AVN Regenexx Stem Cell Therapy Procedure Day 1

Up to my first day in Colorado, all my interactions with the clinic had been via the phone or computer. I woke up so excited to actually meet them in person, but was a little nervous too. My procedure was scheduled with a different doctor than I had had my initial consultation with. Why? Because I was told Dr. Pitts did the most AVN cases and if I was traveling out across the country to get something done, I wanted the person who did it on a regular basis!

Of course I did some research online prior to going, so I knew what he looked like and what he had written in his bio, but that was about it until he walked in the room. I felt immediately at ease when I met him! He was so down to earth, funny and had a great personality. He was much, much younger than I anticipated (and very handsome too!). The nutrition nerd in me freaked out a bit when I was given a nutrition book he penned. We follow a lot of the same philosophies and I really liked that. Honestly, you don’t find that in a medical doctor very often. My Mom liked that his name was like Pittsburgh! Haha

The whole process happened over the course of 8 days. . .

My Regenexx Schedule

Monday, March 23rd, 2015

New Patient Evaluation 12:40 – 1:40 PM

Diagnostic Ultrasound 1:40 – 2:00 PM

Prolotherapy Pre-Injection 2:00 – 2:30 PM

Wednesday, March 25th, 2015

Blood Draw 9:15 – 10:00 AM

Thursday, March 26th, 2015

Bone Marrow Draw 7:10 – 8:10 AM

Spine Procedure TBD 8:10 – 8:50 AM

Stem Cell Re-Injection 12:40 – 2:00 PM

Monday, March 30th, 2015

Blood Draw for Post-Injection 7:45 – 8:30 AM

SCP/PL Post-Injection 11:10 – 12:00 PM

I thought I had a good grasp on how the entire procedure was going to go down, but I learned quite a few NEW things in that first appointment.

– For the first time, ever, I heard a doctor say that although my situation was unique to me, he had seen AVN like mine more times than he could count. My Dad was shocked…. he even brought it up saying that he was the first Dr. that wasn’t off put by my AVN.

– For 6-8 weeks post procedure, I will wear my off loader brace when I put weight on my leg. I’ll have to stay completely off my leg for a week, but then after that I can start to put weight on and gradually move to getting off my crutches. My doc said take my time and don’t be in a rush since I’ve been on them for so long. It’s definitely going to take me a longer time than normal since I didn’t just walk into the clinic.

– I never knew that the standard way to categorize AVN doesn’t really apply to AVN in the knee. Why? Because he said it’s harder to gauge AVN in the knee than it is in the hip or shoulder. He said that arthritis (any kind degenerative or autoimmune) can also cause AVN, but you’d have bruising on your bone prior to the lesions occurring. Because I clearly didn’t have any bruising on prior MRIs, he was pretty confident in speculating that the AVN was due to some sort of trauma (either my surgery or blood clot). I did find it interesting that he wasn’t aware of any research into how blood disorders cause AVN – I made sure to tell him to look into Dr. Glueck.

– I asked him how big he thought my AVN lesson was and he gave the following answer which I loved – he said it’s about the size of 3 blueberries in a line OR an almond covered in very dark chocolate. Haha!!

– During my ultrasound, which he jokingly asked if I thought I was having a boy or a girl haha, he noticed a few other things as well. Apparently I had several strains in my ligaments and tendons. He also mentioned that I had a discoided lateral meniscus which was causing the clicking/crackling noise in my knee when I bent it. I always thought it was the jagged surface of my collapsing bone that was causing this discomfort! He said this is a very normal thing to have happen after meniscus surgery. The meniscus is bulging outside of my joint and is causing me problems when I put pressure on my leg. He said that the injections would definitely help to address this problem as well.

