Banner - Hide this banner





Author Topic: Centeno-Schultz clinic visit  (Read 35814 times)

0 Members and 1 Guest are viewing this topic.

Offline Scooter72

  • Regular Poster
  • ***
  • Posts: 147
  • Liked: 1
Re: Centeno-Schultz clinic visit
« Reply #15 on: May 06, 2011, 04:24:27 AM »
Alright.  So I will finish telling my experiences at the Centeno-Schultz clinic.  First, I will start off with Monday, May 2nd.  This day, I went in for another blood draw.  Nothing to tell, this went smoothly.
The big day was to follow (Tuesday May 3rd).  I want to pre-empt by telling everyone, that despite these minor complications, I still recommend the clinic’s services to anyone.
At 7am I was prepped for the bone marrow draw.  Needless to say, I was nervous.  This is key because I think I represent a subset of people with a "flighty"reaction to new procedures, especially aspirating from the marrow.  Also.. I hate needles.  I didn’t tell Dr. Schultz this per se (although I did tell the nurses this for one of my two blood draws from the arm in previous days).  It’s one of those things that I felt I had to “get over”, because the alternative was either do nothing, or undergo some surgery that had worse consequences.
So Dr. Schultz, being the kind man he is, engaged me in conversation while numbing up the two sites in which the big bone marrow aspiration needles would go into the small of my back.  To that point, all was well.  Then, he put the needles in, and started penetrating to the bone.  Left side first.  As soon as he started boring into the bone, and really pushing hard, my body “freaked out”.  I say my “body freaked out” because it wasn’t as if I started screaming, or overtly panicking.  I was still calmly talking to Dr. Schultz about his career, what to do in Colorado, etc… But my body wasn’t. At some point, I steadily told Dr. Schultz that “I’m not doing so well”.
I started to perspire heavily.  Now, keep in mind, I am losing fluid in the form of aspirated marrow, and through my skin in the form of sweat.  My vision started to blur a bit.  I remember seeing my heart-rate plummet on the monitor.  Not to be gross, but I also had the (involuntary) urge to vomit and defecate.  Neither ended up happening (thank goodness).  During this time, Dr. Schultz asked me if I wanted to proceed with the other side, and I answered in the affirmative, because I didn’t want for the procedure to end in failure, or have any serious delay since I had a plane to catch the same day.  Dr. Schultz completed the procedure with alacrity while having the nurse insert an IV.  This is no exaggeration: within minutes of inserting the IV, I felt 10x better.  Within 45 minutes, I was up on my feet. 
Now, I mentioned unsavory details above to get a point across.  You may ask, what was the problem?  It had nothing to do with the technicals, and everything to do with the way I involuntarily reacted to the feeling of the needle boring into my bone, and my level of hydration.  I’ll repeat this again: I WAS NOT HYDRATED WELL ENOUGH.  I drank the recommended 64 oz of water a couple of hours before the procedure, but for me, that wasn’t sufficient.
A bit of advice to all who get this procedure: try to drink a lot of water, or Gatorade the night and morning before the procedure.  Chug a gallon.. at least 128 oz. Do not take any caffeine.  Do not drink any alcohol.  (They tell you all of this, by the way)  And for the love of not pooping yourself, if you are a panicky type, or even suspect it, ask if you can take a valium before the procedure.  If I remember correctly, that is allowed, although someone else will be required to drive you home. 
I went home after that, warily looking to coming back a few hours later, for the re-injection of the cells into my knee. 
Around 10am, I got dressed and deliberated over picking up some Nytol and Depends Undergarments at the supermarket.  After deciding that the re-injection into the knee couldn’t possibly be as traumatic to me as the marrow draw, I passed up and drove to the clinic.  Once again, I was taken back, vitals recorded, and then taken to the same room (where my pre-injection and marrow draw were done) for prepping the knee before re-injection.  Did I mention that I hate needles? Well, yeah.. this involves at least 6 pokes (that I remember).  Dr. Schultz inserted the “kneedles” and observed, on the monitor,  exactly where to place them to hit my “troubled spots”.  I actually ignored my disdain for needles, and actively watched the procedure and monitor in the latter stages.  It was so cool, because I could see where Dr. Schultz injected the contrast (done first) spot on the trochlear groove, which was subsequently injected with some of the concentrated MSCs.  Folks, this specific skill, along with the fantastic lab are part of what distinguish this clinic from others that do similar procedures.  As for the pain from this procedure?  It does hurt a bit, because the needles have to be “wriggled around” some to afford proper directional placement. 
After the injection, I kept my knee totally still for about 10 minutes, so that a majority of the MSCs would attach.  Then, my knee was cleaned up, and I was released.  From start to finish, the re-injection took about 45 minutes.   I immediately put on my brace, said a few goodbyes, and left.  One other fact, Dr.Schultz does use thrombin as a cross-linker for the MSCs to attach.  I don’t know if the other doctors do this.
My knee was sore that day, and I did a lot of hopping around on my good leg, even with the brace on.  I’ll comment on the brace and how I currently feel, some other time, but suffice to say that the brace is very uncomfortable.  Seeing as how I have never had a patellar brace, I am not sure if this is normal. 
« Last Edit: May 06, 2011, 04:26:43 AM by Scooter72 »

