- January 30, 2019
Overview
In this episode, Lauren sits down with Dr. Harold Kraft, owner and operator of LaserMD Pain Relief in Southern California. With a background in anesthesiology and engineering, he has been working in groundbreaking Class 4 laser technology to treat and cure various forms of pain and injury, from neuropathy, arthritis, CRPS, and sciatica to fibromyalgia, PTSD, and TBI (traumatic brain injury). Sometimes in just a few short treatments, he has observed incredible results and reduced symptoms – and, in many cases, eliminated or bypassed the need for prescription opioids. While his practice thrives, he has plans to make laser therapy (which has been common in veterinary work for many years) more accessible and affordable to the average person – and continues to offer life-changing treatment to the masses.
Key Links
Key links mentioned in this episode:
Takeaway
Listen in as Dr. Kraft shares:
- how laser therapy is non-invasive and has little to no side effects, but can have incredible anti-inflammatory and nerve growth/repair results; in PTSD or Alzheimer’s, it can assist the brain in developing new circuits
- that in terms of pain relief, he has observed a genetic link (through the maternal side) to a patient’s receptivity to treatment – 3 out of 5 tend to see results; this same link does not seem to apply with regard to PTSD/TBI, in which the odds of benefit from treatment are, across the board, “nothing short of stunning”
- that his practice is completely unique in that he uses ONLY laser treatment; he no longer prescribes pain medication or gives injections for pain
- that many of his patients have come to him after having “failed” to manage their pain in every other case
- that the pendulum has swung too far away from opioids for people who need them – some of this need is entirely legitimate, and the difficulty in acquiring pain medications for those in need is a crisis of its own
- how his wife’s dog, Harley, is the reason he discovered hot laser therapy
- that he tested the laser on himself first, and saw incredible results in treating hip bursitis
- his belief that high-dose laser will, in a few years, become the gold standard of treatment for PTSD and TBI
- that previous studies of hot laser therapy in treating PTSD and TBI showed a 30-60% decrease in depression, and appeared to entirely eliminate nightmares and sleep disturbances
- that, based on his research, he estimates 1 million veterans and 5 million civilians in the US suffer from PTSD; females suffering from PTSD are most often survivors of sexual trauma
- that, based on the treatments he’s been offering to PTSD patients over the last year, he’s seen a 30-100% reduction in depression, along with the elimination of sleep disturbances
- that he needs funding and investment to continue genetic research and to scale in the field to create a PTSD/TBI mobile laser clinic; “there is tremendous potential – it just needs to be developed”
- that laser treatment for PTSD is not currently covered by insurance; laser treatment for pain and neuropathy are sporadically covered
- that the VA is flawed, and unlikely to be early adopters of hot laser PTSD treatment
- that the US healthcare system is terribly flawed, and that the introduction of health insurance companies has ended as a bad experiment that we’re sort of locked into; that the VA is an example of a medicare-for-all system that has had equally bad results; and that the major problem with both models comes down to TOO much trust in physicians (and physicians having too much belief in their infallibility)
- that the key to fixing the system is education – that health insurance is not the same as health care, and that health care is not the same as prevention; prevention is the most important of these, and could allow us to treat people at substantially reduced cost
- that, though he is not an expert on depression itself, he sees hot laser therapy as a potential treatment for chronic and major depression
- that he’d love to see hot lasers in every primary care practice, and that he is developing a laser for that purpose right now
- perhaps most amazing about hot laser treatment is that, unlike many opioids, it is not a Band-Aid; rather, it treats a root cause
- that patients should push their insurers to cover treatments like hot laser (if it is not already covered on their plan)
- why patients should keep a journal: so they can speak the same language as their physicians, who are often data-driven
Transcript
Lauren: All right, guys, thanks so much for joining us today. I'm here with Dr. Harold Kraft. He's been so kind to join me and we're recording on New Year's Day, and so starting the new year off right! Dr. Kraft is the owner and operator of Laser MD Pain Relief, which is an amazing organization that I came to, actually, for neuropathy. But you treat, with hot laser, everything from neuropathy all the way to PTSD, right?
Dr. Kraft: That’s correct.
Lauren: Awesome. So, Dr. Kraft, why don't you tell us a bit about hot laser therapy and how it works?
