- Just injecting stem cells is not a complete procedure.
- Stem cell availability has increased with placental and umbilical cord blood sources.
- Proper chemical and hormone balance can get things on the right track for healing. When balance is not optimal, it is not worthwhile to go into the doctor’s office, receive a shoulder injection, and expect miracles.
- Patients do not come to my office and just get an injection. They get balanced.
- The location of the injection, the solution to be injected, and what additional agents that can be included with the stem cells during the procedure and recovery also play a major part.
- Good judgment comes from experience.
One area of antiaging has to do with body parts that wear out. This happens from injury, athletics, and daily wear and tear. Joints can be repaired or replaced. One of the repairs may be stem cells.
My career change and move to New York City has led to significant experience in the field of stem cells. This started over seven years ago with some retired NFL and NBA players. These players were going to Denver for stem cell injections of joints. The doctor there asked me to do prolotherapy injections on each patient several times to get the environment of the joint ready for healing prior to their stem cell injection. So I’m sitting there in front of a 320 pound former defensive player thinking about that involuntary knee reflex before administering the injection. And sometimes one of these big guys would be shaking in front of a little tiny needle and I have to tell them to “be a man.”
First, to harvest stem cells there is a separate procedure where bone marrow is drawn from the hip bone. To process and concentrate the stem cells takes several hours. The specimen can then be injected later the same day back into the patient.Because of FDA regulations, stem cells cultured from the sample are considered a processed or manufactured medication which has not been authorized for use in the USA. Patients will travel to the Caribbean or other countries to receive these cultured cells by injection, which provides a higher concentration of stem cells. Are there differences in results with groups receiving cultured or non-cultured stem cells? Is there a minimal number of stem cells that correlate with the level of the result? This may be more directly related to other variables associated with the stem cell infusion.
Another source of stem cells is adipose tissue which also requires a separate procedure to liposuction the fat as the source of the tissue.
Amniotic fluid and umbilical cord stem cells then became available. Amniotic fluid stem cells are harvested from patients scheduled for a C-section. Donors are 18 to 35 years old and undergo extreme medical clearance. The fluid is obtained at the time of the C-section. These little cells are pluripotential-- in other words, they can develop into anything. This has been shown with clinical experience.
One of the benefits is to save the patient an additional procedure for harvesting stem cells. The other thing to consider is what is the condition of stem cells that come from someone who is medically not very healthy? And older? Here is a better source.
The cells have been filtered so there is no HLA, which is a protein that can cause an incompatibility reaction. The last two sources of stem cells can be used universally and saves the patient from having a painful second procedure for harvesting.
Speaking with colleagues across the country about their experience with one type of case or another, these cells cannot and have not caused any allergic or incompatibility reaction. No adverse incompatibility side effects have been seen over the years. So, very safe with good results.
Also, the list of medical conditions being treated seems unlimited.
Now some important observations:
First, some of the retired professional players did better than others. This correlated closely with chemical and hormone balance of the human machine. Some were in metabolic shape where the body was not ready to heal anything. Patients in a degenerative, aging process and poor overall metabolic health may not have optimum results. Besides slow deterioration, chronic inflammation may not cause any acute pain or symptoms.
These guys were giving their own stem cells from hip bone marrow. How good are these cells that have been affected by environmental toxins for the same number of years as the patient’s age? Stem cell source is important and availability of amniotic and placental blood sources can provide advantages.
Second, consider where to inject. Intra-articular and soft-tissue results are straightforward. It is useful for injecting Achilles and large tendon tears to prevent rupture and can be used to repair partial tendon ruptures, even inside the shoulder or other joint.
Injections for different types of facial pain and migraine headaches have greater than 70% success rate for long-term good relief and over 90% with some definite benefit. The injection for these is in the face and skull.
Injections can be given for systemic conditions. Ulcerative colitis and Crohn’s disease have shown response. Lung conditions are ideal since the first passage of the blood from an intravenous injection is into the lung.
