6. Alex King, DO: The Guru of Osteopathic Manipulative Medicine

Hello everyone, I'm Dr. Darsha Shah, and I'm Dr. Altamash Raja, and welcome to Medicine Redefined, a podcast where we will explore the often overlooked but necessary components of health, what we consider to be the fundamentals. We will investigate topics and practices that can give you and your patients the best chance to optimize a healthy lifestyle. It's time to move the needle forward and put the health back in healthcare. Before we dive into today's episode, I want to share a great opportunity brought to you by my friend Jimmy Turner over at the Physician Philosopher. This is for all the physicians out there who are trying to find balance but are overwhelmed by daily, to-do list and all their responsibilities as partners, parents, and physicians. Or maybe you're doing okay, but you want to be doing great. Does this sound like you? Another so-then-alpha coaching experience is the answer you have been looking for. This 12V coaching program includes weekly group coaching and one-on-one coaching sessions, plus of course library full of self-coaching tools. It's one of the only programs with doctors coaching doctors, so if you are looking to reduce your burnout and improve your satisfaction in life and create a life you love and deserve, don't wait. Spring Roman is on sale now. The door for alpha coaching closed on February 22nd at midnight. For more information, go to drapodcastnetwork.com slash alpha. Our guest today is Dr. Alex King. Alex is the director of osteopathic medicine at the Shins Center of Integrative Sports Medicine. He has degrees in both neuroscience and sculpture to a distinct but interestingly related fields that he talks about. Alex completed medical school at the Philadelphia College of osteopathic Medicine where he went on to do residency training in neuro musculoskeletal medicine. Darshan, I wanted to get Alex on because he truly embodies the osteopathic philosophy but also takes a personalized approach to every patient by incorporating biological injections, medical acupuncture and functional movement assessment with exercise interventions in addition to OMT. He's also passionate about education and performs clinical research at PCOM in the medical use of percussion and vibration therapeutic devices. Our discussion with Alex included many things, some of which we talked about how OMM is an evolving field, the wide utility of OMT beyond the classic musculoskeletal system, how he makes changes stick after promoting manual therapy by combining with exercise interventions and why aspiring physicians should pursue this field and even some of the limitations with manual therapy specific research. Darshan, we're really inspired and we're able to connect with our osteopathic roots after our discussion. So I think this is a great overview and primer for OMT as a discussion and hopefully you guys will learn something from this. So without further delay, please enjoy this discussion with Dr. Alex King. All right, what's up everybody? Today we have a special guest, the one and only Dr. Alex King, Dr. of osteopathic medicine, the OMM guru on social media. Alex, can you tell us a little bit about yourself, you know, obviously the osteopaths listening to this might understand what you do, but there might be some listeners who don't understand it and can you tell us what brought you to where you are now? Yeah, that's a loaded question. I could go off that for like a while, but I guess to sum it up who I am and what I do, I am a osteopathically trained integrative sports medicine doctor currently, who knows where the future will bring me, but I did a residency in osteopathic manipulation entitled osteopathic neuro-mescalo-scalal medicine, talk about a mouthful, and I also did a second year fellowship during my second of three years in training of medical acupuncture and at the Helms Medical Institute. And then I learned a lot of my prolotherapy and prolozone techniques under Dr. Shin, who I work with now in his practice, the Shin Center in Cherry Hill, New Jersey, and it's me and him. When we work in tandem at this private practice, he started two years ago, treating proathletes but also members of the general public who are looking to get their health optimized, so to speak. So that's a quick summary about me and what I do. Awesome, man. Can you kind of explain to us how you incorporate OEMM or at least what is OEMM? What is osteopathic manipulative medicine to you? To me, I came up with this kind of definition of my head. It's the coordinated and academic movement and sculpting of human tissue towards the healing process, the physiological healing process and the bio-mechanical process of healing, harnessing the body's inner potential to do that, to heal itself. I look at it not just through manipulation via the hands, but how do we manipulate via various nutrients, various chemical agents, pharmaceutical agents, injections, and needle work to connect with not just the biochemical physiology, but also the energetic physiology of the body, meaning literally how do we shift the way electrons are delivered through tissues, the piezoelectric effects of fascia, and how do you combine all of this stuff with the osteopathic philosophy to enhance someone's healing potential? That's the kind of thought process I have behind OEMM in the modern sense, granted when it started, osteopathic manipulation or OEMT was manipulation of manual manipulation of tissue, not necessarily bringing in these newer regenerative modalities, which we now have access to, but I think the concept of OEMM, at least for me, is always an evolution of what tools I bring into my practice. Dr. Shin always mentioned to me when he was training me, he's like, if A.T. still was practicing right now, he would probably be a proletherist, and he'd be doing PRP and stem-style or something. That's what I think about it. So that's absolutely wild to me, even when he says the modern sense in terms of electrons and nutrients, I love OEMM, I haven't mastered it obviously to the extent that you have, but how exactly do you use electrons, nutrients, and these types of things in your practice? What exactly is your current practice? What modalities do you use? So currently, I have created and kind of stemmed off from what Dr. Shin does this three-tiered systematic way in my head that I, let's say I'm seeing a new patient the way I approach it. My first visit is typically hour to an hour and a half where I talk to them for a solid third of that time, get a picture of what their goals are, what they've been struggling with, even their kind of genetic makeup, what they are kind of prone to in terms of the five-element theory Chinese medicine side. Like, who is this person? And some people have more of, let's say, a more introverted, disposition extroverted, how are they going to take the needlework? Do they prefer manual OMT over the needlework? So after that history and physical, I will then do a full-body OMM diagnosis and treatment starting at the feet and ending with cranial osteopathy. And then from there, depending how game they are and how quickly I want to accelerate the healing process, I will approach it from a prolotherapist lens doing mostly dextrose-based prolotherapy to specific regions in their architecture. I'd like to touch up just initially. And you've got to be careful because it's a pro-inflammatory. So you have to make sure their system is in a space where they can take a little bit of that inflammation and do something with it. Some people are so chronic in their pathology that it might not have to build to that starting with, okay, what are you eating? How is your sleep and what medicines are you taking that kind of thing? And to finish my treatments, I do acupuncture with electricity to enhance the parasympathetics in the office before they leave. So kick-starting that healing process in the office, especially if they've had prolotherapy and injections prior because their sympathetic get ramped with that style of treatment because it's consistent breaking of the sympathetic nerves of the skin and that can really rile someone up. So I try and like gradual ramping up and then bring them down at the end. It's all variance on that kind of theme. Gotcha. Alex, I love that you kind of started off talking about how you're doing integrative sports medicine. Offline, Darshan, I have been talking about, I'm wrapping up my residency training and I just finished up my interviews for sports medicine and being osteopaths and having all these different interests all the same time. You kind of have to decide am I going to go do spine in sports? Am I going to do sports? Am I going to pain? Am I going to do integrative medicine? Am I