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Podcast Episode #4: How Low Level Lasers Work Part 2 with Dr. Marc Funderlich

laser light show

On today’s episode we dive even deeper into the mechanisms behind how low level lasers work and what makes them such a powerful tool for clinicians. Dr. Marc shares some AMAZING stories of his experiences with low level laser therapy in his practice. To learn more about Dr. Marc you can check out his website here: https://www.oakcityhealth.com/

Transcript

Dr. Chad Woolner: Alright everybody, welcome to episode four of The Laser Light show. We are super excited. We have with us on today’s episode, special guest Dr. Marc Funderlich and we are gonna be diving even deeper on how low level lasers work. This is gonna be part two from our previous episode (How Low Level Lasers Work Part 1 – Ed.). If you caught that we’re gonna talk a little bit further about the why and the how behind low level laser therapy. So let’s get right to it.

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 Jimmy Hendrix and Metallica; they were awesome. Little did I know then that lasers would have such a profound effect on my life decades later. As a chiropractic physician, I have seen first-hand just how powerful laser therapy is in 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 Woolner along with my good friend Dr. Andrew Wells and welcome to The Laser Light Show.

Dr. Chad Woolner: All right, Welcome to the show Dr. Marc. We are super excited to have you here with us today.

Dr. Marc Funderlich: Thank you for having me. We always love going on podcasts and having discussions about medical devices.

Dr. Chad Woolner: Yeah awesome. So tell us, we talked a little bit before we started the podcast about where you are from and it’s kind of a twofold question, where you’re from originally and where you currently are and it sounds like where you currently are is gonna change from time to time 

Dr. Marc Funderlich: So I’m currently in Raleigh, North Carolina. We’re hoping that we can kind of be permanent residents of North Carolina going forward. I’m originally from Pittsburgh, Pennsylvania. So you know I love Pittsburgh, love Pennsylvania but we’re hoping to make our permanent home down in Cary or Raleigh, North Carolina.

Dr. Chad Woolner: Awesome, awesome. So tell us a bit about your background in terms of your schooling, education, and obviously experience with lasers.

Dr. Marc Funderlich: Sure. So I am a chiropractor, graduated in March of 2017. My path through starting my clinical practice is kind of a little bit different than most other chiropractors. So I had a small clinical practice for probably six months in Pittsburgh and then my family decided to move and I actually took a job in neurosurgery working as an independent contractor across a lot of different hospitals in New Jersey, New York – right around New York City. And so, I was an intraoperative electrodiagnostician. I was doing cortical brain mapping and different things like that. The goal being either research – looking at brain function or patient safety. So making sure the surgeon doesn’t basically screw up your spinal cord or peripheral nerves or take away too much tissue during a brain surgery. So that was really where my kind of chiropractic career took a different turn. And from there, I got into the medical device space with Erchonia lasers and things like that. Now, we have a clinical practice that we’re getting ramped up again. I work on the medical education side for lasers and other medical devices and then we do clinical research so now that we’re settled, we’re going to be starting back up our epigenetics, Alzheimer’s, and neurodevelopmental disorder research that we kind of we’re getting into before I moved down here.

Dr. Chad Woolner: Very cool.

Dr. Andrew Wells: That’s what I love about chiropractors. The scope of what we do is so vast that we really like – there’s so many interesting people that I know who are chiropractors that do different things and that’s yeah, that’s amazing. What was there anything about laser therapy that was of interest to you? Like how did you make that connection?

Dr. Marc Funderlich: Sure so inside of the neurosurgery space, there are a lot of different types of lasers that are used. So they will do intravenous types of laser therapies. They’ll do a blade of laser therapies, dermatologists will use class IV CO2 based lasers and so the amount of different types of lasers that I saw in the operating room really kind of made me interested and then from working surgery researching and studying the different types of devices, the efficacy kind of engineering behind them, what made them work was a big part of what I had to do.

And so I learned alot about different types of medical devices and medical lasers and how they had different effects on tissue and so kind of pyramiding through that as I work my way out of the surgery sphere and into private practice. The lasers helped me differentiate myself in the clinical space where I was from the other practitioners and my ability to use that clinically with patients was vastly different than the other providers around me which really gave me a foothold to build my practice and build my own practice quickly. 