Third, what else can be administered along with the stem cells? For instance, hyaluronic acid promotes restructuring of nervous tissue, particularly the nerve sheath or the insulation covering the nerve. This can be used when dealing with chronic nerve pain. Mixing stem cells with hyaluronic acid can help lengthen the duration of dermal fillers. And this is all natural tissue. Intra-articular injection of growth hormone also helps with cartilage formation.
This is not just inject stem cells and all is good. Here is my approach about stem cell treatment:
- What is the goal or attempt to heal or repair? Judgment needs to be used because sometimes the injury is such that a surgical procedure is necessary. An injection alone would not be sufficient. However, adjunctive stem cell injection can be considered to improve healing when surgical repair is performed.
- Look at the overall chemical and hormone balance of the patient. Borderline diabetic or elevated ferritin (indicating liver inflammation) levels can certainly affect results. This is like being a coach, training patients and getting the human machine ready for healing. Sometimes a short adjunctive recovery course of growth hormone can get things started off well.
- Where is the injection located? Intra-articular and soft-tissue sources are easy enough. A sphenopalatine ganglion (SPG) block in the head can be very useful as a location to inject in the relief of many painful facial symptoms. Pain specialists frequently perform sympathetic denervation (disconnection) on the stellate ganglion to try to affect the overall autonomic nervous system. Stem cells will go for repair. Looking at something long-term and possibly permanent, location can be very important as far as the result. The SPG is a site for intracranial penetration of the stem cells by stimulating insulin receptors on cell membranes. Now make a list such as Parkinson’s, stroke, and the potential for treatment of other intracranial chronic diseases. Good judgment comes from experience.
- As a surgeon with over 40 years experience operating on many parts of the body, I see widespread background and experience in medicine can offer additional benefit. Look at dealing with an entire human machine.
- It is important for chemical and hormone balance in the patient for proper healing. There is no current textbook with study proven recipes for stem cell administration. Judgment and experience is necessary.
- What can be added to an injection solution to help support the stem cells can be instrumental to promote a good result. This can include hyaluronic acid, low doses of bio identical hydrocortisone, growth hormone, and specific medications related to inflammation and the underlying condition treated.
- Stem cells can be given intravenously for lung problems. Following the circulation from the intravenous administrative site in an arm, the blood first passes through the right side of the heart. The next path is through the lungs. The lung filters the blood at the alveolar capillary level. Then blood collects and goes back to the heart which pumps it out to the body. After leaving the heart many stem cells become sequestered in the spleen so their numbers diminish. But the first pass through the lungs makes this organ an easy target.
- Chronic inflammation influences stem cell activity. Inflammation can serve as a focus to attract stem cells. Chronic and severe inflammatory conditions produce a chemical called tumor necrosis factor (TNF). This is the real killer that causes problems with chronic inflammation. There are drugs that can block this effect. When this is given at the time of the injection it may influence the efficacy of the treatment.
- As far as systemic administration of stem cells, there is no definite recipe that identifies specific routine measures that can be done to attract stem cells to areas of chronic inflammation for initiating their repair activity. Look at notes above. This requires good judgment and experience on the part of the practitioner.
- During the procedure we will be using an MR4 low-level pulsed laser. Focusing this light over various large blood vessels in the body is used to fully saturate the blood volume with nitric oxide. This helps stimulate stem cell activity.
- Administration of stem cells has no significant risk and can be administered conveniently.
- The big cost is the pocketbook. Stem cell injections for one joint may be in the range of $6-8000 in New York City for a treatment. This may be as high as $8-10,000 in California
One aspect of antiaging has to deal with parts that wear out. The patient can decide whether to promote as good of healing as possible or have a joint replacement. Insurance policies cover joint surgery. To help you decide the best option for you, I try to lay it out on the table for patients to understand and to help them make a comfortable and personal decision.
Stem cells and the method with which they are administered can lead to impressive results, prevent surgery, and disable and repair some chronic processes.
******I reemphasize, just injecting stem cells is not a complete procedure.