going to do functional medicine? But you were like, nope, it doesn't make sense. I'm going to kind of combine it all. So I do love that. But let me ask you this though, obviously you're taking the history and physical component to the next level. That's what we learned in medical school, history, history, history, get a good history all the time that you're spending really getting to the root of how the patient is that got there. What type of patient population are you typically seeing? Is it all musculoskeletal complaints that they're coming to you? I mean, is it a very variety? Because I saw that on the website, they were talking about some of the treatments that sports use but try to bring it to every day population. Could you talk a little bit about that? Yeah. My patient population spans a pretty vast and varied group of people from I've consistent children who come in who are hyperactive, who need that big parasympathetic boost that cranial osteopathy can offer for them. I wouldn't be using acupuncture needles or prolo with these kids but they come in for a consistent 30-minute full OMT treatment for their behavioral problems. I also see a lot of patients who suffer from fibromyalgia, I've treated chronic regional pain syndrome, I've also treated a lot of people bread and butter stuff, low back pain, neck pain, chronic muscle. Actually, those are the easiest and the most fun to treat is the gym rat who hurt his shoulder, benching too much and I'm, oh yeah, this is money. I'll get them better in two or three visits but I really also like to treat the very subtle energetic based patients who have seen five specialists. No one can figure this thing out. They've been told to see a psychiatrist as a last-ditch effort and then they come and see me and it turns out, oh, their C-section scar has never been treated. Then I'll treat the scar, unblock the hip flexors in the core and they immediately feel like way better just in unblocking these specific areas in the body that have been neglected or overlooked by your like quote-unquote traditional approach. So yeah, a very vast array of people. I'm someone who believes that anyone can benefit from OMT. No matter, you just apply the philosophy to that pathology and then if you understand what they're coming in for and what their goals are because some people have very different goals. Some people just want less pain, some want more functionality. You have to explain sometimes the differences between that and so I really like to treat a wide breath of patients. For sure. Yeah, dude, I love that. I mean, I think both of us being physiatrist, we can definitely relate to a couple of people being forth or fifth down the line to try to figure out somebody's back pain. That one strikes home with me for sure. Alex, I'm always interested to hear about what attracted somebody to osteopathic medicine. I mean, people have various reasons. I know I have mind. Arsha says, so why did you even choose osteopathic medicine to begin with? It's definitely not the more popular option. It's funny. You say that. I think it chose me to be honest. I was in undergrad at Mulemberg College. I was at Mulemberg in Allentown, small school, yeah, pre-meddy kind of school. I went in kind of knowing I wanted to go the pre-med route, but still had a lot of things I wanted to explore. I actually picked up an art major since I knew art is going to be a constant in my life. I wanted to get the most out of that education and then I majored in neuroscience. I was a double art and neuroscience major taking the pre-med courses in the summer and was really trying to reconcile and figure out, okay, how am I going to use these together? Is that even possible? Am I going to go get an MFA and just pursue a painting career in New York City? Am I going to apply to medical schools and just hope and pray I get an interview? My pre-med advisor, she was really good. She's actually retired the year after I finished college. She had a lot of experience and ties to the Philadelphia area and she was looking at my portfolio and she's like, you're not like a brainiac, but I could tell you love to work with your hands, you know, you're a sculpture major in that concentration and you really seem to be more of like your hands in many different things and she was like, have you ever heard of osteopathic medicine? I'm like, I have no clue about that. My mom is an MD, she's an MD child psychiatrist and I had always just known about MDs and so when I looked up like what osteopathic medicine is, I was like, yeah, this is like literally right up my alley, you're you're learning manual techniques to treat the body and I myself was very comfortable with the manual aspect of working with people and and and kind of like the idea of treating patients that way. And so it was just like, yeah, why not apply, you know, a lot of Mulemberg alumni go to PCOM and and even Dean Vite, he he was like a Mulemberg grad. So there's a lot of ties between my college and and the school, which is nice. But yeah, that's kind of how it happened. Yeah, dude, I can definitely relate to a lot of that. I think that, you know, I have a background in strengthening conditioning and and sports performance coaching. And so one of the big things in you're talking about, you know, people being Jim rats and, you know, formaling self-mife asher or least that kind of stuff. And I was able to appreciate the value of that for myself, for a lot of my athletes and that kind of things. And so I was like, oh man, there's really something to this. And using it so much, that's when I was looking at medical school, you know, in that time after undergrad, I started looking up more about what osteopathic medicine is. But then even more so, the osteopathic tenets are something that really resonated with me, right? We talked about AT still earlier, you know, the structure and function being to relate it. And a lot of these brilliant sports performance coaches that I was following and listening to, they were talking about how, you know, you have some shoulder dysfunction and elite athletes and you got to look at the opposite hip and, you know, not just the joint above joint below approach, that's very commonly taught in Muscoz-Gelomedicine, but even extending beyond that. And then you talked about AT still doing prolo therapy and PRP, you know, bodies intrinsic capability of healing itself. I mean, that's regenerative medicine or orthobiologic and a nutshell, right? So that's one of the other reason why I'm so fascinated about that. So that's really cool to hear. You know, speaking about the foam rolling topic, we recently had David Ote, which he's an awesome strength coach and we were talking to him about self-myfacial release. He talks about, in his courses, he does a lot of pain-free performance specialization certification. He does a lot of foam rolling and teaches that and talks about making foam rolling sexy again. Yeah. I think that that's super popular, especially nowadays. We have all these different tools like lacrosse balls kind of antiquated. Now you've got all these various balls. You've got massage guns. You've got this. You've got that. People picking those up. Other than you actually putting your hands on the patient and teaching them, do you incorporate those type of modalities and teach the patient to do that so they can go home and continue to use that for their own treatment? Yeah, that's a huge part of what I do is I always give homework at the end of my treatment. So I try and pick one or two things just to give the patient because I found that any more than that, they're not going to do it. So I'll give them and I've even printed out sheets of what the exercises should look like and for how long and what the best foam roller is to get. I always advocate for my patients to get the three-foot smooth foam roller, high density and kind of fine-tune their pre-have movements before lifting or whatever physical thing they're doing. You should just have a full-body foam rolling routine that you do five to ten minutes before any major kind of physical activity because in just doing foam rolling, you're warming up your core because you need core stability to actually perform a lot of the movements. So I'm a foam rolling fiend. I actually partnered with Fitler Club, which is a club in Philadelphia and every month I actually hold like a limited five-person S-self-my-fascial release class in their center. So I incorporate foam rolling, hypervotes, a lot of percussion technology. Myself and a few students at the school are going to publish something about publish a paper about the hypervotes and shoulder range of motion. That's something that's in the works. But yeah, I've been working with hyper-ice for a few years and was