– But, the biggest thing that I took away from the first visit was that he wouldn’t be drilling out the dead part of my bone and replacing it with de mineralized bone. All they would be doing would be a core decompression which entailed inserting a needle into the most necrosed part of the bone and injecting my stem cells into it. My Mom, Dad and I were severely confused. We had clearly remembered them telling us this part of the procedure. Dr. Pitts explained the core decompression, but then we also talked to Dr. Schultz (who I had initially had my consult with) to verify everything was correct. We just wanted to make sure everybody was on the same page. Apparently we must have been remembering someone else’s version of how they’d fix my knee. At first, we were taken a back. It really wasn’t exactly what we were thinking… Did I still want to go through with it? But I honestly felt so positive about the whole experience, I felt that my doctor was extremely optimistic about helping me and I felt that it was the right thing to do.

After my evaluation and my ultrasound, I went back into a little surgical room to receive my prolotherapy injections.

What are prolotherapy injections?

[su_quote cite=”Regenexx, Stem Cells & Prolotherapy” url=”http://www.regenexx.com/2011/10/stem-cells-and-prolotherapy/”]Prolotherapy is an injection technique whereby certain solutions are injected to cause an inflammatory healing response. We’ve used the technique for years to tighten lax ligaments and get rid of tendon related pain. We’ve published research on prolotherapy and based on our experience, this is a great technique that if applied by every family doctor could save the US health care system billions of dollars. … Prolotherapy works in part by causing local cellular injury to an area, similar to debridement of a non-healing wound. For example, it’s been known for centuries that “roughing up” (debriding) a non-healing wound will result in that wound slowly progressing toward being healed. The same applies to prolotherapy, where the solution injures or kills the superficial layer of cells in order to chemically “rough up” a non-healing area, which causes healing resources to hone in on the spot. In essence prolotherapy works by giving you another bite at the healing apple. [/su_quote]

Dr. Pitts explained to me that he was going to create an environment in my knee where it would be starving for stem cells… then, in a few days time, we’d feed it exactly what it needed!

I wasn’t sure what to expect with these injections. Dr. Pitts actually told me this was probably the worst part of the whole treatment. That started making me a bit nervous. He injected me in like 10 difference places (I didn’t count – I wish I would have). It was cool because they had an ultrasound machine that he used to make sure the injection was going into the right place. I was watching the monitor the whole time. Some places didn’t hurt, but others definitely caused pain for about 10 seconds and then would stop. I definitely said ‘ouch ouch ouch’ a few times! haha

I was actually kind of upset with myself because I was trying to calm my body down, but my body definitely went into anxious mode major. I was tensing up, sweating, not deeply breathing. This had been one of the moments I had been practicing for and, in my mind, I had failed to do what I wanted to do.

Oh well, I thought, I will need to do better next time for the bone marrow draw.

It was over very quickly, a few band aids were slapped on and I was on my way outta there! Before I left, I met with ‘Kyle- Regenexx Brace’ (as I have him in my phone) to check out my brace I had brought from home and to purchase my infrared heating pad. I can use the heating pad for as long as I want, but I’m required to use it for 30 minutes/twice a day for the first 6-8 weeks. I’m limited to that time frame because any more and it will damage the stem cells. I love the heating pad – it feels great! I wish I could keep it on for longer – it’s probably a good thing it has an auto-shut off for 30 minutes.

Dr. Pitts said I was fine to do whatever on my leg as long as I wasn’t in a lot of pain. He said that I may have some discomfort, but it shouldn’t be too bad. We followed Dr. Schultz recommendations and hung out in Boulder for the rest of the day. We went to the Tea House for lunch, drove around the city and Pearl Street and then drove up to the top of some look outs. It was a gorgeous day and we saw some pretty amazing views!

My knee really didn’t bother me at all that day. I did wake up in the middle of the night with a pretty sore and stiff knee, but all I needed was a small pillow under it to help support it. Tuesday morning I woke up and felt completely fine! It was a little black and blue in the inside of my knee, around the injection marks, but that was it! Can’t complain about that at all!!

All in all, the first appointment I had for my Regenexx procedure went very successfully!

Wishing You A Pain Free Day!