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Diary of a Stem Cell Knee Patient - Part Two
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Background: on October 14 2016, I underwent stem cell treatment to address osteoarthritis in my knees. Due to the many requests I received, I'm writing a diary of my experience - from initial procedure through rehab through (hopefully) my return to triathlon.

This is part 2. If you want to read part 1, go here:

http://forum.slowtwitch.com/forum/Slowtwitch_Forums_C1/Triathlon_Forum_F1/Diary_of_a_Stem_Cell_Knee_Patient_P6108967/

Part 2 - week 0 thru 6

Pleased to report that post-procedural pain was minimal. Virtually no pain from the knees, slightly more from the harvest sites on my hips but nothing the hydrocodone can't handle. The 7 hour flight home from Atlanta to San Jose was really not the issue I expected it to be.

Exercise-wise, I was under strict orders to take it easy in the first week - gentle activity only. Pretty much just sat on the couch for the first three days - just some gentle ROM (range of motion) work. Days 4-7, I moved to some easy closed-chain exercises - light squats, lunges. Pleased to say I had no problem with any of this, knees feel good.

Probably goes without saying that biking and certainly running are out at this stage, but also swimming - but that's more to do with avoiding infection of the wound site than any physical reason.

Drugs-wise, no NSAIDs for 4-6 weeks after the procedure (Tylenol is OK). but most interestingly, they've got me on a cocktail of daily supplements that are supposed to help stem cell growth and cell regeneration.

First of these is something called Stem Xcell:

http://enzymedica.com/...em-cell-regeneration

In addition, I'm taking L-Arginine and melatonin at bedtime.

Does any of this stuff actually help? No idea, it kinda feels like witch doctor stuff. But I'm already into this for $5000 so I may as well spend the other $200.

Diet-wise, this is also my cue to move to an anti-inflammatory diet. I've been experimenting with Paleo for a while, ever since I read the Joe Friel book:

https://www.amazon.com/...rmance/dp/160961917X

His theme is that fat-burning (vs carb burning) is the route to better health and better athletic performance. But it's also supposedly a great way to reduce joint inflammation. If you're unfamiliar with Paleo, it's a challenging diet and not for everyone - no grains, no dairy, no processed foods, no added sugar, lots of fresh meat, eggs, fruit, vegetables. But this seems like a good time to give it a go.

Entering week 2, I'm now allowed to swim and do progressively more intense weight training (still closed-chain). At the start of week 3, I resumed biking - gently at first but progressively harder. Pleased to report no particular pain - but really no improvement either. Everything feels just the same as pre-stem cell.

Next up is PRP injections (Platelet Replacement Plasma). The Emory post-stem cell recovery protocol calls for PRP after 4-6 weeks. The theory is that it stimulates healing of the soft tissue,

Good news is that there's no need to fly back to Emory in Atlanta for the PRP - it's a routine procedure and I found several providers within 20 miles of my home in the Bay Area. But just like the stem cell therapy, bad news is that PRP is not likely to be covered by your health insurance (benefits not proven yada yada) so my recommendation: shop around for the best deal. I got quoted a low of $357 per injection and a high of $850!

The procedure with PRP is pretty simple - they take a blood sample from your arm, whizz it around in the centrifuge for 10 minutes to separate out the platelets then inject them into your knees. Not especially painful and all done in less than an hour.

No post-procedure pain either (although I hear results vary).

Unfortunately I've now been told to sit on the couch for another week. I can resume biking in 7 days then - hallelujah! - start running a week after that.

So that's the diary up until the end of week 6. At this time, I really cannot report any noticeable reduction in pain from the knees but then again, I was told it would be two to three months.

So see you next time for part 3 of the diary - my hope is by that time I'll be running pain free (my goal is the annual New Year's Day 5 mile trail in Los Gatos).

As always feel free to let me know if you have questions.
Last edited by: smallard: Nov 23, 16 16:56
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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Thanks for the update! I have osteochondritis in my knees and am holding out as long as I can for some sort of treatment but good to see how it is working for you.

I am not sure if you have seen these pedals, but they help a lot with reducing inflammation in the knee from cycling. Most people think cycling is great for the knees because it is low impact but the mechanics are not great for people with arthritis!

http://fitkitsystems.com/product/nikola-xp6-pedals

Ride Scoozy Electric Bicycles
http://www.RideScoozy.com
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Re: Diary of a Stem Cell Knee Patient - Part Two [msuguy512] [ In reply to ]
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Thanks for the tip on those pedals - they look really interesting.

