The Vagus Nerve and Chronic Pain: Can Neuromodulation Help Regulate the Nervous System? | Jon Hacker

0:00Pain is a function of your nervous system sending signals to your brain that will then interpret as, hey, there's something wrong in the sector, right? To be clear, they get sterven pain, not the same thing. If you're that person out there that's been dealing with pain for years, you've already had so many people tell you that, and it just be absolute BS because your body can't prioritize, or rather, it seems to be the case that it does not prioritize healing when it's focused on survival. If a bear is about to eat you, you're not going to be prioritized, you're healing over five months if you're going to die in five minutes. Welcome to Beyond the Pain, the podcast that explores what it really takes to break free from chronic pain and reclaim your life. I'm your host, Lee Branden, and someone who spent over two decades helping people get to the root cause of pain that no one else could explain. Whether you're dealing with long-term back issues, joint pain, nerve discomfort, or mysterious symptoms that just won't go away, this show is here to help you go deeper,

1:06because beyond the pain, there's clarity, strength, and power waiting for you. Each week will uncover the physical, emotional, biochemical, and energetic causes of pain and how to transform them. Let's dive deep into this week's episode. Persistent pain is closely connected to the way our nervous system interprets threat, safety, and information coming from both inside and outside the body. And one part of that system that's received enormous attention in recent years is the vagus nerve. But beyond breathing exercises, cold exposure, and other techniques commonly associated with vagal regulation, could technology actually be used to directly influence the vagus nerve and potentially change pain? Well, my guest today, John Hacker, is a biomedical engineer and founder

2:07of StarSplit, whose own experience of OCD and feeling unable to control his nervous system led him into the world of neuro-modulation. John and his team initially explored direct brain stimulation before turning their attention towards the vagus nerve and eventually pioneering the use of ultrasound as a potential method for non-invasive neuro-modulation. But our conversation goes much further than technology. We also explore how nervous system dysregulation may contribute to persistent pain, why the quality of medical research can vary enormously, and how funding initiatives and poor study design can influence the evidence that eventually reaches both practitioners and patients. So, can changing activity within a nervous system help us change pain? And could emerging technologies such as ultrasound, neuro-modulation

3:10eventually become another tool for helping people with persistent symptoms? That's what we're exploring today on Beyond the Pain. John, welcome to Beyond the Pain, great to have you on the show. Great to be here. Appreciate you bringing me on. I'm a pleasure. I'm looking forward to it. So, John, before we dive into the deep depths of the subject we're going to talk about today, could you share a little bit about your own journey, maybe your academic background, and also kind of what led you to focus on the vagus nerve and its potential role in chronic pain? So, I'll do a long story short. You can do a short story long if you want. Okay, I appreciate the permission there. Biomedical engineering by training. I actually went to the Rochester Institute of Technology, and a lot of my childhood was dealing with OCD. That was one of the things that pushed me to build the technology in this direction and start this company.

4:11Brought in some really cool co-founders that know even more, I would say a lot more than I do, trying to surround myself with people that are a lot smarter than me. And over time, we've pivoted quite a bit. We actually started with trying to do direct brain stimulation to help with that, but realized that there's this nerve that can actually have just as much potential as direct brainstem and is a lot easier to access and can be utilized immediately. And that was the vagus nerve. And I got to be frank with you, when we got started on this, ultrasound was still a young feel for neuromodulation. We were actually ones that piloted it in humans and we actually did our pilot study around that. And prior to that point, it was all about zapping. Zapping the nerve with electricity, and we were like, hey, that doesn't sound very pleasant. Let's see what we can do with some ultrasound. So that is the short story. I mean, I can dive into any piece of that that you'd like my man. Cool. So you got two degrees, right? Yes. Oh, yeah. The other one is my co-founder

5:17always calls it the fake degree because it's neuro-onchvernurorship. It's an individualized degree. I took a bunch of grad courses from University of Rochester on neuroscience. And at the same time, took some entrepreneurial courses as well. And that was actually something that helped build the foundations. I went to college to build this company, which is there's always this myth around the founder dropout, right? Like when you're in college, you go drop out of college to build the company. I did not do that. I went to college to build the company and got the nest in especially in like Medtech and NeuroTech. I think it's critical to get some sort of background in the technology. So you have I'm not understanding if someone's completely bullshitting you directly, which there's not an insignificant amount of that even in the Direct Biomedical Engineering field. There's a lot of people that are just not really treating the data properly, doing accurate methods, doing inaccurate analysis. It's all over the place. And realistically, it's a real shame

6:17that we don't have a little bit more standardization when it comes to the analytical process. We'll say at least a little bit more oversight on some of the studies being published because a lot of the studies that are out there, especially in NeuroMontulation, are worth nothing. Their methods are not done properly. How the data is analyzed is not run properly. And it's incredibly difficult to tell that from an outside perspective, like almost impossible for someone off the street that doesn't have that background to say, Oh, this news article about wine that's going to make me live 30 years longer. This isn't really that hot of a take. Those studies are often very much not done to rigorous standards. And it's usually a survey study on the population. And that's ever kind of knows that that's not real for that piece of it. But when you get into the Direct Actual Medical Research, there's a lot of stuff that looks real and really isn't. And then there's people that don't even do that much effort. Like it's it is a it's a lovely industry.

7:22Yeah, I remember some years ago, a former editor of one of the medical journals said that I think it's 97% of medical papers aren't worth the paper that they're written on. Yeah. And that data is really a big political problem. So the problem is is that it is primarily industry run. I say that's a problem. The industry run trials are usually the ones that are better conducted than the academic ones. Sorry, academia. I have a lot of friends in academia. I respect the intention behind it. But a lot of the studies that are done are done to grants. It's how we fund the system. Basically, what we do is we take people and we say go do 20 years of training through college. We build up these very smart people now to do research. And then we say, okay, now we want you to play sales game. You need to go get a grant. And if you don't write exactly that grant criteria that someone that doesn't understand the field whatsoever has written and put into a political bill because they're playing tower games, we're not going to fund

8:26your research. Yeah. And so then they have the question of going to industry where they are inherently biased. Industry is inherently biased. They want their things that they're selling to work and to look good. I am biased as well. I am part of industry. I will admit that up front. Or alternatively go into the system where you can't do real research without basically spending decades to get the basic stuff done. Getting enough cred street cred behind you that you can have some involvement in the writing process for how these grants are defined. And then you can do something. But even then you're going to spend the vast majority of your time managing grant flows rather than doing actual research work. And so it really becomes a catch 22. And it's part of the reason why in my opinion our speed of medical progress has slowed significantly over time. And I'm sure people could pull facts supporting that or counterfact to that incredibly simply. But it's simply an observation from talking to people in academia and talking to people

