Naman Julka-Anderson (00:00)
Hello everyone and welcome to Rad Chat, founded by me, Naman Julka- Anderson.

Jo McNamara Rad Chat Host (00:04)
and me, Jo McNamara. So Rad Chat is a forward thinking global knowledge hub where healthcare professionals can advance their expertise in radiotherapy and oncology. Unlike traditional academic resources, we blend real world experience, expert insights, best practice, and of course, most importantly, patient perspectives.

Naman Julka-Anderson (00:23)
We make advanced knowledge engaging and accessible, supporting continuous learning and professional development without compromising patient care or personal time. By providing insights into both technical skills and career development, helping you progress confidently in your field and shape your professional future.

Jo McNamara Rad Chat Host (00:39)
Just to let you know, our episodes may contain sensitive and difficult topics that you may find distressing or triggering.

Naman Julka-Anderson (00:48)
This is episode 203 which is part of the Living With and Beyond Cancer series where we will be hearing from our guest Dr. Saahil Mehta about Plexaa Bloom 43 device. Hi Saahil, how are you?

Dr. Saahil Mehta (00:57)
Fine thanks, nice to see you both, Naman and Jo Thank you for having me.

Naman Julka-Anderson (01:02)
Great to have you here. Would you mind just starting and introducing yourself to our listeners, please?

Dr. Saahil Mehta (01:07)
Yes, sure. So my name is Saahil Mehta. I'm a consultant plastic surgeon from London. My last consultant job was at Chelsea Westminster Hospital and I did all my training there in London and I did my fellowship at the Royal Marsden Hospital in breast reconstruction. I recently moved to Los Angeles to concentrate on the launch of Bloom 43, which is the subject of this podcast. But yeah, moved here in September.

I'm enjoying the sunshine and the sort of new pace of life that I'm dealing with in the US, things do move at a very different rate, but that's me. I've been running Plexaa for, gosh, I started the company in about 2020 at the height of the pandemic.

It's nice to have finally made the move out here to concentrate on the launch because I truly believe that what we have is something that's going to change the way we all get ready for surgery. So yeah, that's me.

Jo McNamara Rad Chat Host (02:04)
Saahil, before we go into Plexaa, tell us a little bit about what made you want to go into the field of surgical oncology, plastic surgery, you know, what was it that kind of directed you into that field?

Dr. Saahil Mehta (02:18)
That's a really good question. Well, I...

So I decided I wanted to be a plastic surgeon very early on at medical school. I did medicine as a second degree. I'd done a previous degree in biochemistry and I worked in television for three years for Channel 4 ⁓ and realised that wasn't something I wanted to continue doing so decided to go to medical school. But I knew I wanted to do something practical and so I was looking for a surgical specialty where I could do something

that would be much more kind of tangible to a patient in terms of outcomes and you do something immediately. And actually it was a doctor called Mrs Sarah Pape up in Newcastle where I was at medical school who I met and I remember the operation where I decided I wanted to be a plastic surgeon. It was a burn patient. She had had a horrendous burn to her scalp. She was hairspraying her hair and smoking at the same time and set her hair alight. So she had this big bald patch.

that Dr. Pape was able to cover by inserting tissue expanders into the hairy side and then growing that area of the head and then excising, cutting out the scar that was bald and then sort of bringing all that hair across like this surgical comb over. And I was standing there as a medical student watching this operation and behind my mask my mouth was wide open and I was just like wow

that was amazing because I'd seen gallbladder operations and colon operations, felt like, know, gallbladders gallbladders gallbladders, but this was just something else, was like really bespoke. And then during my training, I finished medical school, went to London, and that was when I started to get involved and interested in breast reconstruction. There was something about the very process of creating something that really gave patients a sense of self and gave them comfort

to leave their house and dress in the clothes that they wanted to dress in. Those are the sorts of things and plus also as I got you know got into the research I really really enjoyed working with that group of patients. There was something about giving something back to them with something you've made surgically that really improves their quality of life and that's why I continued with that and yeah the rest is history as they say.

Naman Julka-Anderson (04:29)
Can I ask, that sounds like an incredible story, but how long does it actually take for you to become a consultant in your field?