So I think that is kind of how and the why and when I first started using lasers. I think I was 20 – I was less than a year graduated out of school and we had a really powerful patient experience and so we had a girl who was in high school and she was completely non-verbal. She wouldn’t talk, never spoke, she had seen a whole bunch of other doctors, she had seen applied kinesiology type doctor, she had done hyperbaric oxygen type treatments, she had done diets, supplements, you know everything that you could possibly do or imagine. And another treating doctor sent her back to me to try the laser since that’s something that she hadn’t tried and parents of children with neurodevelopmental disorders were willing to try and do everything and everything so we decided to use the laser on her transcranially. 

And after the third visit, she got off of the table, she sat up, looked at her mom and said “I love you” to her mom as the first thing she ever said or ever did. And so that really impacted me kind of very early on in my career to figure out kind of what’s going on with these types of devices as well – besides, just my experience and neurosurgery and kind of use it as a platform to push forward how to implement and use these devices to help children which is kind of how I ended up getting teamed up with Erchonia and teaching a lot of the pediatric courses 

Dr. Andrew Wells: Is that the direction of your practice- your private practice is heading, is working with kids with neurodevelopmental issues?

Dr. Marc Funderlich: So I would say 80% of my practice before COVID was just children and so it seems to be that children end up being attracted to me or you know however that “what you put into the world you get back” kind of thing where us in practice you know go and learn about disc injuries and all the sudden, there’s 10 disc patients on Monday. You know whatever that is no matter where I go, I seem to end up really drawing in a large number of children and so you know we do very comprehensive programs for children. So I think we did about 1200 blood draws in three years for children who were pre puberty which is a significant number of kids that we’ve used a laser on, done functional medicine with and done rehabilitation programs for. But I don’t necessarily exclude any other people if that makes sense. 

Dr. Chad Woolner: Yeah, that’s incredible man. What a story – what was your reaction to that when that happened?

Dr. Marc Funderlich: I think the only reaction is just for everybody to start crying and so you know? There is no words that I can describe how that moment is for a parent who has done so much for their child and for the realization of that parent who has done so much for their child, and for the realization of the parents to understand that the child has understood everything that they’ve done for their entire life, and then to finally have that expressive communication where you know it’s almost like saying “thank you” in the best way that the child can. 

And so it’s been a couple years for that child and the thing that I think for a clinician is to really understand about the gravity of that situation is this child, we continue to work with her beyond just these three visits. And so once we had these types of results with her, that parent you know that patient is going to stick with you forever. And we continue to dig in and do more things with her and so what I also like to explain to people is that once we started getting the results with the laser, that allowed the mom to trust us to do blood work and things with the child. 

And so we found out that the patient had an IGE total of over 3,000 which you know the normal range, depending on who you read, should be no more than 25 according to the labs or 300 according to some allergists and hers was 3,000. She had three or four autoimmune disorders – I mean there were tons of metabolic things going on with her and just from using the laser, we were able to shift the function of her brain to completely change her expressive language and you know beyond just not being able to talk. She wasn’t in regular school, she had been banned from Disney World because she had walked into the water around Epcot – she had walked off of a bridge twice and so they didn’t let her go there. 

In the span of six to nine months, she was playing varsity soccer, she was playing varsity tennis, she can speak three languages now, she’s going to college. I mean she can obviously talk, you know it’s a complete shift in the paradigm of that child’s life and none of that would be possible without the application of the laser and so you just can’t unsee that. 

Dr. Chad Woolner: Yeah, that’s like to say that’s amazing is like the world’s biggest understatement. That’s incredible but like holy cow you can’t even articulate just how incredible that is. So how do you make sense of the mechanism right? Because here we’re talking about like how this works, how does it work? How did that happen? Like what have you, I’m assuming you’ve gone back and looked at that and pieced together on some level the research that Erchonia has put together and the current research that’s underway. Let’s unpack this and kind of dig in and share with us what you understand about that and moving forward now using lasers and how it works.

Dr. Marc Funderlich: Sure, so I think there’s really two ways to look at the laser based therapy. The thing that we tend to want to do is look directly at you know, I have a broken bone – I’m going to shine this light over the bone, and it’s going to do you know this and this which is going to drive the bone to heal better. But, I think at least where medicine is really going as a whole is more into the epigenetic factors, more into “how are cells being signaled?” How does that cell signaling changing things like cytokines and growth factors? And I think that is where the conversation with what laser does is heading. 