9:28in industry, especially in the neuromodulation neurotox base, there's these artificial barriers that make no sense. And it's preventing real therapeutics that can help people from getting out there. And it's a shame. There was a really good book that came out a few years ago. It was called The Real Anti-Fouchy by Robert F. Kennedy Jr. And he explained really clearly how their medical grant system works in the US. And you know, for anyone that has faith in your medical research, that faith will be blown right out of the walls if they actually understood how those grants are given out. And like you said, it's very very political. It's the same thing with a lot of, you know, the government grant opportunities that have previously existed as well. I mean, when you take a look at how they're awarded and also how they're built out, it's mostly who do you know gain? Which if you talk to anyone that's in the guv contracting space, it is, yeah, do you know the right people? Do you know the right generals? Do you know the right people in charge of the contracts? You need to talk with them. You need to understand that you have something

10:31there. And that just stinks of corruption to me. Like to be honest with you, this entire industry seems highly corrupt and how the sciences are initially funded, which is going to then corrupt every result that you bring from that. And on the other side, industry has an existing corruption. It's the whole in that corruption. Corruption is the bias the industry has, which they want to sell a product. Okay, we know that factor. When you take a look at academia and the nonprofit space to an extent, and we take a look at how these are built, there is this almost hidden. The whole point of this sector is to help balance this sector and like check the BS of this sector, and it's doing it incredibly poorly. And so you end up having large industries, they'll build products that I'm not going to name products here. I'm sure the law firm listeners already have a familiarization with it that really don't work. Have a high moderate to high risk and then sell those products over and over and over and over again, and then become an establishment. And then that establishment has enough money to lobby to keep this engine from working properly.

11:32And then that's a, I'll call it a anti-virtuous cycle. There might be a better word for that. Maybe you know one there. Well, you might be thinking of something within mind control circles. They use a lot of three word phrases. And one that we heard a lot in recent years was followed by science. Right. I mean, that is the opposite of science, by the way. Like scientific method is questioning the hypothesis. If you want to prove something without doubt, what you do is you make a hypothesis that you potentially like, right? And then you spend your whole time trying to disprove it in every way or you make it hot hypothesis that you just like and you try to disprove it. Either way, you have a core statement and you're trying to disprove in every way possible. And if you can't, then that is baby true. It's still not 100% true.

12:32That might eventually become a theory. Maybe not always. I mean, at the end of the day, most science research should just come up with more questions to answer really. Rather than this is the way on that set and you can't question it. The whole point, like if the thing is the crazy thing is if you actually talk to any academic or any researcher directly, also potentially offer a courted line, depending on who you're talking with, they will say that. They will say almost 100% that number one, the goal of science is to disprove ourselves and to build a fundamental stack of these things are probably right. Or some sort of paraphrasing of that, right? It's going to be some sort of refrain of that because that is actually what the scientific method is. You set a hypothesis, you try to just prove that hypothesis. But just using science as a cudgel, in any case, is the exact opposite of what its intention is to be incredibly clear. Not saying that our current scientific institutions

13:33are working. The whole point of what you're talking about previously is the entire unbiased engine is broken, terribly broken. So the only research that is coming out is highly biased towards industry favorable research. And an industry-funded research is the main research that's gained published, not to mention the publishing bias. Oh gosh, that's its own piece, too. You can have, I'm just going to make a top-in example here. You could have a drug, right? Let's say the drug goes through 50 studies. 49 are no results. One is a positive result. A journal likes publishing positive results. They don't like publishing no results. And no one forces for, depending on the study, there's no clinical trial register that's forced for publication on those study results. So no one has to publish those study results. And so even if it only works one out of 50 times, you only see that one out of 50 times data, which completely destroys it completely biases statistics. And it's the no problem. Because if it doesn't work, if it's not an interesting result,

14:38because publications or some publications are still publications, they want views, they want people to cite it, they want people to get excited about it. And the thing is saying that this thing doesn't, that we didn't see anything, there's no result. We'd answer a question. It's not interesting. So that data isn't published and it doesn't get catalogued. It doesn't get collected. And the fact of the matter is, is that data is part of the pool of understanding reality. And it's slowing things down immensely that we don't have it. The fact that we can all have this copy trail citation pattern, when it, for example, the M.Y. plaque hypothesis, the fact that we all had a copy trail, no one checked the original work for years, for decades, billions of dollars down the drain on a hypothesis that was falsified. That whole point of science is a question that initial hypothesis and try to backcheck it. And that's what the nonprofit governmental academic engine is supposed to do. And it's not. Industry is doing exactly what it is. I will say supposed, it's doing what it's going to do,

15:40which is release results that support a product line that they're trying to sell. Yeah. Is academia's job to say, hey, wait a moment. That product line, let's test that. Oh, wow, that's interesting. That didn't do anything that you said. I wonder if there's other trials that you're not publishing right now. Interesting. And so it becomes problematic entirely to, and it creates distrust for the community in large for good reason, because the fact matters is we're not getting full picture because of this engine not working because of this engine not working. And it's highly problematic. Just just getting back to your company. Yeah. Talking about companies. What was your motivation for Starstuff? How did you get to that point? Nervous system control. I felt absolutely out of control of my nervous system realistically, right? In a way that made life not worth living free in a lot of ways. For from like around,

16:40let's say 1112 all the way up to around 20 realistically, that was the worst of it. Even while I was building this company, it was still a big problem for me. And it struck me as weird that we don't have control of our nervous systems. It feels like something that should be a human right to be able to control your own nervous system. Everyone else is trying to control your nervous system. Why can't we control our own? And so I was like, hmm, okay, maybe we can do something to help with that. At least that's been the underlying core of a lot of this. And I've told this story a number of different ways previously, but that's been the core of it. And that's our mission is nervous system control and giving that back to people. I played around with using agency there. It just doesn't have as much zest to it. Yeah. So obviously what we're going to be talking about a lot to those the Vegas nerve. Yeah. In particular, obviously there might be someone watching or listening

