John's Stem Cell Therapy
History
Apparently the path to where I am today started about 20 years ago with a snow skiing accident in Virginia. On a downhill run, I got into some deep powder and went out of control and hit a pole with my left leg. The impact was at full speed and hit my leg just below the knee. I was taken back to the lodge in a snowmobile sled and to the medical facilities. Nothing was broken but I had hyperextended the knee. The doc suggested bed rest, an immobilization brace and crutches. This lasted about 3 weeks.
The next major event to the leg was a volleyball game about 10 years ago although the major trauma there was to the ankle, the same knee took a beating. I was in a boot for about 3 weeks after that. Since then there have been annual, becoming semiannual cortisone shots into my knee to relieve the inflammation. Each Xray and doctor I saw over the years showed diminishing cartilage in the joint, especially on the interior side of the joint. While we were in Sanibel visiting my sister ( May 2011 ), My knee was quite swollen and painful. I am sure the acrobatics necessary on the boat had not helped it and there wasn't time to rest and recuperate. I saw Dr. John Kagan and the Xrays showed the same thing, except worse. The cartilage in my knee was just about gone. He told us that within 5 years, I would be begging for knee replacement. He injected cortisone into the joint after draining about 2 ounces of fluid. The reduction of fluid in the knee and the cortisone shot helped. Unfortunately my active lifestyle never allowed the knee enough time to recuperate.
While in Sanibel and the following months, I tried to nurse the knee back to health but the lifestyle I was living didn't allow it. Living on the boat is constant movement and walking. Storms at sea require a constant balancing act and the cortisone shot wasn't doing anything after about two weeks. We spent a month in Key West, FL and I used the bike as much as I could as that doesn't put the impact to the knee as much as walking but a lot of walking was still done. There were days that the knee would swell up and be painful enough that I would just sit down and take a day of doing nothing. While in Key West, I started actually considering knee replacement surgery.
Cost of the surgery had me looking at other countries to have the operation as well as alternatives. The trip to Mexico was rough and the storms were bad. All of this made my knee worse and I was contemplating ending the adventure or at least postponing it until I could get some relief.
While in Mexico I kept researching alternatives and came across stem cell therapy. The science behind it is excellent and the results very good. I spent many weeks researching and pretty much decided I wanted to give it a try before knee replacement was necessary. I tried contacting several clinical trials to see if I could get into them as the cost would be much lower. Clinical trials are being held all over the world as stem cell therapy is on the forefront of technology, at least in humans. While there is some controversy of stem cell use, the procedure I was most interested in wasn't controversial. There would be no culturing of stem cells, just amplifying my own body's ability to heal by injecting them directly where the damage is. I am not writing this to explain how things work, you are free to research that on your own, I just want to relay my experience with the treatment.
Current & Ongoing
I had contacted several Clinical Trials including ones in Spain, Beijing and Australia. On Aug 2 I heard back from one of the researchers in Australia. He referred me to Jim Bosch who does consulting work for several doctors including Dr. Purita in Miami Florida. Jim and I exchanged several emails and phone calls via Skype. I explained my situation and history and Jim thought I would be an excellent candidate for Stem Cell therapy with Dr. Purita. My web research on Dr. Purita and the procedure he was doing all looked good and the decision was made to give it a try. Jim and I coordinated my schedule with Dr. Purita's and a date was set, August 16th. Flights and accommodations were arranged and Beth and I were off to Miami on the 13th. We arrived on the 14th due to flight delays. We were to meet with Jim and the doctor Monday at noon.
James Bosch is with Bosch Consulting. The doctor is Dr. Joseph Purita of the Boca Raton Orthopaedic Group.
More information about Dr. Pruita and Stem Cell treatments can be found on the website for The Institute of Regenerative and Molecular Orthopedics.
Each link will open in a new window. If you are interested in stem cell treatment
please contact James Bosch through his website and tell him that you got the information from me.
The main players in my procedure were Jim Bosch, Dr. Pruita and Jeremy Carreno, Dr. Purita's lab tech.
There were several others like the X-ray tech and other lab techs but these three were my main contacts and care givers.
The way stem cell therapy was explained to me was that stem cells by themselves are not capable of repairing the area.
They need to be directed, and the platelets are the directors. Think of stem cells as the construction workers, the platelets as their supervisors and
the fat cells as the building material. Once activated, the stem cells are capable of many remarkable things.
In addition to repairing the damage, the stem cells encourage damaged cells to repair themselves and also take part in the repair process.
The procedure began with a simple but comprehensive office consultation followed by X-rays of the knee.
The X-rays showed diminished cartilage on the inside of the left knee, also where the majority of pain is the sharpest.
