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What if midlife isn't the beginning of getting old—but the beginning of something we haven't quite figured out yet?
Welcome to Second Opinion, where science meets real life in midlife.
Because the second half of life deserves a second opinion.
Hosted by Rosemarie Beltz—a cardiovascular perfusionist, Columbia-trained journalist, and former broadcast medical reporter with more than three decades inside operating rooms and high-stakes medicine.
Second Opinion brings together a career spent practicing medicine and reporting on it to explore health, longevity, reinvention, and the wonderfully complicated reality of being somewhere in the middle.
Because midlife is strange.
Some days you feel 25—curious, ambitious, optimistic, and convinced there's still so much ahead.
Other days? About 105. You're tired. Your body feels different. Your parents are getting older. Your career may not fit quite the way it once did. Relationships change. The future suddenly feels both incredibly exciting and a little more finite.
And somehow, all of those things can be true at the same time.
We're also living through an extraordinary moment. Medical discoveries, emerging technologies, and changing ideas about aging are reshaping what's possible in our 40s, 50s, 60s, and beyond.
We're talking about healthspan, hormones, metabolic health, strength, sleep, brain health, longevity, artificial intelligence, and treatments that barely existed a generation ago.
But more information doesn't always mean better answers and solutions.
After more than three decades working in medicine, Rosemarie has seen firsthand how asking another question, considering another perspective, or seeking a second opinion can change an outcome.
One expert doesn't have every answer. One approach doesn't work for everyone. And sometimes, the most important thing we can do is challenge what we've been told.
That's the philosophy behind Second Opinion.
We look beyond headlines, health trends, quick fixes, and conventional wisdom to explore what the evidence actually supports, where uncertainty remains, and what different choices might mean in real life.
And here's an even bigger question:
We may be living longer—but what are we going to do with all that extra life?
That's where the conversation gets really interesting.
Because midlife isn't just about our physical health. It's about our relationships, financial well-being, emotional health, careers, environments, changing priorities, and the lives we're still living and creating.
Through candid conversations with physicians, researchers, scientists, innovators, authors, and people with something meaningful to teach us, we explore the science, stories, decisions, and unexpected possibilities of midlife.
And sometimes Rosemarie turns the microphone on herself—sharing what she's learning from medicine, journalism, starting over, building something from scratch, and discovering that you don't necessarily become less curious about life as you get older.
Sometimes you become more curious.
What we're exploring:
- Health & longevity: Perimenopause, menopause, hormones, cardiovascular health, metabolic health, GLP-1s, sleep, strength, brain health, preventive medicine, and navigating healthcare.
- Relationships & connection: Dating after 40 and 50, love, sex, intimacy, friendships, family, and the relationships that shape our lives.
- Money, work & reinvention: Financial well-being, career transitions, entrepreneurship, confidence, changing priorities, and finding new purpose.
- Life beyond medicine: Mental and emotional well-being, beauty, technology, travel, our environments, personal growth, and finding more joy in everyday life.
This isn't about trying to be 25 again.
We can't go back. And maybe we don't want to.
We've lived. We've learned. We're not starting from scratch. We're starting with experience.
It's about taking everything we've learned, everything science is learning, and everything we still don't know—and exploring what might be possible from here.
Call it Midlife 2.0.
No perfect roadmap. No pretending we have it all figured out. Just smart conversations, good science, lived experience, a healthy dose of curiosity, and a willingness to look at things from another angle.
Because health matters. But being healthy isn't the whole point of living.
🌍 Independently created and produced in New York City, Second Opinion has reached audiences in more than 90 countries. A growing conversation for curious women and men who believe there's still so much more to discover.
And yes, Rosemarie is still figuring out what she wants to be when she grows up.
Real science. Real life. The bigger picture.
Second Opinion isn't here to tell you what to think. It's here to give you something worth thinking about!
Dr. Kash - 00:00:00:
Welcome to Second Opinion, where we tell the whole health story. I'm Rosemary Beltz. If you've ever wanted a second opinion on some of the hottest topics in medicine, health, and wellness, you are in the right place. Each episode, I sit down with experts, innovators, and even a few disruptors to bring you fresh perspectives on the issues that could change your life, from age rejuvenation and brain health to the weight loss drug revolution and how to reinvent your career and even level up those relationships, including the one with yourself. Together, we'll dig into the latest research, question what's hype and what's real, and give you the insight you need to make your own choices about health and wellness. So if you're ready for a second opinion that's engaging, enlightening, and maybe even a little unexpected, let's get started. Today, I'm talking with Dr. Kaveh Kashani, or as I and many of his patients know him so well as Dr. Kash. Dr. Kash graduated undergraduate from University of California, San Diego. Dr. Kash received his doctor of osteopathic medicine from Western University in California, completed internal medicine residency at St. Vincent's Catholic Medical Center in Manhattan, New York, and he currently practices in Las Vegas. Dr. Kash, thank you so much to join us today. We're really excited to have you as one of our first guest.
Rosemarie - 00:01:31:
Thank you.
Dr. Kash - 00:01:32:
You're welcome. It's so exciting. We've been talking about this for a really long time.
Rosemarie - 00:01:37:
Yes, we have.
