The International BIOFLEX Clinical Users Manual

This document is made available to all professional healthcare providers and others trained in the application of BIOFLEX® Laser Therapy.

It should be understood that there are many regional, national and other regulatory bodies that must approve protocols currently available to users of the various systems manufactured by our company. Some of the more prominent of these bodies include the FDA, the European Economic Union and those of individual countries that permit utilization of Laser Therapy based on their personal knowledge, experience and specifications for the equipment that have already been approved. These include many disease-specific standardized directives and also the customization mode that is available at this time.

It must be noted that Meditech in its thirty-two years of existence has extrapolated protocols based on the development of a database that validates the use of these directives over many years.

It is our belief and opinion that throughout most areas of the world, these protocols can be safely used as the primary therapeutic approach. The ultimate decision on how to apply the protocols listed in the International Manual are at the discretion of the individual practitioner, keeping their regional and national regulatory bodies in mind.

At the same time, we do not wish to deprive anyone of utilizing the most up-to-date and comprehensive therapy for any specific medical condition, as indicated from the clinical perspective.

There is also available an International Review Board generally based at the local hospital or other medical authority which grants permission to utilize the therapy as prescribed. We certainly do not wish to deprive individuals presenting with challenging and complex medical conditions from obtaining effective treatment.

Once again, it should be stressed that the manual presented to you contains information extrapolated from the data derived from approximately fifty thousand patients treat ed globally, which has permitted the compilation of these evidence-based results.

Our approach respects the demands and needs of oversight bodies to provide control in their individual jurisdictions.

To summarize, the International Manual is made available at no cost to all clinicians and enables them to review applicable directives that have been selected on the basis of evidence-based medicine, successfully extrapolated from the database compiled over the last thirty plus years.

Respectfully Submitted,

Fred Kahn, MD, FRCS(C)
Meditech Rehabilitation Centres

If you would like a copy of this manual, please contact Fred Kahn at fkmd@bioflexlaser.com

BioFlex Laser Therapy in the Treatment of COVID-19 Infection

Preamble

In this time of an unprecedented historical crisis, few individuals are able to continue thinking independently while also retaining some sense of balance, and most importantly, common sense. Hopefully some of us are able to cling to these characteristics at a time when reason appears to be lost, and when many politicians and other spokespersons provide many conflicting and confusing directives.

Personally, I am a firm believer in at least one-half hour of daily vigorous exercise, balanced nutrition, and attempting to be active without endangering others. This permits time for reflection.

Over the past weeks, I have received numerous inquiries from healthcare professionals that are trained in Laser Therapy whether they should apply this treatment to patients afflicted with a variety of symptoms, secondary to COVID-19, and most particularly concerning respiratory problems.

It is my personal opinion that this course of action could be highly beneficial, although no large-scale studies have been performed to date. Over the past decade, the clinical staff at Meditech has treated many patients demonstrating an extensive variety of pulmonary diseases characterized by inflammation, fibrosis, and obstruction. This results in limitation of respiratory capacity and inadequate oxygenation of the blood and therefore the tissues. The conditions treated include those inflammatory in nature, chronic obstructive pulmonary disease, etc. In treating these entities we have had almost universal positive results, however for regulatory reasons, we have not promoted this particular therapeutic approach. As we all know, healthcare today is governed by the insurance companies, politicians, and regulatory bodies while the medical profession has become obsequious to these entities. Practitioners have been forced to rely on codes, equivalent to “speaking in tongues”, which have no particular relationship to quality therapy and are completely related to economic factors.

On April 18th, I happened to watch a television program from Italy which has prompted this presentation. The content featured two Italian ICU specialists, both of whom were highly knowledgeable and demonstrated the type of reflection that is so important at this stage of our international dilemma. The discussion revolved around the process of intubation, induced coma, and the widespread use of mechanical respirators in the treatment of pulmonary pathology secondary to COVID-19 infections. These doctors’ comments were apolitical and a true revelation, more significant than any others I have recently heard. The ICU doctors indicated that the above approach resulted in an unacceptable level of morbidity and mortality, a fact which was of no surprise to me. Mechanical respiration and intubation imply significant trauma, particularly in the hands of therapists that may be inexpert in their administration. Lungs affected by the virus are severely inflamed, filled with viscous fluid, and are surrounded by fibrotic and necrotic tissue which severely limits the exchange of gases. The lungs are inelastic and forcing expansion can lead to disastrous results. Clearly, even in the best of hands, this may not be a rational or an elegant approach, although generally applied with the best of intentions.

On the other hand, Laser Therapy has been established over the past 50 years and consistently accelerates the healing process in tissue. With regard to the COVID-19 pathologies in the lungs, the following physiological effects conferred by Laser Therapy would be of immense value i.e.:

Elevation of the immune response.
Potent anti-inflammatory effect.
Improved metabolism of the individual cells.
Increased production of endorphins.
Regeneration of new cells.
Restoration of normal structure and function of existing cells.
Increased cortisol production which is the precursor of cortisone within the body.