But man, they're heavy - 1.2 pounds for a pair of pedals!!
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Re: Diary of a Stem Cell Knee Patient - Part Two [msuguy512] [ In reply to ]
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msuguy512 - a big thank you to for recommending those Nikola pedals.

I picked up a pair last week - very happy with them. Definitely easier on the knees and although I was skeptical of their claims of increased power, I've found that to be true also.

Great product, thanks for the tip!
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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Smallard, thank you for posting your experience with stem cell so far. My wife is scheduled to go to Emory next month to have the procedure but she may have both knees done on the same day. She's signed up for IM Chattanooga, in September, and hopes the doc will say she can at least walk the marathon part by then. Hope you are progressing well.
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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smallard wrote:
Thanks for the tip on those pedals - they look really interesting.

But man, they're heavy - 1.2 pounds for a pair of pedals!!

Smallard, it's been nearly 4 months since your stem cell treatment. Are you noticing any improvement at all? As far as cycling or running goes, are you back doing both now? Thanks.
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Re: Diary of a Stem Cell Knee Patient - Part Two [eye3md] [ In reply to ]
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Hello eye3md:

Thanks for the prompt - I guess I'm overdue posting an update.

As you say, I'm now about 4 months post-stem cell treatment. The clinic told me not to expect to see any noticeable improvement for 3 to 4 months - so I'm right there on the edge.

However, I haven't been waiting around. First up was cycling and I'm now up to about 60 miles a week, largely (but not totally) pain free. I did buy a pair of those Nikola pedals and they do seem to have helped.

I'm also running 6 to 7 miles a week, but at a pretty gentle 10 min/mile pace. Also, I'm being very careful of the running surfaces I use - treadmill and track only. I avoid hard surfaces (concrete, asphalt). I would like to graduate to trails but that's going to be tough - my doc has given me a strict "no hills" protocol and its tough in area to find non-hilly trails.

One of the most valuable things I've done is sign up with a local physical therapist who specializes in running form. He has a high tech lab (cameras, motion sensors, pressure sensitive treadmill) that produces detailed metrics on my running biomechanics. With his help, I'm on a mission to refine my form to reduce the shock impact to my knees - only two sessions in but highly encouraging results so far. Some very subtle changes ("lean into the wind" and "sit in the chair") very effectively incorporate my gluts in the running action, thus offloading the knees. The data shows this to have a dramatic effect on the shock impact to my knees (up to 50% less).

A second investment I made was RunScibe foot pods. Not quite as precise as the lab but for $200, a very effective way for me to monitor my metrics myself.

So in all, I'm encouraged. My knees are feeling good. At this time, it's tough to say how much to ascribe to the stem cell treatment vs the work on my biomechanics, but between the two I'm very hopeful of prolonging my running career well into the future.

Please PM me if you'd like specifics.

Thanks for checking in!
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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Thank you for the update. Glad you are making some progress and I hope you continue to improve.

My wife had the procedure done yesterday at Emory. Last night, her knees were not bothering her too much but her hip (where they took the marrow) was throbbing pretty bad. Hoping for the best.
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Re: Diary of a Stem Cell Knee Patient - Part Two [eye3md] [ In reply to ]
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I had the same post-treatment experience - pain in the hip, no issue with the knees. The pain only last a few days.

Good luck to your wife!
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Re: Diary of a Stem Cell Knee Patient - Part Two [eye3md] [ In reply to ]
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Hi eye3md, I'm considering Emory for stem cell therapy. Has it helped your wife?
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Re: Diary of a Stem Cell Knee Patient - Part Two [FormerRunner] [ In reply to ]
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FormerRunner wrote:
Hi eye3md, I'm considering Emory for stem cell therapy. Has it helped your wife?

