Regenerative Medicine

When you talk about stem cells, almost every single patient I brought this potential treatment up to has heard of it. We’ve all heard of it.  I remember even going back to when I was in, I think, grade school, Dolly the Sheep, anybody remember Dolly the Sheep? The sheep that they actually cloned? You know… we’re not talking about that. OK. NOT, N.O.T. not talking about cloning anyone or anything. God knows I don’t want to clone me. There is way more than enough of me, but I certainly would see a need for cloning both other types of cells but we’re not talking about cloning at all.

Stem cell therapy has absolutely nothing to do with cloning, not these types of stem cells. Stem cell treatment has been around for many years, but what I’m talking about, is adult mesenchymal stem cells. There are all types of stem cells, now imagine, what does, stem, mean? Stems are planted, they grow, they grow into the thing, so when you see a seed that sprouts into a stem, it can grow – into a weed, into an oak tree, into a palm tree. It can grow into a god knows what, a mushroom, but when you first see that little sprout, sometimes you don’t know what it’s going to grow into.  However, with human stem cells, stem cells which are cells, that depending on what type of cells, they can grow into other type of cells.

Now I’m going to divide that up to multipotent and pluripotent. Now without getting into the weeds or getting too specific, that just means some kinds of stem cells, which by the way are found in our body and all different types of places.  Adult stem cells, which means stem cells which we have in our selves right now walking around, are mostly found in two places. Although, they’re found in many, many places, but they’re found mostly in our bone marrow, or they’re found in our spare tire – our fat.  Typically, for those of us with the average American diet – speaking you know, for other people, not myself of course… just kidding – the fat that we carry around our belly is a rich source for these potentially very helpful stem cells. These stem cells have been around ever since we were in our mama’s wombs and they’ve been around since we were tiny little embryos, not even a glimmer in our parents’ eyes. When we were first human beings inside of our mother’s wombs, these cells start to divide, the cells turned into eyeballs and spinal cord and bones and teeth, those are pluripotent stem cells. Pluripotent, which means they can turn into anything. Those are the stem cells that can be used to make other types of things and researchers are furiously working into growing things for people like new pancreases to cure diabetes, or maybe growing a new heart. Forget heart transplants, need a new heart? We’ll grow you a new one! And they’ll surgically replace that when you’re ready for a new one. That’s not science fiction, I firmly believe, hopefully within my lifetime, certainly my children’s lifetime, it’s going to be reality.

What’s reality right now, in the pain world, is stem cell. Let me first and foremost state that stem cells are Experimental treatment with a capital “E” bold, italicized. What does that mean? It doesn’t mean we’re experimenting like Frankenstein… What it means is that the Federal Drug Administration (FDA) has not deemed this type of treatment – hasn’t been studied, clinically approved studies – to be shown to be of clinical use or a standard of care in treating, really, any medical condition. Pain or anything. However, there are pain doctors, and there are all sorts of specialists, not just in the United States, but in the world, utilizing stem cells for a variety of helpful purposes.

Chronic pain is what I treat every day. The techniques we have today are phenomenal, they’re wonderful. And even though we apply these modern techniques and medicines and interventions and surgeries and all these things we do, sometimes it just doesn’t help, or it doesn’t help enough. For those few patients, I will sometimes mention stem cell therapy. Utilizing your own stem cells, which are in all of us, found in your bone marrow, your fat in highest concentration, taking those cells out, separating those cells, getting rid of the fat. We don’t want to inject fat… Lord knows I don’t need any more fat in me. At the Javery Pain Institute, there’s a couple different ways of doing this. We traditionally will use fat, but bone marrow can be used as well, but we use fat. I personally believe that fat derived stem cells are less inflammatory producing – but I don’t want to get into the specifics of that – but we take the stem cells out of the fat and it’s done with a very minor surgery. There’s not even a stitch used… we suck out not even a Coke cans worth of fat from the spare tire and there’s a few of us can use a little bit of that reduced – I know I can – but the little bit of fat removed, and then through a couple different ways, we separate the stem cells from the fat, but we keep the adult mesenchymal stem cells and these cells, when mixed with your plasma, specifically platelet rich plasma. Think of that as the fuel because these cells are living things – they’re living cells. These cells have wonderful characteristics to them. We can use these cells to treat pain from Degenerative Disc disease, Herniated Discs, Osteoarthritis, Arthritis, all sorts of musculoskeletal pain, Tendinitis… A lot of these pro athletes you’ll see, world class Major League Baseball pitchers, these guys will throw innings of fastballs. What do you think happens to their shoulders and tendons and rotator cuff? It can only take so much of this. Football players with their knees and hips, shoulders, backs, necks. Tennis players – I could keep going on and on. This type of treatment has been used but is been reserved for those, unfortunately, that are well endowed enough for those with financial resources. Unfortunately, it is not yet approved by at least any insurance company that I’ve crossed. Certainly not approved by Medicare or Medicaid, Blue Cross – the big ones – but maybe someday it will be.

