosing Spondylitis) cases. The study has reached the 50 percent progress milestone, and we are still looking for patients to participate in the study." Dr. Marvin invited those interested to make an appointment at the Chula Pain Clinic to be examined and diagnosed by physicians to see if they have Back pain and if eligible, patients can choose to participate in the study voluntarily, free of charge.

Stop the pain at the Chula Pain Clinic

"Nobody wants to be in pain, but when ill, they need to be healed. Would it be better if the patients don't need to suffer from pain which is a side effect of their long period of treatment and rehabilitation? This is the concept of the Pain Clinic," Dr. Marvin concluded.

Interested parties suffering from rotator cuff pain, or pain in other parts of the body can receive an examination for correct diagnostics and treatments atPain Clinic,17th floor, Phor Por Ror Building, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society during Monday Friday from 8.00 a.m. 4.00 p.m. by making an appointment in advance or by calling +66 2256 5230.

Information Box

Open for volunteers to participate in pain management research project to improve quality of life

Chula Pain Clinic also has two other clinical research projects on pain management to develop better pain relief and pain management options for patients. We are accepting volunteers to participate in the projects, which require patients with physical pain as follows:

Individuals who are interested in taking part in the aforementioned study may request an appointment at Chula Pain Clinic to undergo a pain diagnosis for any disease. If deemed eligible, patients have the option to voluntarily participate in the study and receive treatment free of charged. Those interested in participating in the above study can request an appointment at theChula Pain Clinicfor a diagnosis of pain from any disease. If eligible, patients can choose to participate in the study voluntarily to receive treatment free of charge.

For the full release and more images, please visit: https://www.chula.ac.th/en/highlight/110448/

About Chulalongkorn University

Chulalongkorn University sets the standard as a university of innovations for society and is listed in the World's Top 100 Universities for Academic Reputation, in the Quacquarelli Symonds (QS)World University Rankings 2021-2022.

If you would like more information about this topic, please contact Miss Thanita Wangvanichapan at (+66) 2218 3280 or email [emailprotected]

SOURCE Chulalongkorn University

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When Blood Is a New Alternative Medicine for Pain Relief at Chula ... - PR Newswire

What Happens When Youve Gotten Filler for Years and Then Stop? – Allure

In our three-part series, The Filler Files, Allure explores our relationship with facial filler. It's still one of the most popular nonsurgical cosmetic procedures, yet more of us are looking to dissolve our filler than ever before. What does this mean for our lips, our cheeks, and our approach to injectables?

If you clicked on this headline, you likely have some relationship with hyaluronic acid fillers the injectable gels, like Juvderm and Restylane, that millions rely on to contour, plump, and smooth their features. Whether youre a diehard fan or a casual acquaintance, youve probably wondered how these sugar-based substances behave inside the body and what actually happens when we decide to quit them after years of routine touch-ups.

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In posing these questions to dermatologists and plastic surgeons, we discovered that theres a frustrating dearth of formal studies investigating hyaluronic acid fillers over the long term how and when they break down, the ways in which they change over time, and their effects on the quality of our skin and elasticity of our tissues, both during peak injectable use and long after weve sworn off the stuff. Given the paucity of hard data, much of what our experts shared is anecdotal insights informed by their decades of experience injecting and dissecting the human face. Reliable intel, nonetheless.

In the interest of not burying the lede, well start here: If youve been getting filler religiously for years, what happens when you stop will hinge on one critical factor: your average dose at each appointment. People who are getting a syringe or two every 12 months doing a little bit for specific points of volume replacement they have a much easier time than those who are receiving 5 to 10 syringes every six months, because theyre not getting to a place of overinflation and tissue distortion, saysJessica Weiser, MD, a board-certified dermatologist in New York City.

And make no mistake: Countless men and women are walking around with gluts of filler under their skin. While Dr. Weisers self-imposed limit for a single session is two or very rarely three syringes, she believes she is somewhat of an outlier among injectors. There are tons of doctors doing 10 syringes at a time, she tells us. Some of the other physicians we spoke to confirmed that they commonly encounter patients whove received 20 or even 50-plus syringes of hyaluronic acid over a one- to two-year span.