able to visit their headquarters in Irvine, talk to Anthony Katz, their founder. He was a really cool guy and I'm a big fan of these self-my-fascial release tools, especially foam rolling because it's so easy. The thing is like 20 bucks and you'll use it for like years and it'll be a great preventative strategy for a lot of patients. So yeah, I love teaching that stuff and I think it's really valuable because ultimately if you can self-diagnose in a way and like treat some of these things before they become chronic, you can avoid like a lot of imbalances down the road. And I especially love treating med students because I were teaching them how to do these things because they're the future and they're going to be teaching their patients. So it's like you got to spread the foam roll word about it. Spread the foam roll. I love it. I'm going to make that a slogan. Yeah, dude, I mean, so exactly, you know, catching these things before they become super problematic, right? Preventative medicine is that's what exactly what you're talking about. I'm providing. Josh and I have talked about that. You know, people talk about preventative medicine being interested in it, but they don't truly practice it. But you know, you're obviously an exception to that. You know, another thing that Dave talked about, you know, that really resonated with me is he talked about when he described what foam rolling does for the system, basically toning down that sympathetic response. A lot of the stuff that you've talked about, you know, and the example I remember he gave really stuck with me is basically kind of like, you know, toning down the alarm at the bank because there's like a heist or something happening and you're trying to calm that down. But he said that after, you know, we do that, there's this window of opportunity, right? Whether you're increasing the range of motion, you're, you're just increasing the parasympathetic drive and calming the pain down where the individual has to build upon those foundational skills, right? You've got extra range of motion. What are you going to do with it? If you're just foam roll and you don't do anything, that's just great massage. Nothing happened. And you, I think, kind of alluded to it a second ago when you talk about pro therapy and just, you know, when you do that and then they actually puncture to calm things down. So when you teach these foam rolling techniques, how do you afterwards, you know, teach the mobility to increase the range of motion or anything like that? Like, how do you incorporate that into kind of homework? Yeah, I actually will say once they develop that foam rolling skill for like five to ten minutes full body, you know, getting everything loose, I'll then start to instill postural based corrections. So corrective exercise, if it's, if they've, they've got upper cross versus lower cross, I'll give initially a little more lengthening based exercises because if they're already in this imbalance pattern and this explain that a little bit, upper cross versus lower cross, what that means. Yeah. So, so you have upper cross where you have inhibited neck flexors, mid traps are inhibited. And then you have vast recruitment and hypertenicity of the anterior upper trap fibers as well as the extensors of the neck. So what that creates is this like scrunched up pattern where, and a lot of people are locked in this pattern if they've been sitting or studying classic med student upper med student back right here. So then I'll start to teach them how to lengthen these fibers of the traps as well as using like a suboxipital release device or a peanut or whatever they've got to start to hit these suboxipital muscles. And then after a couple weeks or a couple visits, however they're doing with that, I'll then get into more strengthening of the neck flexors, chin tucks, more active mid trapezius recruitment, just to start to change that balance. And then the lower cross, you have really tight lumbar spinal erectors, tight hip flexors pulling you into that anterior tilt, really weak glutes and a weak transversus abdominis, weak core. So that's like if you've got both upper cross, lower cross, you've got a lot of work to do, but typically I find more, more upper cross I would say than lower. But again, you're really trying to lengthen these muscles because if you, if you start to recruit a little too soon, this is why people who do PT sometimes can get worse is they weren't, their body wasn't kind of set up and lined up for the success of that recruitment pattern. So sometimes you need to need to lengthen a little bit and rebalance before you get into that strengthening phase. So yeah. So would you say it's important to get OMM done before going to PT because obviously as as me and Altar physiatrist, we recommend our patients go to physical therapy. Should we actually recommend getting OMM done first, getting all the like imbalances corrected and then going to PT? Yeah, I would say it's important because if you think about it, like when you're doing PT and you're remodeling the body origin and insertion of of those imbalance muscles is everything because when they contract, then their contracture is based on the 3D positioning of that origin and insertion relationship. So if let's say they've had like a right anterior enominate and their leg length is a little bit longer on that right side, but they have them doing like, let's say bodyweight squats or single leg RDLs or things like that which are great exercises. However, they could be programming them in an imbalanced position. Whereas let's say they got OMT the week prior or a few days prior timed it up with their PT, their hips are level, then they're going to recruit the hamstrings more equally, the glutes more equally. So I would definitely advocate for that. It can be tough with the timing and everything, but if you could set that up, then you're going to be ideal in that situation. That's amazing. This is freaking why I love OMM. It literally solves the musculoskeletal issues in terms of symmetry, posture, recruitment of the muscles. Like I lift, you lift, Alex, you lift as well. This is what OMM is, right? It makes sure that you have the right balance in your body so that you can get the best input and output from your body. Crazy, because we align our cars. We get our car alignments done. I was going to say they've started an amount of miles. It's no brainer. Like if you don't get that done, you're in trouble with your main mode of transportation. Well, guess what? Other mode of transportation is important. Your own legs, your own hips, your own body. So if you're not getting yourself aligned, both just from an outside perspective, but even internally, like I do a lot of visceral manipulation as well, that people really don't pay attention to too much because it's, you know, out of sight, out of mind. You can see that your shoulders are off, but you can't see, you know, if your digestive organs are all like really hypertonic and tightened. Yeah. And so a lot of the lower back is actually in response to what's going on internally too. So it's like balance everywhere, you know. Yeah, and it's funny. I was going to use the car analogy because this is something, just again, before going to medical school, you know, a lot of these strength coaches and performance coaches would be talking about. Yeah, again, traditional sense PT is what we're talking about is good rehab is strength training, right? That's what it is. And if you're doing that with the misalignment on your car, if you're putting miles on and trying to rev it up, like those wheels are going to fall apart much faster. So that's a perfect example. But what I will say is a lot of good PT's and even more so today are doing adjustments before the sessions. Yeah. But again, the issue then becomes that, and this is another recent conversation we have, if they have a 45 to 60 minute session, they don't have the time to be able to spend 20 minutes doing adjustment. And then, you know, you lose it elsewhere. So this is kind of why it's it's good for, you know, either us to do it if we have time in clinic or do a separate session or again, just send it to the best person who can. Somebody like you. So I love them. Yeah, thanks. Yeah, I think that's a great strategy. And it's all about like who's the best person for that specific kind of job. And yeah, so if you can, if you can do that, if you have a quick second, even if it's like something that, quote unquote, minor, like just making sure their hips are lined up, especially if they've got like, if they're rehabbing something from a leg injury, that could just be huge. And it technique takes a couple seconds or, you know, real quick for our alopathic counterparts or people who