Dr. Kash - 00:01:38:
Yes, we have. So to start, can you explain what aesthetic and regenerative medicine are and how they're different from other traditional approaches? And what I wanted to let you know, too, is I found interesting that many people might not know that you can further explain is that many hospitals now have regenerative medicine actually programs. I think I read Mayo Clinic and San Diego and so forth. So I found that to be really interesting.
Rosemarie - 00:02:09:
Yeah, absolutely. Yeah, aesthetic medicine is essentially, you know, cosmetic in nature, I say. Which means, based on appearance, okay? You're treating wrinkles or treating, um, mostly just for looks, right? Regenerative medicine, a, has something to do with aesthetics, but it's mostly internal, right? So regenerative medicine started, I guess, from PRP to stem cells. Regenerating any tissue, whether it's your joints or your face. Building culture in your face, or any other organ, I suppose.
Dr. Kash - 00:02:54:
So with that being said, could you maybe go into, so now it's clear aesthetic medicine is more on the outside. Regenerative medicine is more about healing from the inside out.
Rosemarie - 00:03:05:
That's right.
Dr. Kash - 00:03:07:
Could you explain a little bit about the aging process and what that looks like and then how it affects, say, since we're targeting it on midlife. So aging, the science behind that, so people can really connect the dots and put that together of where they are now.
Rosemarie - 00:03:25:
Yeah, you know, I wrote these things down to, so it makes sense and it's kind of clear. There used to be six or seven hallmarks of aging. Now it's extended to nine. And I'll go through them and I'll explain each one because. Sort of have scientific names. First one is genomic instability. Second one is telomere attrition. And the third one is epigenetic altercations. That just basically means your DNA. We age because our DNA gets... Shorter damaged and just basically gets old. Okay. That's our main part of aging. That's kind of inherited. We inherited it on birth, right? We get our parents' genes. That determines a lot of how we age and what our life, Spanish is gonna be like The rest of it is based on how we live our life, our behavior, what we eat, how we sleep, how much stress we have. Now, in scientific terms, we call them cellular sensing, mitochondrial dysfunction. Your cells kind of become dormant. Our stem cells get exhausted. So those are all the scientific parts of it. But it's basically because our cells get older. They can't regenerate as well. We consume foods where there's toxins or whatnot. And eventually they slowly can't do what they're supposed to do. Like they were young stem cells, right? And that's how we get old. And that's how our appearance gets older. Our organs shrink. And, you know, we slowed down.
Dr. Kash - 00:05:13:
So say we're born, right? So if we're a baby and then we're growing, at what point? So do we actually then start, I know we're aging, but it's kind of interesting. So we're growing. It's good. You know, we're doing the things that we need to do. But then at what point do we start seeing, say, like all of those things start declining OR when the aging process kicks in? Because I know we're all older right now than we were five minutes ago.
Rosemarie - 00:05:40:
Yes.
Dr. Kash - 00:05:41:
I think it's just interesting, you know, so people can really understand that whole process.
Rosemarie - 00:05:46:
Yeah, so, you know, we were born, our DNA and our cells are brand new, basically, right? And we sort of grow, grow, grow. Our hormones kick in at some point. And that makes US even grow more. Become fertile, right? And I want to say. You can say after 30. That we start the aging process and our hormones start declining. Our lifestyle choices, our behavior. Start affecting our bodies and basically slowing down. Now, some people add 40 or maybe 50, but generally, I think 30 is a good number that I always tell people you should really take care of yourself all your life but after 30 you really have to do more.
Dr. Kash - 00:06:39:
Interesting. So you would say like basically we peak around that time, but then after, between like say 20 and 30, and then from 30 on we should.
Rosemarie - 00:06:50:
We start declining.
Dr. Kash - 00:06:51:
We start declining and it's even, okay. So around, yeah, I guess 30 to 40 midlife, then we start, which is basically our target audience. We start seeing all these changes and so forth.
Rosemarie - 00:07:04:
That's correct. That's correct. And it's mostly, I mean, and I want to say with women, menopause and those loss of hormones, it has a tremendous decline in that era. So, you know, they, they, they really have a big, big jump from, you know, 40 to 50, I would say.
Dr. Kash - 00:07:24:
Okay, great. So with that, a lot of people associate aesthetic treatments with younger individuals, but midlife and menopause are the big life transition. So how do aesthetic and regenerative treatments benefit people in this stage of life that are going through these changes?
Rosemarie - 00:07:46:
Yeah. I mean, just based, if you're talking about aesthetics, aesthetics, I consider... Doing things like Botox, fillers, lasers. Sort of some body treatments for fat loss or muscle building. Those are aesthetics. You can do that at any time in your life, really, after 18. Maybe 20 years old, starting from then to all the way till, you know, seventies or eighties.
Dr. Kash - 00:08:19:
Oh, wow. So it's not really too late to ever. So some women who are watching this, or so say if they're 35, it's not too soon. And if they're even 60, it's not too late to start.
Rosemarie - 00:08:32:
Not at all. No, not at all. There's always things we could do to improve our, you know, our looks, obviously. And, um, you know, we have a recommendation of things. From anywhere from skin creams to like Botox and wrinkles to re-volumizing some of our natural features that have declined. And lost volume. And you could do that for a long time, absolutely.
