Podcast Episode #11: Lasers in Podiatry with Dr. Chris Bromley

We sit down with Dr. Chris Bromley to discuss how he has used lasers to significantly improve clinical outcomes for podiatric patients. We cover everything from neuropathy, onychomycosis, post-surgical protocols, and sports injuries.

Linkedin Dr. Christopher Kent Bromley
Delray Beach Podiatry
https://carepics.com/carepics-hires-dr-christopher-bromley-d-p-m-as-president/

Transcript:

Dr. Chad Woolner: What’s going on everybody? Dr. Chad Wooler here with Dr. Andrew Wells, and today we have a special guest with us, Dr. Christopher Bramley. He is a podiatrist, and today we are gonna be talking about lasers in podiatry. So let’s get to it.

[INTRO]

Growing up in Portland, Oregon, I used to love going to laser light shows at the Oregon Museum of Science and Industry. They would put on these amazing light shows with incredible designs, synced up to some of my favorite music from The Beatles to Pink Floyd, to Jimi Hendrix and Metallica. They were awesome. Little did I know then that lasers would have. Found affected my life decades later as a chiropractic physician. I have seen firsthand just how powerful laser therapy is at helping patients struggling with a wide range of health problems. As the leader in laser therapy, Erchonia has pioneered the field in obtaining 20 of the 23 total FDA clearances for therapeutic application of lasers.On this podcast, we’ll explore the science and technology and physiology behind what makes these tools so powerful. Join me as we explore low level laser therapy. I’m Dr. Chad Walner. With my good friend, Dr. Andrew Wells, and welcome to the Laser Light Show.

Dr. Chad Woolner: All right, everybody, welcome to the show and a special welcome to Dr. Bromley. Welcome to the show, Dr. Bromley. Thank you Andrew and Chad for having me. I really appreciate the opportunity. So I wanna start the show off real quick by kind of putting you on the spot for just a second and letting you know I have a little bit of a bias towards podiatrists. My dad, who is a retired registered nurse from over 30 years ago, told me. He said, if you’re ever gonna have any doctor, Do any work whatsoever, ankle or foot below, he says, do not ever let any doctor look at that ankle or foot other than a podiatrist. He said, podiatrists are like artists. He’s what he said. He said, they are just like the most incredible miracle workers when it comes to anything related to feet. And I was like, you know, and, and I knew that, but it was just like, From coming from my father with such high praise, and he’s like, I’ve worked with all sorts of doctors. He said, I’ve worked with orthopods and I’ve worked with, you know, other, you know, various doctors. And then I, he said, and I’ve worked with, a lot of podiatrists as well. And he says there is a clear distinction, hands down. He says, no one, uh, can, can manage foot and ankle problems like a podiatrist can. And since then, . We have a very, very close family friend of ours down in Arizona who’s a podiatrist. We’ve visited him and he’s done some work for my wife with some toe issues she’s had. And my son, he’s my son, is really an avid athlete, particularly track. And so as you can imagine, he’s got all sorts of ingrown toenail issues that have been taken care of by this  friend of ours who’s a podiatrist and my bias is a favorable bias towards pi podiatrists. We don’t often hear bias in a, in a positive light, but that’s my  kind of background with podiatry I have. I just think podiatrists are the coolest when it comes to you know the echelon of doctors there at the top as far as in, in my book as far as I’m concerned. So, there you go. 

Dr. Chris Bromley Great. I have the same love affair with chiropractic. So, my soulmate in life, my sister in life, my best friend forever, is a world renowned chiropractor by the name of Dr. Caroline Milia. And as I said earlier to Andrew, she converted me over from the dark side. When I graduated from medical school and I completed my residency at Johns Hopkins, when I went into practice, she said, okay, now I’m gonna tell you all the things you really need to know, and you need to forget. Everything you learned from Big Pharma, and let me show you how to integrate nutrition and, and a better understanding of biomechanics in reference to the entire body, gave me an understanding and, and a love and appreciation, for what chiropractic can do for me and my patients. And I always had a very. Good relationship between my chiropractic colleagues because I, you know, every one of them, I literally saw a patient this morning who was here for neuropathy and we were talking about her low back and the radiculopathy. And I said, well, who’s your chiropractor and what are they doing for you? And I literally wrote a prescription for her to go back, because, you know, you, you can take really good care of the lower extremity. You know, sort of, my practice is knee down here in Florida, but without the rest of the body being in tune, I’m just swimming up. 

Dr. Chad Woolner:  Right. That’s a great point. 

Dr. Chris Bromley: It’s funny, it’s funny in healthcare how we end up getting so segmented into our specialties and, and sometimes it seems like, and oftentimes I think to the patient, it seems like these body parts are not interconnected. They live on their own little island on their own. And what a podiatrist does, has no. No effect on what a chiropractor would do, or, a cardiologist or a neurologist. Like, it’s like somehow our body is kind of, is this weird amalgamation of, of parts that all kind of do their own thing. But I think sometimes we forget that every body part affects the other one.