don't know what the heck an anterior enominate is. Could you explain that? Yeah. Yeah. So your enominate is the right side of your hips. So if you're ASIS or your anterior superior, iliac spine is is a little bit more rotated inferiorly on the front and your PSIS is up on that same side in the back. If it's superior, compared to the other side, then that means you have this rotation of your hip that's going to actually create a falsely long leg, which I think is like the main problem of that. Patients won't feel, oh, my enominate is rotated. My leg feels longer. And that means like I'm getting jammed up in the SI joint. That affects the lower back, which affects the ribcage, which affects the thoracic, you know, it's and it just goes poorly from there. So that's why I start at the feet when I treat it. It's like the feet is where I have the picture of how their body is working with gravity, so to speak. Sweet, gotcha. You did mentioned visceral alignment. So that's something I never heard, you know, through my four years of education at V Com Virginia. How do you know if a visceral organ is misaligned? And what do you do exactly to fix that? And what organs are you really looking at? So a lot, especially in my training out in like Lancaster PA, I learned under Dr. Boyer, who is really big on like the balance of the spleen and the liver, making sure, and you can actually feel if the liver is kind of rotated and it twists in a specific way in a lot of people. And that, you know, affects the falsiform ligament, which then affects other internal structures in the abdomen. But also like the core kind of speaks to what's going on underneath. So if someone's got a really tight rectus or linear alba or semi-looner lines along the rectus, I will treat that because a lot of times the lower back is also compensating for the disturbance of the anterior portion of the body. So like we mentioned Dr. Hartman when we're talking, he always told me the quickest way to treat the lower back is through the front. So you treat the core and the abs. And that'll also release the viscera beneath it. So it's almost like it's a great and it's a specific technique I use. It's a combination of like so-as counterstrain where I hyperflex the knees up towards the chest. And then I'll sink my hand deep into their core super uncomfortable, uncomfortable for some people. But I warn them and like, hey, like just keep breathing through it. And if you really need to tap out, let me know. But most people can tolerate it. So it's great for freeing up the viscera, loosening those lower back muscles, even getting the diaphragm to expand and contract and to have better ribic excursion. And so it's a great all-encompassing technique. And so for that, I often ask when I'm treating I'm like, how is your digestion? How is your elimination? Are you constipated? And so we get into a conversation about that too about their gut health as well. Alex, it sounds like you're saying you're trying to take away people's six pack, man, trying to tone down the rectus. I don't really know how I feel about that. Well, so it's interesting you mentioned that because the way to get a bigger muscle is to lengthen the distance it needs to contract. So by lengthening when it's not in use, you can then increase the amount of contraction it has when you're training it. So it's like that length might diminish it in the short run, might flatten it out. But eventually, you can get that awesome six pack once you train. And hopefully the fact that your back is not ejected up will probably help with that. Yeah, better deadlifts too. Yeah, exactly. Dude, this is absolutely insane. So for me as an intern, just starting to see patients, right? I feel like the net last six months. As physicians start to see patients come through the ER and we admit them, no one's really thinking about the visceral, the organ, right? Unless it's like, oh, this guy's an alcoholic must be a liver. Yeah, it must be the kidney, aka I, this must be the spleen, blah, blah, blah, right? It's just, it's so amazing to me how much actual science or data and how much you can actually feel with your hands, right? That's what we do as osteopathic physicians is feel with our hands as a data to say, hey, this might be rotated or this is there, or this is not there. How do we start to influence the next generation, right? You talk about how you speak with medical students. And I'll be honest with you, I'd be con Virginia. I was probably one of 10 students who actually like believed in OMM and knew that they were going to practice OMM beyond graduation. How do we influence it? Because I feel like we might be, do you think that we're losing OMM? What do you see the future of OMM as? I still see a lot of students who are interested, albeit it's a minority. I think the best way, though, to increase the interest is literally to make OMM cool again. Like I should put that on the hat, right? But seriously, it's like, you have to show the utility, you have to show the results you get, and you have to actually be willing to practice what you preach to a certain extent. And that might mean making certain choices when it comes to how you practice and where you choose to work. So you could put yourself in a situation very easily where you never use OMT and you could say, oh yeah, I stopped using OMM because these constraints of my work and that and that. But if you really make the effort to practice how you would like to practice and ensure that your work environment or that where you are practicing can embrace that and can you can actually maybe get paid more doing that, maybe just having an OMM day of your week where that's like most of your OMM cases, something like that to like preserve your skill set, preserve the tradition and offer that opportunity for students to come and learn from you even. And that's why I really liked being a clinical instructor in the OMM lab because it's a way I could leave my practice to go and then teach the techniques I'm using for my patients to the future generation. And so I think again, it's just like keeping it alive. Like at least being able to do a few techniques really quickly and really efficiently, that's what I tell my students is like, you know, you're not going to be an OMM specialist, that's fine. Like there's a few of us who are and we can take care of like the really intense stuff but I would like you guys to really just learn three to five, which five would be crazy, but like even just three solid techniques for common problems. And if you're a family doc, physiatrist, you know, what have you, you could really get a lot of people better and have a unique, you know, aspect of your practice because of that. Yeah, that's awesome. Because as a as a pre-med and medical school coach, the common question I get is, Darsh, why osteopathic medicine? Like do people even use it, you know, and I'm going to turn them to this podcast because this episode, this is exactly what it should be used for. I mean, exactly like you're saying. And people will seek you out. Like if they hear you're doing osteopathic treatments, like you will, people will find you. It's kind of funny how it works, but it's so rare that people who know about it and want it, you know, right. So that's my last, like, so this is my question. In the last five years, do you think more people have sought you out? Like do you think alternative integrative medicine, especially you doing Eastern medicine with copying and acupressure acupressure, you know, these all sorts of things are more people seeking out because of that. Yeah, even even on Monday, I have a new patient coming in who is like all sort of colitis, plus some anxiety component and, you know, it's totally driven by her gut flora for sure is what I'm guessing. But you know, she, she moved from Boston, I believe, and I just read her, her brief kind of, we get like a quick HMP when they call in, but she's just looking for someone to quote unquote treat her more holistically because she is working with like a GI doc at UPEN. But she told my staff that she has not found any real relief other than just being prescribed, you know, what kind of steroid she's on, I'm guessing. But she wanted someone to approach things differently. And so for her, I'm going to be, you know, looking at her sacral plexus and, you know, her viscera and treating her with acupuncture. I would hope the initial visit and a lot of these things that she maybe hasn't tried yet. So I'm all about just trying new things for the patients, seeing how they react to it and then adjusting from there. Awesome, man. For me, getting into OMM. So I'll be honest, the first like two months of my first year med school, I was like, all right, what are we doing? What are