Numerous additional physiological activities which are highly beneficial occur concomitantly. Both local and systemic effects are actualized, and these represent significant factors in the healing process.

Advantages of the Application of Laser Therapy

Technicians can be trained to utilize the equipment with 2-3 hours of training.

Protection of the health care worker’s exposure is facilitated. Therapy can be started immediately. There are no adverse effects associated with this therapeutic approach. The clinical benefits begin to be realized concurrent to application.

At Meditech we have established a group of clinicians and therapists, all of whom share these views and objectives. As a physician, I have always been motivated to help those in need and there is no better time to move forward than the present.

Application of Laser Therapy to the Pulmonary Structures

The entire lung can be irradiated in the course of an hour-long treatment, utilizing large surface arrays powered by specially manufactured SLD’s.

This process can be followed by the application of a 200mw infrared laser probe directed at the most severely affected areas of pathology. Application time in the most acute case would require 1 hour of Laser Therapy in the morning, and 1 hour late in the day. Laser Therapy to the cervical spine may also be incorporated during the course of treatment for purposes of neuro-modulation.

In conclusion, I will summarize what I have already stated; Laser Therapy can be instituted immediately, and the effects will be apparent both systemically and locally as soon as therapy has been initiated.

Fred Kahn, MD, FRCS(C)

CEO and President of Meditech International Inc.

Effects on Anatomical Structures

Musculoskeletal (rib cage)

Diminishes inflammation of intercostal musculature
Reduced muscle spasm
Facilitates lactic acid removal
Improvement of muscular contractions increasing the ability to breathe more normally

Sternum

Improved replication of cells that can potentially destroy the virus directly and remove necrotic tissue.

Lung Parenchyma

Inflammation reduced
Exchange of gases facilitated in alveoli
Fluid retention relieved, allowing improved functional capacity

Cervical Spine, Cerebellum, and Brain Stem – Neuromodulation

Reduced anxiety
Depression gradually lifted
Mood elevation
Restoration of sleep patterns

Tips – Re: Application of Therapy to Lungs

Focus on radiation over the lung tissue that is most accessible, i.e. bases of lungs, apices, and axillary areas.
Minimal treatment over scapulae, cardiac region, and sternum, but these areas do require treatment.

Protocols

L-S Array; 3 minutes Red, 5 minutes Infrared over areas where parenchyma is readily accessible.
L-S Array; 2 minutes Red, 4 minutes Infrared over cardiac area, sternum, scapulae, and thoracic spine.

Initial Protocol Settings

Stage 1
Red continuous / Infrared, frequency 50/duty cycle 80; total treatment time approximately 1 hour. If immediate response is good, continue with these settings.

If progress is slow, after two treatments one may advance to Stage 2.

Stage 2;
Red frequency 100/ duty cycle 90, Infrared frequency 50/ duty cycle 90

Stage 3;
Red frequency 1000/ duty cycle 80, Infrared frequency 250/ duty cycle 80

Stage 4;
Red frequency 1000/ duty cycle 90, Infrared frequency 250/ duty cycle 90

Stage 5;
Red frequency 10,000/ duty cycle 70, Infrared frequency 5,000/ duty cycle 80.

Treatments can be applied in accord with severity of the clinical symptoms and the patients’ overall status.

In moderate cases, 1 to 2 hour long individual daily treatments suggested.

In severe cases, Therapy every 8 hours may be advisable.

In all cases, one may remain at whatever Stage is providing the best clinical response. A good clinician will always be able to easily move from one Stage to the next, depending on correlation of changes in the patient’s condition.

The IR Laser Probe can be applied for 10-20 minutes in areas where consolidation of the lungs is noted to be most severe. Usually apply in continuous mode.

Anterior View Of Rib Cage (Lungs)

Posterior View Of Rib Cage (Lungs)

Cervical Spine Placement Of Arrays

Using arrays over the four positions is preferable in most cases (i.e. A, B, C & D).

Protocols For Cervical Spine (Cerebellum , Brain Stem)

Stage One:
Treatment Head	Frequency	Duty Cycle	Duration (mins)	Power %
DUO Red DUO Infrared LD-R 100 LD-I 200	CW 50 CW CW	50	4/4/4/4 5/5/5/5 6 6	50 25-50
Stage Two:
Treatment Head	Frequency	Duty Cycle	Duration (mins)	Power %
DUO Red DUO Infrared LD-R 100 LD-I 200	CW 50 CW CW	70	4/4/4/4 5/5/5/5 6 6	100 25-50
Stage Three:
Treatment Head	Frequency	Duty Cycle	Duration (mins)	Power %
DUO Red DUO Infrared LD-R 100 LD-I 200	100 50 CW CW	70-90 80	4/4/4/4 5/5/5/5 6 6	100 50-100
Stage Four:
Treatment Head	Frequency	Duty Cycle	Duration (mins)	Power %
DUO Red DUO Infrared LD-R 100 LD-I 200	100 50 CW CW	80 80	4/4/4/4 5/5/5/5 6 6	100 100

If you require any further information, please do not hesitate to contact us immediately.