Dr. Andrew Wells:  Yeah. Absolutely. Absolutely. I wanted to set the stage, uh, Dr. Brownley, can you give us a little bit of, uh, a background on who you are, what you’ve done? Because I think this is important and I know a little bit about your background. We just chatted before we started recording this podcast, and I want doctors to understand why, what you’ve done, because I can tell just behind your bio, you’re a very forward thinking podiatrist. And when we’re talking about laser therapy,  I want other doctors and also especially other podiatrists, to understand what, what your experience has been, professional experience, where you are now in your career. Because I think that’s important in what we’re gonna talk about. So maybe let’s start there. How did, uh, tell us about your, what you’ve been doing over the last, couple decades in practice? 

Dr. Chris Bromley: Yeah, so I, it’s, it actually starts, I mean, I grew up in the ski and sporting good business. My parents had a chain of  very successful ski and sporting groups. I grew up in sports as an athlete, and I knew growing up in the retail business, I didn’t wanna be in the retail business. And I bonded myself to a podiatrist who became my mentor. I had foot injuries very similar to Chad’s son, and, and we became good friends and I, I really liked what he was doing in podiatry and, and he would let me scrub into surgery and he was doing biomechanics. He was taking care of infants and old folks. And I knew very young, probably 12 years old, that I wanted to be a physician. And I spent time in orthopedics in high school and,  because they were miserable, they were unhappy. They were putting plates and screws, but that’s really all they had. They had their cortisone shot or that was it. They didn’t have anything else. And, and my, and my evolution of understanding nutrition and medicine and athletics sort of drew me into podiatry. And after completing my podiatry education in Cleveland, I went to Baltimore where I did a foot and ankle, surgical residency. I got to worked at Shock Trauma and Johns Hopkins and I went back to New York to practice, and as I said earlier, my best friend in the whole world who’s a world renowned chiropractor, said, let me, let me, you know, come and let me teach you. And, and so from the beginning of my practice in 1992, I started to change. I started to evolve as a practitioner and started to talk to my patients about nutrition and, and talk to them about, you know, what they are doing with the rest of their body. And it really, my practice sort of even in the early years where I was sort of resisting, you know, why are we writing antibiotics for things that don’t need antibiotics? And why are we writing for NSAIDs to suppress the body’s natural healing quality? And why are we giving cortisone shots and, and how can we avoid surgery? Although I love to do surgery, there are so many, so many things that you can do. About biomechanically driven. So that’s sort of the, the soul of my, of my practice is sort of always looking to be progressive, looking to incorporate nutrition, well, health and, and, and biomechanics and, and, The subject today about sort of cold laser or low level laser in podiatry was the genesis of that.I was seeing a college athlete with a nasty ankle sprain. You know, I, and I hate the word sprain cuz we use it all the time. It’s like the word concussion.You know, concussion is a traumatic brain injury. We just use the word concussion over and over. So we think it’s not a big deal. Sprain is the same way. It’s a torn ligament, one or more. So I was treating this young man. I got a call that afternoon from Dr. Meliz and she said, do you trust me? And I said, yeah. She goes, well, I’m gonna laser your patient and um, and I’m gonna send them back to you. I said, you’re gonna what? She goes, do you trust me? I said, yeah. She goes, laser the patient. So I forget about it. A week later I go in and, and I walk in the room and there’s the kid sitting there with all of the bandages and, and soft cast off. So I literally backed out of it. Looked at the number on the door. I figured I’m in the wrong room. . . So I, I looked and, and I went back in the room and I sat down and I, and I go, how are you doing? He goes, oh, doc, I’m doing great. My ankle moves. I wanna go back and play soccer. I go, whoa, whoa, whoa. Top of the brakes. I said a week ago, you have a torn ligament. This is what I go, no, no. I’ve been seeing Dr. Lisia. I saw her every day this week. She lasered my ankle. I’m feeling great. I want to get out. , so, well, let’s just, let me get you a brace and let me talk to Dria. So I called at the end of the day. I called her up. I said, what the hell did you do to my patient? She goes, she’s laughing at me. She goes, well, it’s easier for me to show you and you’re overdue for an adjustment. Come to my office on the way home. So I go there and she’s got one of these early RCIA lasers, right? It looks, you know, it’s about this big and it’s got this little thing and I’m laying on the thing and I’ve got some neck pain and she’s doing the laser and she’s doing some manipulation. And I said, well, tell me about this. And she goes, well, she starts to tell me the next day I called Steve Shanks from RC in Texas and I was on a plane a week later and I flew to their headquarters and I became a disciple of the technology. And back then, this is. Around maybe 2000, 2001. There, there wasn’t a great database of evidence-based medicine showing what lasers can do or can’t do. So, you know, you’re sort of starting it with blind faith and, you know, and, and incorporating the laser into your practice. And it was all part of that paradigm shift for me, which is to get away from medications and shots that are going to suppress the body’s ability and to, and to inc. photo bios simulation, which is what lasers do, right, and at a cellular basis, and how we could learn to incorporate the low level laser, what we call cold laser into the practice of medicine. And that was really how I got started. And it’s been a big part of my practice. And I love to teach and speak and, and, and bring and try to bring other podiatrists and other doctors over from the dark.