tart changes? You know, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, then we started doing curse, we started with Spencer's technique of the shoulder, getting the rage emotion, the shoulder, then we started doing cranials and all this stuff. There were literally two friends that I treated that made me 100% believe in OMM. The first one, he was not able to sleep for like the last two years. He was unable to get more than four hours of the shoulder was hurting him. So I did Spencer's technique on him. Like, I'm literally a second year med student at this point. I was like, hey, let me try this out. I just learned it. Did it has gotten a great night's rest ever since no pain? Yeah, yeah. The other case was a friend in med school who had exertional headaches. So every time you exercise, he used to just get a massive headache. And so he went to the ED. They found kind of some inflammation. He said, not specific, like in his head, he was supposed to get a corticosteroid shot. And I said, hey, let me try some cranials. I just learned like Venus sign his drainage. Like, let me just try this out. I tried it the next day, his headaches went down by 50%, the day after 25% and no headaches since the day after. Classic lymphatic block right there. It was insane. And that's when I was like, I literally have almost no idea what I did, although I kind of did, right? I knew the signs a little bit, but I wasn't so into it. Now I was like, oh my god, this is it. Like, no, it really works. I literally just did the things I learned. Are there any, is there any cases like that where it literally convinced you or have you seen the toughest cases be solved by your hands? Yeah, I had an interesting case. A friend of mine had a couple of brain tumors and they were removed. And she was told by the surgeon, you'll never be able to drive again because she lost peripheral vision in her right upper visual field. And so they're like, I'm sorry, you're just unsafe to drive. And you could imagine someone who's in their late 20s, she had a recurring meningioma, I believe. So when she was four, she had brain surgery and then again in her late 20s, when they found it came back. And so what happened is she, you know, it really affected her life because she's 20 something can't drive. Like that affects you like crazy. So we're just chatting and she's like, yeah, I was told, you know, I'd never get my peripheral vision back. And so I've kind of resigned myself to just changing my life in relation to that. And so I was saying, well, what have you tried to get it back? She's like, well, what do you mean they said it's permanently never coming back? Like I had a tumor in my brain. And I was like, well, like I've seen some pretty crazy stuff and what I've treated, you know, trying a different outside the box approach. So she's like, all right, I'm game. Like she had nothing to lose, right? I told her what I was going to do, some cranial manipulation, but really the whole body is what I did as well. Finding her up because she had other things like her hips, flow back, you know, a lot of stuff. And I also, again, this comes back to scar treatments. So I think one big thing I would say is we do not get enough education in how to treat scar, especially post surgical scars. Because these scars go really deep and it can affect the fascia and even just neuromuscular connections way deeper and far distant from where the scar is. So she had a big scar, you know, it went down kind of the occipital area up to the parietal on the left side of her head. And she had this right upper visual field deficit in her periphery. And I treated her, I then actually treated the scar with some acupuncture work and then treated her ear with some curricular acupuncture in the regions of the brain where she sustained that surgery, mostly the parietal occipital regions. And then I got her best friend to kind of watch the treatment, you know, reassure her because she's never had acupuncture. So she was a little bit like, what's going on? Because, you know, I was putting needles like from her head kind of down to her toes. And so her friend, I was like, let me do a test of her peripheral vision. So you know, I did the, the way, can you see my wiggling fingers kind of tests along her periphery. And was like, okay, guys, like, both you don't want you to remember, like, this is the cutoff of where her vision was. And so at the end of the treatment, I retested. And I got about four or five inches of her peripheral vision back from the opathy plus acupuncture to the scar. And she was literally like, she was, she was speechless. She was like, I was told this is permanent. What the heck did you just do to my head? She was like literally, she's like, I don't know, even what to think anymore because all of these specialists that Cornell and like these top doctors in the city and all that were like, sorry, like, so, so what I took away from that is hope is a really big part of that healing process. And at least like enabling patients to entertain the thought of overcoming something quote unquote permanent because a lot of people who, you know, and your guys feel that it's like can be told you're never going to be able to walk again. I'm sorry. But they could also be told like, there's a really small tiny, tiny possibility maybe if you put in the work, if you believe, if you have hope, if you, you know, all these things get treated more holistically and that. So I think that was probably the coolest case this past year. I've never had a case other like another case like that. So it's a really big one. But but it was cool seeing her vision come back within within the hour. And she was having daily headaches as well. And that totally went away actually after that treatment. So yeah. So it's pretty crazy to stuff you can do when you like try something different, you know, Alex. Wow, man. I mean, when you were talking about making OMM cool again, you really were not joking. You know, there's there's a lot to take away from that that story right there. Obviously, I think all of us can appreciate that's an end of one. But I'm sure you have a couple of those end of one. And for that specific patient, that end of one is all that matters. All my patients are. Yeah. Yeah. I mean, yeah. And you know, this is the difficult difficulty I have and the conversation I have with if I'm working with my junior residents or medical students or really anybody is, when you're an individual who is going to have some dysfunction that causes any type of disability, whether it's visual impairments or, you know, physically you can't walk. The only end that matters is your end, right? And you kind of do and you'll seek out whatever you can. And so and the aspect of kind of giving people hope, certainly, you know, not giving them false hope, but also at the same time doing your absolute best. And and the biggest thing is there's just so much we don't even understand, right? You know, you could be the greatest neurosurgeon in the world than in to your part, but there's so much about the brain. There's so much about the visual system. There's so much about the body that we still are just scratching the surface on. But I want to get serious for a second. You know, on the note of trying to make OMM cool, I think osteopathic medicine has been under the microscope for it feels like forever, right? And I think that a lot of times people when they're considering medical school and medicine, they always have this difficulty, you know, do I go osteopathic medicine? If they're lucky enough to know about it versus alopathic medicine, you know, DOMD. And there's just some hesitancy that people have. And especially given recent political events, osteopaths have been even more under the microscope. So my question for you is, how would you kind of encourage those students, those undergrad students or people pursuing who might resonate like, you know, the osteopathic philosophy, the manual treatment, those tool belts, those are important to them. But then at the same time, when they look at future career goals, it's pretty clear that there's a lot of specialties that still kind of have a bias. And then they might not take osteopaths. Obviously, PM&R, the Darshan are, and we're the exception to that. But a lot, unfortunately, in our medical systems, not quite the same way. So how do you counsel those young ones? Yeah, I would say I would try and take that inward self deep dive and figure out how you want to help other people, like how you want to heal other people. And who's opinion do you care about? And for myself, it's like, yeah, I definitely took the road less traveled and the road that almost no one travels nowadays. But the skill set that I have in the way that I treat, it's