(This presentation is specifically intended for the treatment of patients who are hospitalized. At the same time it can be used to prevent progress of presumed early symptoms of the disease following medical assessment.)

Ova Fertilization Through Laser Therapy

The article presented following this introduction describes a specialized application of BioFlex Laser Therapy. Moreover it represents an outstanding research project at an appropriate point in time. Whereas in some aspects it may be considered preliminary, the benefits it demonstrates in elevating the mobility and potency of sperm are significant and should facilitate the process of successful fertilization.

Many articles and factors relating to this topic are explored at a time when a simpler therapy than IVF should be applied in order to facilitate procreation for a population in which the rate of fertilization is declining.

This piece of research might lead to a follow up project exploring irradiation of the ova pre and post ovulation from the anterior lateral and posterior approach. I believe that this might add additional benefit and would be pleased to assist in the design of appropriate therapeutic parameters. Of significance, is the potential benefit that can be derived from the application of precise laser therapy in an area where currently no other specific treatment is available. On a final note, my congratulations to Dr. Heinrich van Wyk and Professor Stefan du Plessis at Stellenbosch University in South Africa, one of the oldest and most respected educational institutions in the world.

Fred Kahn, MD, FRCS(C)

The use of low-level laser therapy (LLLT) to enhance human sperm parameters

Heinrich van Wyk

BSc honours (med) medical physiology
Supervisor: Prof Stefan du Plessis
Co-supervisor: Miss Bongekile Skosana

Click Here To Read Article

Case Presentation: Utilizing Laser Therapy in the
Treatment of Rasmussen’s Encephalitis

Santiago, R.; Kahn, F.; Kim, S.; Oszarfati, J.

This patient had been diagnosed with Rasmussen’s Encephalitis and decided to independently pursue a course of Laser Therapy, making the decision to select this therapeutic approach prior to surgical intervention which had been advised.

The patient is a 23-year-old female who lives in France and has been diagnosed with Rasmussen’s Encephalitis, characterized by frequent grand mal seizures which she had been experiencing since November 2015. These seizures were poorly controlled by individual or a combination of medications in high dosages. Her condition became more severe in April 2017 when paralysis of the right side of the body developed accompanied by an increase in the severity of her seizures. This was accompanied by pain on the right side of the face and tongue, gradually extending to the right side of the body including both extremities.

A CT scan performed in January 2018 noted a hypodense area in the left parietal region consistent with Chronic Encephalitis. During this period, she began to experience focal seizures of the right lower extremity which was poorly responsive to medication. This prompted treatment with intravenous immunoglobulin therapy over a 3-month period, which improved her condition minimally. Over time she developed decreased muscle tone and lack of coordination of the right side of her body which confined her to a wheelchair, and resulted in increased difficulty writing, eating and functioning on virtually every level. She also began to experience difficulty processing information and developed expressive aphasia. Prior to presenting at our clinic, she had been under the extended care of a Neurologist in France.

Treatment with Laser Therapy was initiated in May 2018 at the Meditech Clinic in Toronto. Therapy began with the application of both large surface arrays utilizing radiation at Red 660 nm and Infrared 840 nm, followed by the Red and Infrared Laser Probes at 660 nm and 830 nm, respectively. Therapy was applied to the cervicothoracic spine region targeting the brainstem, cerebellum and the cervical spine including the cord. Cranial coverage was included following a week of therapy to the cervico-spinal area.

The initial positive response from the patient included an increased range of motion of the right lower extremity, gradually permitting short walks independently. Of significance was the improved quality of her sleep which increased in duration and depth along with emotional stability. This improved her overall status significantly. Her seizures became less severe in frequency and duration and the protocols were adjusted as the various symptomatic improvements continued to improve. The tremors she had experienced in her right leg decreased in severity.

Following two weeks of therapy at the Meditech Clinic in Toronto, the patient noted continuing improvement in her overall well-being, particularly sleep duration and quality and improved range of motion of all affected areas, accompanied by an almost total lack of seizure activity. On that basis, she was provided with a portable unit to continue treatment in France. This followed careful training of the patient and her family who were provided with a variety of protocols to use at home in accordance with symptom changes.

The patient was advised to continue treatment on alternate days including the cervicothoracic spine and the cranium with instructions for change concomitant with her symptomatology. She was advised to communicate with the clinic in Toronto by email for ongoing guidance. She was also advised to continue treatment with IV immunoglobulin therapy and anticonvulsants as indicated by her Neurologist. The patient currently continues to respond to this multifaceted approach and at this time, the proposed cerebral hemispherectomy, which had been previously advised has been cancelled.