Dr. Saahil Mehta (04:37)
My goodness. So from medical school, it's taken 14 odd years. So it's just a pretty long time. They say you have to be clever to be a doctor, but I think you actually need to be stupid enough to go through all that training, but anyway, that's the thing. So the way it works is that you finish medical school and you go through a lot of generic training, and then you make the decision whether you're going to go to surgery or medicine or GP or psychiatry or obstetrics

and gynaecology and I chose the surgical pathway. So then you do another two years and then you apply competitively for a six-year training program in your chosen specialty. Now the nuance of that six years is that if you were, it's never six years. You're gonna do fellowships, you're gonna do years out, you're gonna do whatever. So that took me about eight, eight and a bit years I think. So it takes a long time, but in some ways that's reassuring to know that it takes a

time because you kind of have to get comfortable with doing these procedures on your own or rather just leading the procedure and making those decisions and that's really what you're learning to do is that once you've learned the skills you do obviously get better and better with them but it's actually the decision making that is the really difficult bit to learn I think.

Jo McNamara Rad Chat Host (05:51)
Well you look very young Saahil so plastic surgery obviously is good for you. I didn't say that at all. So tell us a little bit about Plexaa and Bloom 43.

Dr. Saahil Mehta (05:53)
It's all the Botox.

Yeah.

Sure, so the history behind this is that I started this project back in 2009 when I was a junior house officer at St. Thomas' Hospital and I've never made any of secret at all but there was no bigger mission in those days than me just doing a research project to become a plastic surgeon.

And what it was, was that I was working with guy called Jian Farhadi who was a professor of plastics at St. Thomas's at the time. And back in 2009, he introduced this type of mastectomy to the UK, or rather was one of the first people to started doing it. Essentially, he introduced something called skin-sparing mastectomy. And what that meant was that it was a way of treating breast cancer surgically. breast cancer is best treated with surgery. So you cut away the problem.

But this technique is a technique where you cut around the nipple and in a circular fashion-ish and you remove the breast in one go with the cancer and that leaves behind this skin envelope that is fantastic for reconstructive purposes. So you can fill that envelope with either your own tissue or you use an implant. But the biggest issue about that skin envelope is that it's thin and thin skin by surgical principle has a poor blood supply which is why it's very susceptible to wound healing problems

problems such as skin necrosis or infections. And so what we were seeing was really great aesthetic results.

So breasts that looked more like breasts following reconstruction than had previously been done. But the downside was obviously you're putting the skin at risk of developing wound healing complications. And so we were seeing a relatively high rate of something called mastectomy skin flat necrosis. And whilst this causes delays in healing and more cost and return to the OR or theatre to fix the problem, the biggest impact it had was that delay that it was causing

to accessing adjuvant chemo radiotherapy. And so that in itself has an effect on survival rates. Now what happened was that Jian had a friend in Switzerland who'd done his PhD in this whole idea of something called super physiological preconditioning, which is a really long term, doesn't roll off the tongue. But essentially what it is, is a way of improving blood flow to the skin preoperatively to prevent wound healing problems. And the way that this guy had done it

was by heating the skin to 43 degrees centigrade in a very specific way, preoperatively. And what that did was it caused a stress to the skin that didn't cause damage, so no thermal damage, but it was a stress. And that stress caused the release of something called heat shock proteins. There was one protein in particular, Hsp32, that when that got released after this heating procedure, it causes the release of carbon monoxide in the tissue that causes vasodilation

so all of your blood vessels open up and that in turn improves blood flow to the skin to essentially prime it to heal. So this is a totally natural process. We can all do it and there's different ways of preconditioning. You can hit the skin, you can cool the skin, you can use drugs but heat is really easy way of delivering this type of therapy to get this kind of result. So my boss, Jian at the time, he gave me this surgeon, Swiss Surgeon,

papers, scientific papers that he'd done the research on mice and he said read these papers and I read them on a night shift and those are in the days when I could stay awake in night shifts and

I had a previous, you know, my previous degree in biochemistry, I had this interest in translational medicine. I always found that, you know, these, these kind of experiments that I was doing in biochemistry, I always ended up with this feeling of what was a point. It just felt like there was just no bigger, there's no, no translatability. didn't mean anything. So this though, was, I read the papers and thought, this is pretty simple. Why don't we just try this in, in humans? And that's what we did.

