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Welcome to Office Hours. This is our dedicated one on one space to go deeper, get clear and explore what truly moves the needle for your health. I'm Dr. Mark Hyman and each week we're going to pull back the curtain and share the insights, the research, the lessons that don't always make it into our conversations with guests. Because at the end of the day, you are the CEO of your own health and for many of you, your family's health too. And you might not feel it all the time, but you have far more power and agency than you realize. I'm glad you're here. This episode is brought to you by.

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Today on our episode, I'm going to talk about some personal stuff. Unfortunately, I'm not just an expert as a doctor in this topic, I'm an expert as a patient. And today we're going to talk about how do we put your body into healing mode after injury or an accident? And unfortunately, I live pretty fast and hard and have had my fair share of bumps and bruises and have had, count them, six back surgeries. And I've had to come back from all of them. And the last one is been quite challenging. I'm gonna get into it, but that was probably the most intense recovery of anything I've ever done in my whole life. Now I've done lots of stuff. I've blown over the handlebars of my bike. I've had a broken arm, I've sprained this, I've broken that. I recently had a bike accident. The truck pulled in front of me. I'm not gonna ride on the road anymore. I was used to riding in the country in the Berkshires where I lived for 30 years and I live in it Austin now. And there's cars everywhere and people are just not paying attention and I just literally car pulled in front of me. I bounced off the car and got some pretty smashed up things in my body. So I've healed pretty quick because I know what to do and I know how to recover and I'm going to teach you what that is. So when I get injured, I'm just amazed at how the body has its own powerful healing system that's better than any doctor, any medication or anything you could possibly imagine. And it's so resilient. I mean, I lost 25 pounds of muscle after my back surgery. I couldn't walk, I was in a walker, I was in a wheelchair. I couldn't get up and down the stairs, I couldn't get to the bathroom by myself. I couldn't brush my teeth by myself. I was down and out. And I've come back and you know, I just was in the gym this morning. My trainer did 15 pull ups. I'm lifting heavy weights, I'm fit and you know, was in Aspen this summer. I rode my bike 11 miles straight uphill, 9,600ft elevation. The body can do it. And I'm an old dude, I'm like 66 now. So it's amazing at any age how the body can recover. Second, it's important to know that you have to have the right conditions. Cause if you don't do the right stuff, your body can't heal. So I've really struggled to recover and I really learned a lot about what it takes from the point of view of food, of rehab, exercise, the right supplements, additional things that are available out there that not available to everybody, but that are in the marketplace. Things like peptides, laser therapy, red light, hyperbaric, oxygen. There's a lot of ways to recover and a lot of elite athletes use these technologies, but not everybody has access to them. But healing doesn't just happen. Like, yeah, if you cut your skin, you don't have to do anything. But if you want to accelerate the healing that your body has, if you want to activate your body's own regenerative repair, renewal systems, there's a lot you can do. It's an active process and you need to learn what to do to make your body heal and repair. And it requires energy, it requires activation of many pathways in your body. You require increased nutrients and protein. If you do the right things, you can dramatically shorten the recovery time. You can reduce pain and you can get back to feeling like yourself very quickly. Two weeks ago I had a bike accident and my face was a mess. I had a giant fat lip, my face was swollen, I had blood everywhere, I had lacerations. And now you can't really tell anything. And it's not because I have makeup on, it's because I use a lot of technologies and tools to help my body heal fast. And I'm going to teach you what those are. So we're going to walk through the science of healing. We're going to walk through the simple steps you can take to repair your body. Whether you had surgery and you're Recovering from that, or you had a sprain or a pulled muscle, or you just had an unfortunate bike accident like I did, that wasn't my fault. But let's talk about what healing mode actually means. It's not passive. It's an active process that your body does and it needs energy. It needs increased energy reserves, increased nutrients, increased blood flow. It needs a inflammatory triggers that are removed and basically a low inflammatory environment. So there's a bunch of phases that happen with healing. The first phase is inflammation that's normal. Redness, swelling, pain, heat. Common when you have an injury like a sprained ankle. And that brings all the cytokines, the stem cells, the fibroblasts, the repair signals, all that stuff, the white blood cells clean up the mess. It's, it's a good thing in the short term, but if it goes on too long, it's not good. And so what do you, what do you have to do? Well, you have to do the next step, which is to bring in the tissue repair component. This is coll. Fibroblasts helps rebuild tissue. The next step is remodeling, where you increase strength and flexibility. And when this process doesn't go well, it's usually because there's some increased level