Dr. Andrew Wells: See, that’s the thing I think is an interesting point in this, is that you’re, you’re very much an outlier, meaning I, I know so many doctors who are so afraid to do anything different than what they were taught in school or what their colleagues are doing for lots of different reasons. Either they don’t wanna be perceived as weird or like the quack doctor who’s trying these things that aren’t especially 15 years ago when he didn’t have the clearances, FDA clearances and the research to support it. What, I guess, what would you say to B before you even ask that question? 

Dr. Chad Woolner:I, I want to interject something there , to that, to your point, Andrew, I, I couldn’t help but think that that story could have gone completely a different way. You know, some doctors, if they hear. You know, their reaction could have been, what the heck do you think you’re doing? This is my patient. I’m gonna treat ’em the way, you know, this is not the way that, this is not the standard of care. And, and gotten offended and or had their ego hurt or bruised even after seeing what you saw. You know, we see that sometimes some doctors where it’s like literally right before them eyes wide open, they see what happened and they still deny it for, for whatever reason, insecurity, ego, this, that or the other. And so I just wanted to point that out, that that story says every bit as much, if not more about your character. Exactly. You being a forward thinking doctor. Exactly what Andrew’s saying as much as it does the power of, of, of the lasers and whatnot. So anyways, continue. Andrew, I just wanted to interject that point. . Great point. 

Dr. Andrew Wells: Yeah. Yeah. I love that point. And I, I guess, um, Dr. Bromley, what would you tell your colleagues who, um, are maybe afraid to, to venture off what they would consider like the beaten path, either for fear of board reaction or colleague reaction or a patient reaction? What would you say to a doctor like that who’s just kind of doing the conventional pediatric or pod podia. I can’t ever get that right. 

Dr. Chad Woolner: I think it’s pediatric, right? Correct. 

Dr. Andrew Wells: Pediatric. Pediatric, yeah. Thank you. Yeah. Yeah. What, what would you say to someone like that, you know, this, this term has really been overused improperly the last two years, but follow the science.

Dr. Chris Bromley: Right. When I left, when I. You know, training in residency in 1992, we knew that at then that anti-inflammatories anset, which was sort of the gold standard, and it still is in some people’s practice. Somebody comes in with some sort of injury. What do you do? You were trained to write a prescription for an anset. And you gave that to the patient. Now, we knew back then that they were maybe not so good for your stomach. You could get a, you could get an upset stomach or an ulcer. We know now that they are really bad for you, that they suppress your body’s first phase of healing is the inflammation phase. So if you take an anti-inflammatory, You are actually suppressing the body’s natural ability to heal itself. In addition to that, we know that NSAIDs are really bad, not only for your GI tract, they’re really bad for your heart. You know that the increased risk of heart attack at stroke, I mean, they took Vioxx off the market way back when because people were dying. So the use of NSAID. It’s really, really fallen out of favor. And really you, there’s, I haven’t written for one. There’s no reason to write for one. You know, and the same thing has happened. What are the other tools that you had in, in podiatry for an injury? You had a cortisone shot. Well, cortisone is worse than an asset because it causes atrophy and it causes the body’s local ability to heal, to be suppressed. And if you’re, if. Really bad at it. And you put the injection into a, into a ligament, into a structure and you don’t know what you’re doing. You can cause it to rupture. You can cause it to make the injury worse. You know, the example would be somebody comes in with an Achilles pain and some well-meaning doctor injects cortisone into the Achilles center and it causes interruption. So these things still happen and I think the evolution of practice to my colleagues would be like, You know, watch, watch podcasts, listen to podcasts, listen to what, what’s happening, what is cutting edge, what is, what is happening around you? And incorporate that. We said earlier, and Andrew and I are talking, when I give a, I give a lot of lecture talks to podiatrists about, you know, regenerative medicine and, and, and cellular based products. And, and I say to them, look at the beginning of every lecture, every. You are going to see two providers before you. They saw Dr. Google and Dr. Webb, MD and they’ve read online thanks to the internet, what is the standard of care and what is new for their deformity before they, before they even see you. So if you’re a practitioner and you’re stuck, In what you learned in medical school or residency, and you’re still doing that. You are out, you’re obsolete, and, and the patients will not only not come back to you, they will go online and eviscerate you in reference to their reviews. So it behooves you as a physician, I don’t care what specialty, dentist, optometry, chiropractic, orthopedics, you have to, you have to modernize yourself and stay up to date with what is the most modern treatment for you. Obsolete. 