Offline dg

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #16 on: May 06, 2011, 02:57:36 PM »
Interesting. I had very little pain with the bone marrow draw, but the knee injections hurt like heck. They did tell me that different people have different sensativities as far as the draw goes. I make sure to drink lots and to clear all of my bodily systems beforehand. The first time you have this done the nervesousness you have really contributes a lot to the problems. The next time may be just as painful (or not), but simply because you know what to expect it doesn't seem as bad. The other thing I've seen is that while after my first round it took weeks for the pain that got aggravated by the injections in my knee to calm down, after the second round I had no pain whatsoever from the actual procedure itself afterwards. I don't know why that is since they hit some of the most sensative spots.

crumpet, I think putting the cells into the ACL may be less to do with tightening the tissue as to healing weak areas to make it stronger. That being said they've done both prolo and cells into my ACL. Without being able to really be active again it's hard to say how effective it has been so far. If you asked them why you haven't felt an improvement they would probably say that without guided injections it is hit or miss. However, there is tons of anecdotal evidence that prolo works on ACL laxity, but because of the location of the thing I think it would be clear to anyone that you'd need a really experienced practioneer with enough skill to hit it without guidance. It's not the same as doing prolo on your MCL or LCL, which are right under the surface. The ligament itself has to be injected, just putting PRP or prolo solution into the joint space isn't going to cut it. I suppose, depending on how good the quality of the treatment is against the severity of the problem, and how well you treat your knee afterwards as well as your general health will dictate how many treatments you might need.

Offline crumpet

  • Forum Faithful
  • ****
  • Posts: 168
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #17 on: May 06, 2011, 08:04:59 PM »
Scooter....

Wow man, sorry to hear you got so sick there...  That totally sucks! I've been know to sweat buckets when they get sticking big needles in me too..  That's what I guess they call an adrenal reaction.  LOL

I'm glad you made it through okay, and hope you manage to figure out how that brace can be comfortable for ya.  Did they say how long you should wear the thing?

You say they gave you a bunch of shots...  Can you name the locations and did they say which treatment they gave you... SD or AD?  Did they tell you how many stem cells they took from ya for your treatment? Did they tell you weather you had good yield or not? 

DG:  Quite agree with all your comments there on the ACL. Still trying to learn all I can...

So in your case, I'd love to know if you were experiencing laxity prior to going there?  If you had laxity...how did it present itself? Did your knee feel unstable?  Did it clunk around a bit when you ran or walk, or even just rolled over in bed? Or perhaps it was difficult navigating down stairs? 

Also...you have been on two rounds now? Did they do the same procedures with you both times and did they tell you what product they used and what your stem cell yields were? You had another issue with your knee besides the ACL..though right? Since you had your ACL treated, did they also offer you a brace? AND...of course, are you going back for more?

Sorry for inundating you with all the questions... I'm just learning this all a bit more complex than the regular treatments out there.:)

~Crumpet ;D




 




 







 





 

acl issue

Offline dg

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #18 on: May 06, 2011, 08:19:13 PM »
It's good to be asking lots of questions. You have to educate yourself. Doctors are not like high priests of information anymore. The internet has been sort of a reformation. That being said I think most people don't bother doing much research and just take what they hear from idiot orthopedic surgeons. If you research for yourself what can happen in the long run with a meniscectomy, for instance, you would never have it done and yet it is all most of these idiot doctors know.

For me the laxity presents itself in all of the ways you described exactly.

I am having the SD treatment done. I am wearing an unloader brace which you stop thinking about after a few weeks. I do have another apt. scheduled. They don't tell you the cell count in the yield. I think they pretty much know what it should be based on general testing. In fact if you read their blog they have a few posts about this, including a recent one about how they've increased the count by altering their draw technique. If you haven't read every relavent post on their blog you should, even if you don't decide to do anything with them. It's a good education in itself. If you learn enough about these things you might be shocked sometimes when talking with some idiot orthopedic surgeon how little they know about all of the alternatives to their business. Of course they have no incentive to put themselves out of work either.
« Last Edit: May 06, 2011, 08:22:48 PM by dg »

Offline crumpet

  • Forum Faithful
  • ****
  • Posts: 168
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #19 on: May 06, 2011, 10:06:39 PM »
Egads...this thing just ate the best post I just wrote to you guys!!!!! ???