Rasmussen’s Encephalitis is a rare and chronic neurological disorder characterized by unilateral hemispheric inflammation of the cerebral cortex, seizures and progressive neurological and cognitive deterioration. At this time, cerebral hemispherectomy is generally offered to patients in this category, particularly those who respond poorly to conventional medication1. Decisions regarding surgical intervention and the appropriate time to institute such measures are challenging to healthcare providers, caregivers and, needless to say, patients, particularly in the absence of a severe neurological deficit and is questionable at best. Immunomodulatory therapy appears to slow rather than halt progression of the disease and does not change the eventual outcome.

Over the past two decades, Laser Therapy has been introduced as an innovative treatment for the modulation of neural activity in order to improve brain function. Treatment requires exposure of the cervical spine and the central nervous system to a low fluence of light using appropriate delivery methods. The safety and ability to customized protocols using Laser Therapy including variations in wavelength, fluence, power density, number and duration of treatments and the mode of application (continuous or pulsed) to the central nervous system have been investigated in many clinical studies. Several reports with regard to the effects of Laser Therapy demonstrate a significant effect on a wide range of CNS disorders2 including epilepsy, traumatic brain injury, neurodegenerative disorders, headaches, vertigo, mobility problems, multiple sclerosis, neuromuscular disorders along with impaired sleep patterns, CVA and transient ischemic episodes.

Although the response of this patient to Laser Therapy may primarily be attributed to its neuromodulatory and neuroprotective effects, the potent anti-inflammatory effect on tissue may have contributed significantly. A number of researchers have demonstrated an increase in adenosine-3’, 5’-cyclic monophosphate (cAMP) following the administration of Laser Therapy. Although it is tempting to suppose that this increase in cAMP is a direct consequence of a rise in ATP following light therapy, clear-cut evidence for this supposition is still beyond the realm of proof. It has been reported that cAMP-elevating agents, i.e. prostaglandin E2, inhibit the synthesis of TNF and therefore downregulated the inflammatory process. Lima et al. investigated the signaling pathways responsible for the anti-inflammatory action of Laser Therapy (administered at 660 nm, 4.5 J cm−2) when applied to the lungs and airways. They found reduced TNF levels in the tissue treated, probably secondary to an increase in cAMP levels3. This would indicate that Laser Therapy may be a useful adjunct in the treatment of certain central nervous system disorders that are accompanied by a significant inflammatory component.

CONCLUSION:
This case of Rasmussen’s Chronic Encephalitis serves as an example of how Laser Therapy can be utilized in the neuromodulation of a serious brain disorder and demonstrates how Laser Therapy can potentially be a significant factor in the neuromodulation of both the central and peripheral nervous system where conventional therapies do not offer solutions. This is based on a significant improvement in this patient’s overall status and clearly illustrates the potentials of Laser Therapy in the treatment of these conditions. This is largely due to its neuromodulatory, neuroprotective and anti-inflammatory effects and supports ongoing research and application of this treatment for this and other neurological conditions. During a relatively brief course of treatment which is continuing, the majority of the patient’s symptoms were markedly reduced and functions at most levels have improved substantially. Currently as her treatment is effective, surgery need not be considered. Moreover, the patient and her family are pleased with the positive changes noted.

Varadkar S, Bien C, Kruse C, Jensen F, Bauer F, Pardo C, Vincent A, Mathern G, Cross JH. Rasmussen’s encephalitis: clinical features, pathobiology, and treatment advances. Lancet Neurol. 2014 Feb; 13(2): 195–205.
Salehpour F, Mahmoudi J, Kamari F, Sadigh-Eteghad S, Rasta SH, Hamblin M. Brain Photobiomodulation Therapy: a Narrative Review. Molecular Neurobiology https://doi.org/10.1007/s12035-017-0852-4.
Freitas LF, Hamblin M. Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE J Sel Top Quantum Electron. 2016 May-Jun; 22(3): 7000417.

Historic Milestone Reached at Meditech International

Release of MultiPort Systems for Clinical Application

In January 2018, a seminal event occurred at the company with the completion and release for distribution of the MultiPort Series of Laser Therapy Systems. This occasion was particularly rewarding to Dr. Fred Kahn, the founder of the company, who had visualized this achievement almost two decades ago.

The design, manufacturing and operation of a system that could power several arrays or laser probes at the same time posed major technical challenges that the designers and engineers involved found problematic. On occasion, they felt that the project was beyond their scope. Over time, however, everyone involved combined their creative resources and were eventually rewarded by a level of success which, from an operational and functional perspective, has proven to be overwhelming.

The premier version of this product-line, the MultiPort Four, features four power outlets which permit the treatment of four anatomical areas in one patient simultaneously, or the treatment of four individual patients at the same time. A second version in this series of devices is the MultiPort Two which offers only two power outlets and is more suitable for lower volume clinics.

A total of three large surface arrays and two laser probes are available for each specific treatment session and can be used in an infinite number of combinations to produce optimal clinical outcomes.