17:41to this and not familiar with the Vegas nerve. Can you just explain what the Vegas nerve is for someone that perhaps doesn't know what that is? For sure. So it's one of your information pathways. I'll start from a top level. Your nervous system is basically your fast communication system. Right. When you're body needs something done now, it'll send information along your nervous system or up to your brain. Pain is a function of your nervous system sending signals to your brain that'll then interpret as, hey, there's something wrong in the sector. Right. To be clear, Vegas nerve and pain, not the same thing, but the nervous system is correlated. And in the particular case of the Vegas nerve, it's this information super highway that's connecting you were gut, it's connecting your heart and all of your steady state. So the things that keep you alive on a daily basis, the things you're not thinking about systems. Otherwise known as your 10th cranial nerve. Now there is a lot of research around the Vegas nerve because it's one of those nerves that's a little bit easier to stimulate very frankly, both non-invasively and invasively. We've

18:45had some really cool technology come out. There is there are a couple devices such as the more recently this up point device that are even taking a look at immune connection. But to be incredibly clear, the company that I'm the founder of the company that we run is an ultrasound Vegas nerve simulator. That is a, we piloted that very clearly in humans. And we, there's now research that's being compiled around that and that's been growing and growing and growing over time. But the difference is is, stimulators at this point were either implanted or they shocked you. Now we can do something. We can actually activate that nerve with ultrasound without shocking you or having to put you through a surgery. And that can be very beneficial in a number of ways. At least we've seen primarily what we focused on is stress. It'd be very clear. Now the decor technology here will eventually have applications beyond this. The entire industry for neurotech is I think incredibly well positioned to make a difference and a lot of indications that have been previously under treated in traditional healthcare. Mostly because the options were available.

19:51But they're becoming available. But also to be incredibly clear, we haven't run our RCTs with pain yet. That's not something we've done with the Zenbud device. We have RCTs and ongoing research around the number of other applications. I'm sure you might have a short version of volunteers. Yeah, it's on the pipeline. And because nervous system problems haven't had real solutions for a while now. I mean, go ahead. Yeah. So for someone tuning into this, this is suffering with persistent pain. Yeah. Why would the vagus nerve or what role would the vagus nerve play when it comes to persistent pain? So I'm going to do something here. I'm going to say first off, I'm not going to be as you hear. We don't have that RCT. I would say as an industry, I am not incredibly compelled by the vagus nerve research with pain. There are better targets out there. What the vagus nerve does is it gets your body into a feeling a little

20:54bit safer and you, you being less stressed, which stressing itself has been there is a correlation there. But until we run that study ourselves, I'm not going to claim that it can cure, treat, or prevent your pain. You have so many people already, if you're that person out there that's been dealing with pain for years, you've already had so many people tell you that and it just be absolute BS. So I'm not going to. What I am going to say is, hey, we built something that gives a little bit of control over nervous system on that vagus nerve. Do your own research with that. Check me here, please. I think that's important. Yeah, I think, you know, without any direct research, what I can say, you know, looking at the pain neuroscience is that, you know, stress, fear, any kind of sympathetic nervous system stimulation, even the, you know, a fear of movement

21:54thinking that that's going to cause pain often keeps some people in persistent pain. And I guess let's just say the theory is that if you stimulate the vagal nerve, what you're going to do is potentially push the body more power sympathetic, and you're going to calm the system down. And again, from a pain neuroscience point of view, the more calm someone is, the more safe they feel, the less likely they're going to experience pain. So you can say that correlation, I would say the big thing when it comes to the vagus nerve is it is one of those systems, those two states, which you have a fight or flight state, which is part of your autonomic system, which is your body ready to deal with a threat in your environment and pain can trigger a sympathetic state that is well validated. And then you have a rest and digest or steady state system, which is what the vagus nerve is primarily responsible for.

22:57And it's decently well validated that activating your vagus nerve can activate the parasympathetic state and doing that consistently can keep you there. And the fact of the matter is there are consequences to being costly in a sympathetic state. And if your chronic pain is driving you there, then maybe there's something there that you need to take a look at. Being in a constant sympathetic, chronic stress state sucks. That's where I was. That's where I'm sure some of your viewers are now. And your listeners are today because it makes everything start to grow worse and worse and worse. Things start to look like they're 10 times bigger of a deal than they are. Like I back in the time when I was dealing with OCD, I would notice that I was starting to lash out my family in ways that I didn't like. Right? Not even intentionally, but I started because everything had become so bad. Small things became a problem, even when they weren't meant to be and didn't need to be. And on that, that's something that I just isn't about to help me with some of that,

24:02to be honest with you. But that doesn't mean that we've run those RCTs. And in a world with such polluted data, I don't want to be yet another voice telling people to do things that haven't been properly validated. Though to be clear with you, I'm starting to question whether anything is properly validated in the start industry. The more I spend time here, the more I look at things, the more that the base fundamental data that our scientific communities built on is flawed. And there's only a few things that have been properly actually validated. A lot of things have been grandfathered in that had to not pass muster in today's regulatory environment. Even with the shifts in today's regulatory environment to be clear, which has gone a lot easier to get things passed now. But even with that, a lot of things that are standard of care would not pass. And the fact that we've had incidents like the opioid fricking over prescription for years shows that the system is broken. So I'm not going to say to you that this is going to treat chronic ring. It does. Yeah. It just doesn't. But I will say this, the options out there, I'm not

25:05compelled by very frankly. And I will also say this, I think it's important for people to get back control of their nervous systems. And the Vegas nerve is one method of doing that. And I prefer using something that's an ultrasound headset. They work just like a headset personally versus having to use something that's shocking me. That's my personal opinion. But if you've been living with persistent pain and feel that nobody has helped you understand why it continues, my book Beyond the Pain was written just for you. It explores how physical, biochemical, neurological and emotional influences can combine to increase the load on your system. And why lasting recovery often requires looking beyond the painful area itself. Beyond the pain is available in paperback, Kindle and audiobook. You'll find the link in the episode description and show notes. Yeah, what I can say from my own clinical experience. I've been working with people in pain for 25 years. And there are multiple causes of persistent pain.