Anyway...I just always have lots of questions.  :-\ Thanks for putting up with me.:)

I was interested in stem cell yields in particular because the Centeno-Schulze clinic makes such a big deal out of it.  After some careful research, I came to find out their theory on that pretty much checks out. 

Apparently count...counts.

Its imperative to have a high yield if you want a therapeutic dose.

So what is a therapeutic dose? AND do different lesions in different places require different counts?

Not all stem cells are the same either.  Not all have a therapeutic effect...  Its like an army... Different guys play different roles.  Stem cell researchers have assigned them markers. That is why high volume counts so much. 

Centeno clearly states that what they have going for them that other clinics do not, is that they have the facility to count stem cells accurately and share that info with the patient.  He claims -- otherwise the patient can never know what he is paying for, particularly when there is so much room for error. 

Sounds reasonable to me.

In fact, there a posts here if you check around indicating some members have had 80 million or 40 million stem cells in their counts...  Pretty cool huh?

It appears...though, the clinic took down its content page showing the average yields for SD compared to C...after the FDA shut down their culturing operation. I'm wondering if that's the point where they stopped offering counts to the patients or if they simply forgot to tell you. This is why I wanted to hear from Scooter as well...to compare your notes.

Kudus to Scooter for working the word "alacrity" into his post. LOL

So..you are in an off-loader? Is this for something besides the ACL?  Do you have a meniscus issue... a lesion?

~Crumpet 









acl issue

Offline dg

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #20 on: May 06, 2011, 10:33:48 PM »
I'm in the unloader for meniscus, yes. About the counts, I suppose it's possible they would have told people with the C procedure, but I don't know. If I recall the literature on their site it was something like 5 million in SD vs 50 million in C. It's all on their site if you dig around, including the information about the types of stem cells. I can't remember all of the details.

Offline crumpet

  • Forum Faithful
  • ****
  • Posts: 168
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #21 on: May 07, 2011, 02:15:42 AM »
DG:

Yeah...for some reason I wrote a bunch of notes pertaining to those figures and have since lost them someplace around here.  Been going buggy looking for them :)

I thought it was 500 thousand vs 50 million.  I'll keep hunting, since I have a BAD memory when it comes to numbers. LOL

Thanks,

~Crumpet
acl issue

Offline Scooter72

  • Regular Poster
  • ***
  • Posts: 147
  • Liked: 1
Re: Centeno-Schultz clinic visit
« Reply #22 on: May 09, 2011, 02:04:33 AM »
  I never got a count on how many stem cells were being injected with the SD treatment; I assume that they have a critical number that is somehow verified via something as simple as an analogue hematocrit, or maybe something more complex, like a flow cytometer.  Just not sure.  As for the areas injected?  I saw the injection into the trochlear groove, but for the others I couldn't definitively tell you the exact spot.  What I can tell you is that Dr. Schultz took a good amount of time before starting the re-injection to once again look over the notes from my initial eval, and then spent about 12 minutes positioning the C-arm, and my bed, to get the perfect shots by which to position the needles properly.  Aside from the lesions of the trochlear groove and petalla, he had to also make sure the cells were placed so as to affect the deteriorated ACL and patellar tendon. As I mentioned, my ACL did not have to be directly injected because upon physical testing, my knee is fairly stable (i.e. it is not so lax that whatever tests they perform reveal a joint completely out of whack).  I also have a meniscus tear, but I assume that he could have injected almost anywhere within the region and hit that.
  As of today (May 8th), my knee feels a bit sore.  I am walking on it more (as per the instructions).  However, compared to the same time point after my microfracture, there is no contest.  In fact, I feel like I could go out for a jog or sprint pretty easily right now.. not that I will.  I am curious.. Dr. Hanson did my first two visits at the clinic (for the initial appointment/blood draw and the subsequent pre-injection).  I asked him about what he recommends to HIS patients upon which he performs these procedures.  He said, "I tell them to let pain be their guide", among other things.  This ties into a recent article on the Regenexx blog speaking of quicker, more intense rehab for shoulder injury patients being better than traditional rehab.  Dr. Schultz recommended that I follow their generic rehab timeline given in the discharge papers, which I will do.  Nevertheless, I can't help but feel that if I pushed myself a bit, I could recover faster.  Unfortunately, there is no way for me to know if my activity would be too vigorous so as to shear away the delicate matrix that has been laid down on the injured areas, especially in the regions with cartilage damage.
  I still hate my patellar brace with a passion.  It is not right that it hurts after extended periods of donning, and that I don't have full range of motion with it on; for example I cannot squat down all the way while wearing it.  It can cut off my circulation (albeit slowly) if I am sitting at a table with my leg flexed at 90 degrees.  The "brace guy" told me to wear it for a full 3 months (after the initial 3 weeks have passed) whenever I am doing vigorous exercise.  Upon wearing it for the first time, in front of him, I commented on its tight fit, and he said that "it's supposed to be that tight". 
  I can say for a certaintly, there is no way I could run with this brace.  In fact, if I tried to play soccer, I would likely hurt myself because my gait is so messed up with it on.  Keep in mind, I have tried to completely loosen all the straps on the brace (which probably nullifies its effectiveness) just to see if that would improve comfort.  It does, but not enough.  I now get what it does, which is to position my patella more medially so as to keep it tracking properly in the groove.  Oh well, no pain no gain?