Dr. Kash - 00:09:00:
Okay. So that's the external, as we said, the two components. So internally, the regenerative medicine part, which is also full disclosure, why I come to see you, and which is why, because I've seen so many benefits that I thought many people could also maybe consider this sort of therapy. So as far as regenerative treatments, what would you say are the top ways that somebody could say, start rejuvenating themselves or helping the aging process from the inside out?
Rosemarie - 00:09:35:
Gotcha. There's one part where we help patients kind of recover or regenerate if they have injuries or whatnot. That could be of any age. But just generally, just for feeling better and slow the whole declining process down, you can start that anytime after 30. And those include anything from like IV vitamin therapy. Like little by own NAD, the substances that our body produce less of as we age. To things like peptides. Which kind of stimulates our natural body to, kind of be a little bit more. One of the most common ones is growth hormone. Our growth hormone sort of peaks at 18, 19, 20. We do all the growing that we do. Our bones kind of fuse. And then growth hormone drops. After that really. And it drops a lot after 40 and a lot after 1560. So that affects obviously our looks, our muscles, our energy. And there are things to help stimulate that and keep us going a little bit longer. And then there's things that... Are not quite common here or common practice because of the FDA and some of the regulations we have. Like stem cell therapies, exosomes, which I know they're controversial, but I think should be part of the future going forward. If our government improves the process of regulation and testing and all these things.
Dr. Kash - 00:11:26:
Right. So I definitely want to touch upon that for sure. And then to circle back around too. So a lot of these, so the NAD, I'd like to explain, like say maybe the top three things of what you were suggesting. So people kind of don't get lost who maybe who are watching this, who don't necessarily understand what some of these terms are, but to go back internally, internally from internally to out to external is that we're focusing at the cellular level. And I knew, I know you throw out throughout the world, mitochondria and cellular level. So, so people can kind of, so that's basically, is that, would you say maybe the center of like the aging, would you say that, well, the telomere so forth DNA, but what would you say like the, and I know it's kind of a broad question because we are all different, but just where things that maybe, uh, some of this medicine kind of really hyper-focused so people can just understand at the cellular level. Does that make sense? And then these therapies, like how do these therapies then affect that?
Rosemarie - 00:12:34:
Yeah, I think everyone has taken biology in ninth grade or 10th grade high school, right? So we all learned what a cell is. And the main component. The powerhouse of the cell is called the mitochondria. That produces all the ATP, which is the energy your cells need to keep going. And split and replicate basically. So that's where on a cellular level, we start basically aging because, these components for the mitochondria and the ingredients that it needs decline. That's where kind of NAD, some of these. Therapies we're talking about will help improve. So yeah, that's one of the big parts of, his focus is how do we keep the mitochondria sort of sustained, keep going and be at its full strength.
Dr. Kash - 00:13:28:
Got it. And these cells, just to be clear, so everyone, we have these cells all over our body, our brain, our heart, our skin, every place. So just these broad therapies, these therapies that you mentioned, like IV therapy, NAD, which I would like to, and peptide therapy, these are just different ways to target the mitochondrial in the cell to help all over.
Rosemarie - 00:13:53:
That's right. That's right. There's so many different cell types, like you said, and it's in the billions and trillions. And we're losing cells every day, and we're kind of making cells every day. Some cells are harder to regenerate. Neurons and then some cells regenerate very quickly like the skin. So it just depends on, I guess, which I was talking about. But overall, they all have the same process.
Dr. Kash - 00:14:21:
So say if somebody's watching who's never explored IV therapy or peptide therapy, so could you maybe explain where a good place for somebody to begin on? Because there's a lot of information on the internet, but where could they start getting more information or, yeah, step one for them?
Rosemarie - 00:14:48:
Yeah, I would say that a lot of online... Sort of companies that do IVs. They have a lot of information on what these IVs are. And what's included in their bags. And for the most part, they're just vitamins and minerals. And that's about it. You know, NAD is chemical vitamin, right? And antioxidants is glutathione. So it's basically just a list of those things. Some put more than others, but they usually explain what each one is.
Dr. Kash - 00:15:23:
Is there one that you being a physician, is there one that you think like, you know, this is like a great place to start? Or is that kind of difficult to say?
Rosemarie - 00:15:37:
Well, yes. I mean, I would say a great place to start is all of them.
Dr. Kash - 00:15:42:
All of them, yes.
Rosemarie - 00:15:44:
And I would say the five most common and best ones is. One vitamin C. Vitamin C, obviously, we're always taking, but... We can't really absorb more than, you know, 2000 milligrams on a daily basis. Because our GI system sort of doesn't allow for more than that. So in the IV versions, you could get up to 10, 20,000 milligrams. And that going in your bloodstream has a tremendous effect on all the cells, immune system. And just are, you know, being healthy. So that's the one ingredient that all these IV therapies, you know, have is a lot of vitamin C. The B vitamins is probably the second one. A lot of our foods have B vitamins. Now, some people don't take all of them, but biotin, niacin, the main common one that we use a lot is B12. I would say the third and fourth, glutathione, the most powerful antioxidant our body has. And NAD, which is kind of a new thing, but it's always been around, but, you know, in. In today's world right now, a lot of people ask for it because of the whole... Association to mitochondria. And how it improves our focus, our sleep, our energy levels. You know, so that's, those are the top five, the top four things on top of the actual IV, you know, the saline or water to keep us hydrated.