When patients come in with too much filler in their faces, it can be almost disfiguring, saysLara Devgan, MD, a board-certified plastic surgeon in New York City. The problem can be more than skin-deep, affecting both the look of the face and its functionality. Its so common that theres a term for it: filler fatigue.

Board-certified ophthalmologist and oculoplastic surgeonMitesh Kapadia, MD, describes the overfilled face as an epidemic for which a growing number are now seeking a cure namely, hyaluronic acid-melting hyaluronidase, a synthetic version of an enzyme found in the body. Youve no doubt seen celebrities, likeCourteney Cox andAmy Schumer, talking openly about being displeased with the look of their outsize cheeks or lips and having their filler dissolved with this injectable solution. Theyre hardly alone. According toThe Aesthetic Societys most recenttrend report, their members performed 57% more filler reversals in 2021 than they did the year before. Indeed, a common refrain among cosmetic providers is that theyre spending more time dissolving filler than injecting it.

Whats behind the about-face? People are realizing that theyre not looking better, but looking odd, saysElizabeth Houshmand, MD, a board-certified dermatologist in Dallas. It may be an old photo or a well-meaning family member that helps them see the error of their ways. Or a complication will clue them in, as they notice their fillermigrating or swelling. Often, though, they cant pinpoint the exact problem, Dr. Weiser says; they just know that things feel strange.

Sometimes, people break up with filler not because theyreoverfilled, per se, but because theyreover filler the look, the upkeep, the headaches and this too is a form of fatigue. The filler becomes oppressive, a burden. Especially when theyve been through bad injectables and dissolving, they just dont want to deal with it anymore theyre done, saysJonathan Cabin, MD, a board-certified facial plastic surgeon in Arlington, Virginia. In other cases, the filler has just exhausted its usefulness, no longer able to obscure insecurities in a natural-looking way and compelling once-loyal users to pursue a more powerful solution, like surgery.

So whats all this filler doing to our faces?

Overdone or poorly placed filler can muck up the mechanics of a face. The facial muscles may not move properly, and that changes not only how you look, but also how you drain, saysBen Talei, MD, a board-certified facial plastic surgeon in Beverly Hills. By way of explanation: Muscle contractions ordinarily help keep lymphatic channels flowing, but when filler envelops the muscles it restricts movement, straining our expressions and causing lymphatic fluids to stagnate and lymphatic channels to swell. All the while, the hyaluronic acid is pulling in fluid notorious water hogs, these gels intensifying bogginess and bloat. When theres such a high volume of filler going in there that the face is not draining properly, it can give the skin a sort of puffy or doughy look, adds Dr. Weiser.

Filler can also integrate with our tissues over time. In small quantities, its no big deal. It may just make certain layers of the face stronger and slicker, notes Dr. Devgan. But when copious gel piles up from repeated injections, this fusion can elicit a microcystic expansion effect, says Dr. Talei. (He describes the concept in a newstudy published in theAesthetic Surgery Journal.) As he explains, the filler penetrates as little gel particles, soaks into the various layers of the soft tissue, and [acts] like a million tiny water balloons, stretching it all out.

The soft tissue expansion reads as bulkiness, he says, sometimes with a bit of a gargoyle appearance in certain patients. In the lips, it can lend a flaccid, low-hanging look. The consequences of this distension will be more dramatic in those whove been grossly overfilled for many years.

What happens when you stop getting filler?

Patients who were filled normally shouldnt have any issues. The filler either sits around harmlessly or slowly metabolizes over time, says Dr. Talei. Dr. Weiser agrees that if judicious doses (treating every issue with as little filler as possible) were carefully injected (in tiny droplets, versus large blobs, at a safe and imperceptible depth), the bodys own hyaluronidase enzymes should gradually digest it. (In areas of little movement, like the undereyes, hyaluronic acid fillers can be rather tenacious, though, and can sometimes outstay their welcome.)

As filler fades and its effects wear off, previously treated features will shrink and flatten, creases and folds may emerge, and shadows can creep in. Whatever you were aiming to veil will be unmasked and likely accompanied by age-related changes that landed, perhaps unbeknownst to you, during your fillers tenure. Uncovering whats happened while fillers been in your face can be a lot if youre not psychologically prepared for it, cautions Dr. Cabin. On the upside, hyaluronic acid injections have beenshown to stimulate collagen production, so your skin could, consequently, be a tad thicker following years of repeated pokes.