Dr. Chad Woolner: Yeah. Patients nowadays, patients nowadays are, are in the history of the world. Ne have never been more well-read and or well-educated in terms of these things. And so, gone are the days where you can wing it, so to speak. You know, you have to, you have to know these things. You have to be up to date for sure. What were you gonna say, Dr. Wells? , 

Dr. Andrew Wells: Maybe Chad, you can reference the study, but, uh, there’s a study that says that it takes 17 years on average for new research to actually reach a certain field. And I think that number is incredible. 17 years. Yeah. Before, yeah. Yeah. 

Dr. Chris Bromley: Something is studying. It actually reaches a doctor’s, reaches, reaches uh, um, clinical procedures inside an office. And that’s like. Two thirds of somebody’s career if you’re practicing for, you know, 30 years. I find that our industry, the healthcare industry, is oftentimes incredibly slow to pivot and to change. If you’re following the standard track, however, there are an incredible number of doctors and providers and physicians that are, like you said, read , have, have an open mind and, and actually look. Things that are researched and we will talk maybe a little bit about some of the research and clearances that RC has for what they’re doing. Um, not just anecdotal evidence for how things work, but actual research that’s there, it’s there if you want to, if you wanna, if you’re open to it, you look for it, you read it, it’s all over the place. And just follow those guidelines. And I just find that that’s, that’s kind of fascinating. It takes that much time on average for, for these therapies sometimes to reach, to reach people. 

Dr. Chad Woolner: Well, and, and I think this goes back to kind of what you had alluded to earlier, Andrew, is the fact.Far too often there is this like compartmentalization that takes place in terms of specialties and disciplines.And that can be for a number of different factors, ego, significance, whatever you wanna call it. Ignorance, all of the above, you know? And I think these things only contribute to that 17 year lag. That was a study. I was just pulling it up. It was done in England, is what, here’s where it was done. And it wasn’t, it was Let me see here. It wasn’t a study, it was a, it was a review that was done, Institute of Public Health, university of Cambridge. It said that the title of it says enough. It says the answer is 17 years. What is the question? Understanding time lags in translational research. And so the whole idea being that, again, you have all this great information, but how does it actually translate? And so you’ve got all these different factors. Unfortunately, it is all at play that, you know, like we said, that this compartmentalization or segmentation if you will, um, various bureaucratic reasons why as well, various special interest groups, et cetera, et cetera, et cetera. But, The thing is it, it’s, it’s doctors like you who are kind of blazing those trails. You know, thankfully you’ve got other podiatrists who can basically take their lead from you, you know, in that sense. And, and not just podiatrists for that matter. I think doctors in general can look at that kind of mindset. That very forward thinking mindset. And I would say that it seems apparent that your motivation is for what’s best for the patient, is really at the end of the day, what’s driving that. And I think that’s something that can only be respected and admired and I, I’m always, maybe this sounds a little bit too kumbaya, but I, I really do believe it.  When you focus on what’s best for the patient, all the other good stuff, the financial stuff and all that will work itself out. You know, I, I’m confident that your practice is not struggling financially, economically. You’re doing just fine and you’re also helping a lot of patients and getting probably great clinical results, is my guess, correct.

Dr.Andrew Wells: I 100% agree. I, I couldn’t agree with you more. My philosophy, and I learned this as a child, is to live, right. Things go right. Um, I, you know, too often I’m having conversations with physicians. Um, Particularly Apathetic. They worry. They’re like, well, in the very beginning they’re like, well, is it covered by insurance?

Dr. Chris Bromley: God no, no, thank God, and they go, what do you mean? I go, I go. It’s very simple. You explain the value, you give the patient a, you know, a, you know, a try on the laser, and you explain to them very simply, look, it’s gonna take six laser treatments for this to make a difference. At the end of six, we’ll reevaluate. If for any reason you’re not happy, I’m gonna give you six more on. . And if at the end of that you still don’t notice a difference and you are unhappy, I will give you your money back and patients a hundred percent of the time go, no problem. Let it. It is all in. You have to believe in your heart. Like you, you, I’m sure both of you as physicians, understand if you believe what you’re doing in your heart is the right thing and you can, you become very believable. You can engage with the patient. The patient understands. They understand you. They believe. They believe, and they trust you. If you are that. And you do that in incorporating this technology into your practice. It’s very easy. When I talk to patients all the time, they’ll give you an example. I have a patient here this morning who has been seen by five other podiatrists for six months for heel pain. At no time during those six month treatments did anybody ever ultrasound the patient to show him what his lenar fascia looked like. I was able to do that. Explain and show him his unaffected versus his affected side. Show him the difference and then say, look. You have three options. Ignoring it, hoping it’s gonna go away. Popular but not effective. Option two, we need to get the fascia to heal. That’s gonna require more blood flow, more collagen. And the way that we do that is we incorporate cellular based healing. We incorporate using a laser to get the heel to start to heal, to stimulate. The healing at a cellular basis, that photo bio simulation. And at the same time, I’m gonna get you into a better shoe, a nice orthotic, which is flexible. I’m going to, and, and, and, and I said, or we could, we could just do surgery, which I would not recommend because it’s an invasive procedure. It’s a new injury. It may or may not help, but it has risks associated. So which would you like to do? And a hundred percent of the time, basically I’ll go with option.  and then we said, okay, let’s do the first laser today and then I’ll, you’re gonna come in three times this week and three times next week and we’ll re ultrasound and, and because we use technology like ultrasound in this type of injury, I can show them the injured area of the fascia, that hypoechoic area, that black hole or that tear.I can show them that they are starting to heal. I’m using objective data to show the response, not just that they’re feeling better, but I’m showing them the difference. And then they buy in and then they tell their friends that.

