Mar 16, 2015
When a patient schedules a Bone Marrow Aspirate Concentrate/Stem cell procedure in our office, part of the recommendations leading up to and following your SD procedure is elimination of Statins for a period before and after the procedure. While Statins are clearly effective in reducing the risk of major atherosclerotic cardiovascular events, and the cardiovascular benefits outweigh the risks of treatment, there is a skeletomuscular price to be paid with the use of Statins. With accumulation of more data and longer term monitoring on the outcomes of Statin prescription, we have learned that adverse events include, most commonly, muscle pain, aching and weakness usually without elevation of muscle enzymes, specifically the CreatineKinase. All Statins can cause myopathy defined here as unexplained muscle pain or weakness. While in rare settings, the myopathy may be accompanied by CPK levels more than 10 times the upper limit of normal, and progression to a serious irreversible form of myopathy, rhabdomyolysis, in most situations, it is muscle pain and weakness without changes in muscle related enzymes. In spite of all of these observations, as of this time there is no scientific explanation in most settings as to why a patient may manifest Statin intolerance.
As far as why Statins are associated with weakness, pain and muscle aches, there is no pharmacologic evidence other than the disappearance of symptoms when the dose is lowered , the proprietary prescription is changed or the pharmacologic is discontinued altogether. The high success rate of the disappearance of symptoms following a period of abstinence and then reintroduction is consistent with nonpharmocological mechanisms for intolerance.
Do Statins adversely affect the muscle cell mitochondria? In a group of obese patients for whom an exercise regimen was incorporated into their weight loss, fitness routine, those on Statins had a more difficult time with a higher expression of diabetes as contrasted with those who had not been prescribed the Statins. I am not an internist; I admit I use Statins as I have a cardiovascular disease family history. They are prescribed by my internist and I don’t challenge his expertise; my recent ultrasound/echocardiogram stress test results confirm his wisdom. Nevertheless, I now have a reasonable explanation for my own transient muscle discomfort and you have a reasonable explanation as to why we recommend the elimination of Statins prior to and following a Regenexx SD Stem Cell procedure for an arthritic joint.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenexx, stem cells, treatment
Mar 2, 2015
It starts with an evaluation, a Bone Marrow Aspirate Concentrate intervention, a custom brace, and sports specific physical rehabilitation protocol that changes with the seasons, a nutritional consultation, a dietary supplement prescription, and a Concentrated Platelet Rich Plasma/Lysate Booster when appropriate. That’s my recommendation for hiking, biking, climbing, skiing, staying fit and fly-fishing. These far reaching futuristic statements are based on my clinical research, anecdotal observations on patients who join me in the aforementioned activities and my own lifestyle. Should your impairment return once you are a Sheinkop alumnus, or should you see an increase in arthritic related symptoms, do it again in a year or five.
You are what you eat is in part a truism. So too, you can be what you want to be. Sure we age and sure we all have to live with age related adjustments; the answer is not to quit. Take my prescription for maintaining or returning to the active life. To learn more, call for an appointment. As an example, we have changed our visco-supplementation formula because of a new development to one injection rather than three. We have improved our Platelet Rich Plasma formula to be much more effective than last year and we are constantly updating our Bone Marrow Concentrate formula.
So what’s in the Cellular Orthopedic news? “Novel Technology to increase Concentrations of Stem and Progenitor Cells in Marrow Aspiration.” Headline this weekend and I looked into it further. After all, I have a responsibility to my patients to stay in the forefront of new developments. As I delved further, I found that this “advanced” technology was tested on three patients before being brought to market. My analysis of this “breakthrough”, come back when you are for real. Then came the Alpha 2 Macroglobulin filter positioned to compete with Platelet Rich Plasma methodologies. The cart was put before the horse on this one, as we don’t even know if Alpha 2 Macroglobulin will work on a human. Then there is the Hip-Spine connection; but I will save that for next time.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, Synvisc, treatment
Feb 26, 2015
As we statistically analyze our Outcomes data, in preparation for presentation at 2015 Regenerative Medicine Meetings, it becomes increasingly apparent that Cellular Orthopedics is not a “one and done” event. Neither for that matter is a total joint replacement. While skiing in Vail last week, I was in the company of two Sheinkop patient alumni, one a patient under 40 who had undergone Bone Marrow Concentrate hip intervention for advanced osteoarthritis several years ago and one, a 70 year old who had undergone stem cell intervention for his arthritic knees back in 2012. Yes, I take care of friends and they still are speaking to me. Not only do they communicate but, bike and fish with me as well. In both cases as I followed their initial responses, I convinced them of the value of a second procedure and in both cases, it really worked. The younger Sheinkop alumnus is a boarder, the older, a skier. Nevertheless in both cases, they are still extremely active in spite of advanced arthritis in major joints. Might only one stem cell intervention be necessary if I could treat you earlier in the arthritic process? That’s to be determined by ongoing clinical surveillance. The important issue is that both individuals are examples of the potential of Bone Marrow Aspirate Concentrate. There are many more and in the coming days I will Blog about statistically significant Outcomes as I prepare my speeches and manuscripts. Incidentally, while skiing in Vail last week, I happened to change the channel from a sporting even to the movie, Casablanca. Truly, one of the greatest movies of all time; of the great quotes was Rick Blaine’s “here’s looking at you kid” (Humphrey Bogart). What really caught my attention in addition to Ilsa Lund (Ingrid Bergman) was her quote “Play it once, Sam. For old times’ sake”.