Dr. Kraft: Sure. The basic principle of hot laser is that it's a high-powered class 4 laser and it's non-invasive. It travels through the skin and into the tissue, and all the work is done by the tissue. So the laser does not melt anything or zap anything. It causes chemical reactions within each cell. And the cell gets more energy, something chemical called ATP, which the mitochondria produce, and virtually all of the benefits come from the extra energy.
So if you're talking about pain, the extra energy produces anti-inflammatory chemicals. If you're talking about neuropathy, the extra energy will produce nerve growth factor and also will help the neural cells to either regrow or just feel better. And if you're talking about its use in the brain – for instance, PTSD or Alzheimer's – then the extra energy helps the nerves basically become more plastic and sort of grow or develop new circuits within the brain.
Lauren: Wow, that's amazing. I'm sure that a lot of people come to you on referrals from a general practitioner. I came to you through a physical therapist. Do you ever find that people come in and might be talking about having pain — but maybe there's a hypochondria issue?
Dr. Kraft: About half my practice is self-referral; half, referrals from other healthcare practitioners or even other pain management doctors who have not been able to get the person well. A very small percentage of my clients have hypochondria. I’d say more common is something called catastrophization, where everything is a disaster. You meet these people in real life all the time. But most of my patients have real problems, and real pain, or real something else.
Lauren: It’s great because I find that of all the practitioners I'm speaking to, I always ask about hypochondria, because so many of us with invisible conditions aren't necessarily believed by various practitioners who we turn to for help. And it's always very comforting to hear from all of you guys that the occurrence of hypochondria is actually very low; that you really do believe the patients — so that's really great to hear. So what illnesses are you most commonly treating in your practice? I know we talked a little about pain management and PTSD, but give us the run of everything.
Dr. Kraft: Sure. So there are really three buckets of people. There are patients with pain; the most common pains are low back pain, neck pain; things like sciatic disc problems. In the second bucket is neuropathy; the most common in my practice is a type called idiopathic or hereditary neuropathy. Idiopathic is a medical term [that] simply means ‘We don't know what causes it.’
Lauren: It’s one of it my favorite terms!
Dr. Kraft: And then the third bucket is a very unique bucket, with patients who have either PTSD or TBI — traumatic brain injury.
Lauren: Wow. So in terms of the neuropathy that you're treating … I'm thinking of myself in particular… I had a bulging disc, I went to my physical therapist, I was having a weird spasm and pain in my leg but it wasn't related to the disc … so that's considered idiopathic neuropathy, correct?
Dr. Kraft: Well, it may have been idiopathic to you, but I think in your particular case it was sort of an unexplained neuropathy. I think if they had done enough digging, they would have found the explanation. It was probably a peripheral nerve; that’s what we lasered — and you actually had an exceptionally fantastic response to the laser.
Lauren: I did!
Dr. Kraft: Most other neuropathies are very difficult to treat. The most common hereditary neuropathy — and this is a perfect case of an invisible illness — I'd say that 99 percent of my patients with peripheral neuropathy, no one ever knows that they are in tremendous pain or discomfort. It's somewhat like diabetic neuropathy. It usually starts in either the hands or the feet and progresses upwards. Some of these people are otherwise healthy. Many of them still go to work. But they talk about simple activities … grabbing a piece of paper is very, very painful.
People use terms like: walking feels like they're walking on crushed glass.
I have other patients …often, unfortunately, psychotherapists seem to have a predilection for some of these … but one of them who's active[ly] practicing and seeing patients talks about a type of neuropathy where she described it as feeling like someone had 20 scalpels twisting in her arm.
Lauren: Oh, how terrible. These various pain issues … I remember when I came to you for treatment, and you explained to me a genetic predisposition toward response to the laser. Is that true in all cases dealing with pain and with traumatic brain injury cases? Can you talk to us a bit about that?
Dr. Kraft: Sure. That's one of my favorite topics.
I've actually done the most laser or hot laser in the country. About 15,000 treatments, and my practice is completely unique because I no longer do injections, and I also prescribe zero medications, of any kind. In my practice, if someone gets better then it's from the laser, and if they don't get better then it was a laser failure. I don't have a second option.