Dr. Chad Woolner: Dr. Bromley, amazing and you should go to him. It’s just, I don’t have to advertise because the patients, you know, they like that and they, and they want to and they want to come in and then they’ll send their children or their mother, and then it’s just a, when you do progressive medicine like this, it is,  an amazing, adrenaline shot to your practice. Yeah. You know, I, I’m reminded of in school when we were learning about plantar fasciitis, I remember them talking about how that term is somewhat of a mis. In reality, it very quickly shifts from an IIS to an osis. And the problem there is, is that the standard management strategy is not only ineffective, but it’s counterproductive. Because if we’re talking about for, for those who are listening, if, because, cuz I’ve, I’ve found that a lot of non physicians have been listening to this podcast, which is really, really cool. IIS means inflammatory osis means, and, and please correct me, Dr. Bromley, if I’m speaking out of turn here in terms of this, because obviously you’re, you’re the plantar fasciitis expert more so than we are. But it shifts from being inflammatory to then all of a sudden neurotic or degenerative. And so,you bring in, my guess is that cortisone injections are somewhat of a standard of care for plantar fasciitis or, or fascist, which imagine exactly what you just said there about, about the rupture issue. Knowing that cortisone deteriorates the tissue. And so, yeah, it, it, the, the management of this, or at least your strategy, makes all the difference when you understand kind of histologically what’s actually happening to that tissue. It’s, it’s not, it’s no longer an inflammatory issue or insights for that matter, right. The very two kinds of standards that you’re talking about don’t make any sort of sense when you understand phys, you know, pathophysiologically, what’s actually happening to that tissue. And so maybe that’s a, maybe that’s a good jumping off point in terms of, cuz I’m, I’m assuming that, that, like you said, lasers are kind of standard go-to for you in terms of plantar fasciitis or fascist cases. Maybe for those, listen explain the rationale why you would use a laser for somebody who’s struggling with heel pain, p plantar fasciitis, fascist. 