And so we know as we believe we talked about in the previous podcast, how when you use the laser, you’re going to change the mitochondrial function by changing the enzymatic processes inside of the mitochondrial membrane to allow more ATP to be produced and that’s kind the – if what you shine the light on the mitochondria, what happens inside of that cell body or inside of that neuron. But what we also know from research with something like the 405 nanometer laser and something like the EVRL, that we’re going to activate different gene types and those different gene types are going to change not only the signaling system but change the cytoarchitecture of the cells. 

And so if we frame this from a brain perspective, the first thing to kind of understand is that the brain is mostly run by immune system cells and really the function is carried out by the neurons or the brain specific cells and so when you look at how the 635 nanometer wavelength of light is interacting with immune system function to change the way that the networks of the brain are actually interacting. I think that’s kind of where the actual magic is inside of how we see these significant changes inside of something like the neurodevelopmental space. 

There are some Russian studies where they put the laser directly into the bloodstream and they look at all the signaling pathways that are changed and so you can see changes in things like CRP, you can see changes in things like decreasing IL6 or increasing growth in factors like [INAUDIBLE] and so the actual genetic or epigenetic response is something that we are actually going to start looking into from a research perspective and we’re doing it across multiple medical devices so that way we can do a finger prick blood test for a patient and then build a treatment plan around it to use the medical devices that are most efficacious for that person’s actual epigenetic responses. 

So I think that is kind of where the paradigm is shifting – the 635 nanometer laser doesn’t heat the brain. So it is a cold laser, you’re not going to create any inflammation. You’re going to change the cytokines such that the astrocytes and the microglial cells are going to function better which is going to unlock and allow the expression of the neurons that are being suppressed by different types of inflammatory markers or really the metabolic system. And so you’re going to get the energy increase, basically that we’ve talked about last time and that energy increase is going to happen in the neurons from shining the laser there. We are also going to change the entire cytokine milieu or cytokine structures that the neurons are bathed in, which will allow for the waste to be cleared out faster. It’ll allow for the astrocytes, if it’s in a very young child, to create better connections and so when we talk about plasticity but we look at solid rounds of brain development around the ages of two and then another solid round of brain development around the age of seven or nine. 

If you’re doing things to change the brain function before the age of two, it is not really changing plasticity. You’re changing this cytoarchitecture of the brain and so the astrocytes are the things that are responsible for the actual pulling and connecting, so the laser is helping to dig better tunnels so the neurons can connect better as a, from a seeding perspective and it’s doing all that through the changing of the expression of cytokines and epigenetics in the immune system. So I think that was kind of a roundabout answer.

Dr. Chad Woolner: No, that was a great answer. How does, do you have a pretty decent idea of how BDNF plays a role in that in terms of lasers and impacting? Does it impact BDNF directly? Does it impact it indirectly that you’re aware of? Because I’m you know, the way I understand it, is BDNF kind of acts kind of, and maybe this is an incorrect analogy but like the orchestra conductor in terms of it. It helps facilitate a lot of these proper connections within the brain. Is that a correct way of looking at it or analogy? 

Dr. Marc Funderlich: So I would say that the BDNF does a good job from a plastic perspective, it does a good job of helping solidify those new connections. And so you, I would argue if you were to use the laser on a patient that you improve BDNF output if you were doing some sort of co-activation within a timeframe of using that laser and doing the action so you’d have to do the action and use the laser at the same time. I don’t think just using the laser is going to create a big enough change in the BDNF -that’s really the responsible factor for brain derived treatments. The- just using the laser is going to do things, I think more around microglial modulation, antipathogenic factors, things like that. But when combined with something like exercise; let’s just say you’re on a HIT bike and you use the laser before the HIT bike which is always – my preference is to use the laser before the therapeutic activity minimally, you get much better production of things like brain derived neurotrophic factors to solidify those gains that you’re going to see from the therapeutic intervention of an exercise.

Dr. Chad Woolner: So almost like the laser helps set the stage for the things that are going to come directly after it to then anchor in the changes that you want to see taking place. Is that a good way of…?