of inflammation in the body, or you don't have enough of the right nutrients or enough protein, or you have too much stress in your system, or not getting enough sleep or rest, or you have too much metabolic dysfunction. Because, you know, one of the things that people don't realize is that healing is impaired if you have pre diabetes or diabetes or insulin resistance to some degree. In fact, diabetic foot ulcers are really common. Why? Because there's no circulation, because there's nerve damage. And so we use techniques like hyperbaric oxygen therapy for wound healing in these patients to actually help bring blood flow and healing. So, you know, healing is going to take time, but there are ways to speed it up and there are ways to support it so you can actually heal better and end up stronger. In fact, I'm stronger now than I was before I had my back surgery, which is pretty amazing. First thing is you gotta give your body the right raw materials. And protein is what your muscles are made of. Protein is what your tissues are made of. Protein is what is the building blocks of your body. And you're not made up of sugar. You, you have some fat. You're made up of all cell membranes and your brain is a lot of fat. But your structural things, your things that matter are mostly protein. And people don't eat enough protein when they've had an injury. So you need to up your protein. For example, I had a protein shake this morning with 50 grams of goat weight and I put in creatine and I put in all these other anti inflammatory compounds. And so when you're injured you need to increase your protein by about 20, 30%. So you need to have good quality protein. Chicken, fish, meat, beans, lentils, protein shakes. Whey protein is probably the most bioavailable. You also want to include anti inflammatory fats, particularly omega 3 fats. These are very anti inflammatory. They help repair tissues. Your cell cells are made of this. You need things like wild salmon, sardines, mackerel, herring. Those are fish that people don't like, but I do anchovies, walnuts, chia seeds, all help reduce inflammation. You also, you know, want a little inflammation, but you want to balance it and this will help that without shutting down the process of healing. You also want to improve the nutrient levels you have. You need higher levels of nutrients. For example, collagen is really important, but it's dependent on vitamin C. You also need zinc. Zinc is an incredibly important compound for wound healing and a lot of people are deficient in zinc. You need magnesium, which is also helpful your muscles and tissue repair. And we've got about 45% of the population deficient or insufficient in magnesium. Vitamin D really important for modulation of the immune system. And again 80% are deficient or insufficient. B vitamins help your cell regenerate. So you need to eat all these nutrients and a good multivitamin fish oil, vitamin D will do the trick. Also you wanna reduce the inflammatory foods cause the more inflammation in your body, the harder your body's gonna struggle with healing. So sugar, refined starches, seed oils or oxidized oils. Ultra processed foods just should not be a big part of your diet. In fact, ultra processed foods shouldn't be a part of your diet at all. Food isn't just fuel. It's basically information. It's medicine. It tells your body to how to repair or if you eat the wrong food, it's gonna tell your body not to repair. So really important to optimize your nutrient levels and your diet. The next step is inflammation. You want to reduce it, but you don't want to block it early. Inflammation is key for bringing all the resources I said to the location of healing and, and you need to do that now. If you have too much inflammation for too long, it can delay healing. So for example, I had this bike accident and I injured my Ankle have a lot of sprain and a little chip on my ankle bone and I injured the other foot. I'm hobbling around and I have a broken toe and a lot of inflammation and soft tissue damage. And that's important initially to kind of start the healing process. But if my feet staying swollen for too long, it can't actually repair. So I've been using these Normatec boots. They're essentially lymphatic drainage boots. And I put them on for a half an hour a day and it squeezes all the fluid out of my legs and out of my feet and gets rid of it. It's quite amazing. And in the days I've been using it, my feet have just dramatically reduced by probably 70, 80% in swelling. So you want to keep the swelling down as the healing process goes on. And if you have too much inflammation, it's just going to delay the healing. So you can do heat and ice back and forth. Sometimes early on you want to do ice, later on you can do heat movement. So exercise, pumping with muscles helps. Omega 3 fats are great to help with lowering inflammation. Turmeric, which is a powerful anti inflammatory herb that you can use, it's you can use in a spice or you could take curcumin as a supplement. Ginger, I use a lot of ginger. And cooking breath work also helps lower stress response. Cortisol when you're stress doesn't allow you to heal, actually makes your tissues break down. You don't want to use anti inflammatory drugs too much because they can slow some of the remodeling of the tissue. So in acute pain you can use them. But I would not stay too much on things like Advil or Aleve or ibuprofen. So we want to, you know, have a little inflammation but not too much. It's kind of like Goldilocks. The next is really key and by the way for my healing and just kind of to keep you up to date, I use a lot of things that reduce inflammation on the dietary stuff, the