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This is Carly Beam with the Becker Spine

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and Orthopedics podcast,

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and I'm thrilled to be joined today by

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doctor Ramen Roch, chief of neurosurgery at Saint

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Catherine of Siena Hospital and Medical Center. Doctor

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Roch, thank you so much for joining us

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today.

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It's my pleasure. Thank you for having me.

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So before we dive into questions, I'd love

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for you to just, you know, share a

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bit more about your background expertise.

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Yeah. Thank you very much.

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As you probably know by now,

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I am a neurosurgeon

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experiencing,

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brain and spine surgeries complex and minimally invasive.

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Can you hear me okay?

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Yes. I can. Oh, good. Thank you. And,

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I joined my current

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team of neurosurgeons

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about nineteen years ago, and so I've been

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in Long Island, New York for, you know,

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about nineteen years now, almost twenty years.

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And,

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we have been,

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you know, one of the busiest neurosurgery practice

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in the country, one of the largest. And

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over the past couple of years, we have

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been recognized as number one neurosurgery

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practice in the state of New York

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by Castle Connolly. But, anyway,

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yeah, I have been involved

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with the brain and spine surgeries for for,

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many years, and I've been involved in leaderships

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at

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the New York State Neurosurgery Society, Suffolk County

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Medical Society, and I've been nominated now for,

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vice president

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of medical society of the state of New

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York or.

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So,

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yeah.

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And

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I can I can I can keep going,

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but but that's pretty much that's that's, you

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know, a big part of it? The the

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other thing is that I have also created

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a brain nutrition supplement,

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plant based

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brand, which is called iMind.

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And,

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it's pretty much a healthy nutrition for a

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brain, nutrition that is missing our daily diet

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that is not needed for, normal function of

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the brain

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as a as a nutrition. And we created

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I created these brands called EyeMind,

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and it's

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organic, non GMO, kosher, and and vegan, and

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it's available on Amazon now.

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So

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but that's what I do on the site

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also whenever you know, just, to do something

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also fun.

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Yeah. That's very fascinating. I definitely wanna circle

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back on that. But to start, I'd love

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to, you know, tap into just this most

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recent leadership role that you've taken on, chief

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neurosurgery

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at Saint Catherine of Sienna. Can you talk

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about your top three goals in that role

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this year?

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Sure.

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So I've been elected

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as I have been, you know, directed as,

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you know,

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as as as a new chief of North

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Australia, Saint Catherine of Sierra Hospital. But, you

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know, I have I have multiple goals this,

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you know, this year for for my terms,

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you know, achieved there.

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You know, probably one of them, maybe the

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most important one is to make sure that

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St. Catherine Hospital is recognized as

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as a place when people can trust and

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and come have their brain and spine surgery

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done there. You know? I've been, behind the

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scenes involved with

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improving the quality and and equipment and operating

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room,

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you know,

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state of the you know,

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advancement in a in in a way that,

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you know, Saint Clair Hospital will be able

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to perform most neurosurgical,

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procedures.

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In fact,

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we have,

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now one brand new

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operating room that is state of the art

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as far as technology and equipment goes for

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brain and spine surgery. So we are able

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to

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perform most complex spine surgeries,

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and, we're gonna be able to do, lots

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of brain operations also. You know, we're also

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trying to get level two trauma level at,

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at Saint Kennedy Hospital,

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taking care of brain and spine traumas.

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Additionally,

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you know, probably, I would say the most

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important thing I wanna make sure that people

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know in the communities that

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we are able to perform most brain and

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spine surgeries, you know, in in in local

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community house hospitals.

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These these hospital, they are, you know, now

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very advanced as far as patient care and

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and availability and

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and and technology. You know? It's like

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you know, when I when I came to

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Long Island,

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you know, many years ago,

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most people pretty much used to go to

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the city,

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to the brand name institutions for their procedures.

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And that throughout the years, because of our

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presence, things have changed.

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And, but still, I see people going to

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the brand names, and they may or may

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not know the name of their surgeons. But

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because, you know, they go to these brand

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institutions, you know, they, you know, they assume

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that they're gonna get the best care better

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than Long Island. But

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my my goal is try to change this,

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perception of

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of, brand name quote, you know, that, you

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know, people they they're attracted to. So I

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wanna make sure that people, they know that

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they don't need to go all the way,

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sit in the traffic,

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go to the city, and and have their

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case done there, and

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everything can be done here in Long Island.

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So

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so that that's that's one of my primary

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goals. And in fact, you know, we are

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you know, even though we are considered,

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like, private practice, but in fact, there is

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nothing private about about our practice. We, you

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know, we are available here for patients in

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their own

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neighborhood. You know, we are available

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twenty four seven. I mean,

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we have mid level

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practitioners who who take care of patients on

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a daily basis. But ourselves, neurosurgeons,

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most of my patients, you know, they can

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find me same day. Lots of patients, they

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have my cell phone.