That's the way I've designed my practice. And as a result of that, I've been keeping very careful statistics. Very early on in my practice, I noticed that for my pain patients they spread out — basically 20% of the patients were very high responders, and there's a subset of them, the top 5% … and actually I would put you in this category …they were amazing responders. They seem to get just a handful of treatments, sometimes as few as one, and have phenomenal pain relief that I couldn't explain otherwise. Obviously pain relief is very challenging, and my results are much better than average. And so many patients who get better refer their friends and family. And I noticed that when somebody who is a, say, top 20% patient refer their family member, that their family member was almost always also a very high responder — also one of the top 20%. And this was a real standout, sort of a giant flag.
If I had a top 5% responder, their family member would also be a top 5% responder, and it's unlikely that you'd ever randomly see that — but it only applied to maternal relatives.
So people who had a mother's gene … that physiologically makes sense because the action of the laser is actually in the mitochondria. That's the part of the cell that produces more energy. Mitochondrial DNA comes only from the mother. The rest of our DNA comes from both parents. So it makes sense that the mother's DNA would control whether or not you can convert that laser into extra energy. And if you did, you produce all this extra energy, you produce all kinds of anti-inflammatories, you'd be a super-high responder. So with my three buckets … with my pain patient bucket, it’s absolutely the case that there's an undiscovered (except here) genetic link on the mother’sside. With my neuropathy patients, I've not yet discovered, we're not seeing that replicated. And part of that is just that it could be there, but neuropathy is usually a much harder condition. If you have family members with neuropathy, we can try it out — only on the mother’s side!
Lauren: Yes, actually after you treated me, I called my mom and said, “Guess what … if you ever have any neuropathy …!”
Dr. Kraft: And then my third bucket, which is the PTSD, TBI (traumatic brain injury) – is also very unique. Out of the 12 patients that I've treated, 10 of those 12 actually responded, which makes me think that it's a completely different set of physiologic processes. And a group in Denver also published 10 patients who were treated for the same condition, and all 10 of theirs got some kind of PTSD/TBI relief of varying degrees. So if you lump all those numbers together, 20 out of 22 responded. So there may be a genetic predisposition. But again, I haven't done enough treatments to discover that.
Lauren: But the bottom line is also that you're really helping people who’ve probably tried everything.
Dr. Kraft: Yes.
On the pain front, about half my patients are in the “failed everything” bucket, and those people are even more grateful than average to have found something that helps.
Lauren: I'll share from my personal experience as well … I came to you after having been first referred to a pain specialist who wanted to prescribe me opioids. And I said, absolutely not. I'm not going to be one of those statistics. And then I came to you and was so lucky with my results. How often are you dealing with people who have become part of the opioid crisis, and who are seeking an alternative therapy or, are perhaps even a little bit doubtful about whether the laser will help them if drugs have?
Dr. Kraft: Well, that's a combination question. On the opiates, I estimate 20-30% of my patients are on some kind of opioid. And it's decreasing over the years, at least in Los Angeles. Most of the legitimate physician population is very aware of the crisis. But more importantly, they're aware that opioids are simply a Band-Aid; they don't really fix the real problem. And so in Los Angeles, for instance, if I have a patient who I believe actually needs opioids — because the laser doesn't work on everybody — it's increasingly difficult to find a pain management specialist to refer them to, because opioids are so hard to get prescribed.
Lauren: And that's a crisis in itself. For people who have real problems.
Dr. Kraft: Yes, that's a second, separate crisis. The pendulum has swung too far. So it varies because many people are just looking for any kind of pain relief, any port in a storm — and so they're very open-minded. Some of them are scientifically oriented; I have a whole white paper that explains how the laser works. And once I explain the science, they're very open and even welcome trying it. There is a small segment of people who are extremely skeptical; it might be 5-10% of the people who walk into the office. Most of those people never get treatment. And it's interesting because it runs across socio-economic and educational strata. I find that some people who are of the lower socio-economic education strata are more skeptical. Perhaps they've been mistreated by white doctors like me. But I've also had people who are highly educated — psychologists — who’ve come in and just refuse to believe that something seemingly so simple and non-invasive could help them.
Lauren: So how did you end up working with hot lasers? Can you tell us a bit about your background and what brought you to them?