And the post-filler expansion phenomenon the stretching and warping of tissues shouldnt really concern the low-key filler user, who is not obviously inflated. Appropriate amounts of filler do not cause this problem, Dr. Talei reassures us. It is more likely seen when excess amounts are placed [for] over a year.

Whether you let filler dissipate on its own or use dissolver to speed things along, dont expect to be left entirely filler-free. I dont think you ever get 100% back to having no filler in your face, Dr. Weiser says. A portion of it does integrate and its extremely challenging to remove every drop.

Dr. Devgan also acknowledges that trace amounts of filler can remain interwoven with our natural collagen, much like ivy thats grown into a lattice in a garden. But she stresses that this isnot something to fear. Filler disappears on a decay curve, steadily disintegrating at a consistent rate, until it becomes almost imperceptible, she explains. Even if remnants are visible on an MRI [or ultrasound], she adds, theyre not necessarily significant enough to alter a persons appearance.

If you cant see or feel your old filler, and its not acting up, the doctors we spoke with all advise against chasing it with hyaluronidase because that little bit of filler thats sticking around could be totally benign. While the gel may change character in the future, move a tiny bit, or draw in water, Dr. Talei says, in such scenarios, dissolving it is usually easy and predictable.

Getty Images

Overfilled patients can also stop and/or dissolve whats in their face at any time, but it may take them longer to reach their no-filler destination and they may not love the view once they get there.

When people have been filled forever and dont remember what they looked like before, they need to know they may be opening a can of worms, saysFlora Levin, MD, a board-certified ophthalmologist and oculoplastic surgeon in Westport, Connecticut. My consent for dissolver clearly states that you may be just as unhappy, or more unhappy, after I dissolve the filler than you were prior to dissolving.

Younger patients tend to rebound fairly seamlessly, likely because they havent been filled for as many years, which means less filler in some cases and less time for expansion [of the soft tissues of the face], says Dr. Talei. Their tissues are also more resilient with a greater healing capacity.

Rarely, in extreme and prolonged cases of filler use, the face can never go back to what it was, says Dr. Talei, because the gel has damaged and, in a way, aged the tissues. He hesitates to dissolve these patients, because removing the HA (to whatever extent possible) can leave stretched tissues unsupported and desiccated, causing areas of the face to collapse and appear darker. He can usually get them to a better place: They may need to maintain some degree of HA filler while also considering surgery to address laxity, plus stem cell-rich nanofat orplatelet-rich plasma (PRP) injections to help regenerate depleted tissues.

The lips are, arguably, the most frequent victims of superfluous filler and, over time, this can carry serious consequences.

But how much filler is reasonable in the lips department? It depends on your individual starting point the undoctored size and shape of your lips. While everyones are different, a unifying characteristic is that they all have a tipping point: Upon assessing your lips, your injector should know precisely how much gel they can receive without complication.

For lips, I very seldom do more than half a cc at once, Dr. Levin says. And I dont have people come back [for touch-ups] at a specific time period. We leave it open-ended.

When lips are repeatedly filled beyond their inherent capacity, filler can seep across the vermilion border (a.k.a., the lip line) into the philtrum (the area between the lips and nose), producing a shelf-like appearance or filler mustache, says Beverly Hills board-certified plastic surgeonGary Motykie, MD. Filler migration is common here because the muscle encircling the mouth is in near-constant motion.

Beneath the skin of the philtrum is a cushy layer of fibrous tissue called the SMAS (short for superficial musculoaponeurotic system), which overlies muscle. This tissue is responsible for [providing] supple support and hydration to the lip skin, Dr. Talei explains. When an abundance of filler sits in the body of the lips and/or the SMAS for an extended period of time, these tissues can stretch and expand sometimes permanently.

If the filler is left to slowly go away [on its own], the lips may eventually return to normal, or the filler could just stay in place for years, Dr. Talei tells us. Alternatively, patients may choose to melt lip filler with hyaluronidase to take control of the process. Many people dissolve without issue and dont require any follow-up, says Dr. Talei. Occasionally, though, dissolving overfilled lips can backfire: The tissues dont snap back to their original state, he adds, and removing the filler actually may reveal the [tissue] expansion and accelerated aging that occurred while the hyaluronic acid was in place. The lips can look lax, shriveled, or asymmetric, and the skin above the vermilion may appear darker and wrinkled due to changes in the SMAS.