We copied the laboratory protocol and used hot water bottles and thermometers and protocols to give to patients for them to precondition their skin the night before surgery at home on their own. So they just followed the same laboratory protocol using a hot water bottle. So I was like this, I was a house officer at St. Thomas's, I had a white coat, clipboard, a bleep pager and a hot water bottle in my pocket. so I would recruit patients to this trial

breast reconstruction patients and we tried it and lo and behold, and I think we were all surprised when we demonstrated we could reduce skin necrosis in particularly high risk patients just with this simple heating procedure. So I published that paper in 2013 and rather than sort of risk being called a fluke, we applied to the NIHR for a grant, just under a quarter of a million pounds to run a full randomised controlled trial on a

patients over three years and demonstrated again that using this hot water bottle technique we were able to reduce skin necrosis and have really positive outcomes and two of the surprising outcomes that came from that were that you could reduce, you could halve the operation rate so if you got necrosis you were half as likely to need to go back to theatre to fix it and also if you had a wound healing issue you had a 70 % reduction in your outpatient follow-up so there was something protective that was happening.

So then I published all of that in 2019 and then that when that niggling kind of well what was the point came back.

It was kind of like, well, this is a super simple procedure. Patients loved it. They felt empowered by just doing this thing before surgery. How do we turn this into something real? How do we turn this into something that everyone can get the benefit of? And that's why I founded the company. Now, simultaneously to that, what we also do with Bloom 43 is we have an app that helps patients pre-habilitate and get ready for their surgery as if they're about to run a marathon. So we give them advice on physical health, mental

health, nutrition, sleep, because why not optimise yourself as much as you can before your surgery? It makes total sense. And that was all that all came from the question I kept being asked on my fellowship, which was preoperatively, patients would ask me the question, what can I do to get ready for my surgery? And they wanted to know all this information. We are really bad at giving that information or we just don't have a resource to do that. And so what we created was the company to build a device to do the preconditioning and an app

to do the prehabilitation and that's what Bloom 43 is. It's a platform technology that helps patients get ready for their surgery. And we've chosen breast surgery firstly because it has a high risk of wound healing issues because of what I've explained about blood flow. The patients are phenomenal and they've helped me do all the research and if there's one group of patients I want to give back to is them. And also I think that we can demonstrate through these principles

prehabilitation and preconditioning that actually if we get it right in breast surgery we can get it right for all other areas of surgery. So that's our plan to expand what we've done in breast surgery to everywhere else. So that's us.

Naman Julka-Anderson (13:07)
It's amazing to hear the research kind of stemming into, yeah, like an innovation basically. Can I ask for anyone listening who might be thinking, oh yeah, I've got these ideas and things, how could they get to where you are with an idea with something medical innovation style? And be honest.

Dr. Saahil Mehta (13:24)
that's a really good quest.

Yeah. Well,

one of the other frustrations I had during training was this whole idea of the surgical coffee room chat of, I had an idea and I could have done this, but I didn't. I always found that frustrating. Now, I just thought, you know what, I've got to make this work. And I think if you're anyone as crazy enough to think, right, I'm gonna bring an innovation, especially a medical device, to fruition, the number one thing you need first of all is resilience

and just to make sure that you start talking to people as much as you can about your idea and figure out whether what you've thought about actually has a place or if there's a fit. And I think...

Once you kind of get an idea of, you know, there will be some form of acceptance within your sort surgical community and things like that. And don't get me wrong, you will have the skeptics, you'll have the haters, you'll have all of that. And that's where the resilience comes in. You kind of just have to go for it and just expect that, you know, you're going to have so many challenges. But I will tell you one thing. All of this is, it's a passion project. It does not feel like work. I'm enjoying this ability to build

something that may change the way that people feel about their surgery pre-operatively and kind of like remove a bit of that fear and to me that that goes back to you know, that's why I'm doing this and why I'm not necessarily doing boob jobs and tummy tucks on Harley Street. It's you know, it's it's I've got to do this for now because the moment is now for this but I would say to anybody that's thinking of doing it just go for it, you know the biggest

failure is not trying and just go for it.