Just think – with only two of the MultiPort Four Systems, featuring eight power sources, eight individual areas or patients can be treated at once. This is a major step forward with regard to functionality, offering a substantial reduction in clinic space required, and enabling one therapist to apply and monitor eight arrays and/or probes in various combinations at once.

Theoretically, and without any difficulty over a 12 hour period, on average, performing one treatment per hour or less, nearly 100 individual treatment sessions can be administered per week. Over a seven day week, using two MultiPort Four Systems, almost 700 patients can be treated, generating $70,000 in revenue. Taking this one step further and utilizing three MultiPort Four Systems, over 1,000 treatments could be administered weekly, generating over $100,000 in revenue. Moreover, from the patient’s perspective the cost would be moderate, while the overhead of the clinic would be minimal compared to the income generated.

With the precise, consistent and highly reliable performance of the Systems, an extensive number of pathologies encountered in the patient population could be effectively treated utilizing only Laser Therapy, with minimal reliance on surgical intervention, pharmaceuticals, and the many ineffective modalities so abundant in the health care systems prevalent today. Realigning the economics of effective therapy in the treatment of large populations would have a significant impact on the existing scenario, i.e. substantially reducing the costs of therapy while markedly elevating the level of therapeutic success. With this approach an extensive number of diseases – the results of traumatic incidents, degenerative conditions, etc. – many of which are frequently resistant to conventional and traditional therapies, could be resolved in a timely manner.

Clearly this historic event represents a major advance in the field of Laser Technology, requiring over 20 years from the conceptual design to application. The process was concluded by prolonged clinical and ergonomic testing, performed at five individual clinical sites. During this period many revisions and innovations were added to the Systems in order to improve function and subsequently increase the benefits conferred to patients.

This major undertaking, which should provide significant value to patients worldwide, has been approved by both the FDA and the European Economic Union. The regulatory process should be completed by a Health Canada review prior to the end of 2018. Preliminary reports from clinics now using the MultiPort Systems, universally state that this represents a major step forward in health care and to date has been met with an unparalleled level of clinical success.

The economics of acquiring the MultiPort System, particularly the MultiPort Four, will revolutionize the application of Laser Therapy, not only with regard to effectiveness but on a highly scalable basis. As a result of the numerous design innovations, therapists should experience less stress, muscle strain and fatigue with the reduced physical mobility required. This will increase efficiencies and extend hours of operation.

The ability to monitor a unique, high-resolution, large touchscreen – incorporating four mini screens – provides continuous data with regard to each array or probe applied from the beginning to the termination of the treatment.

Many other features will be found on your voyage of discovery which promises to simplify the process of application, improve clinical results, and elevate Laser Therapy to an unprecedented level in the pantheon of superior medical technologies.

BioFlex Professional Systems

Laser Therapy is a highly effective, non-invasive technology – the treatment of choice for the resolution of many pathologies including arthritis, sports and soft tissue injuries, wound healing, etc. A series of patented devices utilizing Red and Infrared Superluminous and Laser Diodes in sequence initiates a cascade of beneficial physiological activities within the cell. The Diodes emit electronic particles called photons that stimulate the body’s natural healing processes by eliminating inflammation, initiating the regeneration of new cells and increasing the body’s production of endorphins – naturally produced substances (i.e. enzymes, hormones, etc.) which mitigate pain.

Systems are designed “by clinicians for clinicians” in order to relieve the dysfunction induced from the pathological entities encountered. The result – the restoration of normal structure and function of the cells.

Clinically, this results in the rapid and often complete alleviation of pain and other symptoms accompanied by the restoration of normal physical activities without the need for pharmaceuticals and frequently making surgical intervention unnecessary.

Numerous design and safety features are integrated into the BioFlex Therapy Systems permitting the delivery of precise, consistent and reliable therapy.

Systems are readily integrated into the practice of physicians, chiropractors, physiotherapists and many other healthcare professionals. The symptoms accompanying pathologies, including pain, are mitigated and frequently completely resolved in the majority of conditions, some of which are listed below:

ARTHRITIC AND SPINAL PROBLEMS
Degenerative osteoarthritis.
Multilevel degenerative disc disease.
Spinal stenosis.
Sciatica.
Disc herniations.

Sports and Soft Tissue Injuries
Ligament, tendon and muscle tears/strains.
Knee injuries (meniscal and ACL tears).
Synovitis.
Fractures.
Contusions/Hematoma.

INFLAMMATORY CONDITIONS
Rheumatoid Arthritis.
Myofascitis.
Plantar Fasciitis.
IBS.
Tenosynovitis.

Repetitive Stress Injuries
Carpal tunnel syndrome.
Rotator Cuff Problems.
Epicondylitis (tennis elbow).
Stress fractures.

General Conditions
Temporomandibular joint dysfunction.
Lymphedema.
Fibromyalgia.
Gout, etc.

Conclusion: Administration of therapy is pain-free and in most instances is effective on a short term basis, but in all situations has a long-term cumulative effect accompanied by the restoration of tissue integrity. This results in pain-free activity levels and restores the quality of life.