Dr. Chris Bromley: Take your. . Well, I, to your point, Chad, I think that I, and one of the lectures I give is, there’s no such thing as pan fasciitis. You just don’t have an ultrasound and don’t know there’s a tear. Right. So when I, when I talk to an orthopedist and I talk to a podiatrist, I, I implore them. I, you know, because I have a big, you know, sports practice and we’re looking at musculoskeletal injuries, the time I have a, I have an ultrasound in. So short of taking an x-ray for a fracture of bony pathology, which we do, the ultrasound is really the best tool in my toolbox. And then you can accurately assess, and to your point, the plantar fascia doesn’t get an I. It doesn’t, it’s not like, it’s not like a tendon, it’s not like a muscle. It doesn’t get this sort of, you can see inflammation, but it’s actually a breakdown within the structure of the planet fascia. The planet fascia really. In the body, one of the, one of the, one of the pieces of our body that’s under the most stress, you know, every heel strike, every toe off the plantar fascia is part of that windlass mechanism. Back to the gastroc soleus backed all the way back to the hamstrings, back to the hip, and the low back. So that, that kinetic chain, the weak link between the very powerful. And the, and the leg muscles. The weak link is the planter fashion, and it does tear, uh, at insertion. It can tear and, and ult approximately optic calcan and what we do in our practice is, number one, make an accurate diagnosis is that, you know, you have to rule out things. So they have, you know, some other problem that could be sort of disguised as, as heel pain may not always be a plantar fe injury, may be, um, a tarsal tunnel and may be a pinched nerve, or it may be a stress fracture, it may be a tumor, could be a cyst, could be lots of things. So accurate diagnosis is super important. We see healing pain in kids, which we know is not Plano fascia. It’s a phos. And we, look at our practice at this,, we tell the patient what’s wrong, and they say, look, again, same speech, ignoring it, hoping it’s gonna go away. Here are the conservative things. Here are the surgical things you can do. Let’s start conservative. And what we wanna do is incorporate the discussion about what their body needs, you know, taking care of the underlying cause. How did you get here? Well, you walk around your house here in Delray Beach, barefoot, and you’ve got tile floors and, and you don’t stretch and you have crappy shoe gear. So you’ve gotta assess, mechanically, what’s going on with the patient. And then what we wanna do, every patient wants the pain to go away. . So how do I do that? Well, I do that by incorporating lasers into their protocol. I, we, we bring the laser in, we bring the FX 35 in. We start, you know, we give them a handout, it explains, we come back in and then we start to do what we do so well. And our specialty is to address biomechanics. I might be using some kinesio tape. We’ll get them an impression or a scan for an orthotic and give them a rec, send them to the shoe store, you know, get ’em in a nice Hoka. , you know, get ’em nice bionics or something to wear around the house so they’re not re keep injuring it. And then we see them back after their fifth or sixth laser, which is typically what we do three times a week, like Monday, Wednesday, Friday. And then we see them back and, and invariably the patients will say, you know, my pain was a 10 out of 10. On day one, it’s now, uh, five out of 10 or three out of 10, it’s gonna take time, and then you reevaluate them and you can show them the healing. And lasers really can be used for anything that you want to do in your podiatry practice or in your chiropractic practice where you’re trying to give patients what they need. They need relief from the pain they need.  get the body to heal itself, which is all about vascular flow and collagen. And we’re gonna use the laser to stimulate the body. The term we use is photobiostimulation. We’re on a cellular basis. Every, every cell in your body has mitochondria. Mitochondria produces a t p. That is the fuel. So we wanna use this cellular based healing, and we can set the laser in a, in such a way, depending on what we’re treating. So the setting for pain. And to increase blood flow for a plant of fascia is different than a setting that would be for arthritic pain. Maybe somebody has, great toe uh, limitation with what we call, how it rgis or osteoarthritis. So that bone pain is a different setting than we would be setting in the laser for a soft tissue injury and would be different than the patient who comes in and says, you know, I’ve been diabetic for, for 10 years and my blood sugars are here. My A1C is. Uh, and I have this neuropathy.  in the, in, in podiatry and in medicine. What do doctors do? They prescribe drugs that are, are bandaids that are there to make the patient forget that they have this neuropathy and they, and the drugs they’re prescribing amitriptyline, um, you know, all these different drugs have no benefits at all. They don’t fix the neuropathy. The neuropathy you have in your feet is because you’ve had elevated blood sugar that causes the smallest blood vessels you have to die off. And then the nerves that provide sensation, not. So we use the laser technology to increase the neuro transmission to increase the blood flow in these, in the lower extremity. At the same time, we say, by the way, your blood sugar can’t be 300, your A1C can’t be 10. You need to get that under control with a proper diet. And oh, by the way, I’m going to prescribe a number of supplements for you, you know, b6, , and b12, as well as other supplements to nourish your nervous system back to health. But again, The, when you listen to any of, if you read or watch any of the commercials for Cymbalta, Lyrica, all this stuff that’s on the, the, at the very end when the lawyer does their speak, they talk about, you know, it could result in suicide, death, depression. You don’t want any of those drugs. But other than that, it’s great. Yeah. It’s, you know, you know, you gotta, you gotta think outside the box and, and side effects from medications are real. There’s never been a side effect I’ve ever had from a low level laser other than the patient getting better very quickly. It’s really, it’s really that sort of work across my, the lasers that we have in this practice here in Florida, it has its own. It’s like having another associate in your office. It has its own schedule. You know, patients are coming in, they’re, you’re, they’re seeing the laser and then they see us for follow up. It’s really been a blessing, you know, to me to have that tool in my toolbox. 

Dr. Andrew Wells: That’s amazing. On, on that note, maybe, and maybe we should have started here. What, maybe can you just list off what types of conditions you’re using this laser for? What types of patients you’re. I’m looking at your laser now. I’m picturing it as having a face and an associate name and  maybe, maybe, uh, lighten docs. Like, what are you actually using this for? 

Dr. Chris Bromley: I used to say, you can use it for everything in your practice other than fungal toenails.Now, I can’t say that because, but almost three years ago now, Corne got the Lunula laser approved. Phonic myosis, which I love. It works amazing. Uh, I use it for everything. So, the typical podiatry patient will come. Then, you know, we’re using it for all of the M S K complaints. So patients come in with, you know, plantar fascial pain. You know, they’ve got, you know, ligament injuries, sprains, strains, fractures, all of my surgery patients, patients that we couldn’t heal conservatively, they come in for cold laser every week as part of their healing protocol, and we see much less pain. We, we, we’ve eliminated the use of narcotics. After surgery, which I’ve been doing for probably 10 years, using laser and, and combinations of long acting locales, I haven’t prescribed a narcotic after surgery in 10 years. There’s no reason to. 

Dr. Chad Woolner: Wow.