Dr. Kash - 00:17:23:
Right. So you were saying like diet, so forth, lifestyle a little bit earlier, but some of these things like NAD, glutathione, you cannot just so people can understand like how they can get some of these nutrients. You can't really, you might not get all these nutrients that you really need for anti-aging in just say your diet. You can get a lot of it in your diet, but not always.
Rosemarie - 00:17:47:
Yeah, and that's where I think the system of how... We have agriculture and making food available to people. You know, there's no standard right now, really, right? So, which is what we hope improves. But yeah, we don't get a lot of these ingredients in all of our foods that, we should have kind of available for us, and not everyone could absorb all the all those ingredients either That's why a lot of times you might need you know, the intramuscular or IM versions or IV versions. Over just foods because it might be too little in what we're taking, you know.
Dr. Kash - 00:18:28:
Yeah, no, no, no, absolutely. Because I feel like even when I came to you, I'll just share for anyone listening, even though I ate good and all these things, I still really lack, you know, whether it's just lifestyle working, things like that. And then have, I've been, you know, and many people that I know around my age have been for quite a few years utilizing IV therapy and hormone replacement, things like that. So that we couldn't get the natural way. So anyway, I just thought I'd share. So, how do you approach treatments differently for patients with midlife who may be dealing with things like hormone imbalance or changes? So you have all ages of patients that come to you, say aesthetically or for internal. So how do you maybe treat that? Population a little bit differently.
Rosemarie - 00:19:21:
Yeah, and by midlife, midlife we're saying like 40s, 50s, correct?
Dr. Kash - 00:19:27:
Yeah, maybe like you said, let's say, yeah, 35 maybe. Is that midlife? I don't know. I didn't think I was midlife at 30. But then the data say, well, the numbers say, you know, you start seeing changes at 30.
Rosemarie - 00:19:42:
Yeah, I mean, 100 years ago, midlife was like 25, right?
Dr. Kash - 00:19:46:
Yikes. Yes.
Rosemarie - 00:19:48:
Now, it seems like... What we're doing is I think one out of five people are going to hit the age 100. Over the next like 10 years, right? So living to 100, I think they're called centurion OR something like that. But it's going to become a norm. Over the next few decades. So at that point, midlife would be like 50 or 60. But where we stand now, we call, I guess, 40 midlife because, the age, I guess, limit for the average age of men, I want to say 70, 77. Women are like four to six years after that. So early 80s. But yeah, so... Same approach, obviously different things for each one, but... I would say the more complicated ones is the woman who, basically crash during menopause. Now my approach is usually to start testing them, start seeing them. A lot of times I see them for aesthetic or cosmetic reasons. And we fix some things, remove some wrinkles, revolumize, whatever, their cheeks. But they still feel like they're, they're still aging faster. They're losing energy. And that's where we start testing them, getting blood tests. And seeing what their internal status looks like. And then that's kind of where we see the decline in, you know, estrogen, uh, progesterone, testosterone, uh, thyroid is a huge one. Growth hormone. We want to usually get in front of. You know, these hormone declines before they actually affect you and kind of crash, right? So before women hit menopause and some, some do as, as early as like early forties. Or even late 30s, which is considered kind of a premature ovarian failure or early menopause. We want to basically kind of have a risk and benefit. Assessment for them whether repleting some of these hormones were beneficial for them. And start maybe having them consider some of these therapies. Before they hit that point where they're really suffering, where they don't really need to be.
Dr. Kash - 00:22:26:
Right. I mean, I know so many women that they just think they're tired. They don't even really realize what things are actually going on. They're like, oh, my inside's not matching with my outside or vice versa. And yeah, they don't even realize. They think they're just run down. But actually, like you said, starting at 30 or 35 and then all these things are actually, these changes are happening and they don't even realize it.
Rosemarie - 00:22:51:
Yes. And it depends obviously on what kind of life you've led. You know, how many children have you had? What kind of sleep habits, what kind of working habits, what kind of exercise, how you've been eating. All those factors determine how early you're going to feel like that or not.
Dr. Kash - 00:23:14:
Right. So it sounds like pretty much a lot of your patients, you just get a baseline, get their lab work, see where everybody is, and then take it from there.
Rosemarie - 00:23:25:
Yes, that's the first thing to do. You know, you have a really complete history in the physical. You get all their history from... Themselves, their family. Their kind of food intake, any toxins that they are taking intentionally or unintentionally. And then, you know, a full physical exam, which is usually, you know, benign. And then some laboratory work. Blood, urine, and possibly swab for DNA. And there is now ways that actually some companies analyze your DNA for biological age. So they compare your actual age to what your biological age. Is like and then they kind of show you how to improve your biological age, you know? And there's different supplements or therapies that. Basically you could take and you'd swap your DNA every quarterly, let's say. And you can see if your biological age has gone down.