X-ray of left knee elevated and slightly bent
X-ray of left knee straight, not bearing weight
As you can see by the x-rays, the interior side of the left knee is almost bone on bone.
The Dr. and Jim both commented that they had seen worse and they both felt the procedure would help as there was some cartilage there.
Dr. Purita was most generous with his time explaining the procedure and answering questions. The procedure was scheduled for the following day.
I was to be there at 9am for the initial procedure which was the fat extraction to harvest stem cells. There would be a break of a couple of hours until the second part of the procedure which is the bone marrow extraction to harvest stem cells and another hour break for the final part of the procedure which is injecting the stem cells into the joint.
Procedure Day
I had been advised to have breakfast and take two Tylenol before coming in. I arrived and met with Jim and Jeremy and was prepared for the procedure.
I was lying on my left side on the table and the right hip / buttock area was anesthetized. After about 15 to 20 minutes, the area was numb.
Dr. Purita came and verified the anesthesia was correct and working, and began the procedure.
A small incision was made and the liposuction cannula was inserted. The liposuction part of the procedure has to be
done manually as mechanical means would damage the cells. Dr. Purita talked to me throughout the procedure explaining
what was being done as well as asking if I was ok or did it hurt. This part of the procedure lasted about 20 minutes.
The liposuction syringe and cannula are pretty big and intimidating but the procedure was almost painless.
After that part was over, the staff kept me around for a few minutes to make sure I was ok. They collected about 120cc of fatty material for processing.
I was invited to watch the processing but declined and went out for lunch.
I returned to the office about 1pm for part two. Jeremy was waiting for me and proceeded to explain the process and what to expect.
I was lying on the table face down and my left hip area anesthetized. Shortly Dr. Purita came in and began the process of bone marrow extraction.
While I could not see what was actually happening, I felt the reverberations of the tool piercing bone throughout my body. It didn't hurt it was just
a very strange sensation. Again Dr. Purita talked with me throughout the procedure explaining as he went.
He extracted about 60cc of bone marrow aspirate. It wasn't until after the procedure he showed me the tool used.
This is about a 4 inch or better "spike" hammered into the hip.
This is the x-ray showing the Dr. the position of the device in me.
While this sounds scary and painful, it wasn't. I won't say it was painless as the actual extraction had a feeling similar to a sharp pinch or ant bite.
Jim and Dr. Purita kept me informed as well as entertained throughout the procedure making it relatively painless.
Once that part of the procedure was finished, all the material was handed to Jeremy for processing. Again I was invited to watch but declined.
The processing of the collected material is key to the process actually working. Jeremy explained what was done to the fat cells, the bone marrow aspirate including the light activation of the stem cells. Jeremy has an excellent knowledge of the process as well as excellent patient skills. It would be his "cocktail" of processed material that would be injected into my knee. I dubbed him the master mixologist.
When I returned the processing was almost finished. Dr. Purita came in and was ready to go. I was sitting on the table with my legs hanging off so the knee was bent and there was no weight on the knee thus allowing space for the myriad of needles in front of me to be inserted. I am not sure how many syringes were used but I can remember at least 4.
The first injection was a numbing agent, then another small syringe and then the big syringes were inserted. Again Dr. Purita has excellent patient skills as he informed me as each step was done. The knee injections were about as painful as a cortisone injection but watching them being inserted just seemed to make it worse. This part of the procedure lasted maybe 10 minutes. Jeremy was right there to clean up the injection site and apply a bandage. I was instructed to keep the joint moving, if I needed assistance walking to use a cane. Pain would be my main guide of how much I could do and not to overdo it.
That was it, my stem cell therapy injections were complete.
There was some immediate relief because of the numbing for the injections. I walked out of the office after thanking everyone for their excellent care, this was about 5pm.
We returned to the motel and relaxed. Beth was insistent I start my pain medication as the anesthesia would be wearing off. While my knee was still swollen, the only pain I was feeling was from the fat extraction area.
Day 1 - Post Procedure
Sleep was restless and another pain pill was taken about 2am. The knee was sore but the main issue sleeping was not being able to get comfortable. The liposuction site was on my right hip and as I normally sleep on my right side, it hurt. When I woke up the next morning the knee was swollen and very stiff. The pain was moderate and walking was painful. The use of a cane was a big help getting around. Relaxed most of the day but took a stroll about once an hour to keep the joint moving. By the evening, the knee had loosened up quite a bit but the cane was still necessary. I took another pain pill about 3 pm. I was also taking the dietary supplements recommended by the Dr.