How do the stem cells work? It may not just be the stem cells that make a difference in an arthritic joint. We now know that Bone Marrow contains in addition to stem cells, two other major areas of benefit, Growth Factors and Cytokines. While the Adult Mesenchymal Stem Cell may help regenerate cartilage damaged by injury and arthritis, it is the Growth factors and Cytokines that also play an equally important role in the anti-inflammatory effect and reversal of the arthritic process. What happens when we concentrate and prepare the Bone Marrow and execute the Cellular Orthopedic intervention following the Regenexx algorithm of care is reversal or at least a slowing of the arthritic process, a diminution of pain, an improved functional capacity and a delay, maybe avoidance, of a total joint replacement. While there still may be a need for an occasional Tylenol after a BMAC/Stem Cell intervention, you have a good chance of joining me as an alumnus on the slopes, on the bike, wading up a trout stream, or in a fitness pursuit. As well, we may have to do it again in a year or two; but I have yet to record a complication. “Play it once, Sam. For old times’ sake” or in the stem cell world, play it again Dr. Sheinkop to keep me going.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Feb 16, 2015
Well OK, maybe a week, unless you work from your home or have a sedentary job; then you may go back to productivity in days. What caused me to call your attention to the minimal inconvenience and the potential major benefit when Bone Marrow Aspirate Concentrate/Stem Cell is selected as the treatment of choice for an arthritic joint as contrasted with a Total Joint replacement is the minimal need to take time off from work. In addition to the superior athletic performance inherent in a stem cell procedure along with the almost complete absence of complication is the fact that you won’t miss days from your job.
I was reminded of the minimal and short term impact on your life when choosing Bone Marrow Aspirate Concentrate /Stem cells for an arthritic joint this past Friday when a busy Podiatrist sought consultation because of an arthritic knee. She had experienced progressive impairment from advancing arthritis of her knee and three months ago had undergone a Cellular Orthopedic intervention for that arthritic knee. A week later she was on her way to Europe for a long anticipated vacation. She came to the office looking for a long term plan of action as the patient realized as a mature adult, Cellular Orthopedics is a continuum of care and not a onetime experience. That continuum is something I will focus on next time; but for now, let’s focus on the “No Time Off” theme. Inherent in a Total Joint Replacement is obligatory six to 12 week convalescence; that may become a six-month ordeal if a complication such as an infection is experienced. The patient about whom I am writing made it clear that she did not wish to take time away from her profession nor did she wish to risk complication, hence she was planning six or 12 month boosters to keep her working and active. Incidentally, please don’t forget that a total joint replacement may not be a onetime surgical event either. They wear, they fail, they get infected and need to be revised. That revision never is a happy event nor does the outcome come close to the results following an uncomplicated first procedure.
When comparing the potential benefits of a Bone Marrow Aspirate Concentrate/Stem Cell procedure for an arthritic joint to the lost productivity, financial obligation in the new world of high deductibles, and risks of a total joint replacement, the balance sheet speaks for itself. Speaking of balance sheets, I am off to Vail this week for a ski week with family and friends. On Monday, the 23rd, I will be visiting Regenexx to review our Outcomes Data and set forward several interventional protocols. While I seem to Blog mostly about stem cells and arthritis, there is unlimited possibility in the world of Sports Medicine for you to avoid surgery should trauma put you on “Injury Reserve” Check out Sports Illustrated and Stem Cells- that is for injury, not bathing suits.