Dr. Kash - 00:24:30:
Interesting. Well, I feel like since you kind of went there, that there's so much information, some of it good, not so good. So how, if somebody is going to go down that road into those types of tests, where's a good place for them to start that? So they kind of just, I mean, really, I want to say the word scam, but I mean, how they know it's a legitimate.
Rosemarie - 00:24:55:
Yeah, look, you're right about that. There's the problem with technology and computer internet is... Is that there's too much information now, right? And a lot of it is bogus. A lot of it is potentially scams. So a typical person is kind of left to, you know, figure all this out. And it's hard to do solo. You need help, obviously. And the right places would be, you know, find a reputable anti-aging sort of physician. I would say, you know, your regular primary care doctor. Is not going to address those things. The current system, the way it's set up is... Just kind of wait till you get sick and then we'll treat you. You know? Which is. Completely wrong approach into, you know, having a healthcare system, we should be, you know, starting early with prevention and education and, you know, learning about our bodies, obviously. Rather than that. So, so, you know, if you have insurance, you've been assigned some primary care doctor, they're probably going to be useless, right? But I would say that's a... A place you can start with maybe a referral to some, you know, anti-aging clinic, or maybe one of these hormone replacement offices. This industry, this field is growing. There is a lot more organizations and A4M, for example, anti-aging conferences. And you could always find out more information on those websites, even their shows where there's tons of information at the shows and on their websites. So that's maybe a good place to start.
Dr. Kash - 00:26:50:
Yeah. Well, like I said before, when we opened, I found it interesting that when I was even just researching myself, the whole concept of regenerative medicine, huge medical centers have these programs, but I feel like people don't realize aging falls under them, whether it's developing a lot of organ, when we're talking about organs and transplants and stem cells, I don't even think a lot of people realize that this aging kind of falls under that umbrella. It's just basically healing your body from the inside out. So I feel like, I don't know, would you agree with that?
Rosemarie - 00:27:24:
Yeah, yeah, absolutely.
Dr. Kash - 00:27:26:
So when they hear it, it sounds like taboo, but it's not. Because, you know, it's not those things. It's like people, there's these options. Because I think people get nervous when they kind of stem away from, say, what their actual, you know, their PCP, their primary care doctor says. They don't want to veer off of that. And I think they're afraid to kind of go into this territory that's, you know, very good doctors who are doing really awesome things in medicine that they don't even realize they could look and feel better.
Rosemarie - 00:27:59:
Yes, yeah. I mean, I think that it's not mainstream yet. That's the problem. Is that, um, that, I guess people don't have the opportunity to, they're not advertised so much either, you know? So, I mean, I think it should be part of the primary, primary care practice is, you know, aging, the whole aging concept. But it's not yet and primary care as a result, it's still the way it is, you know?
Dr. Kash - 00:28:30:
Yeah.
Rosemarie - 00:28:31:
So you have to really seek it out. And depending on your city, you know, some cities have a lot more. Than others. Okay.
Dr. Kash - 00:28:38:
Yeah, of course.
Rosemarie - 00:28:40:
And some States have a lot more regulations than others. So, you know, I guess do some research online to figure out what's around you. Go from there.
Dr. Kash - 00:28:55:
Yeah, I think the reason why also I decided to do this podcast were to talk about these things where that, so people could get information so they could. Feel better. You know, there's other things out there that they could do to not only increase the you know, the longevity, but also the quality of their life. Not just the quantity, like not, oh, I want to live to 100, but do you want to live good? You know, like I want to live quality and feel and look good. And I don't think there's anything wrong with wanting to look good. And feel good, especially in women, we are, a lot of midlife women, we're just getting started. We're, you know, we're running corporations. We're the heads of departments. We're just actually peaking, whether we've raised our family or have aging parents. But we're just at that point where we are, you know, we're in positions of leadership. And so, and we live in a very visual. So we want to also have the stamina to do these things, but we live in a visual world. Let's face it. I mean, so why not look and feel the best that we can, you know?
Rosemarie - 00:30:00:
Absolutely. I think, I think as a must.
Dr. Kash - 00:30:03:
And so with that, what are some, I mean, we did talk a little bit about it, but in your opinion, what you see with patients, what are some misconceptions about injectables and aesthetic treatments and regenerative medicine treatments? Would you like to clear up for our listeners?