Ironically, the fix for this may be more lip filler a conservative dose, injected periodically, to revolumize and rehydrate the tissues. If the area above the lips looks long and droopy in the wake of overfilling, a surgical lip lift can shorten the space to youthful effect. As with other parts of the face, nanofat or PRP injections may also help repair damaged tissues.

This all sounds a little scary, we realize, and we never aim for sensationalism, so lets be 100% clear on this point: A modest amount of lip filler, even sustained over years, willnot accelerate tissue aging it just doesnt do that, Dr. Talei says. But when lips or any part of the face, for that matter have housed a ton of hyaluronic acid for a time and its inhibiting movement and stretching skin,that can speed aging tremendously.

What to do once you quit

Once youve decided to take a break from filler for however long considerdiversifying your treatment portfolio. When I see patients whove been getting only filler for 20 years and have never had any kind of radiofrequency or ultrasound or laser treatment, what I find is that their skin the luminosity, tone it just doesnt look that good, Dr. Weiser says. Try refining your complexion with a proven device or getting a subtle volume increase from collagen-stimulating Sculptra. Dont lean on hyaluronic acid exclusively. I think if you really maintain the quality of the skin and keep collagen levels boosted, the need for volumization is less, adds Dr. Weiser.

Ultimately, all procedures have limitations and respecting them can keep you looking undone through the years. When your old reliables start to fall short, you can either pause and accept your reflection as is or explore the next-level surgical realm. Happily, the choice is yours.

Check back for the third installment of our three-part series, The Filler Files.

Read more on injectables:

Watch a dermatologist explain how hand fillers work:

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What Happens When Youve Gotten Filler for Years and Then Stop? - Allure

‘Brotox’ takes over TikTok: Why more men are getting cosmetic surgery – PR Week

Botox, which celebrated its20th anniversaryofFood and Drug Administrationapproval last year, is becoming increasingly popular among young men a trend dubbed as brotox.

The trend is perhaps unsurprising given Gen Z and millennials tendencies to focus on self-care,glow-ups and self-improvement.

The brotox boom is making waves among both young and old men and TikTok is home to various iterations of it.

Since brotox is having its moment in the sun, its worth looking into how popular cosmetic procedures are among men.

According to theAmerican Society of Plastic Surgeons(ASPS), cosmetic surgery and non-surgical aesthetic procedures among men rose by 29% between 2000 and 2018. In 2020 alone, more than 265,000 men got Botox procedures to target wrinkles in their face.

In particular, buttocks lifts and cheek implants saw the greatest increases among men between 2000 and 2020, rising 1,616% and 644%, respectively. Procedures including lip augmentations and laser skin resurfacing also became more popular during that time period,according to ASPS.

The trend has taken off partially due to the fact that negative connotations around Botox or cosmetic surgery for men have begun to dwindle, according toCynthia Elliott, owner and primary practitioner at cosmetic surgery clinicSkinspirations.

The stigma of vanity surrounding cosmetic procedures for men has evaporated, Elliott said in a statement. Minimally invasive treatments with little downtime and natural-looking results give men the same benefits women have enjoyed for decades enhanced self-esteem, confidence and sociability.

Indeed, a quick search on TikTok will unveil numerous men trying out Botox to treat fine lines and wrinkles giving a rundown on how the experience went for them.

Here are a few Brotox trends theyre trying out.

1. Getting rid of forehead wrinkles

Perhaps one of the most noticeable areas for wrinkles to appear is on the forehead either horizontally or within the glabellas (also known as the 11s between your eyebrows).

Before and after videosshow how a Botox treatment can minimize forehead creases, with men showcasing the differences for their followers.

2. PRP injections

In one recent video, TikTokerAndre Gadboisprovides a rundown of his recent cosmetic procedures including under-eye injections andnasolabial fold PRP injections. Gadbois explains that PRP injections involve using his own blood to extract platelet rich plasma, then injecting it back into the area of concern to stimulate healing and improved appearance.

While PRP injections have grown in popularity among cosmetic procedures, becoming a trending therapyaccording to the ASPS, the scientific evidence surrounding their efficacy for that purpose is still limited.