Guidelines for Patients To Explain the Progress of Healing With Laser Therapy

As most of us know, disease entities follow many different paths. The clinical picture may be chronic or acute and in most cases lies somewhere in between. Periodically, symptoms may be severe and may even constitute an emergency.

Rate of Healing
Surprisingly, a significant percentage of patients will feel markedly improved or even be asymptomatic after as few as 2 to 5 treatments. On the other hand, cases with similar diagnoses may take up to 15 or more treatments to cure the same condition. This relates to the severity of the disease process, the genetic makeup of the patient’s individual cells and their inherent preponderance to healing.

In the majority of cases, the rate of healing cannot be predicted in advance; however, it generally becomes apparent after the first 3 to 4 therapeutic sessions. Excessive degrees of physical activity however, may aggravate the disease process; therefore this is a factor which should be controlled during the course of treatment. The level of compliance with the physician’s directives are also of significant importance and should be carefully followed.

In the course of our daily activities at the clinic, I frequently see patients who state that they are relatively asymptomatic, again following only 2 to 3 treatment sessions and others with similar problems who have improved only minimally after as many as 8 to 9 treatments. In the latter situation, we find that resolution may often be only 1 or 2 treatments away. This demonstrates the many pathways of healing in individual patients.

Cooperation in order to accelerate the healing process is required by the patient, the therapist and the diagnostician. As you may appreciate, healing is not a direct or instant process as the enclosed testimonial indicates (see page 6). This patient was treated with many manual therapies, a number of conventional modalities and medications over a period of 3 to 4 years. Despite this, prior to the application of laser therapy, minimal improvement had only occurred at infrequent intervals. Many similar records of this type of healing endeavor are contained in our files and serve to reinforce my comments.

To reiterate, the following factors are of paramount importance in the production of a satisfactory healing process:
1.) Compliance with the physician’s directives – When the patient carefully follows the clinical dictates prescribed and pursues the course of treatment indicated, healing is generally more rapid than if the patient presents only on occasions of convenience.
2.) Activity levels – When symptoms are acute, rest should be prescribed by your attending clinician or as dictated by the severity of symptoms. Generally, it is important to reduce activities involving the injured area to a minimum. Frequently, one may enlist the use of aids such as crutches, canes and walkers, etc., depending on which area of the body is most severely affected. Bedrest along with the utilization of specific medications may be beneficial concomitant with the utilization of laser therapy, particularly when associated with arthritis and injuries of the spine.
3.) Analgesics and other complementary modalities – These may be utilized as indicated and advised by your personal physician. The patient should disregard the simultaneous advice of multiple healthcare advisors as this may be confusing and counterproductive. Laser therapy, rest and medications as required generally provide a relatively rapid and satisfactory course of resolution of the pathologies encountered.
4.) Common sense is always applicable – Do not engage in activities that increase symptoms including pain, etc. If it is painful to walk or engage in any activities, avoid those activities until symptoms have largely disappeared. Some factors that exist cannot always be controlled and therefore require persistence in continuing Laser Therapy. Do not cease treatment too early as a cure may be only a few treatments away. Laser Therapy is cumulative and in the majority of instances, coupled with rest and time, the healing process can be completed effectively. Progress can often be measured by serial measurement of the dimensions of the joint, the circumference of a limb, the range of motion of the spine or a computerized assessment of the three-dimensional wound.

Your physician should always takes a positive approach. If you follow this lead, complete healing in over 90% of cases can be achieved. As someone once commented, patience can be a virtue, particularly when applied to the process of tissue healing. Laser therapy, properly utilized, can speed the resolution of your particular problem and restore the normal standard of health and quality of life expeditiously.

LASER THERAPY AND OTHER TERMINOLOGIES

Laser Technology, from the descriptive perspective, is also identified by a variety of alternative terminologies. These include – photobiostimulation, phototherapy, light therapy, low level laser therapy, cold laser and the list, depending on the origin of the therapeutic culture, is literally endless. I think the time has come to describe the technology more simply and accurately. This should resolve any existing confusion and its accompanying inaccuracies.

A considerable number of years ago, during the course of a two-day focus seminar at Meditech International, several experts attending the meeting decided to coin the term, “Low Intensity Laser Therapy,” which was generally felt to be the most correct by definition.

High intensity laser diodes, which can cut steel and other materials in the course of utilization will inevitably destroy cells if used in their environment. This can be useful during the process of cauterizing veins and arteries while performing surgical procedures and the ablation of many types of tissues, including moles, polyps, tumors, dermolysis and other situations where a localized destructive process is required.

For the purpose of simplification, we have shortened the most accurate descriptive terminology to “Laser Therapy”. Whereas this process is sufficiently potent from the power perspective to initiate a cascade of positive or constructive physiological reactions within the cell, it is distinguished from the extensive number of higher powered lasers, which are generally utilized in the controlled destruction of tissue. For the purpose of tissue healing, the process works according to the dictates of the Arndt-Schulz Law.