a natural extension of myself and the way that I would like to see humanity change and heal. I wouldn't be comfortable myself working in a massive health system. That's like a factory just churning out people, keeping people alive, but chronically ill, making people dependent on certain pharmaceutical substances. And it's like, people could think, I'm a quacker that I'm doing this weird OMM stuff for that. And a lot of people are still like, does that keep puncture really work? And I'm just like, no, dude, I just do it because it looks cool. Obviously it worked. It's like, what can I say? And I think it comes back to how we value certain types of knowledge more than others and how we can be biased in that. So there's a big bias for empirical evidence being the gold standard. Well, can empirical evidence be the gold standard for more of an art form? I don't know how you could empirically say that this type of painting is better than this piece of sculpture or what have you. Because that's what OMT is. It's really more of an art form about that end of one person and finding their potential than it is about generalizing a certain technique protocol for this type of diagnosis, featuring an end of a thousand or something like that. Yeah, there have been great OMT studies that really value that empiricism. The promote protocol for pregnant patients, it really has helped a ton of patients with a specific protocol that you can use that will probably help a lot of the pregnant moms out there. But you also have to value anecdotal evidence and also have to value logical evidence. To me, it's like OMT is logical. It's like logical medicine. If the structure of something is altered, then yeah, it's range of motion or its function or its ability to heal is going to be altered because we are created of this structure. And so for myself, I really wanted to do something true to myself in the way I practice. And so if you're feeling, oh, I just want to do this specialty or this thing because of the way it'll look or because of how easy it'll be to repay my loans or for this for other reasons, I find that you might get burned out quicker or you might be totally not totally be fulfilled with what you're doing. Because I really see becoming a physician as like more of a sacred type of service you're giving to unity of humanity, not just some profession that looks good for people. My grandfather was an herbalist and acupuncture physician and he said like doctors are servants. We're not supposed to be these bougie people who are making millions of dollars. And what we do for me is this sacred level of helping where you're literally changing someone's life because they're experiencing less pain, less discomfort. And it's all about finding yourself and knowing how you yourself can offer disability to others, whether it's maybe you're a great surgeon and you love doing surgery or for me it was doing osteopathic manipulation and acupuncture and these needle-based things. And for you guys it's doing being physiatrists and osteopathic physiatrists and changing lives through that method. So I would say as a student, as a resident figuring out where you exist in this medical system, you got to know about yourself a lot first before you fully go one way or the other. You want to reconcile that within yourself. It's like what type of healing do I want to support and how can I do that to the best of my ability. So I was a kind of a long answer. Now dude, I loved that. I mean I think there was a lot of things to take away from that and you know the other thing I think in terms of just specific differences for those who are trying to figure out and hey like you know is osteopathic medicine anything less than alopathic medicine or diodes? No, I mean we do the same exact training. In fact we do more training, right? We take extra credits in every curriculum because what we end up doing an extra depending on what program you go to anywhere from 250 to 350 hours of extra training when you're learning these practices. So yeah, you know I think it's a little bit more challenging and you have an extra tool in the tool belt. And if this is truly what you're interested in, the art of medicine that you're talking about, the integrative side, learning that there's a better way. I mean 80 still himself was an alopath. He was an MD. And then and then he realized hey, some does not right here. Things are working. Let me look at another way and that's how it developed. So I love that. And you know, but going back to the art of medicine, it's as individualized as it can be osteopathic medicine. But at the same time I think that there's always this balance as physicians. We have to find between the art of medicine and the science of medicine, right? We still always have that. And you kind of touched upon doing research and the challenge of doing research specifically for OMT. Could you talk about that? Like first of all, why is this so challenging to have good quality research? Although I do think that there's a lot you're talking about the promote protocol. There's a lot of good, you know, stuff. People always talk about that classic ankle injury, emergency medicine one. There's some good shoulder stuff out there. But still there's there's a huge gap that I think that we still need to address. Talk a little bit about that. Yeah, I think one of the biggest things is the whole concept of sham OMT. It's really tough to create some kind of study whether, you know, it's similar to the to the issues with like sham surgery. For example, that's why, you know, it can be tough to empirically study surgical procedures. But with a lot of the OMM studies, it's like, yeah, sham OMT was a component of the study, but but they're still, you know, putting hands on the patient, which certainly has like an effect, regardless of if they know exactly what they're doing or not. So that's a tough thing where like one of your controls might not be a great control, so to speak. So that can be a tough and then also there's just not there's not a great great amount of OMM specialists and and a lot of OMM specialists treat in their own ways even within certain techniques. So you could say, you know, sub occipital release was tested for headaches, but but and like, you know, ideally it would just be that one practitioner doing all of the techniques, but that would then limit your end because it's hard for that one person to just be like cranking out a lot of subjects. But even within sub occipital release, there's like nuances and there's different ways that practitioners work. So that's a few of the reasons why it's tough is it's because it can be very nuanced and there's a limited number of specialists offering it and even more limited number of specialists who pursue research in OMT. Like you'll see a lot of the similar names in a lot of OMM studies who are PhDs who, you know, like studying OMM, but a lot of OMM specialists go in it purely for the clinical aspect kind of like myself. Like I really just like seeing patients and, you know, I've done a study with hyper ice and the hypervote, but it's not like an OMM study. It's like a percussive study. So, so yeah, it depends. There's a lot of factors. OMM. I believe what I think that was the biggest thing with students in terms of asking me, hey, what's the research at? Where's this? And like you said, and I think it comes down to the end number, right? And I always talk about N equals one because that is in definition individual personalized medicine, right? And equals one. And we have to treat every end of it individual as if it's its own because when you look at all the big research out there, sure, it'll tell you the average, right? It's all under a bell curve. But when it comes to OMM, when it comes to things like an art form, but also including some science, it comes to what works for this patient because it's going to be complete different than anyone else. Yeah. I kind of want to switch topics here because I told my wife that you're coming on and she's been having upper-cross syndrome, like no one else do. She's been up here typing. She's been up her shoulder shrugging, like no one else for the last month. She's always like, Darsha, I need you to crack my back. I need you to crack my back. And I'm like, this is the only thing I'm good at, Kurt's film. Boom, boom, boom. You know, I hear the cracks. I'm like, great. You probably did not do anything because it's going to come back in like five minutes, but sure. Thank you. So she wants me to ask you, what are like five lifestyle hacks that you do either for like your own good or better posture or like what you would tell people to live a healthier lifestyle? Yeah, I would say what is driving this upper-crossed for some people? It's