26:14You know, in my book that you can see over my shoulder there, you know, I talk about four different potential, four main causes. I'm sure there's more than what I've talked about in the book. And I do go into more detail in my master's thesis. But you know, I talk about the four main causes being structural, metabolic, nervous system regulation, which is kind of what we're talking about here. And emotions. And they all interact. But you can't separate them. You know, we are a multiple system of systems. And you can't separate them. They're all part of the same thing. And what I've experienced as my knowledge has grown over the years, because you know, 25 years ago, I was working almost entirely structurally. Pretty successfully. I have to say, but I guess over the years I've attracted different

27:19types of clients as my own education has increased. But in more recent years, working with people and not through any kind of physical stimulation, but working on their their nervous system regulation, using a number of different techniques, has been majorly successful helping people at least massively reduce their persistent pain. And basically get their life back. Some people going from bed ridden to be active for seven or eight hours a day. You know, so pretty massive transformation. Yeah. So, you know, from my own experience, being able to regulate the nervous system, I've seen I've seen real-world results now. You know, there's I haven't seen enough people to make that into a significant research study.

28:19Might not be a bad thing to do. I think that over time, it's decided up in a way. Get your clients and patients permission, obviously, have an informed consent. But if you have an informed consent, and you're willing to spend the coin and IRB, putting out real research on your methods that have been seeing these results, adds to the pool of knowledge. Not doing so allows the pool of knowledge to remain without those results. And until we have that, it becomes a whoever has enough money to put stuff in there, or has enough initiative or reason to. What I would say though, again, I think this is a weakness and science often is, science is often measuring one thing. Yeah, right. But when you're working with a multi-factor system like the human body mind system, it can be quite difficult to nail down. Okay, so, you know, well, people have stacks, right? Like, and people use multiple things at once. And the system is highly complicated. We understand very little by how the body works,

29:21or how the nervous system works. Realistically, we understand almost nothing. We're maybe like 0.1 on a scale of 0 to 100. 0.01, more knowledgeable than we were like 50 years ago. And there's a lot more to go. And I agree with you that science is one of the weaknesses of a lot of studies is that they are only focusing on single modality of therapeutics. There's a reason for that. And it comes down to the regulatory framework because the real research is coming out right now. The research is actually pushing the narratives and pushing things as usually industry based. Again, the nonprofit engines are broken. And until that's fixed, this is probably not going to shift. They can, it's very difficult to get stacks approved almost impossible. You get stacks approved through traditional medicine. And it's usually the medical companies that are actually publishing studies. Very rarely will a wellness company do the work and effort required to do that. Because frankly, they can sell without doing that. Medical companies can't. That's the only reason why they do this anyway. And so in this incentive scheme, it's going to be incredibly difficult to get

30:24people to do these stacks. But that's why it needs to be done. That's exactly why we need to be putting or lining the symptoms in another way so that it is done more often because you're correct that the body is incredibly complicated. And you're also correct that it's doing a one-size-fits-all approach is unlikely to do everything that's needed, especially when it comes to incredibly complicated syndromes like pain. Because pain is simply a report saying I am having a report from your body to your brain saying there's a problem. And that can be caused by so many different things. You have two people with identical pain systems and they have completely different causes. So how can you have a one-size-fits-all approach? Even if you get a full biomarker, say you aren't necessarily going to be able to figure out what the real cause is. And so you're correct. It is difficult. But I do think that there is validity in putting together the research and putting if you can in your own practice, putting together at least some sort of report on how people have

31:29been responding. Ideally, you'd be placebo-controlled randomized control trial, but I understand that that's a little bit difficult in a typical practice environment. And I'm not going to ask for miracles here. But just even playing together something simple will start contributing back to that forest of all knowledge. And I think that's important. Because right now there's only one perspective being told in that forest. And that's a perspective I would say really only one. And that's industry-pushing products. I wouldn't even say that the academia engine is not working as intended. There's some stuff that comes out of there, but it's way slower than it needs to be. And the government engine is honestly also not working as intended when it comes to this field. And when it comes to a lot of related fields, and perhaps in general, but this is not a politics podcast. So we won't give into that. Yeah, I mean, I have come across what I consider pretty good papers, paint papers, talking about, on neuroscience. I'm trying to remember how many

32:29references I used on a master's thesis, but probably getting on for a hundred. So there is some good science out there in terms of the nervous system and persistent pain anyway. Which I find really interesting. And as a fellow nerd, I'm sure. Which is why you understand. Oh, it's fast. There is good research out there. I mean, you always have to have to detect the methods because bad research will hide in good. And sometimes by prestigious universities on journals that really shouldn't. There is good research out there, but for the sort of inclinic use utilization, I have seen less of it, at least to say the least. Like the sort of what you do with your clients, right? I haven't seen a lot of that. I would love to see more of that in the first of all knowledge because that would give us a little bit more weight when we're talking about these things. And they would give the people and your listeners a little bit more. Crean's to be able to when someone says, Hey, there isn't a study on XYZ.

33:31You're like, well, there is this report. It's early. You got to qualify that unless you have a ton of cash to throw at this. But we're seeing progress. And that's the same approach that we took with Zenbud too. It's early. We put some studies out there. Some universities have actually some of the university systems working and this actually picked that up and their validating and verifying us on that saying, Hey, check our homework, please. And that's all you can really do, right? At least in the sage. Yeah. So where are you with your RCD? So at this point, I've had remission for most of my severe symptoms. Not saying that there aren't some phantoms every once in a while that come to plague me a little bit. But definitely out of the worst of it. I am not entirely sure what got me through everything except just focusing on the nervous system control part. To be honest with you, because they got really bad back when I was

34:34already get the age range. So I've gotten through the worst of it. And now it's really just by focusing on building this, I run it enough. There's a lot of money. Also building a stress tech company, one of the most stressful experiences of my life. More irony. You go to love it. Well, I always say to achieve anything amazing, you've got to go outside your comfort zone. Yeah, that's fair. I think that makes a lot of sense. Yeah. So again, for the audience, how can chronic stress and autonomic nervous system dysregulation keep someone trapped in a recurring cycle of pain, even when the original tissues have healed? So the autonomic nervous system, that's the system that's operating, whether you're thinking about it or not, like breathing, right? When you're not thinking about it, when you start thinking about it, suddenly, which I've made you think about it now, suddenly you start noticing

35:36it and you take more control over it. But your autonomic nervous system is regulating that. The part of the autonomic nervous system that's responsible for your survival response, otherwise known as your fight and flight response, is your sympathetic or fight or flight system, right? And what can happen in this, I'm not going to necessarily tie this to any particular cause, but what happens for a lot of people is they get put in this fight or flight state by either environmental cues, by something it's happening to them or by a threat. And when you're put in that state constantly and you never move out of it, your body's always prepared to fight something. And when you never have a time to recover and your body never has time to rebuild, it's becomes a little bit problematic because when you're in that fighter flight state all the time, your body's always going to be prioritizing that exact moment. It's not prioritizing a day, two days a week, a month a year. And that's why it can be really dangerous to be stuck in chronic stress, especially. And at least in my experience, I will say that when I've had a lot of problems with