Dr. Kraft: Sure. The key item is the dog Harley! So I have a dual career in software and I came to California because of the sale of my one of my software companies. And my wife who was still on the East Coast told me that her dog Harley, who's a pug, had stopped walking. And she loved Harley very much — perhaps more than any other creature alive including her family members! (laughs)
Lauren:What's wrong with that?!! (laughs)
Dr. Kraft: And she tried everything — doggie acupuncture, doggie chiropractor, doggie physical therapy, doggy supplements — and nothing was making Harley walk.
Finally, the vet said, “Why don't we laser Harley?” And after a few treatments of laser, Harley began walking again. I saw this with my own eyes. And even though I saw Harley going from a baby carriage — being carried around — to walking again — not running, but walking — I was very impressed.
But I'm a cat person, not a dog person. So I thought, it’s just the dog. And then a former patient of mine came to visit my wife; she’s actually my wife's friend, and her back went out. I had been treating her in the past when I was doing injections as an anesthesiologist, and like so many people, she did not get substantial relief from anything. Her back went out when she was visiting. And my wife said, “Why don't we have the vet laser you?” And the vet lasered her and she got more substantial pain relief than I had ever been able to get [her]. And so I felt if the laser had helped her, there might be some potential. At that point, I started researching the laser.
There were very few controlled trials. But the science, the basic biology published papers were very strong; and it made sense, and the pain treatments weren't few and far between that actually worked.
So I decided to go out on a limb, and actually bought a laser and I sublet a very small office so that my potential downside was very low. But I felt as though I couldn't hang a shingle unless I knew it worked. And I still was not convinced that this device was going to work. Fortunately at that very moment, I had hip pain. I had hip bursitis myself that was increasing …
Lauren: You say ‘fortunate’!
Dr. Kraft: Yes, it was very fortunate that I had substantial pain. It was so substantial that I was going to go see a doctor myself. And for one physician to see another physician is a very high bar! And so I started lasering myself — and in fact, nothing happened. And so my immediate response was that I had just blown $50,000, and that I knew this thing was a scam. Then I realized that the manufacturer kept saying there are no side effects. So I thought, if there are no side effects, why don't I just increase the dose? And so just empirically, I raised the dose by about five times what they recommended.
And within a few treatments, my pain started disappearing — which I initially attributed to placebo effect. But after a while, my pain completely disappeared, and I increased my activity — and actually the pain’s now been gone close to five years. And at that point, I felt it was potential enough that I could start treating friends and family — and three out of five of those got better. I didn't realize, as I do know, that that's sort of the rule of the laser at my dose.
And then I hung my shingle, and started getting people who were desperate for treatment, and found a few of those people who were sort of home runs — people like yourself who get better, just amazing responders.
Lauren: I think I was only two treatments, something like that.
Dr.Kraft: Yes, if you're high responder, it's an amazing device.
Lauren: It's incredible. And I love that you were using yourself as a test subject first. It shows your faith in the science of it as well, doesn't it?
Dr.Kraft: Well, at first I had no faith! But I could not possibly treat patients in something where I had any skepticism whatsoever.
Lauren: Sure. I think that's a really fair assessment. And so we've touched on the PTSD results; we've talked about the pain side of it. But I'd love to know more about what you're seeing with PTSD and traumatic brain injury, and from what I understand, also CRPS, right?
Dr. Kraft: Yes, CRPS I’ll cover first. That’s actually a slightly different topic. CRPS stands for Complex Regional Pain Syndrome. I put it in the bucket of both pain and neuropathy; it’s really a type of neuropathy. And there are people who have Complex Regional Pain Syndrome— and you may be aware of this — they rate this as the highest, worst pain in the world.
Lauren: I only actually learned that based on the information you had sent me about your practice. They call it “suicide syndrome”, don’t they?