Dr. Chris Bromley:  So we’ve been helping fight the opioid crisis that way, and I’ve been teaching other doctors how to do that. Uh, we use it for neuropathy, so our diabetic patients who have, uh, burning neuropathy that are very painful, keeping them up at night. There’s some compounding that we prescribe for them for creams, but we also use the laser to restructure the way their nervous system’s working patients who have loss of sensation, again, the loss of sensation is due to the death of the C fibers. So using the, the B sticks, nine, E 12 in the conjunction laser gets those c fibers to regrowth much faster. Pretty much the only thing that we don’t use co laser for is  sort of maybe somebody has a tine, like an athlete’s foot, or maybe they have a wart. I haven’t found that. Warts. Those are really the two things like, you know, superficial, um, Uh, fungal infections and warts. So the only thing I really haven’t, been able to figure out how to use a, a laser for, but again, uh, if I did a laser, uh, maybe if I did an excision of a, of a, a work where we surgically removed it, I would use the laser. After that, very successfully, to help increase the healing, to decrease this scar tissue. I love using lasers. In my pediatric practice. I have a large pediatric practice. We see a lot of young athletes who come in with injuries. Again, we’re treating them for their biomechanical stuff, but we’re also using lasers and, and the kids, the kids feel very cool. And one of the PowerPoints I give, there’s a wonderful picture of my daughter, who’s now almost 18, who was an avid lacrosse player, and she’s sitting in my, with her glasses, through protective glasses on lasers. Her heel, for her for a pitis is I’m fixing dinner. So she’s one of the pictures in my slide present. I said, are you smarter than, I think she was, I think she was eight or nine at the time. I’m like, are you smarter than an eight year old? 

Dr. Andrew Wells:  I love it. That’s something, something I wanna cue doctors into. Um, that, that you mentioned, I think is worth kind of connecting some dots on. One of the things we have a program, Dr.Wells and I, we have a program teaching doctors, uh, how to help patients with chronic health issues. And one of the terms that we use to help our doctors kind of wrap their heads around the ideal standard of what we want them to think of themselves and what they’re doing. As you know, some doctors will think of themselves as chiropractors or podiatrists. Medical doctors or osteopaths, some will think of themselves as healthcare professionals. Some will think of themselves as like coaches or whatever the term that we use that we always repeat for them is we want them to think of themselves first and foremost as solutions curators, that they’re curating solutions for people. And the thing that was really cool about what you were talking about is you’re describing how you’re using these lasers, you’re not simply having patients come in and be like, okay, press the button. That’s that. That’s done. But rather what you’re doing is you’re fitting these lasers into a comprehensive solution.

Dr. Chad Woolner: You know, you talked about that example of the, uh, was it the Delray Beach, uh, pl uh, barefoot Walker on the tile, you know, the, uh, whoever that patient is that, but it wasn’t just laser and then that’s it. Even though the laser is incredibly powerful, I think. That doctors need to clue into a far greater strategy. And I think anyone and everyone, Erchonia would say the same thing is what you want to do is you want to create a total solution for them. And so you talked about nutrition, you talked about orthotics, you talked about doing a biomechanical assessment and addressing what that, and that solution might include other providers potentially, you know, obviously mechanically above the knee, hip, and pelvis. My guess is you’re probably sending a lot of these folks over. To your friend who’s the chiropractor, to, to address those issues as well, to some extent, right? But the, but the point is this, is that at the end of the day, again, it goes back to what is going to be best for the patient. And when you curate a total solution, what that’s going to do for the patient is that’s going to surprise, surprise, or not surprise, solve the problem, right? And when you solve problems for people, Better, obviously clinical results, obviously problem solved, but then as a result of that too, those people are more than likely going to then be referred to as a natural outgrowth. I’m guessing, I could be wrong, but I’m guessing a substantial amount of your practice is driven by referrals.

Dr. Chris Bromley: Correct.  A hundred percent. You know, people have lots of choices and, you know, people look at online reviews. Um, you know, I remember one when I, when my, my youngest son was 10. I remember one day I came home and I said to myself, You know, you’re, you’re recommended by all the breastfeeding moms on Facebook as the podiatrist. Everybody should say . Oh my God, I didn’t know that was a thing. She goes, oh no. I was on the, I was on the breastfeeding mom Facebook thing today, and everybody’s saying, who should you see as a foot doctor? And they, all the moms, are recommending you. That’s amazing. Oh, that’s a good thing. So, right. You know, the internet is a wonderful thing. And I, and I think. You know, this podcast is a perfect example of how you are leveraging technology and doing this podcasting, using this medium to advance. You know, the, your mission, which is to elevate the level of care for everybody. And I think that that’s why they share that common mission. You know, I believe that continuing medical education should be something you’re doing every day. You know, you should be listening to things and reading things and, and learning from, from our, from our colleagues in all specialties. I tell podiatrists all the time, I do quite a bit of lecturing and different disciplines, and I say, you should go to conferences. Don’t just go to a podiatry meeting, go to a chiropractic meeting, go to a vascular meeting, go to a dermatologic, or go to a wound care meeting. Learn from your colleagues. I learned about pedal access, which is the restoration of blood flow into the foot. Almost 10 years ago I was lecturing at a Chicago vascular conference, about wound care. And I was just sitting there listening to whatever the cutting edge vascular treatment was, and I didn’t know that didn’t exist in my location, New York and I, and that just helped me learn, and I think that. You know, our goal, I’m, I’m sure the three of us share that. Our goal is to, we want to be able to bring the very best care to our patients, but also to our colleagues, so that they can, they can raise their level of care.