Offline crumpet

  • Forum Faithful
  • ****
  • Posts: 168
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #23 on: May 11, 2011, 10:46:58 PM »
Heya DG:

Hope you are doing okay.

Got some down and dirty totally granular questions for ya.  Hope you are ready.:)

When you had the ACL treated at the clinic, do you remember if he guided the needle into the ligament once or a bunch of times?  It would be interesting to know how he characterized your ACL.  Did he describe it as having one lesion or area of torn or disrupted fibers, or if there were small signals up and down the length that would give the appearance of Wwiss cheese? Maybe Swiss Lorraine.... since it has smaller holes?  ha ha..

Anyway..if it does have these little holes... did he inject the cells into all the little holes, and then pump up the ligament as if it were a straw? 

And...how do they make sure the stem cells don't just float away into the synovial fluid? After all...one could imagine that if they got deposited into the hole or holes...they can come back out again???? 

Thanks...

By the way, I read one entry on the blog that said SD is approximately 3 million cells...

~Crumpet
acl issue

Offline dg

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #24 on: May 17, 2011, 06:55:09 PM »
How's it going Scooter?

I'm almost 2 weeks out from my second round. I'm cautiously optimistic. I didn't get any relief after the 1st round, but I'm starting to notice what seems to be substantial improvement. However, I don't know how much I can attribute this to the usual peaks and valleys...but there does seem to be a real difference. I continue to do everything they instructed including a half hour, twice a day, of the heat pad. Don't know if you have to use that or not.

I'm reassured by the big news about the Yankees pitcher, Bartolo Colon:

http://www.nytimes.com/2011/05/12/sports/baseball/disputed-treatment-was-used-in-bartolo-colons-comeback.html?_r=1&ref=stemcells

I contacted his doctor who told me that they charge as much as $4800 a treatment. They also use floroscopy for the marrow draw, but my impression is that it may be more of a one man show without the sophistacted lab, science, and openness with results that you see with Centeno-Schultz.

Offline Scooter72

  • Regular Poster
  • ***
  • Posts: 147
  • Liked: 1
Re: Centeno-Schultz clinic visit
« Reply #25 on: May 18, 2011, 02:26:39 AM »
Hey Dg!

Yes, I use the Thermotex infrared unit 2x/day, for no more than 30 minutes each go.  I love it; it feels very good after each use, and to be frank, I use it on other aching parts as well.  (E.g. neck, my other knee etc...)  I also take the recommended supplements, along with Cosamin DS, diligently.

I'm surprised you had no positive result after the first go-around.  You should have had some improvement, given what you told me.  I'm not trying to be a pessimist, but it's too early to tell about your recent (2nd) treatment, although it may well be that you are home-free in a couple of months!  I sincerely hope that's the case. 

The reason I err towards indifference is related to my own condition.  If I had never received the MSC treatment, and just decided to totally lay off my knee for a month, I am sure it would feel a lot better, although I would surely be able to tell there was no healing, just a reduction in bone inflammation.  Now, speaking of my case currently, I think the knee feels.. I dunno how to describe it other than to say "more whole".  It's as if that certain range of motion that made me involuntarily flinch, or gasp whenever I went up stairs (e.g.), whether it hurt or not, is not there anymore.  Nevertheless, this could be some kind of placebo effect, and is hardly indicative that the MSCs have even begun to produce a significant healing matrix.  (In fact, I'd say this is the case, being that it has only been a few weeks since I received the treatment)

For me, the real test will come in a month, when I start to put the knee through some rigors.  Until then, I remain cautiously optimistic.  I think you will do the same?