36:44my back actually over time, I had a herniate disc and I'm sure it's and it still gives me problems to the state. Whenever I have that pain, it definitely puts me into a stress state. And being there all the time is problematic because your body can't prioritize. Or rather, it seems to be the case that it does not prioritize healing when it's focused on survival, which tracks from an evolutionary perspective. If a bear is about to eat you, you're not going to be prioritized. You're healing over five months if you're going to die in five minutes. And if your body's thinking you're going to die in five minutes all the time, that's going to compound over time. Because it's not going to be prioritizing digestion. It's not going to be prioritizing long-term muscle growth. It's not going to be prioritizing basically anything that is not relevant to a medial survival. That's why I like to say it. Because I think it's a good way to think about it. Yeah, yeah, I mean, it definitely has a big effect on healing. The other thing that's involved as well is so you've got no-seceptive pain. So for the audience, we have no-seceptors.

37:55Well, what sometimes is called danger receptors. All over our bodies. So if you put your hand on a hot stove, those no-seceptors will send the danger signal to your brain. Your brain will then send a signal back to the muscles to take your hand off. So it's giving you safe. So that's no-seceptive pain. It's got neuroplastic pain, which is normally damaged to a nerve directly. And I don't know if you experienced like sciatic pain when you had your bulging disc, but I've certainly experienced that. That's one example of neuroplastic pain. But then you also have, are you talking about mentally induced pain? Yes. Okay. Okay. I mean, you could call that psychiatric pain. I don't think that's the... Yeah. I don't know why I'm talking about it. There's a different name for it. I know what you're talking about. There is definitely different name for it, but mentally induced pain.

38:57There's also phantom pain from lost limbs, but that is a mix of no-seceptive and other responses. But anyways. Yeah. So just going back to that word, I can't remember. Okay. Been a long week. I'm sure we'll be called out in the comments. So what happens is when there's a perceived threat, but there's no actual threat there, and you're more likely to have a perceived threat when your sympathetic nervous system is activated, then because people think that pain means that there's tissue damage. But actually, there's not always the case. All it needs to be is a perception or the belief that there's going to be damage is enough to cause pain. Well, and when you're in that sympathetic state, you're more likely to have that kind of pain because your nervous system is more what we call sensitized. You know, I wonder if there's

39:58been any good research around the nocebo response and sympathetic drive. That would be incredibly fascinating because that would validate that hypothesis quite well. I believe there has been, I actually wouldn't have started on that, but I would need to go back and check my sources there. But yeah, no, no, no, she plastic. That's the one I was thinking of. No, she plastic. There we go. Okay. Love it. Love it. Okay. There we got there eventually. Yeah, no, it makes sense from a first principle perspective as well. Very frankly, if you think about the nervous system, if your brain is, if your brain thinks there's a threat around, it's prioritizing your attention to that threat, it's and you will actually have some immediate pain relief from a high sympathetic response, actually, because it is doling your senses with the adrenaline. But the problem is, is if you stay there all the time, it's, it's not going to necessarily maintain. And constantly adrenaline state is not a really good thing. I'm not sure where I'm really going with that. I

41:00got to be honest with you there. We've both had a long week, obviously. Yeah. Hopefully this is still someone interesting. Yeah. So moving on, people often advise to use things like breathing, could be meditation, could be cold exposure, or other, you know, vagus nerve exercises. What can these practices really simply achieve? And where do you think their limitations lie? If this conversation has encouraged you to think differently about your pain, but you're unsure how these ideas apply to your own situation, you can book a discovery call with me. Together, we'll explore the different factors that may be contributing to your pain, whether we are a good fit for each other, and identify the most appropriate next steps for you. Visit bodycheck.co.uk forward slash consultation, or follow the link in the episode description.

42:01So I'm not very compelled by a lot of the research that's been done on these practices, very frankly, because it's not been done in the sort of setting that I would be compelled by. There's there a few double blind RCTs done by third parties. A lot of the times the research being done by people that have a direct interest in selling a course or selling you something, which just always, it always decreases credibility in my headspace. That being said, I've done breathing exercises, I've done meditation, I've seen some personal benefits. So it's not, and I've done the cold plunge thing too, and it definitely feels you feel a little different. I'm just not really compelled by the long-term studies done there, and that doing it consistently is going to have a major result, because it just, yeah, it's really the biased sourcing. I will say this, there is some evidence that stressing your nervous system out in certain ways can train over time, just like how your lifting weights to build muscle. We always look at the Zenbud as adding some weights to the, getting you a weight set, as opposed to trying to push it from your own, because you could definitely

43:05train your sympathetic, parasynthetic nervous system without outside's tool support, as long as it's not to a place where you can no longer enter the state that you really want to train. But it's a lot easier when you have outside support. To be honest with you, and like I find a lot of benefit personally, and we have a lot of people that find a lot of benefit from having the Zenbud be that support. So the answer is you probably could do some training. I don't, and I'm not in love with the research that's been done on it. I have heard a lot of people, whenever I question people on these practices, they point to a spiritual principle, and they don't point to data, and that always gets me a little bit, spirituality is great. I'm a very spiritual person, but it's not data. What we need is a data set around this practice, and spirituality can be part of that, but we still need a data set. And if you can't point to that when I ask questions about it, it starts, it may make me question about the practice itself. Just to be very frank. Apart from a lack of research on that,

44:10is there any other weaknesses or limitations to the practice? I think practice is your way of. One of the big limitations is the time factor. From what I've seen, and I'm not saying that there's no research, there's plenty of institutes that have done meditation research, other sorts of research with EG and otherwise. It's just not the sort of research that has outcome orientation that I would be happy with in mind, and I'm sure someone will pull up a study that I just am not aware of. After this, 100%. So I do want to qualify that. Cusmentation especially has been one of those topics that people looking at for a very long time. But rather than experimentation, breathing exercises, or your lovely cold plunge, it is an animal effect that takes a very long time to be oriented, like potentially six months to two years to really do what it needs to do. Direct nursing relation can speed up those theoretically. And the time I said we've been looking at is between a week to four weeks, which is a lot faster. It's similar in the fact that it's kind of subtle on the effects that you notice at first. That's what we've noticed with actually a lot of the neuromod devices. If you're not