Jo McNamara Rad Chat Host (15:06)
Saahil, is there, ⁓ in terms of kind of the procedures that you do, is it different in terms of the rates of necrosis and kind of infection rates from if you were to have breast implants for a cosmetic purpose? What is it about kind of the mastectomy specifically that then causes that increase in kind of necrosis and post-surgical complications?

Dr. Saahil Mehta (15:22)
Yeah.

Yeah.

Yeah, really good question. So the main thing is the skin flap or the skin envelope that you create through your skin sparing or nipple sparing mastectomy. It's the thinness of it. So basically, if you imagine a mountain.

Okay, and at the top of the mountain, the peak is your nipple, or one's nipple. And the inside of the mountain is what you're coring out, you're taking all of that away. So what you're left with, and that's the breast tissue, what you're left with is this kind of shell of a mountain, and that's gonna be what we call the skin envelope, where you can either put an implant into or a...

or your own tissue. Now when you're doing a cosmetic operation, let's say you're doing a breast augmentation or a boob job, the inside of that mountain is still there. So you're putting your implant, it depends, there's different planes of where you put it, but you've got, you you've still got that thickness and there's blood vessels that go through the base of the mountain all the way up to the nipple are still there.

But when you do a mastectomy, you are cutting all of those blood vessels. You are relying on the blood supply that goes on the side of the mountain, right?

So that's the key bit. It's the fact that you are disrupting parts of the blood supply that mean that you're relying on the thinnest, sorry, the narrowest blood vessels to perfuse your skin. And that's why you have the extra risk. Now, if you're having a breast reduction or a breast lift, you are also disrupting the blood supply. And so there's use for Bloom 43 in those operations as well. So really it goes down to a basic surgical principle.

It's all about blood flow and the ability to deliver oxygen to your wounds to help them heal, to get them to heal. So that's all we're doing. We're just augmenting a basic principle of ensuring that you've got good blood supply to the skin in order to heal. And that's the other thing is that I'm sure you know is radiographers, radiologists, and you know, doing radiotherapy is that your skin is an end organ. So it's the most distal part of that chain that is the last bit

gets the blood flow and so that's the one that shuts down the quickest if you imagine you go out into the cold you get cold fingers that's what's happening it's your periphery that gets cold and shuts down and we're keeping all of that blood flow open through this preconditioning procedure.

Naman Julka-Anderson (17:54)
So linking to that style, the other types of reconstruction, so like a DIEP flap, is that similar kind of process as well? Or then obviously thinking about the abdomen as well to look after for the pre-hab.

Dr. Saahil Mehta (18:02)
Yeah, so.

Yeah, absolutely. you're absolutely right. So actually when we look at the complication rates in implant-based versus own tissue-based reconstruction, the implant is slightly higher. And the main reason for that is because an implant has no inherent blood supply. So you're putting a thin skin envelope on top of an implant. Whereas if you're using your own tissue that you vascularise, that means you create your own blood supply in that unit of tissue that becomes your new breast

you're going to get angiogenesis or new blood vessels growing from there that will help refuse the skin. So that's the slight difference. But we still see the issue of wound healing problems with deep flap reconstruction. Now, your question, Naman, about can you precondition your donor site? Yes, you absolutely can. Because again, you are disrupting the blood supply, the native blood supply

the skin on a DIEP flap can become a little bit precarious from time to time. And that's part of what we want to do next. We want to a that can do that part of it as well. And that's actually what we've started to work on yeah.

Jo McNamara Rad Chat Host (19:12)
So if you had to describe to anyone listening, so they're sitting in their car on their way to work, what is Bloom 43 and how does it work as opposed to a hot water bottle?

Dr. Saahil Mehta (19:22)
Yeah.