Day 2
This was a travel day and walking was necessary. We drove to Miami airport and boarded our flight. Walking through the terminal wasn't a big problem. The pain was moderate but manageable. No pain pills today. By midday, walking through the airport was becoming difficult and I requested a wheelchair at our final destination. The evening was spent relaxing.
Day 3
After a good nights sleep, everything seemed to feel better. The knee was still stiff in the morning and swollen. The pain was still there but different from before the procedure. Walking was still a chore and the cane was necessary. A few Tylenol made things manageable. Most of the day was spent relaxing and going on short strolls to keep things exercised.
Day 4
The day was overcast and rainy so it provided the perfect excuse to lay around and rest. The knee was still swollen but less than before. Movement isn't as painful but range of motion seems restricted by the swelling. Tylenol again today.
Day 5
The knee remains stiff in the morning but relaxes much quicker. No cane today and did some extensive walking and swimming. Swimming was great as you can move the knee without bearing weight. A few twinges on the return walk but no worse than before the procedure.
Day 6
The swelling is less, almost looks like a knee again. Again, no cane and some extensive walking. I think I may have overdone it as the knee really hurt about midafternoon. An ice pack helped and I quickly slowed my pace and stayed put for a while. After a bit of rest, I returned home and rested the remainder of the day. The liposuction site is not as tender anymore and doesn't bother me while sleeping. The area where it was done feels "different" but all bruising is gone and the incision is healing nicely. The bone marrow incision is healing nicely as well and has not caused an issue other than itching because of the bandage.
Day 7 - One week post procedure
After the abuse the previous day I was surprised to find that the knee wasn't overly swollen or stiff. It was about the same as the previous day. I managed to do some small chores and walking wasn't an issue. While there was still some pain when exerting the knee it was better than before the procedure. Again did some walking but did not feel the sharp pain like the previous day. I have put the cane away.
From this point, I will update weekly and post X-rays when I get them done.
Week 2
Week 2 was a gradual improvement every day. I did some extensive walking and swimming through the week without the sharp pain I had experienced the previous week or pre procedure. The swelling continued to diminish as the week went on and by the two week mark, the knee looked like a knee again. Range of motion has improved and walking doesn't hurt like it used to nor does the thought of walking somewhere make me cringe like it did before. The regrowing of cartilage is a slow process taking months so while I am not ready to declare the procedure successful, I remain very hopeful given the current results and state of my knee.
Week 3
Week 3 was much like week 2 in the sense that there was gradual improvement each day. There was a day that the knee seemed to throb but that could be that I had overdone it the day before. Being back on the boat and actually using it under adverse conditions does stress it in different ways than normal walking. Since the procedure I have had the opportunity to walk on the beach without being in pain. Range of motion hasn't improved much more and occasionally it is a bit stiff when I first wake up in the morning or when I sit in one position for too long. Overall, improvement continues and the knee feels much better that before the procedure and 85% of the time, it feels like it did over a year ago.
Week 4
Week 4 was good with steady improvement with only a day on the down side. I don't know if it was over activity or stress but it did swell up some and give me some pain this week. It was a different type of pain than pre-procedure but pain none the less. I have still not taken any anti-inflamatories just the occasional Tylenol. The liposuction site occassionally has an odd feeling, not pain, just a funny feeling. The bone marrow extraction site is completely healed and there is no pain nor side effects at that site. Its hard to believe it's been a month since the procedure. Overall the knee is much better than pre procedure.
Week 5
Week 5 was a good week. Several walks of a mile or more and the only pain was when the ground wasn't level or I didn't see a curb coming. I no longer have to sit and rest every couple of hundered yards and my stride has improved dramatically. I don't wake up at night because I shifted and put pressure on my knee. Overall, I am ready to call this therapy a success and can wholeheartedly recommend the procedure to anyone in a similar situation. I still take my supplements daily and while I am not running down the beach, I can enjoy a long walk with my wife without being in pain. With that said and while the knee pain is minimal or nonexistent, I have noticed other things that hurt that are just from getting older.
Week 6
Week 6 was more of the same. Daily walking, no issues with any major pain. Took the boat up to Isla Mujeres this week and the waves and bouncing didn't affect me.
Occasionally after overdoing things I feel the knee a bit more but its almost equal to the pain I feel in the right knee. Pain of just getting older.
Week 7
This week I really overdid things. Several miles on the bike, several miles walking and the knee pain was back. There wasn't any swelling as there was before and the pain wasn't as intense but there was pain. Each time after a good nights sleep, everything was back to normal. The overall range of motion hasn't returned and the bike helps with that. It is much better that prior to the procedure but the right knee has a greater range of motion. I still believe that overall things are much better than pre procedure.
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