supplements. But also I, I used for example ice. Ice, yeah, ice plunges which are no fun. They actually work and they learn information. I use sauna hot and cold and that really helped me a lot to recover. Mitochondria is the next topic because these little factories that make energy in your body, there's thousands of them in every cell, they're really key to repair because getting your body to repair from an injury is really energy intensive. So you need to have good quality high functioning mitochondria. There's a lot of ways to improve mitochondrial health. I'm gonna tell you the basic foundational ones and I'm gonna tell you some things that I've been using that have been remarkable. And again, there are things you can get in different places. The first is sleep. So you need sleep to rebuild your energy source. You need hydration, you need minerals, you need movement. Exercise improves mitochondria. Nutrient dense food also help obviously improve your, your mitochondrial nutrient health. Omega 3 fats are critical. Good fats are really important. Alcohol is not good actually for your mitochondria, so you don't want to drink. And the things that I've been using for my mitochondria are two things that have been really helpful and have healed my face pretty dramatically pretty quickly. And I have one area in my body that I got a scrape that I've not been using it and it hasn't healed as fast. And it's two things. One is laser therapy and red light therapy. And both those have different functions, but they can be incredibly helpful improving tissue repair, regeneration. Because they activate your mitochondria. Red light and laser will do many things, but one of the key things they do is to activate your mitochondria. So I really encourage people, if they can get those, if they have an acute injury, to use those. And this is, this is a lot used again in athletes and sports. When you take care of your mitochondria, your body will repair. They're your repair crew. You want to feed them well, you want to take care of them, and they will help you rebuild and heal faster. Now, what about movement? How do you move without making it worse? So if you don't move, and a lot of people when they're injured don't move, it's a bad idea because you want to keep the blood moving and the blood flowing and the lymph flowing and the lymph moving. And literally two days after my injury, I got my trainer in the gym and I was pretty banged and bruised up. There were things that I could do and I did them. And it just gets your body moving. And now I'm back to almost a full routine. I can't stand up that well on my feet yet, but I'm doing a lot. The goal isn't to avoid movement. You want to use the right movement for your injury and you can work around it. So, for example, if you have an ankle injury, you can do circles, and gentle circles would write the Alphabet with your toe, your back hurting, you can do walking, you can do pelvic tilts. You can do gentle stretching. You can do glute work. There's a lot of things you can do if your muscles are torn. You can do range of motion work. I actually have a device that I've used as part of my recovery, which is blood flow restriction. They're little like a blood pressure cup, but you put them on your arms, your legs, they pump up and they restrict the blood flow. But that really activates muscle building and repair and healing and increases the metabolic function in the muscles, and that can really help healing. So I've been using that as an adjunct because I can't do as much heavy stuff. So I'm doing lighter stuff with blood flow restrictions. There's a lot of really cool stuff out there that you can use. 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When I had my back surgery and I couldn't even walk and I was on a walker, I had the physical therapist come to my room and where I was staying in this hotel, and Sandra was just going by surgery and, and had to do rehab with me. And rehab was just literally laying on the table on the, you know, physical therapy table and having a band around my knees and just moving my knees apart slowly to start to build and activate my glutes and doing some simple squeezes between my knees to activate my inner adductors and just simple things. I couldn't even do a pelvic tilt for probably like six weeks. So I just did whatever I could and I kept moving. What about sleep, stress, and your nervous system and why that's so important? Well, there are hormones and growth factors that happen when you sleep, it's the repair time. When you sleep, you literally activate your repair hormones. Growth hormone is the repair hormone. And when you have good deep sleep, you increase growth hormone and you actually will start to repair your body. And that's what happens at night. Cortisol goes down and collagen formation can improve when you sleep. So when your cortisol is high, it's gonna really impact your collagen formation. You know, people often will see people with Cushing's syndrome, which is where you have a tumor that makes too much cortisol. You'll get these stretch marks cause your tissues start to get weak and your, your tissues start to fall apart. So stress will do that and also paradoxically, can increase inflammation. So simple things you can do. Breath work, yoga, nidra, non sleep, deep rest. Lots of tools out there on free. They're free. They're on Spotify or YouTube. I encourage you to just do something to help every day. And I do that every day. Also. Sleep is important. Prioritize that. Get into an early nighttime routine. Get yourself set up for sleeping. Lower the stress levels. Get morning daylight exposure. I get up every morning. I go on the roof of my