Speaker 1 · 00:00
Um male laser therapy or the orthotics.
Speaker 2 · 00:03
Can I hear you first? How you do it? And um. Okay. Yes well so let's start with nail
Speaker 1 · 00:11
laser. Okay so for nail laser are you usually having some type of whether you do a culture of the nail or nail biopsy or anything?
Speaker 2 · 00:19
Okay so I will have gotten 90% of the time. I will get a nail specimen. Okay
Speaker 1 · 00:27
perfect perfect. So that male specimen you're gonna have in front of the patient. Okay here miss jones. This is the this is the result of the nail culture that I sent and it shows that you do have a fungus. And these are the recommended treatment for the fungus. So the um the best most effective treatment is the nail laser therapy which is FDA approved. And we also have that in the office for your convenience. And the second is oral tremendous scene which is also known as llama still. And then the third is a topical and we do a combination of multiple treatments because we know because um fungus is mold and it takes multiple ways to get rid of this. Think of it as uh the basement flooded. And now you gotta go downstairs you can't just spray a can of Lysol. You literally have to cut the sheet rock out, get some deep eat into that area. So that's my speech. Right? So now I give them give them the options. I always say that you you are gonna do best if you do multiple treatments simultaneously. If you're not wanting to do that then it's probably best that you don't start any treatment at all because the results you get will not be good. So my recommendation is if you and I do do the post, I do love a steel poles. So what we'll do is when you're ready to begin the treatment you will come in and we do one um nail laser therapy per month, times three months. The full cost of that is $1,200. And there's a little bit extra 1230. I can't remember exactly. And those are my exact words and then but we can divide that by three and if you like we can you can pay $433.20 each time you come in monthly. And that will cover your medications that you'll get from the office. Because again remember I said it's not just the topical word. The laser you want to do a combination. So the combination can either be laser oral or topical. Now with the oral there's a small risk of liver damage. So to decrease that risk I do what's called a pulse dozing. And the pulse dozing is um I do the same protocol that my uh dermatologist Um in the area do. So we'll do one capsule, twice a day, week one week six and week 12. And that's um twice a day for seven days. Okay so what you'll do you'll let us know when you're ready to get started and my job is to give you the information and you make the informed consent. Okay? Do you have any questions? And then they'll say yes, Oh that's a steep price. And I said well it's a steep price, but it's the best therapy that's there. And again, usually one form does not work sufficiently. That's why I recommend it. We do a minimum of two and maximum of three. And when you when you come in to get the nail laser therapy, all the topical medications, the medication to spray the shoe out. I'm sorry, the the shoe spray, because it's important to understand that you can't just treat the skin, you must also treat The shoes. And in order to treat the nail, you must treat the skin of the feet. So the medication for the nail, the medication for the skin of the feet and the and the spray for the shoes are all included in the price of the $1,220. Okay, let me know if you have any further questions. Yeah, so that's I mean, I went into it a little bit more in detail, but that's pretty much um the speech that I have and most patients are like, well I don't want to do Lana still because I've heard this, but majority will say that they're they're totally fine with it. Um Of course if they're older, I'm not gonna recommend it. Um But and I on the script that I have for the office um It I have it in yellow and I think I shared that with you that I tell them that while you're doing the post dozing, we do not recommend that you consume alcohol, You know because Llama still needs to be treated to deliver. So I do mention that as well. Um yeah but most of the time I have this speech at least once or twice a day with patients and I would say probably about 50% will say yes, we'll go ahead and do it there. Some will say can we do it today? And um then I'll say well I've got to check with my staff because I don't want to um I don't want to negatively impact the flow of the office and so we have done it the same day and some will say okay, you know what, that's a big chunk but I can get that together and they'll come back and then and then we'll get it started. So but you have to offer it. But very matter of fact
Speaker 2 · 05:52
though, now what happens if they say no, I just want to do the topical and write me the prescription for the
Speaker 1 · 05:57
posters. No problem. I say well here's what we're gonna do that and then I will re evaluate you in three months so we can see if that's working well for you and then we will keep doing that but it's not, well we at least have this as another means. So you know that you have something else that will work exceptionally well. Okay so you get them out because you know that and then somebody may say, you know what, I don't want the pills and I can't afford the laser. But let me at least start with the topical and then if they only want the topical, they're gonna pay for The 47% Yuria, they're gonna pay for that. They're gonna pay for the clear if they're gonna pay for the um all of that from the office which would be maybe 75. No, I'm sorry. That's probably like 150 that they're gonna pay. But either way they're still gonna pay for that. Does that make sense
Speaker 2 · 07:00
when you do the, the antifungal, the bokko kit, do you do cara nail gel also automatically? Or depends
Speaker 1 · 07:09
automatically. I do the 47% and I do the um I either do Formula three or I do the clearance. I always do Clarence and 47% as as part of my nail protocol. And then I also told you I go to Amazon and I get the court. It's um 1% is very expensive. There's another company. I get it from like a dollar per tube but it's hard to find or you can go to the dollar store and Amazon. So I give them the court tube of the all um so they're used to one tube per week to the bottom of your foot Like and they're gonna send you know $150. That's no big deal.