3. Crows feet

The peskycrows feetthat form in the corners of your eyes when you smile arent just an aesthetic concern for women.

Now, more men are seeking to minimize crows feet through Botox.

4. Lip flips

Lip flips have become increasingly popular as they offer a more subtle way of plumping your lips. The procedure involves injecting Botox into the upper lip to relax the muscles and make the lip flip upwards a little bit. Men are picking up the trend as well.

5. Eyelid lifts

Dilip Madnani, a plastic surgeon in New York with a TikTok following of more than 156,000, posted a video last year showing how his elderly father healed after getting upper eyelid surgery.

Eyelid lifts help to reduce the appearance of bags under the eyes, notesDr. Cat Plastic Surgery, in addition to removing excess skin from the upper eyelid. Not only does the removal of excess skin improve the field of vision, but it also creates a more youthful face and brighter eyes.

My dads upper eyelids surgery progress over the last 3 days. facelift, Plasticsurgery, drmadnani, FacialPlasticsurgery, Fillers, EyelidSurgery, NeckLift, fattransfer, ExpertInjector, NYC, LongIsland, blepharoplasty, eyebags, skincare, earlobe, minilift, localanesthesia, facesurgeon, #drmadnani #woodbury #centralpark beforeandafter, #newyork

6. Fillers, and more fillers

Men are realizing that its possible to get fillers for your nose rather than going through a fullrhinoplasty.

Whether your nose was damaged from an injury or you simply want to tweak how it looks, nose fillers and Botox are becoming increasingly common for men.

In one video, TikTokerxthuyledescribes how she managed to persuade her boyfriend to get filler and Botox on his nose after he got his nose broken at age 14.

Couples who get fillers together stay together, she says.

7. Botox for aging prevention

Anti-aging isnt just an area of concern for women; men want to appear youthful for as long as possible too.

More men are turning to Botox as a preventive measure to avoid forehead, frown and crows feet wrinkles. Boys get injectables too, the caption states.

This story first appeared on mmm-online.com.

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'Brotox' takes over TikTok: Why more men are getting cosmetic surgery - PR Week

Global Joint Pain Injections Market Report 2023: Growing Occurrence of Osteoarthritis Fuels the Sector – Yahoo Finance

Company Logo

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Dublin, April 07, 2023 (GLOBE NEWSWIRE) -- The "Global Joint Pain Injections Market Size, Share & Industry Trends Analysis Report By Injection Type, By Distribution Channel, By Joint Type Channel, By Regional Outlook and Forecast, 2022 - 2028" report has been added to ResearchAndMarkets.com's offering.

The Global Joint Pain Injections Market size is expected to reach $9.9 billion by 2028, rising at a market growth of 7.7% CAGR during the forecast period.

Key Market Players

Bioventus Inc.

Pacira BioSciences, Inc.

AbbVie, Inc.

Teva Pharmaceuticals Industries Ltd.

Pfizer, Inc.

Anika Therapeutics, Inc.

Zimmer Biomet Holdings, Inc.

Eli Lilly And Company

Ferring Holdings SA

Sanofi S.A.

Direct injections into the joints are used to treat joint pain and reduce swelling and inflammation. Geriatric patients typically have joint discomfort as a consequence of pre-existing medical conditions or illnesses.

For example, joint pain from arthritis, a common condition that primarily affects the knee, ankle, hip, shoulder, elbow, and facet joints of the spine, causes inflammation and adds to joint discomfort. The market for joint pain injections is also anticipated to grow due to the rising prevalence of rheumatoid arthritis and osteoarthritis and the rising demand for economic therapies for these diseases.

The demand for joint pain treatment solutions is increased by the aging population and the rising prevalence of obesity. To meet this rising demand, the main market participants are doing research and development operations to produce more effective treatment options, such as prolotherapy, autologous conditioned serum, platelet-rich plasma, and plasma matrix therapy.

Moreover, platelet-rich plasma (PRP) is created from the patient's blood and injected into a troublesome joint to reduce arthritis-related pain and stiffness.

Furthermore, developing such cutting-edge procedures offers major market participants chances for investment, which is expected to fuel the market's expansion throughout the forecast period. In addition, the primary reason driving the expansion of the joint pain injections market is the rise in the frequency of accident-related injuries in modern society.