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Hip, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells, treatment
Feb 9, 2015
As we worked away in our Chicago offices last week, a group of five skiers were Helicopter skiing along the Columbian River basin in British Columbia. What is so special is that each of the five is over age 65 and three of them are able to ski because of the care received in my office. 15 years ago, while I was still a joint replacement surgeon, one of the five underwent a uni-compartmental knee replacement. About six years later, because of progression of the arthritis in the remaining compartments of his knee, I converted the “UNI” to a Mobile Bearing Knee Prosthesis. Fast forward to 2012 when I began Bone Marrow Aspirate Concentrate/ Stem Cell interventions for an arthritic joint to postpone or prevent a joint replacement. The patient for whom I performed those surgical reconstructions presented with end stage arthritis and thus would not have been a candidate for a Cellular Orthopedic Regenerative procedure. The other two skiers ascending the slopes via helicopter in search of fresh limitless powder have undergone Bone Marrow Aspirate Concentrate / Stem cell procedures over the last 24 months and there they are enjoying an ultimate skiing experience as “master “ skiers. As a point of reference for my notion of the continuum of care for the scope of cellular orthopedics, one of those two has undergone the procedure several times. The first year, it was for the left knee. The second round was for the right knee and this year, a “refresher” for both knees. While actually thinking about this Blog, I received the following ALERT real time from the lodge –I just received word from the five skiers that there is a blizzard so the helicopter couldn’t fly this morning but the group hopes to get out this afternoon.
If I have piqued your interest, read more about skiing here: Knee Stem cells in Chicago and Heliskiing-Regenexx. Not only is the article of interest, you get to see what I looked like in 2012 in my retro ski outfit.
The January 13, 2015, article Stem Cell ACL: Cutting Edge Knee Repair Sans Surgery appearing in www.onthesnow.com is also informative and it features one of my five alumni.
Reader be aware, Cellular Orthopedic benefits are not only realized by heli-skiers. What happened next to those skiers was that the rains came and that resulted in a premature ending of their Canadian Mountain Heli-skiing adventure. Now for the happy outcome, the group went back home and this week, each member is preparing for a repeat ultimate skiing endeavor by returning to training on their road bicycles in this balmy weather.
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, stem cells, treatment
Jan 29, 2015
From a Patient in Canada
On January 20, 2015
“Thank you, Doctor,
How are you today? Hope well.
My Mom is very grateful for your kind help, mentions your name frequently and wants to schedule the 3rd Rx-SD visit to your office in 2-3 months.
Please provide us with the special 50% discounted price for the procedure similar to the last time in July and the time convenient for you if possible.
Thank you for your help.
My Mom is currently almost free of pain, walks around the house with a walker. The 2nd Rx-SD procedure on July 9,11, 2014 went really well and with the anesthesia was painless. My Mom trusts you, wants to see you every 8-12 months and to start walking without a walker this summer.”
This was the Holiday greeting last month
“Thank you, Doctor,
We wish you a merry Xmas and all the best in 2015.
Thanks to your kindness and knowledge, we found you when we were in real pain and needed you the most and you saved us. My Mom is very gratefull to You, calls you God and mentions your name daily, she’s feeling better only because of your help. My Mom and I both wishing you good health and all the happiness, many years ahead and a Happy New Year 2015.
Thank you for your help
Kind Regards,”
On Oct 7, 2014, at 8:32 AM
“Thank you, Doctor,
3 months passed after the 2nd SD procedure (9 July).
My Mom feels a better improvement now vs right after the 1st procedure.
We have no words to express how grateful we are.
She still uses a walker but occasionally tries a bit on her own with a cane. The pain is almost gone, just occasionally when its rainy or she stands for too long. She didn’t find a great improvement after the PRP refill (2 May), followed by the 1st SD procedure (4 Dec).
What do you think, Doctor, should she just do the 3rd SD procedure in 6-11 months or is it better to do the PRP refill now prior to this. I was surprised to learn the latest Rx SD 2013-14 data show the result doesn’t depend on age (74), OA severity (3), BMI (35).
With BMI=35 what’s the average total hrs per day should she stand/walk?
Thank you for your help.
Kind Regards, “
On Aug 9, 2014, at 12:16 PM
“Thank you, Doctor,
The 2nd SD procedure on 9 July went well and with the knees anesthesia was very painless. After 1 month my Mom feels good, no pain, just a little bit of pain when its humid and raining, still can’t walk without a walker.
My Mom is really grateful for your help and hopes to start walking one day.
Thank you for your help.
Kind Regards,”
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