Dr. Marc Funderlich: So that’s that was important so that’s kind of route one, one route two is it’s going to prevent negative side effects. So when you look at the research with laser and how the 635 nanometer light decouples the COX enzyme to allow the electron to be transported through to the final oxygen acceptor better. If you do something to stress the system and that COX enzyme is not diluting at a rate that is equivalent to the amount of energy expenditure you end up creating a backlog and the oxygen will end up being pushed off into hydrogen peroxide. So what you can end up happening with the increase of blood flow to the brain in the increased amount of oxygen to the brain,  you can end up with the negative side effect of producing hydrogen peroxide which then leads to cellular death or mitochondrial death and that’s kind of you can classically think of that as if you had a concussion patient, you put them on a treadmill and made them run, they’re going to crash. And so you can make people crash from doing very simple exercises. You can make tissues besides just brain tissue crash and you can make it fibrose so if you’re a chiropractor and you’re dealing with an orthopedic type practice and you were to you know adjust a patient and put them on traction or decompressions and that tissue is not ready to be stretched, you’re going to make it fibrose. The laser is going to make sure that the appropriate amount of energy is going to be produced by those mitochondria stabilizing the cells so they can adhere to therapy and not go down the negative pathway that you may get with the percentage of patients that are going to have a quote-unquote negative response to whatever therapy you end up doing. So it’s protective and beneficial. 

Dr. Chad Woolner: So if i’m hearing correctly, just as an overly simplified way of thinking about this – you can use the lasers pre to help get better results with the therapeutic activity you’re going to engage in and post to help protect against any of the potential negative consequences of a certain activity that a patient is involved in or that you’re going to do there. Is that a correct way? Is that what I’m hearing?

Dr. Marc Funderlich: So I would frame it as by using the laser for even 20 seconds before you were to do therapeutic intervention, you’re going to minimize your risk of a negative or adverse event as well as improve the mechanics of whatever that therapy as well. 

So you can do it afterwards as well – you know something that we like to do since we do a lot of neuro rehabilitative exercises is we use the laser before the therapy and we use the laser after therapy. I don’t find, at least from my clinical practice, I haven’t found that the idea of using the laser for neuro rehabilitation during the exercises – it seems to be too complex and fatiguing for the patient. Just from a mental perspective then running around with the laser and things like that. So we do short bursts of laser before an activity and after an activity. If somebody wanted to do it during… you, I would count that really as doing it before. If let’s say about a disc patient that you were going to have do Mackenzie press ups or something like that or bird dogs and you had the laser on their back while they’re doing those things you’re going to start to see positive cellular responses to laser in about 20 seconds at least from the research that I’ve seen. So to get it quickly and all those benefits from very very short amount therapeutic intervention.

Dr. Chad Woolner: That’s amazing 

Dr. Marc Funderlich: Yes, so at least in our research that we’ve seen; 20 seconds seems to be like a super sweet spot for the minimum intervention necessary to create a significant change. We’ve seen significant reductions per the research. I believe there is a study with like 5,000 women with trauma and wound-like trauma and wounds, skin broken, everything like that, infectious disease coming into that as well. And just from 20 seconds of laser, they had a 98% satisfactory rate of reducing pain for those women with a 20 second treatment. 

So it’s not like more treatment is necessarily always better in every practice and that’s something that we also found as well. When I first started using the laser we kind of just preset you know 10 minute treatments and I thought okay, this is having significant changes – why don’t I move it up to like a 20 minute treatment and then my results weren’t necessarily as good and so then I moved it back down to 10 minutes and then slowly started moving it to smaller and smaller increments based off of looking and reading all the research of how small the time frames are to get these significant backed results. 

And now we do very very short laser treatment multiple times throughout a visit and we’re getting better results than we got when we did 10 minutes straight and so that’s why also think that when you look at something like the ATP production and we want to visually think about – I turn this laser on and I shoot it into the tissue and it’s dissolving the enzyme to allow for the ATP to be produced, if i keep doing that, you’re not going to keep dissolving the enzyme. The enzyme gets wrong in the ATP can go through and so the idea of just continuing to crush the tissue doesn’t necessarily make sense to me. I rather dissolve the enzyme, have an activity be performed, If it’s going to start to come back you know dissolve it again and then have an activity performed in these short bursts per se rather than just pushing and pushing and pushing and pushing and making the patient lay there for 20 minutes. So I think that really gears towards the cell signaling response theory as opposed to like the photons going into the mitochondria and like becoming something positive.