Good question. So, Bloom43 is a platform that includes an app for prehabilitation and that takes you through a training program to get you absolutely optimized for your surgery. So it deals with sleep, nutrition, physical health, mental health. And the other part is a wearable device that you put into your bra the night before surgery, switch on, and it delivers supraphysiological preconditioning with heat to the skin. And the key thing about that

wearable device is that we've built it to be the absolutely most safe way possible that is accurate and reliable to deliver the preconditioning to your skin so you don't even have to worry about it. reason we went you know people say to me why can't you just use a hot water bottle well if you've had radiotherapy previously or you've had an implant based reconstruction you have to have your implant changed your your sensation to your skin has been is generally disrupted most

patients say they can't feel anything. So the temperature control is paramount and that is what we work so hard on with Bloom 43 is that it is the most accurate, most safe and most reliable way of delivering thermal preconditioning to your skin. So it's all under sensor control, it's all automatic, you don't have to worry about it, you just put it in, switch it on and go. That's it, done.

Naman Julka-Anderson (20:46)
Are there people who can't use the device? And is there any difference between men versus women?

Dr. Saahil Mehta (20:51)
So the current form factor of the device means that we have unfortunately had to preclude patients who are either having a delayed reconstruction, so they have a flat chest, or women who have smaller breasts. The reason we took that decision was when we looked at the demographic of my randomised control trial, we looked at the largest population. So we wanted to create a size that would treat the most patients possible. So we looked at the various breast sizes and things like that. So this is generation one

we've now quickly moved on to generation two that will allow us to treat the opposite ends of the spectrum that we've not been able to treat with this size. The other thing that we say in our...

sort of randomised controlled trials that we're testing the device with. We sort of say to patients who have what's called inflammatory breast cancer, maybe don't do this, but that's mainly, that's not really something that would necessarily preclude patients per se, but ultimately what we've done is we've built something that we want to be available to everyone as much as possible because it's so safe.

So, you know, if you've had previous therapy, radiotherapy for example, you can use this device and we've had good results with patients and even a surgeon who has undergone her own breast cancer journey. She had previous radiotherapy, used the device and she said, you know, I healed so well after this and that really was something I didn't expect. So there's a long way of saying no, just use it.

Jo McNamara Rad Chat Host (22:23)
And in terms of radiotherapy, could you envisage and do you have any plans for looking at research that potentially then is going to help patients who are going for radiotherapy maybe before surgery?

Dr. Saahil Mehta (22:37)
Totally, you know, I'm

really, happy you asked that question and I was gonna bring it up somehow, but absolutely.

In surgery, when a patient has had radiotherapy, we often, forgive me for using the term, but what we call the tissue, often we say it's woody. So it's a different feeling when you make your incision, when you've gone through skin that's had radiotherapy. And we know, and we see this in plastic surgery all the time, that patients have problems with their skin. So radiation, dermatitis, all sorts of problems like that, that in plastic surgery, you have treated pretty successfully with fat transfer.

I was talking to my clinical counterpart here in the US at Stanford and he was asking the question

What if you use Bloom 43 to precondition the skin before you have radiotherapy? Now I think that's a really, really good question. And it's a research project that I absolutely want to get done. So that's what we're going to do. And I'm confident, I'm really confident that we will see a difference in outcome. It may not necessarily be a visual outcome, but it might be one that patients feel. I don't know, but it's something that's warranted. And the other thing about developing Bloom 43,

means we have a platform to do this type of research because a problem with the hot water bottle is that safety aspect again and a good way of delivering it and so you can't just buy something from Amazon and put that on your chest because it's not controlled in the way that we are. So we now have the ability to conduct research and you know in the safest most accurate way for these types of patients and I can't wait to see what we come out with. It may be negative I don't know but it's worth doing for sure so watch this space.

Jo McNamara Rad Chat Host (24:18)
I'm so

glad that you're so passionate about prehabilitation because it's definitely something that I myself would love to see much more across the oncology pathway. I know prehabilitation often gets associated with kind of surgical interventions, but we absolutely can see the benefit across that pathway. And you know, if I could wave a magic wand, I would make sure that every patient had prehab throughout all of their oncology pathway at every single touch point, you know, in the interval.

Dr. Saahil Mehta (24:47)
Yeah.

Jo McNamara Rad Chat Host (24:49)
that potentially they need. So I can definitely see how the app itself, just that on its own, could actually improve patients, know, conformity to patient, to treatment, adherence, you know, these things that potentially give them control. Have you, just with conversations that you've had with patients, obviously the skin is one thing, but have you noticed anything anecdotally just from patients themselves using the app?