their anxiety stress. So I'd ask what is going on in her life that is bringing on anxiety slash stress? How to minimize that? Does she have a mindfulness-based exercise? She's doing once a day, if not a couple times a week, meditation or something like that, at least. How is she exercising? Is she getting regular exercise? What kind of exercise she likes? Also, how is her sleep? So making sure her sleep hygiene is good and that's like in her nutrition as well. So it's like really I'm thinking in terms of, you know, she does have upper-crossed, which is like her chief complaint, but I'm also thinking about, okay, what is driving the nervous system to create a pattern like this? Typically, if you look at upper trap fibers, which is like the first thing to start creeping up to your ears, that is tied heavily in with stress, anxiety and like professional performance and academic performance. So again, we're getting into more of emotional mapping, which is a term I get from the guys, trainers at StrongFit. You can emotionally map a lot of muscle tissue to various states of mind. For example, anger and the lumbar spinal directors. So a lot of people with some anger stuff in their life get really cramped up lumbar spinal directors. So I'm kind of thinking of it from like the root cause. Like we mentioned before, it's like, okay, what is driving the upper cross? Because you can go about it. Like I would definitely say foam rolling for her. I'd definitely say definitely say get a trap massage from Amazon. It's like a heated rotatory like thing. You can slip your elbows in and like really lean into it. I have one of those. And then also just from a soft tissue health perspective, maybe seeing if she could get some needle-based, maybe a dry needle or trigger point release of the trap, because it goes both ways. Her mind could affect this upper cross syndrome, but also the increased hypertonicity could affect her thought processes because they are so facilitated. And so yeah, I would approach it from like a very 360-way and looking at nutrition, sleep, mood, biomechanics. So no magic pill. No. No. No. Exactly. What to say. That's what I want to say. How many people have gone in with this complaint to their primary care doctors? It had been told that 360 approach. Almost none. They probably say almost none. And said exactly. Here's the pack. Here's go to PT. Exactly. But I love it. I love it, man. And it's crazy, right? Because the things you're suggesting, okay, buy this off Amazon, buy this off, you know, whatever it is, these are investments, right? They're not a one-time buy. And I think, you know, I started using this so right. I don't know how you feel about it. It's good. It's good. It's got the standard of approval. Yeah. I'm using now. I use like a crossball thing or just some like, you know, but so right. It's fancy. Yeah. That's funny because that's the exact question I asked him when he talked about it. Dude, this is like a year ago. I was like, how is this different than the crossball? But yeah, I mean, if it whatever works for you, man, whatever works for you. That's right. You did ask him. Yeah. I think it's got more height to it. Maybe a little more to this probably. It's probably easier to get into. Yeah. It dives in right to like where you need it without your abdominals getting the way, I guess. So I guess. Yeah. And that's, and it's kind of nice, but I bought the knife hand. I bought the knife. I do want to put this disclaimer in. In case somebody's listened to it and they try it, you know, you have to be careful when you're doing the self-mife-assure or least things. Please work with the physician, work, go seek out Alex, talk to him, do a consultation. So learn, you know, before we start jamming things into your visceral parts. I'm not going to see Alex. Yeah. Yeah. Josh did a consultation for you with you for free, man. You got to send him a bill there. Seriously. Seriously. This is my little thing. I'll go to any free 15-minute phone. Just call my office. Yeah. That's awesome, man. That was really cool. I'm about to come see you, though, honestly, man. Yeah. I mean, I need to, because I don't think I need someone on the East Coast or West Coast or any coast like treats kind of the way we do. Very unique. That's why we see a lot of the pros in the area because it's like they feel it. We get the results and how it works. That speaks for itself, man. I think that one thing that's probably worth mentioning and clarifying, I know you've talked about this a little bit on social, but what's the difference between osteopaths and carpractors? Yeah. Yeah. I think it's a great discussion. I get this question a lot. And I've talked with carpractors too about it, and like I'm friends with a lot of them. I have no animosity. It's like a different branches on the same tree, so to speak, and both of them are kind of arose out of a similar time period. So, D.D. Palmer started chiropractic. I believe in like the 1880s and 1880s, just a couple decades before I believe, but they were definitely like similarities and like the philosophy. Chiropractors typically, you will have either mixers or straits. So, straits are just like very old school just treating the spine kind of HVLA. And then mixers will use that, but also use all these other components like grass tin or ART or even acupuncture too. So, it's like a lot of there's kind of branches within chiropractic. There's even specific chiropractors who will just adjust C1 like the Atlas Axis component. They'll even use these activator kind of trigger gun looking things that'll like adjust specific vertebrae even. So, I think with chiropractic, they use different terms. So, they'll say like more like sublox or they'll treat more of the axial spine more of a focus on those mechanics. I think osteopathic doctors or osteopaths in other countries will just focus more on like, yeah, we'll focus on the spine, but also on the viscera, on the ribcage, the extremities, the head, the skull, the cranial component. And then the Venn diagram in my head just overlaps in that HVLA adjustment component where you're adjusting vertebrae with a quick thrust. So, you know, and then it's of course the main difference is the medical school behind it. So, yeah, I mean, I talk shop with a lot of chiropractors too. I actually will do injections for patients who already see chiropractic. I'm not like, oh, why are you seeing them? You should see me. I'm like, osteopathic, we can do it all. I'm like, if you like your chiropractor and they're helping you, keep seeing them. I can just do kind of stuff on top of what they're doing and then talk with them about how we can, you know, work with each other on that. So, you know, for me, it's like there's some amazing chiropractors out there and we speak a similar language and, you know, and it's more of a kind of household known thing in American culture. So, as long as patients are like, you know, able to get some good level of biomechanic work, whether it's from a DO or a chiro, as long as, you know, they're being treated safely and getting results and I think it's good, you know. Well, even a massage therapist, honestly, I found some massage therapists who are amazing. Yeah, for sure, a massage therapist, acupuncturists, like really. I mean, it just goes back to, hey, the patient's the most important member of that team, right? And some of the other experts who've come out here talking about leaving your ego at the door and, you know, I think that as physicians, sometimes we all struggle with that. I've learned from, you know, licensed acupuncturists. They don't have medical degrees. I've learned from chiropractors. I've learned from physical therapists. Like, absolutely. You know, you just learn really cool things from other practitioners, no matter what. So, it's like, if you have an ego about it, you're going to limit yourself. Yeah. That's, that's so awesome. You know, Alex, I think that our hope is that some, some people are going to listen to this. Some medical students are going to listen to this. Maybe even trainees. And they're going to say, wow, this is really cool. I'm inspired. I know both of us here are inspired. And even, obviously, we're going to try to figure out how we can incorporate a lot of this into our practice, right? A lot of what you're doing, integrative, you know, we have a passion for that. But again, the difficulty comes at the end of the day that the current medical model has a lot of limitations on it, right? So the question for you here is, you know, first of all, do you have, do you accept insurance as a primarily a cash-based practice? And then, you know, what is the role of insurance companies in terms of reimbursing OMT treatments and a lot of the integrative