Dr. Chad Woolner: You know the analogy that I’ve heard used and I use you know is once water is boiling, you can’t boil it more. And so once it signal’s been signaled – once a reaction is in full effect, it’s gonna do what it’s gonna do whether the laser continue or whether it’s stopped and so that’s an interesting concept. How many typically in a typical visit will you laser them for these short bursts?

Dr. Marc Funderlich: So because we see such a variety of people, it’s really different for every patient. You know some people they come in, they might spend three hours at my clinic doing something and they come in for 40 visits and so those people we may be lasering them five or six times for 20 to 30 seconds. For some people you know we may end up doing like five minute treatments. If they’re just coming in for a specific issue and there is no kind of excess rehabilitation going on. 

So I think for a standard chiropractic practice, using the laser before the adjustment before the decompression may be during something like electric stim, whatever your musculoskeletal complaint is doing it for five minutes before is really all you need to do. You know,  I think there’s oftentimes we feel the need to provide value to the patient by doing something for x amount of time – so I think it might be hard for like a pain management type of clinic or a disc herniation clinic to convince those people to only do 20 seconds. But I really don’t think that if someone has an acute disc herniation, they need to go more than two to five minutes. Just really see the bulk of the benefit and then do whatever other therapy they’re going to do. And if you in a perfect world could do another 20 seconds out the door – that’s what I would do.

Dr. Andrew Wells: We were speaking to Dr. Dan Murphy about the Arndt-Schultz law, meaning that you don’t get a higher benefit for doing more of a good thing to a certain point. And so I’ve always heard a lot of docs using this ten minute protocol but you’re saying even as low as 20 seconds has a positive benefit or multiple rounds of 20 seconds. That’s a lot. That’s a lot less than I would have thought originally. 

Dr. Marc Funderlich: So, if we shift the mechanics for a second. We know that if you were to shine the laser on your right arm and you have a left arm injury, we can see changes in the left arm at a more rapid rate. So we also know that things like the red blood cells are going to change. We know that you’re going to get proliferative changes in the cell signaling mechanisms of those tissues the same way that when you have an injury in one area, the stem cells may be driven up right? Everybody loves to talk about stem cells. 

So, say you break your left arm, the stem cells get driven up in order to help repair that area. The growth factors get driven up from the rest of your body to get help and heal that area. It’s not just osteoclast fibroblast response at the left humerus. And so by lasering those other areas of the body, we know that those tissues they’re going to ramp up their production and their cell signalings for growth factors and things like that are going to go and help other areas as well. And so we have to also account for the systemic of the laser and not just the local effects of the laser. 

To put that in a different perspective. If you’re looking at brain health, there is the want to laser over the area of proposed injury. So, let’s just use a stroke because it’s the easiest, clearest defined injury. Let’s say someone has a stroke in their right hemisphere… actually let’s go back as I have a stroke patient. 

My stroke patient, who was seven years post stroke, had a middle strieble artery infarction. He had some good receptive language, he had terrible expressive language. He could say yes, no, and okay. That’s all he could say. He came to us, obviously, no change. He was in a nursing home style situation, his wife would drop him off at daycare or different babysitting groups that were just disguised as therapy groups that do the same stuff everyday. 

So he came to us, we were doing our rehabilitation protocols but we started with a laser because we wanted to stabilize the area metabolically before we had him start doing these therapeutics and the idea you would want intrinsically to just laser over that expressive speech area but no, we just did kind of a global brief treatment protocol right? I believe we did two minutes and we kind of just did the neck. We did it globally on his brain and by the time we were done with our program for him, after about six months, he was able to put six to seven word sentences together. He got his driver’s license back, he was able to raise his right arm which has been spastic over his head and get things like towels off of the top shelf. He was able to integrate back into society again, becoming a functional member of the family. He had a son who was in college who he was basically absent for.

And so you know we lasered sometimes his neck. We lasered other areas of his brain and we saw the symptomatic areas of the areas where the stroke actually occurred. We saw functional changes but without just lasering over it. So again, you know how much of this is creating systemic changes as far as growth factors are concerned, not just having to laser over the area of the injury right. 