Rosemarie - 00:30:24:
Yeah, there's a bunch, obviously. I think... In general, the aesthetic stuff, it's a matter of preference. I think the fact that, you know, they have a lot of States, they have that almost a lot of people. Like anyone, be able to do some of these things, you know? So there hasn't been a standard and much training to do aesthetics. So far, you know, it's kind of starting and it's growing. There's a lot more courses and classes, but I think just bad jobs, you know, bad jobs by. Untrained people and untrained providers. Or unlicensed people, right? So bad jobs, whether it's your lips or toxin, whatever, it you know it's people see bad jobs and they think, oh my God! I would never want to do that. Which is actually false. because if you actually, you know, know what you're doing and you do a good job, it goes undetected. You know, no one really actually could tell you've had something, right? It's supposed to be supernatural and you just look good, you know? Someone sees you, you know, after afterwards, they recognize you look good. They can't quite tell you what it is, but you look good. And that's a misconception that basically these things will make you look like those bad jobs. And that's actually very rare. But yeah, social media spreads them. There's always someone you see at the gym that looks like that, right? So that's one. And the other thing that I think was a big injustice to, I guess, women was the lack of... Testing and I guess, education and talking about hormone replacement. You know, um, women really didn't have a chance to to you know replace their hormones because they they crash so much harder than men do men kind of slowly decline the testosterone go down right But a lot of them are still fertile at 60, 65 years old, right? But women, they completely cry. So it wasn't... You know, it wasn't really talked about or there was false information on hormones, for example. And they thought that hormones cause cancer. In a lot of the studies that, you know, Big Pharma did over the last decades, 50 years. And they didn't actually differentiate that it was the synthetic hormones that caused cancer. It was never bioidentical hormones. So they kind of spread that fear into people, and especially women, that hormones would cause cancer. And you just gotta take our drugs. And that's just a part of life. After menopause, you get old and just deal with it, right? That's where I think a big misconception still is. We lose our hormones and we decline. And that's just the way it is. It's not supposed to be that way, though. There's options. There's ways to stimulate hormones or gently replace them. So, That's something that every woman should start thinking about after 40, for sure.
Dr. Kash - 00:33:54:
Okay. So you hit quite a few things in that. So thank you. So basically, if somebody's considering this for the first time or nervous about it, it's gradual. Find someone that's credible. I always say my role is I don't do anything that requires a Groupon. I don't give you a Groupon.
Rosemarie - 00:34:15:
Yes, absolutely.
Dr. Kash - 00:34:15:
I do not. Anything that involves putting anything in your body, on your body, things like that, do not skimp when it comes to cost. Find someone credible, not be so fearful of what's out there. I think even I talk to women, they're nervous to try these things. I'm like, you're going to feel so great. And then they do it. Oh my God, I feel so good. I told, you know, it's just amazing how many people are so scared because of the information that's out there that might be a little misleading.
Rosemarie - 00:34:46:
The misinformation, yep.
Dr. Kash - 00:34:48:
Misinformation. So basically, so if somebody was to start just gradual, you know, find that person that's going to take that approach, whether it's rejuvenating the aesthetic medicine, you want to just look like a better version of yourself is basically the takeaway. Look and feel better.
Rosemarie - 00:35:08:
Look and feel. Yes.
Dr. Kash - 00:35:10:
Okay. And then, and I guess we actually, we just talked about this too, but just to be clear, there is a lot of hype around anti-aging, but we really, it's not anti-aging, right? And then these learning how to separate the, when you see these things, what's the facts of it, like the false promises maybe that kind of come around these things. So they, how to weed out the information. I mean, we did kind of talk about that a little bit, but if you just want to touch on that again, when people promise youthfulness, basically.
Rosemarie - 00:35:46:
Yeah, it's hard to do. You really can't guarantee or promise anything in... The world of aesthetics or anti-aging because everyone is just so different. And everyone responds to every psychotherapy differently. And some people might require many, many years of something. I think the false promise. Lot of times is that like you know, a few sessions or, one or two things will make you feel great. Or, you know, you got to constantly be working at it. It's got to become part of your life. Like, you know, when you go to the gym, right? Right. That's part of anti-aging. Anti-aging is, you know, taking care of yourself in however way you want to do it. So your jam, your nutrition, what time you go to bed, how much. Screen time do you have? How do you deal with stress? All those things are anti-aging. So I would say that's the most important part. Seeking out for these different therapies and injections and IVs. That should be secondary after you've really worked on some of these main core stuff, right?
Dr. Kash - 00:37:05:
Right. Basic diet, nutrition, moving.
Rosemarie - 00:37:09:
Yeah. People want to kind of bypass those, you know? They want to not sleep, have a, you know, stressful life. Eat like crap and go do a few injections or shots and reverse all that, right?
Dr. Kash - 00:37:25:
Right.
Rosemarie - 00:37:25:
You can't do that.
Dr. Kash - 00:37:27:
Right, right. And also too, because when say someone, they're doing all these right things, they're looking for a provider, just to be clear, because I know that there's a lot of, things are virtual now. And like you said, some people live in areas where things are just not available. You know, you're on the West Coast. I think West Coast just does health and beauty amazing. I'm in New York, so I have access, you know, big cities, so forth, or even other countries, right? People who are watching, you know, across the pond, and sometimes they even tend to be, when it comes to skincare longevity. So if you were to seek somebody, say virtually or telehealth, that's not bad. It's just do your research to make sure who's at the other end of it.
Rosemarie - 00:38:11:
That's right. Someone that's credible, someone that has the proper education. Has done the courses or the basic requirements and has maybe done a little bit more, which is... Extra education and training. Into these topics.
Dr. Kash - 00:38:30:
So what do you see as... The future of. Regenerative and aesthetic? Is there anything for women in midlife or just this type of medicine? Like, I'd love to talk more about, is there something that I didn't ask you today that you'd like to talk about?