Increased R&D efforts by the major market players and innovations like single injection therapy and plasma matrix therapy will present profitable opportunities for the market players to invest.

Story continues

Other factors driving the growth of the joint pain injections market include the prevalence of obesity globally, the rise in geriatric patients, and the increase in the number of arthritis cases along with joint disorders. Nonetheless, physical therapy is frequently used with injections to preserve or increase joint stability and mobility. While physical therapy alone may not be sufficient to control pain &inflammation, the pairing typically produces superior benefits.

Market Growth Factors

Growing occurrence of osteoarthritis

Osteoarthritis is one of the leading causes of disability among the elderly and a prevalent illness (OA). As the population's average age rises, the incidence of knee osteoarthritis (OA) increases. OA is the leading cause of chronic disability and the most common articular disease in the industrialized world, with knee and/or hip OA being the most common form.

As a result of population aging and the incidence of obesity and overweight in the overall population, it is anticipated that the number of people with symptomatic knee OA will increase. Joint stiffness and pain may become severe enough to make ordinary tasks difficult. Due to the rising prevalence of osteoarthritis, it is anticipated that the market for injections to treat joint pain will undergo significant growth.

Increasing global geriatric population

The World Health Organization predicts that by 2030, one in six people will be 60 or older. By this date, there will be 1.4 billion persons aged 60 or older, up from 1 billion in 2020. By 2050, the number of people worldwide aged 60 or older will have doubled. (2.1 billion). The number of persons aged 80 or older is anticipated to triple between 2020 and 2050, reaching 426 million. By 2050, two-thirds of the world's over-60 population will dwell in low- and middle-income countries.

In the elderly, back and neck pain, osteoarthritis, COPD, diabetes, depression, and dementia are all frequent diseases. As people age, they are more likely to suffer from many ailments simultaneously. In light of this, the need for joint pain injections would increase dramatically over the forecast period due to the population's aging trend.

Market Restraining Factors

Lack of knowledge regarding this treatment option

Injections for joint discomfort are unheard of by the general public. Joint soreness is treated with hyaluronic acid injections, corticosteroids, and platelet-rich plasma. It takes extensive knowledge and training to use these injections. Injections for joint pain are often given to patients by doctors and other medical personnel. Professionals are provided the equipment and instruction required to complete this. However, the market's expansion is constrained by the absence of government initiatives to support joint pain injections.

Scope of the Study

By Injection Type

By Distribution Channel

By Joint Type

For more information about this report visit https://www.researchandmarkets.com/r/qx7ca2

About ResearchAndMarkets.comResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

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‘Orgasm Shot’ Caused Excruciating Pain, San Diego Jury Told in … – Times of San Diego

On March 30, 2021, Dr. Nadine Haddad was excited to test a new service at her Fifth Avenue elective medicine spa near Balboa Park. Shed just been certified to give the O-Shot.

But before she could offer clients the clitoral and vaginal injections of their own blood PRP platelet-rich plasma she needed practice.

According to court testimony last week, Haddad asked four or five of her own employees at the B Medical Spa and Wellness Center to volunteer as models for the controversial shot which she promised improved sex drive and oh-my-God orgasms.

Jaime Herwehe, an esthetician, was one of two employees who agreed to the shot.

Two years later, testifying in downtown Superior Court, Herwehe (pronounced HER-way) described a terrifying ordeal.

With another staffer holding open her vagina by hand and the Syrian-trained physician sometimes using an iPhone to shine a light, an extremely nervous and scared Herwehe was injected with a local anesthetic that had expired three years earlier, she said.

Unaware that the liquid lidocaine offered no numbness, Haddad injected PRP into her nerve-rich clitoris, Herwehe told a jury of nine men and three women.

It was beyond excruciating, said the 32-year-old mother and former San Diego City College student. The most excruciating pain in my life.

She soon passed out on the floor a possible seizure, a witness said and has since suffered vaginal numbness.

After the botched O-Shot procedure, plaintiff was unable to have enjoyable sexual relations with her partner, her lawyers wrote. Plaintiff and her boyfriend of almost eight years and the father of her daughter broke off their longtime relationship because of the lack of intimacy and plaintiffs change in mentality towards sex.