Dr. Kraft: It's a very unpleasant condition to have. There are no good treatments. There’s something called the Cochrane Review, which is often referred to as sort of the gold standard in research; it reviews all kinds of published papers and they rate efficacy. And if you look up the Cochrane Review of CRPS, the conclusion is there's absolutely no treatment that we can say is the standard. Everybody has their favorite treatment. And when I first read these articles … my favorite treatment is something called astellate ganglion block… I was surprised to learn this was not everybody's favorite treatment. Everybody else has a favorite treatment. And two or three years ago, I had a patient who came in with substantial CRPS — a very young man, around [his] early 30s. He'd had multiple surgeries and he basically could not hold a job. He was in constant pain, on extremely high-dose narcotics and other sedatives, just to function. To your point – he was, in a sense, invisible. He didn't use crutches, but he was completely incapacitated. And really on a lark, he ended up in my office.
I told him, nobody ever treated CRPS [with laser], but we could try. And so I tried a combination of techniques— the local pain, plus the neuropathic pain. And by happenstance, he was a member of a family that is an extremely high responder, probably the top five or 10%. I didn't know that at the time. And he had tremendous relief. After a number of treatments, he became completely pain-free, back to work, on zero opiates. So sort of a triple winner.
And I subsequently have lasered both of his parents. He was actually the first patient where I had a suspicion that family genetics was involved. His mother was also an extremely high responder, and his father was a zero responder.
Lauren: Oh, interesting. So it really goes to show that your theory may indeed be true!
Dr. Kraft: Yes, that was the first hint.
For CRPS, it can be but I wouldn't say that it's the gold standard. For PTSD and TBI (traumatic brain injury), I believe that high-dose laser will in a few years become the gold standard for treatment. It is truly amazing.
There was a series of 10 case reports published about two-and-a-half years ago out of Denver; a chiropractor and, I believe, a child psychologist got together and had the chutzpah to laser 10 patients with PTSD and TBI. They published in a peer review journal, and had amazing results. All 10 got somewhat better. The results varied from roughly 30-60% … for instance, decrease in depression. They didn't grade the PTSD symptoms, but they did report that all 10 had their nightmares and sleep disturbances cured, which is the main common component of PTSD. And for people who are not familiar with PTSD, this is not just a single nightmare. This is usually three nightmares, five nightmares, sometimes 20 nightmares a week.
Lauren: And we should probably pause to quickly say, for those who are listening and aren't familiar with PTSD, it’s Post Traumatic Stress Disorder. And there are lots of people who suffer it for varying reasons.
Dr. Kraft: Correct.
So my estimates, or the published estimates, are a million veterans/wounded warriors have PTSD, and 5 million civilians — just in this country. And the most common cause of civilian PTSD are female victims or survivors of sexual trauma.
So I thought this study looked very interesting. Nothing has that kind of response rate for such a horrible condition. And so I really wanted to both try it myself … and at the same time, because of my engineering background, when I ran their numbers it looked like the doses they were using … and also based on my experience, I'm using the highest doses in the country for pain and neuropathy … were probably on the low side, and they spread the treatment out over eight weeks. And I thought, if I had a condition like PTSD, I really wouldn't want to wait eight weeks to recover.
So for the past year, a little more than a year, I've been treating a few people — about 12 people — in my office with PTSD and/or TBI. And the results have been nothing short of stunning. These results have not been published. But my first patient, actually, is a female — not a victim of sexual trauma — and she had a 95% reduction in PTSD symptoms, including sleep and depression. And it's lasted one year, actually more than a year, at that exact level. And she said, I think I'm actually better off now than I was before the traumatic brain injury.
Ten of the 12 people have been adults.
They all responded, varying from 30 to really 100% reduction in depression. All of them had improvements in sleep disturbance and nightmares, often within three or four treatments.
Lauren: Now, in terms of the genetic link here that we're seeing through the maternal side, is there a way to, or do you think in the future that studies will be developed, to measure a person's receptivity?
Dr. Kraft: Yes, all I need is a research partner who's a geneticist for them to apply for funding. So I now have,I think, about 15 families where I've treated at least two people and in some cases, three or four members — all of whom have shown very high responses. And so what we do is a fairly simple study … you get a couple of dozen people, which I could easily produce, who I believe are high-responders, and you do some genetic testing. And then the geneticist looks for which gene is which, and then you see if you can replicate that in the future. I actually have enough patients now, where somebody with a genetics background could, I believe, easily do that study.
Lauren: So, in terms of the treatment for PTSD as well, is there a potential for it, in the future, to be something that the VA is offering, or that counselors could offer?