Offline dg

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #26 on: May 18, 2011, 03:03:47 AM »
You hit the nail on the head. If you lay off it for a while the pain goes way and you almost forget until you try some minor atheletic activities and whammo. So since the course of treatment requires that you layoff for a while it can be hard to know what to attribute improvments too. I have problems in both knees so it bothers the untreated one when I want to test the one being treated. Makes it a little more complicated.

Offline Scooter72

  • Regular Poster
  • ***
  • Posts: 147
  • Liked: 1
Re: Centeno-Schultz clinic visit
« Reply #27 on: June 05, 2011, 12:43:00 PM »
Just wanted to drop a line here, and say that I haven't updated recently, because there really isn't much to say until I can put the knee through some rigors.  As mentioned above, I could get cheery and spew optimism because the knee "feels good" (i.e. little to no pain everyday), but it isn't meaningful at this point.  So, until I participate in a soccer match and/or start lifting weights with it, I will just let things be.  I am about one month out from doing so.

However, I will make a comment concerning the clinic.. I received an email asking for me to provide data that will go towards evaluation of patients who are 4-6 weeks out from their respective procedures.  They want me to grade my improvement by giving a percentage. (I surmise that they are collecting these subjective stats for possible publication, or at least as a barometer) I went ahead and did so, but think that it's nearly a meaningless number.  They are asking people who have likely been told to do nothing with their body part of interest for at least 6 weeks (according to the discharge sheet they hand to patients) to give a percentage improvement?  How would one do that?  From what I have read, cartilage grows notoriously slow, and I doubt 4-6 weeks is long enough to grow a significant layer in the areas where it is bone on bone.  In my case, I haven't done any running, jumping, cutting, weight-lifting with this knee, and have generally babied, albeit to a lesser degree these past two weeks.  But I'm supposed to say how much it has improved?  It feels good, but then again the inflammation is at a minimum right now. 

To be fair, it may be that those with much worse damage than my own (e.g. knee replacement candidates) would feel significant pain relief after 4-6 weeks. 

Anyway, don't take this as a damning of the procedure or clinic. I'll definitely let you all know how much it has helped in a couple of months.
« Last Edit: June 05, 2011, 12:47:01 PM by Scooter72 »

Offline dg

  • MINIgeek (20-50 posts)
  • **
  • Posts: 21
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #28 on: June 05, 2011, 02:09:44 PM »
I didn't respond to the questioneer. There are just too many factors which I could attribute to feeling better. I understand why the would ask, it's certainly no critism.

I don't have arthritis and they told me that even if they could do the C treatment now, for me they would have probably recommended the SD treatment anyway. As I understand it, for arthritis, C is obvisouly going to be much more potent that SD. So in comparing my progress and yours, Scooter, we might see some differences, don't know.

I certainly got no relief from the first procedure. It took a month to just get over it. It's now a month for me from the second procedure. I will say that the popping in my knee is 90% gone and it does not feel nearly as loose as before. The last time I was there I got prolo and cells into the ACL. I have had a lot less pain especially in the last two weeks. I think I am becoming more and more optimistic. I've been able to take longer walks without any problems and even do some gym excersises I wouldn't have dared a few months ago. My other knee, which was the better knee, almost seems worse than the knee being treated. However, as good as that sounds it's pyscologically difficult to believe without reservation that the treatment is really working despite some evidence. It's not like having a cut where you get stiches. You can't see the progress, but you notice less pain or that you can do things that before would have caused aches and now don't seem to. But at the same time I'm being so careful not to over do things. Is it possible all the "rest" the knee is getting is allowing it to just calm down? I'm also wearing an unloader brace all the time. I think the proof will continue to be the increased physical capabilities, reduction in pain and ultimatly in ultrasound imaging, new MRIs eventually and the radiologist report. A lot of the doubt probably comes from the echoing discourgement of "establishment" orthopedic docs I've seen. Just the simple fact that it's not a "standard" treatment plants a lot of, perhaps unreal, disbelief in the mind that is hard to overcome.
« Last Edit: June 06, 2011, 01:47:11 PM by dg »

Offline WestPoint

  • Regular Poster
  • ***
  • Posts: 104
  • Liked: 0
Re: Centeno-Schultz clinic visit
« Reply #29 on: June 11, 2011, 12:43:01 PM »
When you are told that you are not supposed to stress the knee for 6 weeks, does this mean that we should also not be doing physiotherapy? Anytime I stop physio for even a few days, my muscle wastage becomes stronger, which means more pressure on the knee when I walk.















support