Dr. Saahil Mehta (24:55)
Yeah. Yeah.

Yep.

Yeah.

100 % so we now have had over 800 downloads of the app across 46 different countries and So we can now put some data behind the feedback So we have a net promoter score of 86 % which which is off the charts It basically means that you know patients are going to recommend the app to other patients We've also had a metric of dwell time so that's how long patients spend on the app going through our videos

and programmes and it's over an hour per session which is really quite something.

I could not agree with you more about the need for prehabilitation to be essentially a standard part of the surgical conversation. And that's really what we want to be at Plexaa. So we want to be the company that scale the idea of prehabilitation. We want to help hospitals, clinics, you, any service provide prehabilitation to their patients because we can do it digitally through the app and we can do it

for a wearable, whether it's appropriate for that type of an operation. So where we're heading next is, we are about to sign a very significant co-collaboration agreement with...

a major hospital here in UK, US. I can't talk too much about it just yet, but we're looking at how we can help pre-habilitate elective C-section mothers. this all goes back to, now there's a different wound profile there and we don't need to get into that now, but the point is that, you know, when I was a medical student up in Newcastle, I went to see my first C-section and

I went to then visit the mother afterwards with the junior doctor that was shadowing and this was when I was a medical student and the mother said, you know, well what do I do when I get home? And the doctor said, well I don't know, just don't pick your baby up. And I was kind of, is that the, that's the advice? Like there was no preparation for it. This is an elective procedure. And this is all the way back in, I don't know, like a hundred years ago in 2007. you know, that's, that stayed with me all this time. And actually what we have again is this, this platform that we can adapt to all surgical procedures.

But what we want to be, the vision absolutely is, is to make sure that we can provide the solutions of prehabilitation and preconditioning for any surgical procedure for any patient across the world. That's the goal.

And I kind of think that, you know, we've spent so long understanding and getting better at operative procedures. now have robotics. We now have, you know, all these really amazing post-operative dressings and, you know, some in most places rehab programs as well. But one thing we just haven't dealt with is that pre-op phase. And, you know, the whole idea of optimising your patient, you your raw ingredient of your operation, it just feels so obvious. But, you know, there are very, very, very few tools that allow

a service or a hospital to do that and that's what we want to be. We want to make sure that we can occupy that space. So yeah, it's an exciting journey to be on but it's a mountain I'm enjoying climbing.

Jo McNamara Rad Chat Host (28:16)
And I also envisage that because waiting lists are...

quite significant in the UK at the moment. It's about ⁓ giving patients control, giving them something to really focus on that they can then take control over and hopefully improve their outcomes moving forward. So I can definitely see it from that perspective. And obviously, as someone who has helped write a lot of business cases to implement pre-habilitation services around oncology pathways, is proving that pre-hab saves money in the long run.

Dr. Saahil Mehta (28:26)
Yeah.

Yeah.

Yeah.

Jo McNamara Rad Chat Host (28:47)
⁓ Trying to make that link isn't always tangible to people that sit and sign the checks.

Dr. Saahil Mehta (28:47)
Yeah.

No, absolutely, but we have done our own literature reviews and there's more more evidence coming out there that, you know, pre-habilitation on its own can reduce costs by 26%. Only a third of institutions across the US, for example, would offer it and spending on pre-habilitation, mean, it's less than 1 % of overall spending goes towards this. It just seems crazy. And you're absolutely right about the way that patients feel about pre-habilitation.

and pre-op. The words control, empowerment, confidence, preparing for my rehabilitation or my recovery, these phrases and words keep coming up from what we do and they're really powerful because you really want to make sure that patients feel totally empowered going into their surgery and one of the other metrics that has really been obvious is the change in patient experience. we say

often in surgery that if you've got a well-informed patient who is well prepared, even if they get a bad outcome that wasn't planned for, they will deal with it in a much better way than if they aren't prepared or aren't informed and they get a bad outcome. That's just disaster for everyone. So what we want to do is just change that and flip the sort of, you know, make sure there's a tipping point towards that informed and empowered and control, have as much of that as you can preoperatively. That's the goal.