Javery Pain Institute, for the past few years, has been offering stem cell injection therapy for selected patients that again have been tried on and failed, non-experimental treatment for their chronic musculoskeletal pain, so it’s not a first-line treatment – it’s not even a second line treatment. In fact, I would venture to say that if you were to take a poll of 100 Pain Doctors from around his country where would they rank stem cell treatment as far as used in chronic neck pain, back pain due to a variety of different musculoskeletal pain? Probably at the bottom. Not because it doesn’t work, au contraire, because it’s not supposed to be used as a first-line treatment. In this case, most of the things that we offer – at least for most of patients – work, but for those few patients that we tried everything and they’ve tried everything and it doesn’t work, sometimes I will mention this to a patient – say, “for the past few years I’ve been trained and we have the proper equipment, we have the proper experience and the staff, we’ve done many patients – several dozen patients – that suffer from chronic neck and back pain chronic pain, rather it due to accidents in the past, too many miles on them or whatever. These poor folks have failed everything and so I say, “listen, are you willing to except that this is an experimental treatment – not been FDA approved – to treat, diagnose, or even be used in any kind of medical form or fashion,” and if the patient says, “yes I’ve tried everything and I would really like to do this and I’m suffering greatly etc.,” then I will occasionally offer that to the patient. I wish I could offer this to more people I really do.

Most of you should be asking, does this work? Does stem cell injection therapy help? Would it help me? Would I be a candidate? The best thing to do is talk to your doctor, about that, but it’s not a first line therapy. For those patients that we’ve helped, the past four years at Javery Pain Institute, I can tell you unequivocally, yes. Stem cell injection therapy does work! It seems to work peculiarly well for arthritic, degenerative complaints, but it also helps with nerve pain. It helps patients with RSD. It helps patients with back pain, patients with pain to the lower extremities, neck pain, and all sorts of chronic pain disorders for reasons both known and unknown, didn’t respond or didn’t respond very well to more traditional therapies. Again, I emphasize the fact that this is not a treatment that is a first line treatment, but that this treatment – while it is still experimental – we’ve gotten pretty good results from this, in fact better than pretty good.

To be quite frank, we’ve only had two cases of the over two dozen cases we’ve done over the past few years that didn’t do extremely well. Most of these patients will tell you that they’ve gotten anywhere between 50-90+ percent relief with just a single treatment, and that’s after one year. I’ve been following my patients and they’ve been kind enough to let me know – both in person and via email – telling me, “thank you, I’m doing great.” When they would see me back a few weeks after the procedure, again after a couple of months, and again after six months and again after one year… I ask, “how are you doing, how is your pain, is it still working for you?” An emphatic, yes, is being given to me in response – “Yes, thank you so much, I’m doing much better” – with the treatment that was done just six months ago or one year ago. Many of these patients are years out and still doing well.

Yes, it does help and yes, it’s more than worthwhile to look into this. If you’ve tried and failed other traditional treatments, it is a very promising technology that I know, undoubtedly will be standard of care within the next few to several years.

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