45:12shocking someone, you don't get the most subjective response from the immediate shocking sensation. You still, the effect is decently similar there. But anyways, it really is a timeline thing. Right? If you need it, it's just the same thing as lifting weights. If you do enough push-ups, you can get to a certain body type that you want to get to. If you're lifting weights, you can get there faster and easier. That's the whole point of technology is to remove the restrictions that are limiting us in shifting how we want to live our lives. At least that's where I think technology needs to be coming in. Okay, interesting. Which leads me very nicely onto my next question. Okay. So let's talk about the Zembud. If you could explain kind of what that is, how it's intended to work, the evidence that you have so far, and particularly, I know you said you've not done any research particularly on pain, but perhaps what you think might potentially be the benefit for people with pain. So running through it, Zembud is a

46:18decently-sumphled device all around. What it does is it's a pair of headphones that you wear like any other pair of headphones, but there's one big difference. While you're wearing them like headphones, these little blue pads right here and here are touching a part of your ear called the Zembud Concha region, which is the middle of your ear. If you're wearing it, don't think about it. It'll auto-locate if you think about it too much. You might actually push out a place. And in that region, it's innervated. All the innervated means is there. There's a nerve there called the Vegas nerve, like we've talked about previously. And so what we do is we shake that Vegas nerve with that ultrasound waves on a certain frequency and we cause it sensing those long-its pathway. Now, there is a ton of research on what that might look like in general. The stuff that we've researched with Zembud, there was a really interesting pilot that was open label very early to be clear with you. Though we published on a number of different mental health indications, Zembud's not approved to triodactose any of those, but we did publish that and that

47:19can be very simple to find if you look it up online. More recently, there's been a number of independent institutional publications, which I'd like to point to a little bit more, on how this Zembud actually interacts with that nerve and how this Zembud can be utilized in a number of different indications nervous system side. Some of those are from your university, not in him. Some of them are still coming out actually actively, but those are peer reviewed, blinded, and there's some that are double blinded in the works. They'll be publishing. And for audience, peer reviewed means someone else looked at it and said the methods were decent. Blinded simply means the participants there know, double blinded means participants and researchers didn't know. And RCT is a randomized control trial. That means that you randomized who's in which groups a double blind peer reviewed, double blinded RCT is the gold standard for research, because it means someone's checking the homework a couple times and you're removing the bias from the researchers and the participants, which is important. Now, there are people that have

48:20published studies around the vagus nerve in pain, but those are with electrical devices. And so they're not a direct analog. Now, projectively, they have the same mechanism as we do, because we're both targeting the vagus nerve and we have shown good, dagus nerve engagement at this point in time. And some of those studies are still releasing now. There's going to be some really exciting stuff over the next couple of weeks, which you can't really do with electrical devices, but don't worry about that one. What I can say is that there is that stress analog, which is interesting. And there are a lot of, there's a lot of talk around inflammation. There's a lot of talk around specifically with the set point medical device, which is an implanted vagus nerve simulator. But again, that's an implant. That's not the ZinBud. Like the reason why I really want to clarify this so much is I don't want this to devolve into ZinBud can treat all your problems and make them go away. That's not how it works. What it is is it stimulates a single nerve in the middle part of your ear and it does it while you wear it. You just, though extra subscription, no nonsense, you just

49:24put them on and you plug it into your favorite USB-C or use an adapter for lightning if you still have the old apples. And it works. And it does what it does. And it's subtle. It's not going to be over like massive. Oh, five second biggest change in the world. And it's not going to work for everyone either. In our studies that we've seen it's 86% of people are responders, 86 to 94, depending on indication space. That's not 100. Every prophet isn't 100 either. F.I. But you know, like most approaches aren't 100% but that's also why we implemented our 90 day return policy. Because we know that some people aren't going to see benefit. And so we want to have given the chance to send it back. Now to be clear, what we re research, it's five minutes a day daily for a month. So if you're sending back before you try that, then you don't really know if you respond or not. But that's why we gave people 90 days because you have 30 days. If they're off out of the country or they're doing vacation or something, 30 days to actually try it and 30 days

50:27to either continue or just in case. I could talk to more of the neuro mechanisms. I just, I'm concerned here a little bit. I don't want to claim that this is treating chronic pain because it's not what it's doing is it's helping regulate your nervous system, which can have implications there. But I'm just so tired of there's so many companies that are telling people that they're going to solve all their problems. It's so exhausting. That's not why anyone in this industry got into this industry. We got into this industry to actually help people with what we know. We didn't get in here just to sell people on random BS every day of the week. I can tell you what this does. You can try it. And if it helps, I am so glad. And if you give a testimonial on an indication, we cannot put it on our website. We've, please. But didn't be another person's health. Yeah. So what's the experience like? Was it when you put the headset on you've a lot of people aren't going to feel something immediately. You put the headset on you'll feel a little bit of pressure in the middle of your ears. I plug into my iPhone.

51:28Is it a vibration? You feel the vibration? You don't feel the direct, but it's ultrasound. It's actually very, very high frequencies from the blue pad. So you don't hear any sound. You're not going to hear any sound from it. That's one of the biggest user complains is there isn't our immediate feedback on electrical device. They shock you. So you can very much tell when it's on and off with the Zenbud, the biggest indicator is the light we have on the chest or which is on the Y connector or alternatively the pads heat up a little bit after the five-minute mark. Now we're seeing really great results with the consistent usage. And we have really good data validation, but that's still a user experience problem. No one likes saying is this working being so subtle. A codeplunge is a lot more, you know, to yet. But that's how the technology works. Technology is not meant like putting any indicator in that was a little bit more visceral is just going to be lying to people. Essentially, I'm not in love with that. And so five minutes a day.

52:34Can you be just doing everyday things or do you recommend people to sit down, lie down? First time of usage. Don't operate heavy equipment. There is a subsector of users that have been stuck in that sympathetic state for so long that this really conquers them out. It's not everyone, but it's a significant subset that you need to be using it outside of heavy equipment at least one time. Outside of that, usually in your daily. However, wherever it fits in, attach it to a habit you already have. Right? If you brush your teeth in the morning, slap it on them. Why not? If you're someone that gets sleepy with it, put it right before you go to bed. We've had a lot of users self-report around sleep. We're still, there's still some studies in the works around actually looking at that. It's wherever you can fit it in. Five minutes a day. Use them in a place where you usually use headphones. I'll usually use them on a podcast, but I already did my session this morning and I don't want to do another one right now. I'm going to do another one at the end of the day.