In recent years therefore, as indicated, we have abandoned all previously utilized terminologies in favor of the term “Laser Therapy.” This description is simple, accurate and more widely inclusive. It should be noted that the technology is constructive with regard to the restoration of the normal morphology and function of the cells. Moreover, it is used to stimulate the replacement of cells that are functioning suboptimally or not at all. It is athermal, rather than thermal – another common belief that is erroneous. Ambient temperatures should not be elevated by more than 4 to 5 degrees at the treatment site.

I believe that this explanation, although brief, should clarify the concept of the BioFlex Laser Therapy System and most Class III Devices.

A Summary of the Signs and Symptoms of Cerebral Concussion and Guidance – Re: Clinical Management

Etiological factors may vary from a minor blow to the head, often combined with a whiplash-type injury of the cervical spine resulting in a symptom complex that may be minimal in degree. However, when the trauma is more severe, it may render the patient comatose for prolonged periods of time and even result in death. In most instances, symptoms are brief in duration and last for a matter of days to several months.

The Center for Disease Control and Prevention defines concussion as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces, secondary to direct or indirect forces applied to the cranium.”

Symptoms can last from minutes to days and in some instances become chronic or permanent. Early symptoms include headaches, pain in the cervical spine, nausea, dizziness, an inability to focus or concentrate, memory loss, visual disturbances and in a small number of cases induce loss of consciousness or even coma.

The Glasgow Coma Scale classifies concussion based upon the level of consciousness of the patient. Mild concussion typically allows complete neurological recovery. Moderate concussion can result in stupor and lethargy. In cases of severe concussion, patients may experience a comatose state, a heightened risk of hypotension, hypoxemia and edema of the brain. Invariably, all forms of concussion result in varying degrees of inflammation of neurological tissue, accompanied by pain and neurological impairment.

It has been determined that MRI, PET scans, EEG studies, etc., generally do not reveal any significant abnormalities in the early phases of the disease. Macroscopic changes of cellular tissues may not accompany the symptoms that exist until a significant period of time has elapsed.

Usually, traumatic episodes that result in concussion include a collision with an opposing player when engaged in sports activities, falls and other incidents sustained in the home, motor vehicle accidents and the numerous traumatic episodes related to military activities. The majority of episodes cause only minor symptoms, which usually disappear over a finite period of time, in most cases without any specific therapy being applied.

It has been calculated that somewhere in the vicinity of 10 to 20% of all cerebral concussions that have been formally diagnosed result in symptoms, which if they persist over a period of time may become chronic. In all of these cases, appropriate therapy should be applied and continued until the patient has been asymptomatic for a period of at least 2 months while engaged in relatively normal activities.

The symptoms most frequently reported consist of headaches which may take many forms. Generally, they are fronto-occipital in location accompanied by pressure sensations, stabbing, aching, throbbing, etc. They may be intermittent or exist on a 24/7 basis. The majority of these patients also complain of pain in the cervical spine with or without radiation to the upper extremities. Insomnia, irregular sleep patterns and cognitive impediments may be minimal to extreme. These include difficulty in finding words, the normal comprehension of reading material, TV content, an inability to focus and concentrate and in essence, mentation is impaired in varying degrees. Memory loss may be short or long term and in some instances both. Often this relates to the duration of the period of loss of consciousness, which however in the majority of cases does not occur. As previously indicated, the injury may induce a prolonged state of coma or even death.

Symptoms may also include a loss of sense of taste, reduced auditory acuity, tinnitus and visual disturbances including blurring, double vision, etc. Both light and sound sensitivity are frequent and may persist. The patient may be unable to attend school, work, lose the ability to socialize and be unable to engage in normal relationships. Irritability with periods of labile mood disorders may be accompanied by loss of anger control. Fatigue, anxiety and depression may be present in both the early and late phase of cerebral concussion. With the development of chronicity however, they may become the most dominant long-term problems.

An increasing number of neuroscientists believe that many years later, neurological diseases such as Parkinson’s disease and the dementias may result from a traumatic episode of the brain experienced much earlier in life and long forgotten.

All patients who have sustained cerebral concussion with persistent symptoms should be monitored until asymptomatic and in most cases based on clinical findings and progress, should be subjected to curative Laser Therapy and in some instances preventative treatment.

Certainly, in patients who remain symptomatic even for a week without improvement, a course of Laser Therapy based on thorough clinical evaluation is advisable. A standardized or individual customized course of treatment for each patient should be administered as clinically indicated.