Unfortunately, no! Both of her knees were bothering her. The doc did not want to do stem cell injections on both knees on the same day because it requires taking a lot of bone marrow from the hip. So, he did the stem cell treatment on the right and PRP on her left knee. The treatment on the right did nothing but she says her left knee feels great. Of course, this is N=1 but thought I would share.
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Re: Diary of a Stem Cell Knee Patient - Part Two [eye3md] [ In reply to ]
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I'm glad the PRP has helped, but I'm sorry the stem cell treatment did not help her. Probably wasn't cheap either. I've been reading about some successes from adipose tissue-derived stem cells vs s.c. from bone marrow. Perhaps that will be the method that can help many of us. Thanks very much for the response.
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Re: Diary of a Stem Cell Knee Patient - Part Two [FormerRunner] [ In reply to ]
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FormerRunner wrote:
I'm glad the PRP has helped, but I'm sorry the stem cell treatment did not help her. Probably wasn't cheap either. I've been reading about some successes from adipose tissue-derived stem cells vs s.c. from bone marrow. Perhaps that will be the method that can help many of us. Thanks very much for the response.



Yeah, I'm not sure which is more effective. A buddy of mine had the adipose tissue transplant performed. It was done by a neurological surgeon in Atlanta but I don't know the name. The doc took it from his "love handles" area. My buddy did well with his knee stem cell treatment. Again, N=1 but worth a try. If you go to Emory, I'd make sure to ask the doc about the two options of bone marrow vs adipose
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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smallard wrote:

Thanks for the tip on those pedals - they look really interesting.

But man, they're heavy - 1.2 pounds for a pair of pedals!!

After looking at the site, it seems the 1.2 lbs is the shipping weight. 395gms is the pedal weight.
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Re: Diary of a Stem Cell Knee Patient - Part Two [eye3md] [ In reply to ]
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I will. Thanks for your thoughts on this.
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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What are closed-chain exercises?
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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This is great info. Could you share the cost information? I'm surviving on hyalauronic acid injections now, but anticipate going the stem cell route in the next year or so and wondering what to expect cost wise.
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Re: Diary of a Stem Cell Knee Patient - Part Two [GhiaGirl] [ In reply to ]
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GhiaGirl wrote:
This is great info. Could you share the cost information? I'm surviving on hyalauronic acid injections now, but anticipate going the stem cell route in the next year or so and wondering what to expect cost wise.


I believe the PRP was right around $750 and the stem cell (using bone marrow) was $2500. I'll have to go back and look it up for exact amounts but it was around $3000-something for both.
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Re: Diary of a Stem Cell Knee Patient - Part Two [GhiaGirl] [ In reply to ]
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I had mine done in Atlanta. Price was $2500 per knee. I then followed it up with PRP injections (on their recommendation) - another $700.

Prices seem to vary considerably. I live in the Bay Area and the cheapest quote I got was $9000. It was cheaper to fly to Atlanta and have it done there!
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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Another Emory Ortho stem cell patient, here...

I'd been scoped by Dr. X in June, '16 and the first words out of his mouth, post-op, were I was looking at a partial knee replacement sooner than later. More problematic than my knee was arthritis in the big toe of the foot on the other leg, a problem that came out of nowhere but made even walking, much less running, really uncomfortable.

Dr. Mautner was already my ortho, so he was familiar with my endurance-sport habit. He was encouraging about the prospects for improvement in the knee but non-committal about the toe. I had both knee and toe injected in Dec., '16 and the PRP follow up in January.

Six full months later I can report significant improvement in the knee; it doesn't bother me at all when running or cycling. I'm registered for IMFL this year but only running 15mpw, with all but the long run done on the treadmill. I think I have a workable situation based on compromise in my training habits - if I just don't overdo things, I should be able to show up at the start line in November.

The arthritic toe is better, too, but that's a work in progress. I have more range of motion and it hurts a lot less but I couldn't call the arthritis 'cured' by any means. No one made any promises but I can definitely tell a difference since the injections.

In general, I get blank stares when I describe the injections to my MD friends. It seems like there's skepticism aplenty about whether this is quackery or placebo or whatever. N=1, very encouraged six months later...
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Re: Diary of a Stem Cell Knee Patient - Part Two [smallard] [ In reply to ]
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Can you update us on stem cell treated knee Mr Smallard.

I am enthused after watching Mayo clinic utube video stating they documented
80% pain relief in a study onstem cell knee treatments.

Seattle clinic quote 2 weeks ago was 15,000 for both knees up to 3 treatments.

.
..
.
Gonna need 3 glow sticks.
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Re: Diary of a Stem Cell Knee Patient - Part Two [go.dog.go] [ In reply to ]
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go.dog.go wrote:

Seattle clinic quote 2 weeks ago was 15,000 for both knees up to 3 treatments.
That's just for the parking.

Source: I am from Seattle.
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