Since we spoke about what these procedures are, let’s talk about how we do them. The stem cell injections, most commonly known. These are actually injections that we’re performing. There’s no cutting involved, no stitching involved, it’s more needle-based procedures, so very, very, minimally invasive. We use autologous, that means we use your own blood products. We’re not using products from an external source, so there is no question of infection, transfusion issues, and the mismatch. We’re using your own body stem cells, which gives a tremendous opportunity for the body to adhere to them.
Procedure, typically how we do the procedures are once we evaluate the patient … We tell the patient, “Okay, you’re a candidate, this is what you can expect out of it. You have a meniscus tear, or you have shoulder repair, or cuff tear, you have minimal arthritis,” whatever the reason may be. Then we will check their other medical issues and stuff, make sure the medications that the person is on is not interacting with the procedure that we’re doing. Once we clear all of those things, we’ll bring them to the office.
At that point under fluoroscopic guidance, or x-ray, or ultrasound guidance, we aspirate bone marrow stem cells, predominantly from the pelvic, iliac crest area. That’s a big reservoir of bone marrow for most of us. We all have significant amount of bone marrow right there. Once we aspirate it, depending on the need, if I’m injecting one side versus two sides, aspirate 60cc, around … That’s an average, or maybe 90cc of the bone marrow. Then that procedure is, contradictory to popular belief, that is relatively pain-free. I mean, believe me, trust me on that. People do very, very well. They walk out immediately after the procedure. That aspirated bone marrow is given into our proprietary labs where we process the cells and we exclude some product like the white blood cells and red blood cells away from it. Then we make it into a concentrate. The patient returns back that afternoon.
That afternoon, the patient will be under a fluoroscopic guidance or an ultrasound guidance, and we re-inject the stem cells that was been concentrated from the bone marrow sample into the specific areas under precise needle placement of these cells into the exact areas where we want to. We also inject plasma-rich platelets obtained from the patient as well that morning because the stem cells definitely need plasma-rich platelets to go with it for synergistic effect and the stimulation and the growth effect. Once that’s all done, the patient will be placed in some kind of support brace. If you’re doing a knee, basically we do a knee support brace. We do a non-weight bearing. We may give some crutches for them to wear for two to three days to use them. The patient goes back home. We give them post-operative instructions, what to do, what not to do.
The patient returns back again within that three to four day period. At that point, we will take just the plasma for out of his peripheral blood. We process the plasma into platelets, platelet mix. Then I inject the platelets on top of his stem cells, what we have done, which is more like a fertilizer shot, basically that’s where all the growth factors inside [inaudible 00:03:55] . That will help grow the stem cells much better. The results have been significantly more improved when we started doing these techniques.
That’s how then the patient goes back home. We give him a good home exercise program with our physical therapy instructions. We follow them on phone and as well as I’ll see them back within one month period of time. By that time most of the patients are significantly getting better. If not significantly, they are moderately getting better in regards to the pain and symptoms. We follow them for up to seven to eight months. At that point, we will consider them as maximal improvement has happened. We will see them as needed from that point onwards.
In the meantime we are always available to guide and direct and improve their lifestyle. That’s always a constant feature of our patient’s practice. That’s basically how we do the procedure part of it. All this is done under sterile conditions and an outpatient basis. They come to the office, get the treatments done, they go back home. There is no need to be hospitalized or bed-ridden, none of those things. We just have to have a minimal activity as we direct them. That’s very convenient for most of the patients, to undergo these kind of procedures.
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