Alleging medical malpractice, a lawsuit suit filed Sept. 15, 2021, against medical director Haddad and Haddads husband, office manager Mark Khashram, also claims that Herwehe didnt give written consent for the procedure gone awry.

And wasnt told its risks beforehand.

And according to the complaint filed by San Diego attorneys Josh Gruenberg and Pamela Vallero, Herwehe was fired May 11, 2021, for refusing to sign an O-Shot consent form 42 days after the fact.

No monetary figure is specified, but the legal team that also helped Sandra Maas win a judgment against KUSI-TV seeks a variety of penalties, including punitive damages in an amount necessary to make an example of, and to punish, defendant, and to deter future similar misconduct.

Medical battery and retaliation are also alleged, but several of the original claims were dropped.

In the formal answer to the complaint, submitted Nov. 22, 2021, the defendants said in part that Herwehe had the express knowledge of the risks and hazards set forth in the Complaint, as well as the magnitude of the risks and hazards, and thereafter knowingly and willingly assumed those risks.

The response also said:

Times of San Diego attended trial sessions Monday, Wednesday and Thursday in the fifth-floor Hall of Justice courtroom of Judge Carolyn Caietti Department 70.

Current and former B Med Spa employees testified, text messages were shown and expert testimony given.

Haddad who appeared only days before on Fox5 News and Khashram are represented by Maya Fawcett and Jack Reinholtz of Prindle, Goetz, Barnes & Reinholtz LLP, which has a University City office.

Reinholtz also is defending Haddad and Khashram in a separate lawsuit involving Jessyca De Lara Herwehes older sister who was B Med Spas manager during the same period and alleges wage violations, business fraud and intentional infliction of emotional distress.

(Trial is set for January 2024 in Judge Keri Katzs court, with Gruenberg representing De Lara.)

In Herwehes case, the spas co-owners since January 2021 have mainly attempted to throw cold water on Herwehes motives and veracity and deny she gave no prior consent. At one point, they argued a text suggested Herwehe offered a bribe to a colleague in the case.

With lawyers for both sides using sexual terms seldom heard in a court, the defense team Monday challenged expert witness James Tappan, who has 50 years of experience as an obstetrician and gynecologist.

Bottom line, youre not an expert in performing an O-Shot, Reinholtz told San Mateo-based Tappan, being paid more than $15,000 as a witness for Herwehe and appearing virtually on a video screen.

Happily, yes (not an expert), the 79-year-old Tappan replied after previously labeling the PRP shot not a recognized and accepted modality. He said it was useless to treat sexual dysfunction and that 64 risks are associated with the shot. He also said OB-GYNs dispute the existence of a G-spot, which the O-shot also promises to enhance.

Haddads certificate of completing O-Shot training with inventor Dr. Charles Runels, Tappan said, is a piece of paper not recognized by any national body. (Runels and the O-Shot are roundly mocked by other OB-GYNs.)

Ex-boyfriend Brandon Smith an SDG&E high-voltage lineman who used to live with Herwehe provided some of the most searing (and explicit) testimony.

Under questioning by Vallero, he described their sex life, which he said was great before the March 2021 procedure. But after her O-Shot, the boyfriend since 2014 said he couldnt touch her without her being uncomfortable.

She was so sensitive, she wouldnt want me to touch her anywhere, Smith said. She did a whole 180 from her previous self, showed zero patience, becoming a completely different person. Their relationship constantly turned into a fight, an argument.

Vallero asked Smith if he blamed the O-Shot for the end of their relationship.

Yeah, absolutely, he said. That whole process takes a toll and snowballed since the start of it.

Herwewe dabbed her eyes as Smith said hed made clear he never wanted to wed but planned to have a child, which they did in 2019.

Asked if hed like to get back together, Smith said: Id love to if we could work this stuff out. if we could get back to where we were.

But Herwehe didnt want to, he said.

At the next jury break, in the courtroom hallway, Smith put his arms around Herwehe.

Also on the witness stand Monday was Haddad, who said she told potential volunteers that the O-Shot improves blood supply to that area (and) overall it improves sex drive and sensitivity.

She said spa manager De Lara reported that Herwehe was fine with having the procedure and I thought I could trust her.