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And then it's like family care, one to

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one care, and they are not like a

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number.

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So,

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and the quality of care is it's fantastic.

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So, this is a message that I wanna

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make sure people understand that that,

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you know, if if I have a family

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member who needs care, I I won't take

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them to the city. I'll just stay in

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Long Island because

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because we get the best care here.

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Yeah. And I'd love to just kinda dive

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deeper into your strategy, especially when it comes

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to you know, sounds like you're acquiring acquiring

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a lot of new technologies. I love to

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you could just kind of dive in a

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bit more on how you're gonna really differentiate,

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yourself

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from, you know, the the big names.

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So, yes, as far as the big name

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I've heard what the the the the technology

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and the the capability and availability goes.

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We have everything that the big names have

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as far as the operating room.

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You know?

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Let's try to talk about, like,

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interpretive

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monitoring, interpretive navigations,

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interpretive,

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microsurgical

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stuff,

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and anesthesia,

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post op care, pre op care.

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And so so

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so we have what we call the I

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we always call the three three a's, which

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is availability,

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affability,

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and,

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and ability. So we have we have all

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those three three

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big a's, and and

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and,

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there's really not unless it's, like, something that

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it's some clinical trials or something that people

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that need to go for specific

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reasons, then

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then maybe. But, otherwise, everything can be done

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pretty much here. And and it should be

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left up to the surgeon

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that if the surgeon thinks that, okay, this

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needs to be dealt with in a, you

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know, major

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academic center, then then that's fine. We'll take

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care of that. But, you know, short of

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that, most most thing can be done here.

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Then primary doctor, they should know that. They

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should know that,

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you know, rather than just directly send the

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patient to big name, they should just contact

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the local neurosurgeon,

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your spine surgeon or brain surgeon,

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and,

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and discuss the case with them. And if

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that surgeon thinks, okay. This needs to be

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done in major brand names, then that's an

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oratory. But, otherwise,

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you know, it can be dealt with here

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and on.

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Absolutely. And I'd love to hear, you know,

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what are some of the biggest headwinds that

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you're facing this year, and how are you

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gonna be getting ahead of them?

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Yeah. I mean, there's always,

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challenges with

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patient,

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you know, navigating through the patient's

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outreach and and

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and and and and and and and support.

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And,

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again,

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you know, there's always concern that,

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you know, patients'

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insurance will or will not cover certain

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admission surgeon certain surgeries.

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So dealing with those,

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you know, insurance situation is always is always

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a challenge, but we are here to

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help patients

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through through this,

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through the, you know, question that they have

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regarding their,

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insurance coverage. It's it's, you know, it's one

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of the,

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I would say, you know, major,

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concern that patients they have,

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of course, beside the brand names that we

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mentioned.

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I also want to ask you about you

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mentioned the top of the podcast, your,

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your supplement that you've created. You talk more

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about that and how that kind of incorporates

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into

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the overall,

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spine and brain well-being that you do?

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Sure. Yes. You know, again, throughout my, you

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know, my my career, I have,

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noticed that, you know, you know, everybody is

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worried about the the number of calories they

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take a day. You know? What is the

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sugar coming,

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or what is the protein? And at the

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end of the day, it's like, no one

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really think about, do I really feed my

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brain properly?

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Does the nutrition that I'm consuming every day,

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does that really provide the nutrition that my

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brain needs as an as an

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human organ?

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And the answer to that, it's it's no.

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As, you know, the diets that we have

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here in, you know, pretty much western countries,

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like,

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lots lots of ingredients that they are needed

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for the health of the brain. It's it's

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it's missing in our in our daily nutrition.

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And lots of them is provided are provided

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by mother Earth. You don't need to create

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some some chemical or artificial stuff or man

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made stuff.

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You know, throughout

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thousands of years of

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human relation with with nature,

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you know,

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everything is provided pretty much for health of

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the brain by by mother earth and plants

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and roots and nuts and fruits.

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It's it's all in there. And

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so I put together this this brand, and

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00:11:11,794 --> 00:11:14,754
I choose 15 plants and roots and nuts

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00:11:14,754 --> 00:11:15,735
that they are

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good for the health of the brain and

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00:11:17,769 --> 00:11:20,570
the nutrition, and I try to avoid stuff

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that could eventually cause potential side effects or

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too much of any ingredients.

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And, try to put these plants together without

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adding any any sugar or any color or

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any artificial

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stuff. And

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to be honest, it wasn't easy to make

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the taste right because, you know, some of

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00:11:39,384 --> 00:11:41,225
those ingredients, they are bitter. Some of them,

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00:11:41,225 --> 00:11:43,384
they are sour. Some of them, they are

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not sweet.