If you have someone who has autism or someone who has a brain stem infarction, you don’t know you can’t see, right? No picture is really useful for defining how to rehabilitate that person or else you know, medical doctors would be amazing rehabilitating these patients because they would look at a picture and say there’s a problem. Just like we do in X-ray and so creating global changes with the laser occurs no matter where you place the laser. It doesn’t have to just go over the area of injury. We know that the immune system is systemic. They’re growth factors are systemic. The ability of the immune system to use those and guide and direct those are more important than just lasering over the area of pain. And so I think it has to be thought of as systemic therapy. Even though we want to just laser over the area of pain or injury or whatever it may be. Which then again leads to a larger mechanism of action that has to do with cell signaling and cascading as opposed to just enzyme degradation of the mitochondria in that one specific area where you’re lasering over. 

Dr. Chad Woolner: That’s amazing, seriously. Mind blown here in terms of that, no wonder you’re doing what you do. That’s got to be extremely rewarding for you to be able to see these types of results and get to experience firsthand. How many of your patients would you say are in this category? I mean is this what you’re describing here as pretty typical cases that you see?

Dr. Marc Funderlich: Yeah so, we see a lot at least from before we closed our practice and moved. We saw a lot of people but you know because of the therapies we’re integrating with people in the way we work with them. We have specific pillars and specific goals. 

Like if you’ve ever seen My 600lb Life and I think it’s like TLC or something with the weight loss surgeons. Now, the patients come in, they have to do a dial lifestyle nutrition before he will approve them for their weight loss surgery and so we work with a lot of patients and we don’t just have a preset model of care and so we have patients come in. We make very clear and defined goals that we take them through to make sure that each phase of care, they’re getting optimal results and by the time you compile all of those whether it takes three months, three weeks, or you know, nine months; we’re gonna make sure that patients has optimal function around whatever it may be at the time they are through with their care plan which is custom made to them. 

So I think the total number of patients that  we saw in the three years was somewhere around 3,000 patients between me, and my wife, and kind of the team. But, each one of those patients was spending somewhere between 40 hours to probably 10 hours in the office. So, very intense work you know. We’re really building relationships the way that my model really runs is, we have occupational therapists and kind of other licensed providers who are carrying out the daily treatment protocols that are set forth by me. I’m looking at the diagnostics and we have almost an open area of rehab, so someone may be doing like a virtual reality rehabilitation for their spastic arm. Somebody may be doing primitive reflex exercises and we have an open gym style where I can work with a bunch of people at one time where it’s more me helping the therapists provide the therapy properly. If there’s anything that’s wonky and then me doing intakes and things like that. 

So we can give people very specific and guided care and then help them so they feel like it’s a personalized experience and then it is but you know we’re teaching and learning and going through everything together.

Dr. Andrew Wells: Dr. Marc, what would you say to a clinician who maybe has very little to no experience using laser therapy and wanting to introduce this into their practice? What advice would you give them as sort of a standing point? 

Dr. Marc Funderlich: So, I think because whenever I got…the laser was the first large purchase I would say that I had out of school. I graduated in 2017. I think about six months into practice is when I purchased the first laser that I ever got. And so…the thing about laser, especially when it comes from a place of being like a 635 nanometer class II laser is that you’re going to see results. It’s very very hard to mess it up. And so from my perspective, and this will be a two-part answer, from my perspective. I wanted to see more intense cases. I wanted to see harder cases. 

Those cases kind of came to me using something like the laser insulates your results so that way you can learn to deal with these harder, more complex cases if that’s what you want while you’re still learning. Because it’s hard to do these things without seeing the patients, but it’s hard to ethically market that you do these things when you’ve never seen the patients. And so using the laser to provide the cover that you are going to help somebody get the result that they desire really helped me have the confidence to build the practice that I wanted so that’s kind of one. Two; if you stay with the standardized protocols and you’re just using them for an everyday chiropractic practice, because it’s a non-thermal device, you’re not going to aggravate the injuries that other types of lasers may aggravate. 

So, once you get into class IV lasers, which are designed to heat and/or cut, or you get into sauna type situations, or you get into the infrareds which also create heat in vasodilation, you start to have to know what you’re doing more because those devices can create negative impacts. If you have an acute disc herniation you use a class II laser, there’s not going to have to be any heat to inflame an already inflamed injury or if you have an acute concussion, you’re not going to inflame that inflammatory process more to where you’re going to create more and neuronal damage and more symptoms with the class II laser. 