Speaker 2 · 07:57
I do the bacal kit that has the prey the polish and the cream
Speaker 1 · 08:04
polishing extreme. Okay. And so have the shoes as well.
Speaker 2 · 08:07
Yes, so that's
Speaker 1 · 08:10
That's fine. Yeah but I do all of those. I declare 47% the topical and I do the spray and then
Speaker 2 · 08:21
some scrub their nails with a toothbrush and toothpaste you said. So have them use an
Speaker 1 · 08:27
emery board that I all the nails which is the thickness of the nail and then you know what I'll do? I'm gonna record to record me doing it in the office so you'll hear and I'll send that with you share that with you. So that will be
Speaker 2 · 08:43
because we bought some um I went and bought like 12 toothbrushes that came with the toothpaste and we are laser kits now. Oh tell them that I got to scrub that but I'm not used. I'm not good. I'm not used to explaining it. And then we got some of the thick nail files off of amazon and we included those in our laser kits also
Speaker 1 · 09:08
how you,
Speaker 2 · 09:11
they haven't had it to do
Speaker 1 · 09:13
like that. So if you let them know it's just like it's like brushing your teeth. You got to get on your teeth and you equate that to you know that sits around the,
Speaker 2 · 09:30
so hygiene
Speaker 1 · 09:33
is what you're doing okay. Yes, it's really just so yeah and a lot of people, they understand the
Speaker 2 · 09:41
sickness of the nail. When do you have them do
Speaker 1 · 09:44
that? They are using the emery board once a week and once a week as
Speaker 2 · 09:50
well. So the tooth brushing and the and the emery board or just once a week, correct?
Speaker 1 · 09:56
That's only once a week because you don't want it to be insensitive because if they're doing it every day that the nail becomes very sensitive very fast. So I don't know about you but I don't have that fantasy micro driller
Speaker 2 · 10:07
think um oh Yeah and the Doctor said Ackerman then wanted that the antifungal that he recommends. And it's already like I think it cost it was $100 or something like that. I didn't want to deal with that. I just didn't want to even deal with that because already for the expensive cost that it was for us.
Speaker 1 · 10:35
So cheap. Yeah. Yeah. And the return on investment, I'm like you'd have to mark that up so high. No. So so what I do is I have them so weekly they're using the emery board to file the nail plate. Um and then they're gonna brush with, I say Colgate whitening peroxide or baking soda and that's that's on a weekly basis and then daily they're gonna alternate the 47% area with um with the Clarence but it doesn't matter if they use one in the morning, one in the evening, so that's and then they're gonna for four weeks they're gonna put the and we have it all written down for four weeks, they're gonna use the topical which is the core trim a soul. We we alternate between portray Mazzola and there's another one um It's on my well and just I just do that because sometimes something this are a little resistant to something, so I'm like so I have a little different just in case something is not responding and they love it. I have, we take pictures before and after and they come in and and what you do is you cover the nail, so you can see just the nail, the proximal nail where the nail is coming in and it comes in clear and they're just ecstatic but you show you cover the distal part, that's still my Codec. And so they can see the new nail growing in and they're like oh my gosh, I can see it. And I
Speaker 2 · 12:00
also think like a before and after
Speaker 1 · 12:02
picture, I do a before and after picture and that goes that gets um included in the my staff does that, that gets included in the really? Hello