Dr. Kraft: The reason I really got excited about the PTSD treatment with laser is that my software background is in scalable software.
And I believe that one of the failures of modern medicine — and PTSD is a perfect example of that — is that people often ask the question: What's the best treatment for this? When the real question is: What is the best treatment that we can scale? — if it's a widespread problem. Drug companies ask that question, and that's why drug companies make a lot of money. But physicians rarely ask that question. And if you look at the common treatment for PTSD, which is CBD (cognitive behavioral therapy) … that is not a scalable treatment.
You just can't have trained psychologists and psychiatrists going out into the field and spreading out and taking 20, 40, 60, 100 hours to treat somebody. The laser could theoretically be scaled down and be made smart; I’m actually working on this and looking for investors to help to make it a smart laser and a safer laser. The lasers today are safe in the hands of a physician, but not necessarily in the hands of a medic.
And our goal is actually to make a PTSD/TBI treatment that one could take into the field, one can take into the outskirts of Bakersfield … and basically have a truck drive around without a physician in it, with just a medic, and treat people who are dispersed throughout the country.
Lauren: A mobile clinic.
Dr. Kraft: A mobile clinic where you wouldn't need a physician. So there's tremendous potential; it just needs to be developed.
Lauren: And most of us are also finding out, and I’m wondering actually, with health insurance … that the treatments are covered as well, right? Because mine were, I know.
Dr. Kraft: For the PTSD, treatments are definitely off-label; they would not be covered by any insurance at this time.
Lauren: Wow, that's rough.
Dr. Kraft: The pain neuropathy treatments are sporadically covered. At my clinic, they are generally covered.
Lauren: I guess I was lucky!
Dr. Kraft: Yes, by most insurances, not all. By some local HMOs; not by many. And part of the reason is, there's just not enough research. In terms of the VA and PTSD, the Veterans Administration and the people who work in healthcare, generally speaking, they're all great people. But the system is flawed. And the VA is what I would consider a laggard organization. They're not going to be early adopters.
Lauren: And that's so much of what this is about, right. I mean, you were an early adopter because you saw the results in your wife's dog. And I guess this is also sort of a reading on our health care system in general, which I do want to ask you about. So I can segue into that now … I wonder about how this treatment is accepted generally, because it sounds to me like it's showing results. And there are studies. But that it's still generally regarded as kind of an experimental treatment. Would that be correct?
Dr. Kraft: Yes. It's currently off-label. We need to come up with a device, which we're working on. And then you go through a series of clinical trials — phase one, phase two, phase three — and often multiple phase two and phase threes. And publishing those studies in order to gradually convince the scientific community that it's better than average. The advantage of the laser in both pain and PTSD is that in the doses that we're using, the differences between existing treatments and high-dose laser are not small differences, they're quite large differences. So it's much easier to come up with an interesting study and interesting papers than if there are subtle differences.
Lauren: That’s a very fair point. So why don't you talk to us a bit about the US healthcare system? This might be a can of worms I'm opening here. But how do you see the system — particularly with regard to your practice — working for patients? And in what ways do you see it falling short and requiring improvement? And are there ways in which, aside from doing a mobile clinic and developing a laser that can be part of a mobile clinic situation, you would see applications of the laser in order to address those shortcomings?
Dr. Kraft: I think that the US healthcare system is just terribly flawed.
And that the introduction of third party payer health insurance companies, as they're widely known, has ended up as a bad experiment that we're sort of locked into. And the VA is an example of … if you will, a Medicare-for-all system if you're a veteran … that has ended up with an equally bad result. And I believe the problem in both cases stems from too much trust in physicians.
Lauren: And this is a physician telling us this …so that’s interesting!
Dr. Kraft: And physicians having too much trust in themselves and not enough emphasis on what today would be regarded as almost big data. So if we could roll the clock back and look at 100,000 veterans who get treatment X, somebody should look at that and go: ‘Treatment X is not effective, or not as effective as we’d like; we’re not getting our money's worth. Let's look at other things.’ The third party healthcare system insurance companies probably know what doesn't work and what physicians do or don't do to improve the status of their patients. But there are a ton of bureaucratic legal issues and medical issues that the country is not willing to own up to. So the health care system is broken. I don't believe that, necessarily, more money or more insurance is any more than another avenue to fail.