Rosemarie - 00:38:49:
Well, yeah, I mean, I could talk about that, I guess. What everyone thinks is going to be the future is, yeah, basically, you know, how do you make, stem cells differentiate to any tissue that we want. Right? So in a sense, we could replace all of our cells, all of our organs with something that starts with like a umbilical tissue and It could essentially fix a lot of problems for a lot of people. Eliminate disease. You know, but we're still in the infancy stage. But that's what I think will be the future. And along with maybe integration with technology, you know, which technology somehow is connected to our body and we could benefit somehow from that, which is a little weird, like cyborg stuff, but. The FDA currently doesn't allow a lot of things in the U.S.. But once it becomes a little bit more I guess, open or lenience and allow some more research and testing. We could kind of expand on our current stem cell. Growth factor sort of baseline we have right now.
Dr. Kash - 00:40:10:
Right. More that they were considered the alternative. Treatments might become more the mainstream, not so much alternative.
Rosemarie - 00:40:18:
That's right. That's right. And right now I think the. The reason people are waking up to this, then they're realizing that our system sucks.
Dr. Kash - 00:40:26:
Yeah.
Rosemarie - 00:40:26:
Our healthcare is kind of a fraud. The system is based on capitalism, dollars. You know, and people are benefiting from them getting rich and not really caring about real people. Right.
Dr. Kash - 00:40:42:
Yeah.
Rosemarie - 00:40:43:
So once we get those individuals or groups out the way, as far as the corruption. And put in people that could make a difference, sure.
Dr. Kash - 00:40:57:
Yeah. Well, it's funny.
Rosemarie - 00:40:58:
There's hope.
Dr. Kash - 00:40:58:
Yeah. Good. There's hope. Because even when I talk to a lot of my friends, actually one of my girlfriends, she's in medicine. She's like, are we going to live? I want to live like a vampire. I want to live forever. I look good. I'm like, well, you know. She's hilarious. She asks very good questions. But I'm like, I don't know. I mean, we're doing all the right things. We're eating good. We're doing these things. I guess time will tell. They say there's no studies, but how are we going to get data if we don't use things to study them?
Rosemarie - 00:41:30:
That's right.
Dr. Kash - 00:41:30:
Right? So how do we do these things? Like if we're going to, we need to use them so we can study them. You know? I know a lot of people that would gladly, I'd gladly participate in these things. Well, like you said, you know, a lot of people, even in the hospital setting, women, you know, even when it comes to different heart health, they're like, I wish I knew, I wish I know, or I would have done that. or, you know, they feel like it's too late. But what you're saying is when it comes to these things, you can, you know, just awareness start, you know, working at the cellular level, it will help. Inside, outside. And, um...
Rosemarie - 00:42:07:
Yeah. And it's gradual, you know, obviously it's starting on the basic stuff first, you know, which is what most people don't do, right? So start with those and yeah, and then keep learning because life is just one big learning about yourself. That's, the whole purpose of life.
Dr. Kash - 00:42:25:
Right. And what also I think a takeaway is with regenerative medicine that you mentioned PRP, which a lot of people might not fully understand what that is, but like platelet-rich plasma, where we take, if you want to explain it, but your own blood, we take your own cells and basically put them in all parts of your body, whether it's your hair, your face, we use it for wound healing in the OAR for patients. So it's not like this, there's science behind this stuff. It's just, for whatever reason, it's not out there in the mainstream, but there's there it's being used in the OAR setting for wound. You know.
Rosemarie - 00:43:04:
Yeah. You know, the first time I heard about PRP was when... Kobe Bryant. You know, tore up his knee or something. This is like... Like 20 years ago, and he went to Germany. For this thing called PRP and he healed so well he was like back to his old self. This is like 2005, 6, 7, something like that. And he had to go to Germany because no one in the States will give him PRP.
Dr. Kash - 00:43:33:
Well, yeah. And that's the thing, like 10 years ago, actually probably longer than that, we were using it in the OAR in California. And then, but other people were using it in other facets, which makes sense if it's, but like you said, different States have different regulations. And so depending on where you live, what's readily available. But what I think the takeaway is too, it's like you're using your own cells just in different parts of your body and concentrated amounts to stimulate growth.
Rosemarie - 00:44:06:
Yeah. I can explain a little bit of this. Yeah, you're right. You're right for your audience. So PRP is essentially you. Our bodies... One of the main healing factors is our platelets. So our platelets are cells that are in our blood. There is red blood cells, there's white blood cells, and there's platelets. They're kind of small and they're the lightest. But they carry all the growth factors and healing factors. So when, for example, you go and you cut yourself, usually platelets aggregate there. You know, your body signals, hey, I've been cut. You rush platelets there and then they release all their growth factors and you start healing and closing the wound and your skin recovers, right? So this has been known for, I don't know, decades, right? The science has been known, but... I guess we've probably known about PRP for a long time, but just never was used because of all these regulations. So in the technique of PRP, we actually dry your blood. We get a bunch of blood. We spin it down to get rid of all the red blood cells, white blood cells. And they all kind of go down to the bottom and there's kind of this gold. You know, liquid. Serum that's left and the platelets are lighter so they're kind of suspended in that. And then we get that part out and then we spin it again. And then... And then again, there's a kind of a better part and a poor part. And get the better part that has all the platelets and all the growth factors. It's very, very super concentrated. And then we inject it into whatever tissue that we want to help regenerate or help smoothen out or heal a tendon or ligaments, right? So that's a very simple, obviously procedure. And they're doing it all over the place. Now, a qualified, a center that knows how to do it does a lot better job than others, you know? And the places that you don't want to go is, you know, someone that has some sort of centrifuge and just dry your blood and they put it in there. There are specific centrifuges, specific kits for PRP, you know? And that's where I think people have to be more knowledgeable of and aware. That's, you know, what places have what. So they don't get ripped off, you know, it's, I don't think it's. They'll ever get hurt from the process, but they just will spend money on ineffective things, at the worst.