house. There's like a little deck out there, top floor. And I just sit there and I write a little bit my journal and I, and I let the sun come up and get, get a good 20 minutes of sunlight. And I go to bed early and I take a hot bath. I also, oh, by the way, I'm using this cool bath thing. It's a hydrogen bath. I don't know, the science is kind of interesting about it. I, I, I don't think it's conclusive, but it again is another tool I've been using to help reduce inflammation after the injury. So getting enough sleep, going to bed early, prioritizing sleep hygiene, quiet room, cool room, dark room, all really matter. Not being on devices, all that's really important. So, so you can do everything right and you can eat right, you can move, you can do all these things, take the supplements, but if you're not sleeping and you're too stressed, your healing is going to stop. All right, what about your mindset? Now? This is really where the rubber meets the road. And I'm kind of a weirdo. Like I'm the guy who's going to get the trainer after having a massive back surgery and losing 25 pounds of muscle and start in my hotel room when I'm still on a walker. I'm that guy. Or I'm that guy who's going to. When I get in a bike accident, not just going to sit on the couch and watch movies, I'm going to start working to get better. And I think it's really important because if you don't have a good mindset, nothing matters if you don't believe you can heal and repair. And by the way, folks, when I had my back surgery last year, I was in such bad shape, I didn't know if I was going to come back from it. I didn't know if the pain was ever going to end. It was six months before I could turn over in bed without being in a lot of pain. I didn't know if I was going to recover. But I kept at it, little by little, day by day, step by step. I. Every bite of food I took was medicine. Every time I got in the gym was medicine. Where my trainer was medicine. I. I did all the things that I had to do to recover. And now I feel better. I'm stronger and healthier than I've ever been. So it's incredible. When you actually do the right things and you give the right inputs and you activate your body's own repair, regenerative and renewal system, what can happen? So getting this in between your ears straight is the biggest thing you can possibly do. Because I see so many people when they have an injury, they just stop. And if you stop and don't continue to be active and don't continue to do the things that are gonna make you better, you're gonna get in bad shape pretty quick. So this isn't really thinking about being positive and getting better. It's about doing the things that actually help you to make those small steps every day, they're gonna get you better. So your mental state, your emotional state is really important. And having the will and the determination every day to get up and do the small little steps, the things that are gonna make you better. And I, I probably spent like, I don't know, 300 hours in the gym this year, and I just was consistent with it. And it was like building blocks. I, I first, I couldn't do simple thing like, you know, a pelvic tilt, and now I can do a lot of stuff that I could never even do before. So when you're, when you're in a good mental state, it affects your immune system, it affects your level of inflammation, affects your perception of pain, it affects your hormones, wound healing, all that is affected by what's going on between your ears. When people actually understand the neurobiology of your mental state, of your mindset, it can be profound. The MRI shows, for example, when you look at MRI studies, they show that if you have belief that you're gonna heal, it activates your body's own pain receptors. So your opioid pathways, the narcotic pathways in your brain, actually get activated by your body's own pharmacy, which is between your ears, and that lowers your perception of pain. Another big study in the Lancet found that when patients expected they were gonna get better, their outcomes improved regardless of the treatment type. So I talked to my surgeons at ucsf and they were like, I don't know what you're doing. We have to learn from you, because we've never seen people recover like you. Most people with what you had are still on a walker. And look at you, you're like riding bikes on mountains, you're lifting weights, you're back to normal life. It's all about mindset. If you have the expectation that you're going to get better, you're going to set into play an enormous pharmaceutical treasure trove, which is the pharmacy between your ears. And it's real and it works. So don't, don't actually underestimate that. If, for example, if you're an optimistic surgical patient, they needed fewer pain meds and had fewer complications. So your brain and its ability to think that you're going to get better actually influences the biological pathways of healing. Really important. And regulating your nervous system is also really important. When I was really struggling and sick every day I would do a, a restorative meditation. It was hard for me to sit up, so I couldn't sit up, but I would lay down. I would put headphones on. I would go through this 30 minute relaxation sequence like a yoga nidra, like a deep sleep, what Andrew Hu calls non sleep, deep rest. It's been around for thousands of years. It's just where you go through a body scan. You just breathe and you kind of reset your nervous system. And this activation of this parasympathetic nervous system, this rest and repair system, is activating all kinds of amazing things. Cause like when you think about it, when you're stressed, your blood vessels are constricted, you're