Naman Julka-Anderson (30:30)
So Saahil, kind of alluded to what's coming next, but what can people look out for in 2026 and beyond?

Dr. Saahil Mehta (30:36)
Yeah, so that's an exciting question for us. So our goal is fundamentally to change the conversation from why would you precondition to, or pre-habilitate to, what do mean you haven't? Go and find a surgeon or a service that is pre-habilitating because that's what you need. And I mean that in the best possible way. mean that what we want to make sure is that we're heading towards the sort of as close as we can get to standard of care or

starting that conversation. The other things that are coming are our second generation device. We'll start doing limited testing on that to help patients who either have flat chests or smaller breasts or even larger breasts that don't fit the device. And then also we're just looking to keep expanding. We are undergoing CE marking for Europe and the UK

and that's something that's just going to take a long time. It's just the nature of medical devices, but we are running trials at the Royal Marsden and also at Portsmouth to do that with our NIHR grant. So looking forward to doing that. But I think one thing to say is that if there's anyone who's listening and they have a friend or...

they themselves are about to undergo breast surgery of any kind, do download the app. There is so much information in that app. You don't have to pay for it either. It's all free. And it can really help you get ready for your surgery. And then one day in the UK and Europe, which is my goal, is to make sure it's regulated for that market as well.

Naman Julka-Anderson (32:02)
Exciting. I really hope in your office you've got like the first water bottle or something there in a glass box so that whenever people start coming in they know how it started.

Dr. Saahil Mehta (32:06)
Hahaha

Yes, I think that first water bottle never made it back to St Thomas's so it went out to the patient but I think they all just kept them but I think I bought I think 250 hot water bottles and I think we ended up with two. yeah, but you know my office here I have my Bloom 43 hat and yeah just a few memorabilia actually which is fun. I actually have our first check so we started taking on revenue

for the company here in the US and I actually have the first check which is kind of kind of cool.

Naman Julka-Anderson (32:47)
So Saahil we always end our episodes with top tips for our listeners. Do you have anything for patients, healthcare professionals, students, anyone listening?

Dr. Saahil Mehta (32:55)
I think, yeah, so from the point of view of prehabilitation, the top tip is do look at what we're doing. In fact, if you're not having breast surgery, you can still use the prehabilitation program. go and download our app. It's at www.bloom43.com. It's on the app store. It's on the Android store as well, whatever that's called, Google Play. So from that perspective, yes. Go ahead and find out more about prehabilitation.

From a sort of device and medical innovation perspective, just go for it. You know, there's plenty of resources out there. It's become much more normalised. You're not considered a crazy person by wanting to do this. I think, you know, feel free to drop me a line on LinkedIn and I'm more than happy to talk to anybody who's thinking about doing this, but I would recommend it. It's not easy, but it's also tons of fun. So yeah, just go for it and yeah, keep an open mind and you know you never know what a small research project is going to become so ⁓ you know just just go for it and just keep saying yes.

Naman Julka-Anderson (34:02)
And if it goes really well you can move out to LA with Saahil. Well thank you so much for coming on, it's been very insightful, really excited to see where it goes and hopefully we can help support with anything radiotherapy related as you get there.

Dr. Saahil Mehta (34:04)
Yes, exactly. Yeah, plenty of sunshine. Exactly. Yes, thank you. as I say, I have a commitment to doing that trial in radiotherapy and preconditioning. So let's keep in contact and watch this space.

Naman Julka-Anderson (34:25)
Brilliant, thank you and thanks everyone for listening to Rad Chat with me, Naman Julka-Anderson and Jo McNamara. So our next guest to feature will be Jess Singh as part of our Living With and Beyond Cancer series talking about her experience of cancer and a career in radiation therapy. Thank you for listening and take care.

Naman Julka-Anderson (34:42)
You can use this episode as part of our free, continual professional development, accredited content, which offers flexible learning that fits your busy schedule. Just check out the show notes for the reflective questions, links to literature and resources, and a link to complete the form to receive your accredited certificate.

Jo McNamara Rad Chat Host (34:58)
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Naman Julka-Anderson (35:09)
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Jo McNamara Rad Chat Host (36:15)
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Naman Julka-Anderson (37:31)
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