Dr. Kash - 00:46:47:
Yeah. Well, that's why I wanted to bring it up because even though it's been around, not many people know about it and how it can be used. And so it's even though it's, you know, it's here now, but people just might not or, how versatile it actually is in different parts of the body.
Rosemarie - 00:47:05:
Do you put it in anywhere? It's your own. It's your own cells. It's your own body's liquid.
Dr. Kash - 00:47:11:
Exactly. So it's your own body, again with regenerative medicine, using your own body to heal yourself. I know women that are using it in their hair for hair loss in midlife, their face and replacing, you know, helping with collagen and filler, like you said, injuries and things. There you go. And so, you know, I feel like I just thought that that would be interesting for people to maybe think about if they and it's natural. I think that it's a whole thing.
Rosemarie - 00:47:41:
Supernatural. I guess the here's the here's what I see. The expectation is like you do this procedure. Let's say a vampire facial. Right. And someone trademarked as vampire facial. So, you get paid from that word vampire, but it started as basically PRP facial, which basically get the PRP and then you microneedle it into the face or you stamp it into the face. You basically injure the face and then you inject PRP all over it. So you heal faster, right? Um, the process is very easy, very minimal downtime, but. Um, you know, and the results are not like night and day, you get slight improvements. But, you know, and it's nice, but the expectations have to be set in front of the very beginning, right? I think a lot of people go into something and they think, okay, I'm going to spend, let's say a thousand bucks. It's going to completely change my whole face, get rid of all my eye bags, you know. It's not like that either, right? It's not miraculous, but it's something that improves things a lot. With repetition, obviously.
Dr. Kash - 00:48:52:
Great. Well, and before we wrap it up, because I'm really glad we talked about that because, like I said, I've used PRP. I know many women who use PRP, and these are women in all different areas, whether they're engineers, medicine, you know, women who've done their research so people understand. And also to clear up, that's what, like you said, vampire facial, you know, years ago you heard that was kind of trending in the celebrity world, let's say.
Rosemarie - 00:49:18:
Right.
Dr. Kash - 00:49:19:
I don't want to go into celebrity. Exactly. I was going to bring her up, and I'm like, oh, sorry, Ken, if you ever come across this podcast. But anyway.
Rosemarie - 00:49:29:
Hit me up.
Dr. Kash - 00:49:30:
You never know. Hit me up. Yeah, yeah. Hit up Dr. Kash. She's actually not too far from you. But before we do wrap, is there anything that you came to this podcast today that you wanted to talk about, and how do people find you, or accepting new patients, et cetera?
Rosemarie - 00:49:47:
I mean, yeah, my main reason to do this podcast is because we've been talking about it for a long time. And you're one of our favorite people in the world.
Dr. Kash - 00:49:54:
Thank you.
Rosemarie - 00:49:56:
We want to kind of help the process. I wanted to learn more about podcasts myself because. It's something that's kind of replacing TV and information. And I think not a lot of people are doing it correctly. They're just... They're just putting out controversial things for clicks. Popularity so they could get enough subscribers to, you know, be sponsored by some bullshit product, right?
Dr. Kash - 00:50:28:
Absolutely. And again, the health person in me and the journalist in me decided to do this to bring to light the people who I feel in my experience and my knowledge who are credible, who shouldn't be talking about these things, who don't have the platform. And sometimes we just don't have the time. You're seeing patients all day. Most people are seeing patients to dedicate a whole area to this. It's just, it's, you know, it's definitely, you have to be really intentional. So my goal was to have people like you to talk about these things. So people get the right information. So thank you so much for taking the time and hopefully we'll have more conversations like this. I would love that.
Rosemarie - 00:51:14:
Absolutely. A pleasure. If anyone wants to look me up in Las Vegas, Dr. Kash INC, just Google it. My office always takes consults. And looking forward to your next podcast.
Dr. Kash - 00:51:26:
Thank you. And with that, that's a wrap for today's episode of Second Opinion. A huge thank you to Dr. Kaveh Kashani, Dr. Kash, for sharing his expertise on aesthetic and regenerative medicine, especially how these treatments can benefit those navigating midlife and menopause. I hope you've gained some valuable insights on how to look and feel your best during these transitions. If you've enjoyed today's conversation, don't forget to subscribe, rate, and leave a review. It helps others to find the show. And if you have a topic you'd love for us to explore, drop us a note. We're always looking for new ideas. I'm Rosemarie Beltz. Until next time, take care of yourself, embrace your unique beauty, and remember, always get a Second Opinion.