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So but it took couple of years to

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figure out the taste without really,

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adding anything,

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any artificial stuff to it. But

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00:11:53,850 --> 00:11:56,910
so now, this this EyeMind, they are in

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sort of bars now.

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You know? It's like, you know, you can

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purchase them on Amazon, but it's it's a

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00:12:03,575 --> 00:12:05,514
very earthy and

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natural taste, and we are almost five star

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on Amazon. So

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so that's that. I think it's just something

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that it should be on every household,

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every everyone's backpack. Should it

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be part of people's lifestyle. You know? So

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00:12:23,160 --> 00:12:25,580
Yeah. That's really fascinating. And I'm wondering

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00:12:26,355 --> 00:12:28,835
how else, you know, besides, you know, your

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00:12:28,835 --> 00:12:31,394
side hustle, how else are you approaching kind

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00:12:31,394 --> 00:12:32,455
of like that more,

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whole health, approach to your spine patients, not

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00:12:37,075 --> 00:12:40,115
just operating on them, but also just making

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sure that

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you have full wellness.

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00:12:44,070 --> 00:12:46,789
Absolutely. Yes. It's it's all about lifestyle. You

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00:12:46,789 --> 00:12:49,190
know, we measure nutrition, but also lifestyle. You

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00:12:49,190 --> 00:12:50,570
know, we always talk about

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exercises, activities,

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and and,

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you know, take care of your, you know,

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mind and body. But, yes, surgery usually is

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00:12:58,794 --> 00:13:01,355
the last thing that, you know, you you

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00:13:01,355 --> 00:13:03,754
you know, I will recommend if if you

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00:13:03,754 --> 00:13:06,154
can avoid it as much as possible. But

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00:13:06,154 --> 00:13:08,699
when people, they they come to us, when

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00:13:08,699 --> 00:13:10,860
it's needed, it's needed. And these days, the

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00:13:10,860 --> 00:13:11,360
surgical

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00:13:11,740 --> 00:13:14,000
procedure have advanced so much that

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00:13:14,379 --> 00:13:16,860
pretty much my goal is to for lots

355
00:13:16,860 --> 00:13:19,179
of patients to get patients home for dinner.

356
00:13:19,179 --> 00:13:21,039
You know? It's like minimally invasive,

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respecting

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00:13:23,705 --> 00:13:26,445
the the anatomy, normal anatomy, and and natural,

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00:13:27,665 --> 00:13:30,264
you know, tissues and really fix the problem

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and and make patients feel better. And, you

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00:13:32,825 --> 00:13:34,264
know, one thing I would say is that

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people, they should avoid looking to all the

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00:13:36,424 --> 00:13:37,325
stuff that is

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00:13:37,789 --> 00:13:40,350
online or or social media because it can

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00:13:40,350 --> 00:13:42,750
be very confusing. People, they can put whatever

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00:13:42,750 --> 00:13:44,509
they want on there, and there's really no

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00:13:44,509 --> 00:13:45,009
filtration.

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00:13:45,549 --> 00:13:47,629
And I would say they should listen to

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their doctor, to their surgeon,

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00:13:50,044 --> 00:13:50,544
and,

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you know, doctor Google can be can be

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confusing.

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So,

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but yeah. I mean, you know, really, we

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have combination of, lifestyle

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00:14:01,929 --> 00:14:04,649
and and eventually surgery when it's needed or

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00:14:04,649 --> 00:14:06,670
conservative management. All that stuff

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00:14:07,129 --> 00:14:08,970
really is helping a lot. You know? Patient

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00:14:08,970 --> 00:14:11,129
do not need to to suffer for for

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00:14:11,129 --> 00:14:12,570
too long. And one thing I was

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00:14:13,690 --> 00:14:15,070
I I I wanna add is that,

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00:14:16,054 --> 00:14:18,855
you know, yes, my pain management colleagues, I

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00:14:18,855 --> 00:14:20,134
love them. They're great,

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00:14:20,534 --> 00:14:24,054
physicians, extremely helpful for patients' quality of life,

385
00:14:24,054 --> 00:14:25,735
but there should be some sort of limit

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00:14:25,735 --> 00:14:28,475
to that. It's like too many epidural injections,

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00:14:28,695 --> 00:14:29,434
too many

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00:14:29,894 --> 00:14:30,394
of

389
00:14:31,080 --> 00:14:33,720
any of too many medication, too I mean,

390
00:14:33,720 --> 00:14:35,480
all those stuff can have more side effect

391
00:14:35,480 --> 00:14:37,720
than just fixing the problem when when it's

392
00:14:37,720 --> 00:14:40,600
recommended or needed. And the patient should not

393
00:14:40,600 --> 00:14:41,559
be afraid of,

394
00:14:42,200 --> 00:14:42,700
indicated,

395
00:14:43,720 --> 00:14:45,100
procedures. That's all.