In conclusion, all patients who have sustained a cerebral concussion should undergo an ongoing course of Laser Therapy, unless symptoms improve rapidly post-trauma spontaneously. The purpose for this is not only to relieve symptoms but to prevent chronic damage to the intracranial tissues. Therapy can be standardized or customized and ideally should be applied every 2 days initially.
• Depending on clinical change, the protocols are changed according to the progression or resolution of the severity of the symptoms.
• This applies particularly for patients who are severely affected and present for an assessment relatively early after the injury.
• In chronic cases where symptoms persist regardless of the time period elapsed since the trauma, curative therapy should continue for at least 2 months subsequent to the resolution of all symptoms. Depending on the nature and duration of the injury and unless symptoms are improving rapidly spontaneously, treatment should be applied as early as possible and continued for a minimum of 8 weeks during which the patient is able to engage in normal activities.
• Each case must be assessed on its own merits and treated accordingly.
• In our experience, Laser Therapy should be considered the treatment of choice and be continued until the patient is asymptomatic, fully active and does not require any other therapy, including medications.

Conclusion: All patients who have sustained a cerebral concussion and continue to demonstrate symptoms receive a course of Laser Therapy tailored to their individual situation. Ideally therapy should be continued every second day until the patient has become asymptomatic for at least 2 months.

Generally, protocol settings are initiated at lower levels and increased in accordance with clinical change. As symptoms diminish in the degree of severity, the frequency of treatment can be gradually reduced, but not during the first 2 to 4 weeks.

All patients require periodic clinical assessment incorporating appropriate measurements to determine improvement as the course of treatment progresses. Symptoms should diminish rapidly in most instances when all appropriate parameters are observed.

The entire process should result in a significant improvement/cure rate in all categories of cases treated. This should be accompanied by the restoration of the patient’s quality of life, normal activity levels, and a total absence of symptoms.

BioFlex Laser Therapy Patient Review – Agnese Nunno

I came to Dr. Kahn because I wanted help with my long term memory. I noticed slowly over time, that I had started to forget events that happened in my life, words of songs I use to sing every day amongst other things. I had no idea how much the laser therapy could help heal, amongst many other things.

After the first two treatments I started to notice small changes occur. My sensitivity to light started to become less pronounced, as well as my sensitivity to sound. This was incredibly encouraging to me as I did not think changes would happen so quickly, nor those kinds.

On my own time, throughout the laser therapy treatments, I would work to rewire my brain. I paid close attention to things that occurred that were out of the norm for me. For example, one day while I Was eating, I noticed that I absentmindedly picked up my fork with my non dominant hand and started to eat with ease. The change that become most pronounced throughout the treatments was my overall mood was calmer and happier making my thoughts clearer. My concentration on topics often deemed less enjoyable, became easier to the point where I would describe it as not human. I became able to focus with so much strength that hours would go by before I realized how much time had actually passed. I became able to translate my thoughts into words faster, with the uncategorized fog I had lived with for so many years in my head, disappearing. My procrastination habits vanished where beginning topics no longer needed my rituals of the slow staggered start with scrolling through Facebook, watching YouTube videos until I’ve psyched myself up enough to begin.

I would read different articles and parts of books on rewiring the brain, and apply what I could. I would practice memorizing new topics using all the available senses. I looked at the laser therapy as a tool to work with and I used it as such.

My random anxiety where I would be performing a task and out of the blue have a panic attack for no reason, went from being a 10/10 to a 0/10. My depression and random crying had ceased to exist where now any reason I may feel down or anxious can be directly explained to an event occurring or that has happened. Same can be said for my random unexplained feeling of irritability, which went from again being a 10/10 to a 0/10.

Interesting to note, in order to control my anxiety I had slowly progressed to drinking every night more than a healthy amount for the past five years, which helped calm me but was obviously becoming a problem. The laser therapy had made the desire to drink become less pronounced, and I took that clutch to help me stop drinking.
I sleep sounder at night, and I’m less tiered than I was before where it felt like no amount of sleep was enough. I find that it is also easier to fall asleep without having to take any sleep aids like melatonin.

When in an argument or discussion I find I can now keep up, as before it was difficult because due to the stress I would forget what I had just said or what the other person has just said. As a result this has given me confidence which has helped me not to be afraid as I previously was. The laser therapy has helped me in other areas not expected as well, but the ones that I have spoken about I thought were worth mentioning.

Overall I am incredibly happy with the results of the laser therapy. Currently I’ve had over 15 laser treatments and I would say I feel 98% healed. The 2% that remains is my noise sensitivity, which I have been able to narrow down to two specific situations that affect me. First one being, when I’m on a crowded subway during rush hour where it becomes stressful due to the crowds, the pushing, touching, shoving etc., and the other being people yelling. I feel that the reason why I’m not 100% healed yet is because right after my treatment I have to take the subway back home. I compare it to, having just had a foot cast taken off and then running a marathon right away. I still live at home with my 5 younger siblings with four of them being teenagers and there tends to be a lot of arguments and yelling between them which will make my ears start to ring and vibrate. In the end though, the reason I came to Dr. Kahn was for my long term memory and as far as I can see it has taken care of that concern.

Fred Kahn, M.D. FRCS(C)

Commentaries, Insights & Case Reviews