on a, your, your, your blood sugar goes up. All these things happen to deal with an acute response, which you need to run from a tiger, but it's not gonna help your body heal. So when you activate the parasympathetic system, it makes your blood flow increase, it gets your tissues more oxygenated, it helps your digestion, helps your hormones all these things really help. There's also something that you can measure, and a lot of people have oura ring or other devices. You can increase your heart rate variability by a number of practices. But heart rate variability basically measures the health of your nervous system. And the higher the variability, the healthier you are and the better correlated it is with wound healing and surgical recovery. So what this means is, you know, your heart rate, let's say, is 70, but it's not actually 70, it's like 70 and a half, it's 69 and a quarter, it's 68 and two thirds, it's 72 and a and an eight, you know, and the more variability there is between every beat, the healthier you are, the more complexity to your heart rate, the healthier are this the most pernicious heart rate and variability is a flat line like nothing, no variability. And if you have low variability, it means your heart's not good, your nervous system isn't good, and it's really bad. So people with high heart rate variability actually recover faster. They have fewer complications. And there's ways to increase that by breath work, by meditation, by gratitude practices, by shifting your body into a healing physiology through yoga and, and all these various practices that you can do to increase your parasympathetic system. And there's a lot of devices out there, there's a lot of apps out there you can do, but we'll put those in the show notes. But there's a lot of ways to do this that are. They're really important and it takes an active process. You have to deliberately relax. Okay, what about supplements? Yes, I use supplements. They are needed and they're essential if you're recovering. They're individualized so you want to talk to your doctor. But in functional medicine, we use supplements not as replacements, but to help optimize and encourage the body's own healing system. For example, Omega 3 is really important for inflammation and tissue repair. Collagen formation requires vitamin C, magnesium for muscle recovery, curcumin, which is an herb for inflammation. Lots of good quality protein like whey protein can help repair our tissues. Really important. So I use proteolytic enzymes, for example, I have. When you have a sprain, there's a lot of things that can be helpful, but one of them is these enzymes that you can take that help break down some of the damaged tissues and clear the tissue, clear the waste out of your system. And I found those very helpful. And there's a bunch of research on them too. Sometimes you need help Right. So you need professional help. So I got help from people. I got help from a trainer, physical therapist. I got help from acupuncturist. I, I got help. But, but you want to do things that are going to help your body heal. So when you're healing from an acute injury, like a fall or a sprain or you have a surgery, you know, which is just a plant injury, the principles of healing are the same, but the timelines and the warning signs are not. So let's talk about when you should bring in extra support first. If you're not getting better, right? If you have more swelling, more redness, more pain, that's not good. Time to get seen and see what's going on. If you're losing mobility and function, get seen. Maybe you have weird symptoms like numbness or tingling. Not a good thing. If you're not getting better over two or three weeks and you should be seeing improvement, you want to go see somebody because maybe there's something else going on, maybe there's some other injury. Functional medicine, practitioners, physical therapists, body workers, all that can really help your healing dramatically. And what's really cool is that there's a lot of techniques. I mentioned a few of them here. Red light therapy, laser therapy, pmf. We didn't talk about, but I'm using that as well. Pulse electromagnetic frequency helps also repair inflammation, healing and bone repair. These lymphatic drainage boots that I was mentioning, Peptides, Something's gonna be helpful. I've used DPC157 and others to help my healing and tissue repair. Cotton cold therapy. All kinds of therapies are available that, that you know, some are accessible, some are not. So much for people, Hyperbaric oxygen therapy. There's a whole suite of tools that are available to use, but the foundations that we talked about will work for most people most of the time. Now, if you're like me, you want to get on it. I don't want to get better faster. I'm going to use some of these things. So healing is not luck, it's, it's just biology. And when you create the conditions your body needs, it knows exactly how to repair it. So whether you were coming from a sprain or a strain or a fall or overuse, just remember you have a lot of power here to make yourself better, faster and heal well. Thanks for joining me for office hours. I love diving into these topics with you. Remember, you are the CEO of your own health and every choice you make can move you closer to healing and vitality. I want to keep these episodes as relevant and useful as possible. So tell me, what do you want to explore next? What questions are you wrestling with? What breakthroughs are you chasing? Share your ideas in the comments on social media or through the link in the show notes. I'm listening. Until next time, keep taking charge, keep asking questions and keep showing up for your health.