396
00:14:45,565 --> 00:14:47,964
Yeah. And I'm curious how how, you approach

397
00:14:47,964 --> 00:14:49,745
these conversations with pain management

398
00:14:50,284 --> 00:14:52,544
physicians to really strike that balance.

399
00:14:53,725 --> 00:14:56,125
It's a it's a it's a very good

400
00:14:56,125 --> 00:14:59,259
question, and and it's sometimes not easy. But

401
00:14:59,259 --> 00:15:01,519
I think pain management physician, they should

402
00:15:02,059 --> 00:15:04,779
consider to refer the patients to surgeons when

403
00:15:04,779 --> 00:15:06,819
they have tried a couple of months or

404
00:15:06,819 --> 00:15:09,339
a couple of injections or, you know, few

405
00:15:09,339 --> 00:15:10,559
times rather than

406
00:15:11,545 --> 00:15:14,185
continuing doing same thing and patient to get

407
00:15:14,185 --> 00:15:16,825
only temporary result, they should really refer the

408
00:15:16,825 --> 00:15:19,404
patient to to proper surgeons. Like,

409
00:15:20,105 --> 00:15:21,705
you know, lots of time, you know, it

410
00:15:21,705 --> 00:15:23,565
becomes like a band aid treatment.

411
00:15:24,024 --> 00:15:25,485
I mean, it's one thing if patient,

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00:15:26,920 --> 00:15:30,600
physically or mentally or not not candidate or

413
00:15:30,600 --> 00:15:32,300
not ready for any surgery, yes,

414
00:15:33,000 --> 00:15:35,259
pain management would be a good alternative. But

415
00:15:35,559 --> 00:15:37,019
when there is really anatomical

416
00:15:38,120 --> 00:15:39,580
problems and, like, say,

417
00:15:40,040 --> 00:15:42,379
severe compression on the on the nerve roots

418
00:15:42,785 --> 00:15:44,625
in the spine. I mean, you can do

419
00:15:44,625 --> 00:15:46,465
as many epidural as you want, but then

420
00:15:46,465 --> 00:15:47,985
at the end of the day, it will

421
00:15:47,985 --> 00:15:50,545
be band aid treatment. So and once patient,

422
00:15:50,545 --> 00:15:53,105
they start having, like, neurology or deficits, like

423
00:15:53,105 --> 00:15:55,976
weakness, numbness, and stuff like that, then then

424
00:15:55,976 --> 00:15:58,029
it they should it should be really referred

425
00:15:58,029 --> 00:15:58,769
to a surgeon.

426
00:15:59,389 --> 00:16:01,550
The last question I had for you today

427
00:16:01,550 --> 00:16:03,230
is, what do you think will be the

428
00:16:03,230 --> 00:16:06,529
next big game changer in spine surgery?

429
00:16:08,110 --> 00:16:09,884
I think we are going more and more

430
00:16:09,965 --> 00:16:10,445
towards,

431
00:16:11,004 --> 00:16:12,945
minimally invasive procedures.

432
00:16:13,965 --> 00:16:14,365
And,

433
00:16:15,485 --> 00:16:18,304
you know, we talk always about robotic surgery

434
00:16:18,524 --> 00:16:22,924
and, endoscopic surgeries, all that stuff. Endoscopic surgery,

435
00:16:22,924 --> 00:16:25,019
we are doing it now robotics. Yeah. We

436
00:16:25,019 --> 00:16:27,980
start doing that. But but even before that,

437
00:16:27,980 --> 00:16:29,519
I think, spinal navigation

438
00:16:29,820 --> 00:16:31,199
technology and microsurgical

439
00:16:32,059 --> 00:16:34,320
techno techniques are are really,

440
00:16:35,339 --> 00:16:38,299
extremely helpful in patient's outcome. And, again, you

441
00:16:38,299 --> 00:16:39,120
know, patient,

442
00:16:39,665 --> 00:16:42,485
they recover, like, very fast and

443
00:16:43,184 --> 00:16:43,684
and,

444
00:16:44,225 --> 00:16:46,144
you know, with the again, our goal is

445
00:16:46,144 --> 00:16:47,445
to get patients home,

446
00:16:48,785 --> 00:16:52,225
and back to lifestyle and and activities as

447
00:16:52,225 --> 00:16:53,205
soon as possible.

448
00:16:54,299 --> 00:16:56,139
Right. Well, doctor Rock, thank you so much

449
00:16:56,139 --> 00:16:58,080
for joining us on today's podcast.

450
00:16:58,460 --> 00:17:00,379
It's a great conversation, and I look forward

451
00:17:00,379 --> 00:17:01,840
to connecting again in the future.

452
00:17:02,379 --> 00:17:04,799
Absolutely. My pleasure. Thank you very much.