53:34But yeah, wherever you can fit them in. Is it something that people need to continually use after the first 30 days or how I can always get to the data we have? Right? So the data we have is there is a durability of effects for at least 30 to 60 days after a month of use. But the effect size definitely returns back to baseline during that period slowly. So give me like this. Like this is the effect size and then over time after you stop usage here, slow return. The more common sense way to think about it is if you go to the gym and lift weights, you'll build muscle. And then if you stop doing any physical activity, you're slowly going to lose muscle. Your system actually, your body works very similarly on a number of different analogs. And there's actually a lot of analogs training how you build and maintain muscle and how you build and maintain nervous system

54:35health. Because your nervous system needs to be exercised in the proper way. It's being in perhaps based on your circumstance or based on your environment or based on where you are, a part of your nervous system that you don't want to always be active as being trained all the time. So it's good to add some training on the other side as well. So to me, it seems like there's almost like a 30 days that you're creating that initial regulation of the nervous system. And then perhaps maybe a maintenance usage after that. Have you looked into that tool? We have. It's still ongoing for the most part. What I would realistically say, because compliance is hard. Once you get into habit, there's no, we haven't seen any adverse events with continuing usage afterwards. The worst mild adverse event we've seen is a slight headache, which was also present in our placebo group at a higher rate. So the realistically, the things that are real with somebody usage that you need to be cautious with,

55:39ear pain, if you're using it for too long, because it is pressing in the middle of your ear. Right? Especially if you're using it for two, three hours a day. Not recommend it dose. Some people do it. Anyway, you need to be cautious around your ears. Pass that. That's about it. Okay. And when you got the headset on, can you still hear your surrounding arrow? Does it blow up so that it's not noise canceling? We've had that as a very big request from some of our users. We're looking into it for maybe future development, but that's going to be a while on the pipeline. Right now, it functions as a passable headset, but a really good thing to start simulator. Cool. And from the studies you've done, sorry, fall. Is there certain people that you'd suggest don't use it? Yes. There are certain people I would suggest not to use this. Primarily, if you're someone that notices that you have a lot of parasympathetic engagement

56:41already, the benefits to you might be less. Right? If you're not someone that ever gets stressed, you're may not know as much of a fact. You always give a shot. I'm not going to say it's not going to hurt you. In general, there's the typical disclaimers, individuals that are pregnant, or that have an existing heart issue, or have an implant. I mean, we haven't seen, like, there are people that have bought purchase and used them those indications anyway. We haven't seen problems with those indications, but the reason why we do that is because these are at risk populations. So just be cautious. Or talk to your healthcare practitioner if you have any questions. Like, talk with them honestly about it, point them to the research that we've done. They'll give you a general understanding. If you're not comfortable with them, AIs are increasingly becoming confident, confidence, which is interesting, but point it to the research that we have and make your decision from there. And is there a particular group of people that perhaps you've seen

57:42the most benefit? Highly stressed individuals. The more that your nervous system has stressed, the more benefit that you see. So about 99% of the population. I would say, but there are people better in the 99%. There are people that are even more stressed. It's really interesting, but we do have a group of what I like to call super responders. I'm actually in that group. Interestingly enough, but people's whose nervous systems are so tuned to being in that fight or flight state that they see a pretty massive immediate benefit from this. Then we have a lot of people like, don't see that immediate massive benefit. They need some time for the nervous system to train. That's why we try to expectation set. The thing we always get is we'll have this small subject or group talk to all their friends and they're like, oh, I saw this massive immediate benefit. I'm like, you did. Not everyone's going to see the exact same thing. People are so different. It's crazy. From the biological side, it makes sense. People have different problems with their nervous system that are going through, even if they have similar symptoms, even if they're usually a syndrome. There might be different causes.

58:45I mean, I would love to see studies with the use with people with persistent pain. In the UK, one metronautical analysis, I've read suggests that it's between one in three and one in two adults in the UK are suffering with persistent pain. And 10 to 14% of the adult population suffering from disabling persistent pain. It's a huge, huge area. We're talking tens of millions of people just in the UK. In the US, I've seen similar metronautical analysis, but the figures are much lower. I don't exactly know why. That actually is an interesting question. I wonder if it's who made the scorecard that's being built on? Who made the scales that these men and analyses are being utilized for? Was that a US or a UK based research group? I'm not sure.

59:48I'm asking you a very detailed question about a study. You're not an author on that study. That might be part of it. There is a lot of variability in bias from my understanding in pain, especially. I think there's a lot of self-reporting as well. I've not looked at each of the papers that the metronautists have looked at. I just don't have the time. That can be your full-time job. That can be 50 full-time jobs. That's part of the problem. But one of my potential hypotheses is the fact that the UK probably medicate a lot less. It might be if someone's taking pain medication or opiates. I saw online pain. That could be a valid hypothesis. I wonder if the men and analysis itself accounted for that. If they didn't, that's a poorly run study. It should be part of the self-reporting. Are you taking pain medication? The answer is yes. That should be for

1:00:49its subpopulation. I'll have to look into that a little bit more. Pain is on our pipeline. It's something that we want to take a look at. We don't have the data right now. I'm not compelled by the industry VMS data because a lot of it's really poorly run. For the non-invasive electrical devices, as long as you have a 9-volt battery and two leads, you can shock yourself. It's not hard. It's not really big a star stem, but you can call it that in a study. You call it that in a paper. The peer reviewers might let it through and they've done that for a lot of those studies. For the implantables, they're only focusing on certain medication spaces. The data that's being taken look at for the exploratory data for all these small spaces is usually run by grad students or very young PhDs. The methods aren't really well done and the analysis isn't really well done in a lot of cases. It pollutes the data pool. There are some I'm interested to see because I can

1:01:51understand why there would be compelling mechanism. It's just until we've done it, I'm not going to say that we can do it. Even once we've done it, I'm going to say look at our research because we're a lot of students right now. Until we're approved for that, I'm not going to say we can do it. That goes the case for a number of different indications too. Yeah, I mean, my gut feel is more than a gut feel. I'd say my experience and my gut feel together, so my right and my left brain, I would feel like that kind of therapy would play could well play a part of the process for people in pain. For some people, it might be all they need, but I would say for other people, you probably need other stuff as well, but yeah, I'd really like to see how that goes. If so, keep your interest in running a study on pain. Let us know. We are looking for partners. It actually goes for anyone that runs a pain lab.