Once you start getting into the saunas the class fours, you can actually find growth plates. If you’re using it on children, you can create postural tachycardia symptoms in patients who have a neurologic disease. You’re going to create just inflammatory processes and so you don’t know what you’re going to get with those. With this, you know what you’re going to get. You know if you use it for 20 seconds to 10 minutes you’re going to get a positive result. Let’s say that  whetherI use the laser for 20 seconds or 5 minutes, I’m going to get 80% of the positive result and you know maybe if I use it for “too long” maybe I don’t get that last 10% of optimality. But you’re still getting the patient an 80% significant result in the positive direction. So, just getting the laser and not necessarily worrying about what settings are. You’re putting in and just start using it on people. If you’re not comfortable using it over the area of injury like if they broke their left arm and you’re afraid to use it on the left arm, start with the right arm, and you’re going to start seeing results by just using it in a very non-invasive way. Build your confidence and it won’t take you very long to end up using it more intensely with people if that makes sense. 

Dr. Andrew Wells: Yeah, that makes perfect sense. It sounds like this is kind of a very easy crawl-walk-run approach to using this without having to worry about hurting somebody, making a condition worse. And just this is what I’ve heard from other doctors as well so you’re reaffirming what’s being said is that just start somewhere on people. If that’s an oversimplification. I kind of learned if you want to advance to a higher level and start dealing with more complicated conditions, more complicated patients. There’s a runway to be able to learn those protocols but even you know that you can’t really mess it up is what you’re saying. 

Dr. Marc Funderlich: So, if you look at the people and again, I don’t like this thought process, but you know people inside of the laser space will argue if you’re using this many milliwatt laser at this many nanometers and this much output and that’ll be this dose of… and like that doesn’t matter. It’s not like a medication where if you don’t get the right dose you don’t get the right outcome. It has to be thought of as therapy that is creating a signaling cascade response and it’s creating a modulatory response and since it’s creating a modulatory response, the dose as far as getting it perfect is not the important thing. It’s creating the response that’s the most important thing. 

I can only get that response from using the right wavelengths because it’s a photochemical effect and not a photothermal effect. Or else you would just say we would spend the money on a laser and just buy a hot pack. 

Dr. Andrew Wells: I’m visualizing this is almost as if you’re doing a domino rally. If you want to knock over all the dominoes to get to the last one, you start by pushing the first domino and the body will do what it needs to do to correct itself right. 

Dr. Marc Funderlich: 100% just if you look at the research and you say okay, using a laser will systematically decrease IL6 in this scenario and it’ll increase in this scenario and it decreases reactive oxygen species, but this scenario the reactive option species actually increased intracellularly for this amount of time which then allows for a hermetic increase in the antioxidant system, so it ends up being a net pot right? You can bog yourself down with all of the micro details, but what it really boils down to is creating a positive modulatory cell signaling response. It’s changing enzymatic processes. It has to be doing it in a positive way because we’re seeing positive systemic changes. 

Dr. Chad Woolner: That’s amazing, absolutely amazing. Dr. Marc…

Dr. Andrew Wells: You do a really good job by taking complex things and making them really simple. That was one of my fears I had with these episodes. We’re talking about how low level laser therapy works? It’s like man, I can tell that you know the science, but it’s also really reassuring to say like start somewhere, you’re not gonna hurt people. I love the comment they made, it’s not like you can’t mess up the dose like you could with pharmacology and really do some major damage and so I hope Docs listening to this are very encouraged by that, even if you don’t have the brain like Dr. Marc obviously has that shouldn’t dissuade you from connecting with a life-changing therapy that’s available to you. 

Dr. Marc Funderlich: Yeah and there’s no reason, I mean from my perspective when we look at it from a practice management perspective, one 20 seconds is 20 seconds. If you can’t find 20 seconds to improve your therapeutic outcomes, then I don’t really know what…there’s no argument I can make to convince you because you’re coming from a place of presupposed bias of some kind. 20 seconds is 20 seconds. That’s kind of one. And two, if you’re able to use it, you know anywhere on the body and create a systemic positive change, then the level of risk factor to using it in a let’s say high volume practice where you know you may not be able to have all of the micro details managed right? Your risk factor or risk mitigation with a class II laser is so small right you don’t have to really change much from a malpractice perspective. 