Dr. Chad Woolner: Absolutely. Well said. Yeah, that’s exactly right. , Dr. Bramley. If there are podiatrists listening to this podcast and like, wow, I’d love to follow Dr. Bramley and what he’s doing and, and, and maybe, um, use you as kind of a lighthouse for information. Are there any ways that they can follow you? Are there any events that you do in terms of speaking events and lectures, that they can, they can, be a part of?

Dr. Chris Bromley: Sure. Well, the number one, the number one way that they could listen to me talk about these types of topics is there’s a company called  present podiatry, which is the largest meeting company, um, in podiatry. They have a really great resource. I go to a lot of their lectures. Full disclosure, I own no stock in the company.I do, I do chair meetings for them, but you can, podiatrists can go and, and be, become a member of that particular database. And they can see, you know, 20, 30, 40 lectures that I’ve done. Uh, and to be able to see those, uh, meetings where we, where we go and do cutting edge stuff. We, you know, the problem with podiatry education is, um, the meetings that we’ve done in the past used to be the same guy given the same lecture year after year, after year. And it was really boring. So when I go to meetings, I want to talk. Something that’s cutting edge. How do we incorporate the use of low level laser Veronica Mycosis, or how do we incorporate it? You know, what, what’s going on, for nutrition? What’s going on? How do we, how do we advance the practice? I gave a lecture thanks to Dr. Melissa years ago about the standard process. And talking about whole food nutrition and, and things like that. So the podiatrist can make, there are YouTube videos available, but present really has the largest database of stuff that I’ve, that I’ve taught, or, and then we do one hour. And, and as, as well as full day learning events all the time. So that’s always available and, and I would encourage anybody who listens to this, you can find me, by googling me. Feel free to call me, email me, text me. You know, it gives me no greater pleasure  than to help my colleagues.

Dr. Chad Woolner: It’s apparent that you’re very passionate about not only helping patients, but helping other doctors as well. And that’s, you can’t help, but number one, respect that. But also it’s, it’s, your energy is very contagious, and so it’s exciting to see your passion and excitement for this. Uh, it’s been a ton of fun chatting with you about this. So, um, any final thoughts in closing for doctors, lasers, words of wisdom insights you’ve learned over the years.

Dr. Chris Bromley: I think that, uh, my words of wisdom would be that if you incorporate this type of technology and a regenerative approach to healing into your practice, it’s gonna bring new energy and new life to your practice, which is going to make you as a practitioner more energized. So by, by stepping outside your comfort zone, by incorporating, you know, wellness and that concept of being a curator of, of the solutions being that person is going to be, bring more reward to you and your practice. So think outside the box. Take a step maybe in, in a direction you didn’t think you were gonna do, and, and let us help you incorporate this into your practice, which you’ll, you’ll bring you years of, of reward.

Dr. Chad Woolner: You I would simply, I think that’s a great place to close and I appreciate that. That really was incredible words of wisdom there because, Um, I think a lot of doctors for various reasons, um, find themselves, myself included, to some degree, getting caught up in the motions of the day-to-day minutia. And sometimes we can just get in these, in these kinds of ruts or these patterns and to a certain degree, sometimes that kind of zest or passion or excitement in practice can kind of diminish like the volume knob gets turned down a little bit there and so I think that’s incredible. And again, very insightful, very wise to kind of think about it through that lens of, you know, trying to focus on the cutting edge, whatever that is, to really get the very best results. And in turn, cuz we’ve seen that, honestly, we haven’t had the lasers in our practice terribly long, but in the short period of time that we’ve incorporated them, We have definitely seen an elevation in our excitement and our passion with the patients. Uh, it’s just, it’s very contagious in that sense. And so it’s been really, really exciting. I think that’s spot on what you just shared there. So, any final thoughts, Andrew you wanted to bring up?

Dr. Andrew Wells: Yeah, I just wanna say, Dr.Remley, thanks so much for being a guest on the podcast. I, I’ve found this, um, really entertaining and you, you, bring, uh, a lot of, like Chad mentioned, a lot of really good energy to this topic and I hope, um, docs listening to this will be inspired and hopefully. Well, because you learn more, read more, follow you, and maybe get not only more information to help more people, but also like Chad mentioned too, just more excitement about being in practice and doing what we do and helping, helping other people get healthy.

Dr. Chris Bromley: Yeah. Again, thank you for having me. I, and I’ll come back anytime you want to talk about anything please feel free to reach out. 

Dr. Chad Woolner: We definitely will. For sure. So, docs, thanks for listening. I hope you guys have enjoyed it as much as we have.It’s been awesome getting to sit down for a minute and chat with Dr. Bromley. If you wanna learn more about him, what we’ll do and what and what he’s doing, we’ll make sure to put links in the show notes to him and thanks for listening to Docs. We’ll talk to you guys on the next show. 

[OUTRO]

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