Lauren: How do you fix it, do you think?
Dr. Kraft: I believe that really, number one, people need to get educated that health insurance is not the same as health care.
And that health care is not the same as health prevention. In most cases, prevention or early treatment is much less costly and ends up with happier patients, than our current situation: which is focused on treating somebody who's already sick. And then you can't get treatment, even in the case of pain … everybody tends to go towards the high-price procedures, the epidural injections — when if you had a more effective treatment, in this case laser, it could treat people at substantially reduced costs.
For instance, one of the local HMOs sends me a substantial number of their pain patients way before they go to an interventional pain doctor. And even though the laser often requires — not in your case — but often requires five, 10, 20, 30 treatments, their cost is between 30 and 50% less than sending them to an interventional pain specialist.
Lauren: So it’s also a cost-effective treatment.
Dr. Kraft: So it's extremely cost-effective. The laser could eventually, I believe, play a very large role in pain treatment. And actually a practice with sort of an integrated approach — which I do not have in my office — but an integrated approach of practice of laser plus prevention would really be the most cost-effective way to go. And I think in the future as the country and healthcare providers focus on results, and not on the rule of what we did in the past must be okay because it didn't hurt anybody, I think that the power of the laser to treat people — both for pain (neuropathy) and PTSD — it will really shine.
Lauren: Now, this question is kind of out there. But, since you're having such success treating PTSD and traumatic brain injury, is there any potential to also treat depression as a generalized diagnosis?
Dr. Kraft: I'm certainly not a depression expert, but there are three types of depression. One is situational depression — something bad happens to you and you get depressed. And for those types of depressions, I'm guessing laser is not the answer. Probably standard talk therapy or even short-term drugsmay be the most beneficial way to approach those situations, where with enough of a little help from your friends — whether the friend is a person or a pill — may be all that's required. There are various types of chronic depression and major depression, where those people are refractive or just can't get out of their depression, no matter how much therapy they have, no matter how much talk … basically pills or people they talk to. And those are cases where, absolutely … if the laser works in PTSD, depression is a huge component of PTSD. I think it will be equally effective from what we're seeing in most types of depression. Not all. Major depression.
Lauren: But the potential is huge.
Dr. Kraft: Yes, absolutely, that's the case. And then the third type of depression is the depression that's associated with other illnesses. So that could be PTSD, Alzheimer’s, all kinds of other illnesses or even depression associated with traumatic brain injury.
And for that, the laser, to the extent it can help the original injury, for sure it could tremendously help depression.
Lauren: One of the things that those of us in the invisible illness community often come across is that we're shuttled between specialists a lot. Someone doesn't have the answer or thinks they have the answer. And it's not the answer. How do you address that when patients come to you? You're so sweet, and everyone who assists you is so sweet. Do you find that a lot of the patients coming to you are really just needing a home base, or needing someone to really just make them feel like everything's okay?
Dr. Kraft: They may be, but I don't play that role. As I tell my patients, I am not Mr. Holistic. And I'd say if anything, the deficits in my practice are the … so to speak … the “laser focus” that I have on treatment.
I honestly believe that a future laser that I'm creating will end up in many, many primary care practices. I would love to see it in every primary care practice. And a lot of the reason that today patients end up going to multiple specialists, without the answers, is that not only don't most specialists have the answer, they also don't have the treatment. And the laser is such a potent treatment.
I liken it to three tiers of treatment. At the baseline, you have, “Take two aspirin and call me in the morning.” Which today is, “Take two ibuprofen.” And that's treatment that has such a low cost and a low index of side effects that literally you can get it from a doctor on the street. It’s surprising how often that will fix the problem. You might end up going to your doctor for that; they might reassure you, your primary care doc, and then today if you fail that, then you go on to sort of the maze of specialists who have their own version of what to do. They spend a tremendous amount of time and money diagnosing you, but without hugely effective treatments. But it would be the first pit stop. And if this were in every primary care doctor’s office, they could say, “Lauren, I'm not sure what's ailing you. But we're going to try this laser, because the side effects are close to zero. There's a 40 or 50% chance it may help, and you'll never need to go see another doctor. And the beauty is that it's not a Band-Aid. We don't even have to bother testing you, which is a humongous expense. It is so simple to receive that we don't have to test you. We’re just going to try it. And it costs less than a simple blood test in most cases, or an inexpensive blood test, say, for thyroid. And if it works, that's great. If it doesn't work, we'll proceed with the old-fashioned plan.”