1:02:51Go ahead. Interesting. Yeah. I mean, we could maybe do something there. I would be interested. We have to get it RB approvals. We have to go through the proper process and ideally, like one of the things that always gets me, it's one of those ethical concerns when it comes to research is you should be doing a placebo group in all cases. I already figured out what you're doing is making an impact, but that means there are people that are getting placebo devices in research studies to be clear. Like, be clearly clear, this is in research studies, but in those studies, it means that you have to basically create a highly compelling fake to test against. It's always been an interesting huh moment when saying like, I wonder what the ethics are on this from a human perspective. We've kind of cleared them because the benefit to society is very high and people are informed when they come into those studies, but it is interesting. Yeah, very interesting. So, I guess I've got one more question that my curious mind is desperate to ask. So, ultrasound going into the

1:03:56to the ear to the outer ear, the middle of the outer ear. Yeah. How does that actually stimulate the vagus nerve? There is the branch called the irregular, which just means outer ear branch of the vagus nerve, which is located in that similar contra region. If you're doing post editing, you could bring up a graph here or people can just look up a regular vagus nerve. They can see the supply. And that region there, when you stimulate that branch, it actually travels along the pathway to the main branch of the vagus nerve and the locus surrealus as word. It meets in, you can think of a meeting at the brain stem is the easiest way to think about it. That is how we modulate the vagus nerve. We actually prefer the irregular or the ear target versus the cervical or the neck target. Most people are doing cervical. There's so much else there. The energy is not targeted. It's just like a blast. It's an electric shock blast on your neck is what the industry standard is right now. And you can't confirm that you're getting only vagal engagement or

1:04:57reason actually vagal engagement. It sounds a lot more targeted and we're targeting the regular branch because it's a simpler starting point. We have other technology in development. This is not our final product. You could say you heard it here, but we have other tech on the pipeline right now better suited for different indications and for different populations. But a regular branch super simple to hit properly. And ultrasound means that we don't have to shock our users. I'd so tired of people shocking themselves in this industry like there's gotta be a better way and there is. In life. Do you need to use like a specific frequency? Yes. So you need to so the industry space, primarily people are looking at transcranial right now, but the same for peripheral. You have to be above, around a megahertz, actually significantly above that for certain indications. We use above a five because we don't want to be doing brainstem with this technology directly. And then you have to have a very

1:05:58certain in duty cycle and waveform in order to be doing this properly. A lot of the diagnostic devices out there are continuous wave. Continuous wave doesn't stimulate. That's about all at a date at this point. So for the baby scans, that's safe. You're not going to stimulate your baby by accident. I was really worried about that when I was came to this industry. I wanted to do some deeper research. Continuous wave doesn't seem to do any stimulation. So you have to pulse it. And how each company pulses it is different, but it's all within certain range established by the literature, which is usually between 10 and 75% duty cycle. It's a pretty big range within a response. So pulsing ultrasound right in the outer, it's like, it's clear. It's not going in. It's here. Yeah. Like that's where the nerve actually intervenes. It's not inside your ear canal. Like we're not trying to send ultrasound to your cochlea. It's not like binaural beats or something. It is directly stimulating that nerve in the outer ear. And is the frequency always the same?

1:07:00Or can you check the frequency? Our tech it is for now because we tried out modulating frequencies and we found out that this worked pretty best across most individuals. We could build a system that could do something different, but people would see less benefit. So we have it. And we could charge people for that dial if we wanted to. But our ethics prevent us from doing that. Yeah. Awesome. So before we wrap up anything else you'd like to add? Well, I would say I'd like to say thank you for inviting me on. This has been a pleasure talking about some of these things with you. And I would also like to add if people want to say hi to us. Go to our website, fill out the contact form. We're a pretty small team. We've put our life's heart and soul into building this technology. We're going to have to people. And yeah. See us at zinbid.health. Please. Carol, say hi. And what's your website? zinbid.health.zinbud.health.

1:08:02If you just look at zinbid you'll find us. Cool. And it will be in the show notes as well. Thank you. So, Jo, what's next for you? And what else have you got coming up in the pilot line? So some of these things I can't talk about here. Sadly. No one's listening, John. No, no, no, no, no, no, no, no, no, no. We can just... But our goal, our mission as a company is nervous system control. So we're going to continue refining that technology to give people back control of their nervous systems. That is the goal. A regular branch of the Vegas nerve is a starting point. And it's a good one. It's a very simple nerve to target. And it's a very definable outcomes. And we can show engagement, which is critical first step. But there's other indications, like chronic pain, that can be better situated with other technology. And so we're building some stuff out. Not going to be out for a while. And we very frank with you because we're doing our diligence and we're actually running studies before we bring out technologies. It takes a bit longer.

1:09:05Not going to lie. And it's not like those studies are getting funded by the non-profit government engine. We are taking money out of our own pockets to do this research that it sometimes feels like no one cares about because people are selling products on research that doesn't exist all the time. They're like, oh, that'd be so much easier. You won't have this extra piece on our balance sheet. But especially like when you're when you sell fund a company at the start and you bootstrap, it feels weird that we have to do this and no one else does. But we're sticking to our principles here. We're building up that data set that over time will compound. And what's next for us is what I see what I think is next for humanity is getting control of some of these systems that have been out of whack for a while. And giving people back control in an era that's dominated by things that we can't. We can't control our media exposure. We can't control what our governments are doing, not really. Unless you're a very small percentage of population listening to this in which case, interesting. And you can't really control what these

1:10:06AI things are going to do. Not really. It's clear that nothing's slowing down. We just want to give you a little bit of control in that time. And I think it's going to be core critical to our survival as a species that we do that. So that's going to be our focus. Yeah. Awesome. Awesome. John, thanks for sharing your wisdom with the audience and thanks for your time. I've really enjoyed your honesty and your clearly, you know, an ethical person and us quite rare these days, especially when someone's, you know, selling things as well. So that's really good to hear. But yeah, I really thank you for your time today. Thank you, man. This has been a pleasure and a half. It's great spending time with a fellow nerd. It's awesome. Yeah. Great stuff. So that's it from John and me for this week. But be sure to tune in same time, same place, next week on Beyond the Pain. Thanks for listening to Beyond the Pain. If this episode resonated, please follow the show,

1:11:11leave a review or share it with someone you know who's been struggling. And remember, pain is not permanent. With the right insight and support, you can turn it into power. Until next time, stay open, stay strong and keep moving beyond the pain.