treatments that you're doing? Yeah. So we do not take insurance and we have a flat rate for new patients and then follow-ups. But we do print it super-bill and a lot of our patients self-submit for insurance and get reimbursed back anyway. So sometimes they're paying like the same as a copay to another specialist, you know, when certain instances. And for us, we opted to go that route because I mean, I myself, I kind of like the idea of working, working for the patient on like a fee basis because it makes me a better clinician because if I'm not getting results for them or if we're not making progress, they're not going to pay me like, you know, harder and cash. They're just going to like, they're either not going to come back or not recommend people or so. So it really kind of ensures that you're doing your best to help them and then they're kind of helping you back in a way by taking that load off to not have to call insurance companies and get pre-authorization of all this craziness. I think and also in residency, we did take insurance like in my residency and you know, it did seem like a lot more kind of hoops to jump through. So if you're going private practice route and I think across the board and people in OMM typically go cash only because there's so few of us that that a lot of patients are just willing to do that and just pay cash and and then see their primary docs or other docs with insurance. So I think for me, it's like, that's just how I always envision myself practicing even as a student. It's every mentor I was with and I have like four or five OMM mentors, no one took insurance. It was just all cash-based because you need that long amount of time with each person and you know, a lot of times the reimbursements were not, you know, survivable in terms of like what you would think of that. And even I don't even think prolotherapy is, you know, insured, so to speak. So a lot of the modalities I use, you know, they're just non-insurance-based. Right. And it's a common theme that I've been seeing with integrative practitioners, nonchal medicine practitioners, OMM. And again, for the listers out there who might be patients, this is an investment into your own health for longevity, right? The same way we talk about cars, the same way we talk about our laptops, all that good stuff, you're putting your own money into your own health, which is what fuels the rest of your life. Yeah. Right. So Alex, before we let you go here, this is probably the most important question of all because I've been stalking you on Instagram, which by the way, people, listeners, you need to follow Alex King on Instagram, doctor.allix.king, great Q&A sessions, great paintings, by the way, which is where this is going to lead to. Tell us about your paintings. I know you're an art major, but I look at your paintings. I see the abstract and I'm actually in love. So I've probably got to do it. Yeah. I started doing art since I was about three years old and my mom really saw my interest in it. And like the fact that I would just not stop drawing and stuff. So she just kept like buying me art supplies. She signed me up for these private classes, like with other kids, I guess, and who are into art. And then in high school, I kept taking art classes. And it was weird because it never was a purposeful thing. It was almost just like a side effect of who I am. It's like, yeah, I'm taking art class. That's literally what else am I supposed to do. I'll take science and I'll take art and science and art. For me, it's always an expression of just like, I don't know if it's my subconscious or what, necessarily, I just pull things from a lot of different artists. So I'm a big fan of art history. Like big artists who are, I mean, very, very common, obviously like Picasso and Kandinsky and more modern days. It's like George Kondo, a friend of mine, Bereke Cobbs is an inspiration of mine. So I'll kind of like pull things from both the past and present. And then just express them like without even thinking about it. So like none of my paintings are ever planned in advance. I just go off like immediacy and like speed because I feel like the quicker I do things the less I get in the way of it. And so I do mostly acrylic on canvas paintings nowadays. A lot of custom pieces, but I also sell through a store called search and rescue, which is in Philadelphia. And I sell prints with them as well. So I also have a couple buyers internationally who I'll ship to. And it's a fun, you know, it's a fun thing. You get to meet people with it. I've collaborated with other artists. And it's just like, I mean, my dream is to one day have my art in, you know, the MoMA in New York City. And I think I'll have a show in Soho coming up in the spring. So I'm like slowly creeping up there. We'll see whatever happens, but like I'm gonna keep trying. So it will happen. And I've seen your paintings. It will definitely happen. I appreciate it. Yeah. Like that would be super cool. So so where do I, if I want to buy one, where do I go? So you can always, if anyone like wants to do a private consultation for a piece, they just DM me on Instagram. And we talk about, you know, what size, color, time frame, pricing. And then they'll, you know, pay half up front and half when it's completed. But but yeah, that's kind of like the easiest ways to just message me. Or if you know you, there's a piece that you would like that you maybe don't want the original, but like a print of that, I do custom printing for certain pieces as well. So yeah, that's that's how you can do it. That's good, man. Awesome. So before we let you leave again, can you just tell everyone where else can we follow you? So definitely follow me on my Instagram account. It's, as you mentioned, at doctor dot Alex dot King and doctor spelled out. So D O C T O R. And I just put up a link tree on my bio so you can follow the link tree to all of my other podcasts, YouTube videos I'm featured in. I'm starting a YouTube channel actually this weekend. So it's going to be, it's going to be a mix of vlog style because my, I've been told my life is very unique in a way where I'm like one minute, I'm at, you know, the art store, like selling some pieces that I'm treating a friend with some OMM acupuncture and then I'm going to do like a workout. So it's like all over the place. So someone was just like, they're like, you know, I would watch like a video of just like what you randomly do during the day. Vlogging it and see what happens. So y'all do a patient series as well, like certain friends of mine who are just all jacked up and they're just like, dude, can you just fix me like a few times? And I'm like, yeah, let's just do a series on it like where you started and how, how you end up after getting treated a few times. Can I be a part of that? Yeah, yeah, no. Listen, man, if you're looking for that end, I feel like I need more for you, bro. Right now we're half. Yeah, we're not. He's an hour and a half. Yeah, that's it. So we'll set up a couple episodes. Yeah, that would be cool. So yeah, that YouTube channel is starting and I've got a bunch of other, you know, podcast appearances and stuff on there. So check the link tree. Alex, dude, yeah, I mean, definitely unique. I agree. I've been following you for a little bit now and, you know, definitely I would say an exceptional individual. Obviously a man of many talents, you know, a physician and osteopath with amazing manual therapy skills and an amazing artist as well. But, you know, I, I love this conversation. I, I feel inspired, you know, I'm in my program kind of recognized as the, the OMM guy, even though I do like a little Spencer here, I'll do a little counterstrain on the inpatient units. That's more than anyone else though. I know we, we get some patients, you know, because I went to an osteopathic recognized program in Philly. And so we, we learn how to do inpatient side, but obviously you're doing stuff at the next level, man, when the world allows it, I cannot wait to drive up to Terry Herald. I've been like right outside the shinsenter, but this time, you know, we're going to set something up, man, I want to come learn from you, actually see you in action. But I'm just excited to continue these conversations, man. Thank you for coming on. It's been fun. Yeah, thanks for having me guys. That was like a really cool conversation. I'll have you on my, my stuff to my YouTube and maybe a podcast. I'll start, we'll see. But yeah, thanks. Absolutely, man. Thank you, Alex. And we might need you for a part two, not might. We definitely will need you. Yeah. We'll be more specific. So yeah, sure. Awesome, man. Appreciate it. Thank you so much. Of course. Take care. Yeah. 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