Lauren: So how do you think we keep this dialogue open so that people are receptive to the idea of hot laser — not only within the healthcare system, but [also] outside of it as potential patients, and how that ties into the invisible community? How do you think we keep awareness about these potential treatment options? Do we just have to keep talking about it and telling everyone?
Dr. Kraft: Well, I think there's a three-fork approach. One fork is that patients themselves, as they become aware of the potential of the hot laser, need to push their healthcare provider and more often their healthcare insurer, to pay for this kind of treatment. That happens very rarely today. And the second fork is that there needs to be more research published. And then the third is programs like yours.
Lauren: Well, I hope I'm helping in some way! We've covered so much today, and I'm so excited for people to hear about this because I had no idea about hot laser a year ago and it changed the game for me. So I'm really hoping that people listening in will make the trip to LA and come and see you!
Dr. Kraft: Thank you!
Lauren: I like to tie up the episode with a top three list. I'm wondering if you have top three tips that you would offer to a patient who suspects that they may have something invisible going on. What would you suggest that they do, in your opinion as a practitioner, as a caregiver?
Dr. Kraft: The first tip would be: Don’t give up. If you feel like you have a problem, if you feel like you have pain in particular, then you probably do. As they say, all pain is in the head. And you must respect that. The second tip is to definitely explore. And sometimes you have to push your primary care doc to get you to see other specialists. And even though I'm not necessarily a fan of getting all kinds of tests and specialists, unless you have access to a hot laser, that is the second best option. There are medications and ways to understand and treat problems that are often available and people just don't push enough to get those discovered. And the third tip I would give, which is probably the easiest and most direct, and which very few patients follow … is to keep a journal. Whether it's pain, or if you're feeling shaky, or if you have a thyroid problem and whether you're feeling hot or cold, or any kind of symptom, most physicians are data-driven. And the moment that you open up your notebook — and you've got to keep it short and simple, not pages and pages— but you've got to say, “Look, on this day, here's my temperature graph. Here's my pain graph.” You don't have to graph it. But have a little table that's concise.
Lauren: Like on a scale of one to 10, for example.
Dr. Kraft: Yes. And I think that would help many patients automatically be treated as non-hypochondriac.
Lauren: Because you're speaking the physician’s language.
Dr. Kraft: You're speaking the physician’s language … and frankly, there are hypochondriacs out there, and it makes it easier for the physician to see if you are a hypochondriac! So from our perspective, it would be great! But to notice patterns. The simple one in pain management is, if every time you sit down you notice that your pain goes way off scale and your leg goes numb … that’s a pattern. If you see that the pain only occurs at night, that's a pattern. If you see that your temperature only goes up on, let’s say the first, second and third days of every month, maybe it's related to pay day and you drank too much over the weekend! Whatever the case may be, patterns and data are key.
And not making it flowery and long, but just keeping a journal helps you focus on what's important. And it will help somebody else see the patterns and may help them believe that it's real.
Lauren: That's a really great tip. Is there anything else that you'd like to add, to tell us about your practice … or where can people find you?
Dr. Kraft: Well, we have two offices in Los Angeles, one in Santa Monica and one in Manhattan Beach. They can always go on LaserMDPainRelief.com, and just look us up and make an appointment. If you don't have insurance, the consultation is free just to come in and talk. And for people who are not from Los Angeles, if you call the office we can usually arrange a phone consult to determine if it's worth coming out here.
Lauren: You're really accommodating people's needs, which is wonderful to hear from a physician. Dr. Kraft, I cannot thank you enough for being on the show today. I really hope that people will listen and you'll get a geneticist out of this, or more research funding because I really see fantastic potential in what you're doing, and I commend you for testing yourself and going for it. So thanks so much for being with us today. And we hope to talk to you again soon.
Dr. Kraft: Thank you very much, Lauren.