I asked consent and she said she signed and was ready. Haddad repeated: I was told it was signed. I hadnt seen it.

Herwehe attorney Gruenberg displayed a printout from the Medical Board of California showing that Haddads medical license had expired the previous Friday and was now delinquent.

Haddad said she had been preoccupied with this case and didnt get to it. (By late Tuesday, the license was renewed and current with an expiration date of March 31, 2025.)

Haddad acknowledged having used expired lidocaine on both her subjects, first on employee volunteer, Jessica Nieto, who didnt proceed to the actual O-Shot because it was so painful she asked me to stop.

On Wednesday, the defense called Andrea Muoz, a physicians assistant who works at Sharp Rees-Stealy but also part time at B Med Spa.

Muoz said that after discussing contraceptive options with Herwehe, she inserted an IUD in July 2021 four months after the O-Shot. She said Herwehe mentioned no pain, sensitivity or numbness.

No abnormalities in the vagina. No abnormal findings, she testified.

Muoz said she hadnt heard of Herwehes O-Shot until yesterday, having learned of it in the past 24 hours through counsel.

Herwehe, an El Cajon native who graduated from Grossmont High School in 2009 (two years after her sister), took the stand next and began describing work-related complaints.

She said everyone was promised pay raises after Haddad and Khashram took over. But it never happened. She said Khashram pressed her to expand her volunteer social media postings for the business, especially Instagram.

Soon she was doing it all the time, including her free hours, and it became exhausting.

It wasnt fun anymore, she said. And worse despite a marketing company posting we werent getting paid for it.

On the day of the O-Shot, Herwehe said colleague Evelyn Hernandez-Cardenas, who had just assisted with Nietos aborted procedure, looked very nervous, very uncomfortable.

But the doctor was still excited, telling how it was the greatest treatment ever, Herwehe testified.

Despite an excruciating lidocaine shot to the clitoris, Haddad told Herwehe: If you are past lidocaine, you should be good to go.

Haddad said shed let the area get numb and then inject PRP into the G-spot of the lying down Herwehe. Haddad used an iPhone flashlight to find the spot and said: I thought you had a kid, Herwehe told the court.

Haddad was heard saying the process was successful.

I couldnt even speak it hurt so bad, Herwehe recalled, saying co-worker Cardenas was out of breath, shaking and crying.

When helped to her feet, Herwehe felt as if she would pass out. Waking up later, as if after a long sleep, Herwehe said Haddad told her: You passed out 30 seconds, tops.

Cardenas looked like shed seen a ghost, Herwehe said. (Later that evening, the aide told Herwehe she had a two-minute seizure.)

Then Haddad noted the 2018 expiration date of the lidocaine and slapped her head, said Herwehe, licensed to give various skin and face treatments.

When Herwehe later texted Haddad about whether she needed to see a doctor, Haddad said no, suggesting she didnt have enough fluids at the time.

On her drive home, starting to feel dizzy, I was very paranoid, Herwehe said. Every injection site was red, puffy and inflamed.

When Cardenas took the stand, she recalled Herwehe falling to the floor and having some kind of convulsion or seizure.

She kept grabbing at her face, Cardenas testified. I panicked and went down to help Dr. Haddad, trying to move her arms away from her. I was scared. I was very much in shock.

Asked about the earlier procedure on colleague Nieto, Cardenas said Nieto screamed and had a lot of blood coming right out of her vaginal area. It wasnt like splashing out, but there was blood.

Cardenas said Haddad told Nieto: Dont tell Jaime how much pain you were in because she wouldnt want to go through with this.

On the stand Thursday was B Med Spa assistant manager Nieto, promoted from front-desk worker.

Attorney Vallero asked Nieto if written consent were obtained before her procedure.

Well, it was a verbal consent, not written, she said.

Nieto confirmed she had felt a high level of pain, but Haddad stopped after Nieto called for a halt. She said her vagina bled, but it wasnt excessive.

Was she asked to sign a consent form after the procedure?

Yes, Nieto said. She signed May 11, 2021 the day Herwehe balked and was fired.

Testimony resumes Monday, with closing arguments expected Tuesday or Wednesday.

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'Orgasm Shot' Caused Excruciating Pain, San Diego Jury Told in ... - Times of San Diego