When you add that therapy in because it’s a known effective safe therapy if you want to integrate like Asana, if you want to integrate something like a class IV laser depending on which one it is you may have to disclose that to your malpractice insurance because if something goes wrong, and I’ve worked in a practice that has had class IV lasers. I kind of worked in it when I first graduated to supplement while I was building my other business and I mean we made disc injuries worse. We created burns you know that became boils right? These are things that get you in trouble and if you have a high volume practice and you are using chiropractic assistants or people there’s going to be some level of error. There’s going to be some amount of people that are going to get hurt. 

That’s just not going to happen with a class II. The worst thing that you’re going to do is do it for too long and not get as positive over a result? Yeah well right because I was using the laser on people’s brains for 20 minutes and it wasn’t that it wasn’t helping it was just not helping as much. So I said why am I wasting my time doing this for so long when it’s not creating any net therapeutic positive over what I was doing before and so between only needing 20 seconds which can be integrated into any space, having to be a class II device that can be run by a chiropractic assistant so it doesn’t even need  to take up your time and being safe and efficacious. There’s no reason not to use it. 

Dr. Chad Woolner: That’s amazing Dr. Marc. For Docs who are interested in learning more from you, where would you recommend they connect with you?

Dr. Marc Funderlich: I don’t know! If they reach out to Erchnoia or put them in contact with me. We are developing some new class work to come out in 2022. If you guys want I can give you an email and a phone number that they can contact if they want personal help, or if they want to be put on a waiting list for future education. 

I do own some other distribution and some other companies that we are building online education out for that. They can be put on a waiting list that way we can take these topics and five deeper into them where we have no time limit so we can go through everything and you know then they have that forever to rewatch and play because we’re designing it to be watched on a cell phone. We’re designing it to be app based so that way it’s really designed for the 21st century as opposed to just you know, filming people behind a teleprompter upon a stage talking. You know we’re designing it for an iPhone for handheld devices, so that way you can integrate the education wherever you are!

Dr. Chad Woolner: Yeah, we’ll make sure we put any links in terms of that here in the show notes so that Docs can connect with you for sure because I guarantee you’re gonna have a lot of docs who are very interested in learning more about these subjects. Dr. Wells, was there anything else you wanted to add?

Dr. Andrew Wells: No, other than that thank you so much for being a guest on the show. This is exactly what we hoped this episode was going to be and I think a lot of doctors are going to benefit from this. Hopefully, they will and you know one of the resounding messages I got of this and hope Docs also got was there really is no reason to use something like this in your clinic. Whether you’re high volume, low volume, complicated cases, there’s a spot for laser therapy for every type of practice.

Dr. Marc Funderlich: Yeah, if we look at just the way that we, you know, whatever term you want to use, evolved, designed, as people we have an entire lobe of our brain dedicated to the visual system right. We have the endocrine system linked to light based off of the sun and our circadian rhythm that helps control your endocrine system so it makes sense from a fundamental perspective that a light-based therapy is going to create significant changes when people are so visually driven. You know we’re not near infrared drive. We’re not sona driven, right. We are visible light spectrum driven entities and so it only makes sense to use a visual light based laser to help signal those changes inside of our body, so I think it falls in line with us in kind of the most fundamental of ways. 

Dr. Chad Woolner: Yeah, thank you again Dr. Marc. We appreciate you being here. We could definitely go on and on and I foresee us trying to get you on the show again at some other point here in the not too distant future for sure. So, we appreciate your time Docs. I hope that you also found this as valuable as we did. We would encourage you to share this with your colleagues. We know this can help you ultimately more patients so that’s it for this episode and we look forward to sharing more with you guys on the next episode, so have a good one. 

Thanks for listening to The Laser Light Show. Be sure to subscribe and give us a review. If you’re interested in learning more about Erchnoia lasers, just head on over to Erchonia.com. There you’ll find a ton of useful resources including research news and links to upcoming live events, as well as Erchonia’s e-community where you can access for free additional resources including advanced training and business tools. Again, thanks for listening and we will catch you on the next episode.