Diary of My Regenexx Knee Stem Cell Procedure in Philly

What follows is a diary of my Regenexx knee procedure. I had the procedure done in Philadelphia, Pa., more specifically at The Center For Sports Medicine in Springfield, Pa, a suburb of Philly. Dr. Shiple's office was the closest location at this time to have the Regenexx procedure done.
I hope this account helps others who might be deciding whether to have this procedure done or not. I've already been back to find out the results, and I'll share that in the next post. Read on if you'd like to find out what the procedure involved!

Friday, May 11th: My father-in-law passed away at 2:33pm. I was blessed to be at his side with the family. However, I knew that I was going to Philadelphia for my pre-treatment on May 15th, so I was nervous that I might miss the funeral. Thankfully, the funeral was planned for the 16th, but I was still nervous how this would all work out!
------------
Monday, May 14th: I went to work as usual, then to the calling hours from 6-9pm. I had planned on leaving for Philly immediately after, but I decided to sleep in my own bed for the night and leave early in the morning.
------------
Tuesday, May 15th: Left for Philly in the morning and arrived 1 hr before my appointment scheduled at 1pm. The drive from Perry, NY is about 5 1/2 hrs, without stopping, via Binghamton/Scranton on the PA Turnpike.

The pre-treatment I had this day was to get the knee prepared for the actual stem cell procedure I was to have the following week. Dr Shiple said the pre-treatment 'wakes up' the knee, so to speak. The treatment is called PRP (Platelet Rich Plasma), and here's what it entailed:

1st- Blood was taken from a vein in my arm. They then spun it down and got the platelets out, mixing it with something else (of which I've forgotten what that something else was--hmm. It was minor, whatever it was--the platelets were the important thing!).
2nd- Dr Shiple then used ultrasound to look at my knee. This is what he found:

• Significant amounts of fluid from my injury, which he said would have to be drawn out.
• I had a herniated torn meniscus. My meniscus was not only torn, it was actually popping up out of the cavity in which it was supposed to be sitting.
• He also discovered that I had badly damaged a ligament in the knee, near the meniscus, 
• as well as damage done to the bone from arthritis.

3rd- My knee was numbed up. The fluid was drawn out, and Dr Shiple proceeded to inject the platelets into the arthritis area, as well as the meniscus/ligament area. During most of the procedure, I felt no pain. Then suddenly, as I was talking away to the nurse, .....OUCH!!!! A huge sting and some pain, and it was as if I was suddenly hit with laryngitis!! Some more novocaine, and thankfully he was able to finish the procedure without any more pain.
Now, for those of you who say you wouldn't do this procedure since I had this sudden pain: this particular doctor said if I had ANY sort of pain, he'd stop, numb me more or go more slowly, whichever would keep the pain from recurring. This doctor will even numb your arm before taking blood! He's all about making sure you are as comfortable as possible and as pain free as possible during the entire thing!
[You have to remember: traditional surgery involves pain too; yes, you may be knocked out, but when you wake up, you are bound to have some pain. Making a decision as to stem cell or traditional surgery shouldn't be based on the actual procedure itself (and whether you'll be awake, asleep, afraid of needles, etc), but on the longterm--the actual outcome of the procedure and how it will affect the rest of your life (my last post explains this thought process). As an example, you can compare it to eating habits. If you only ate candy all day, every day, simply because you don't like the taste of vegetables and other good-for-you foods, you have the temporary pleasure of a sugar rush. However, the long term effects over a life time and probably a short one at that) would be very obvious: rotten teeth/tooth loss and sickness due to malnutrition are two big ones I can think of, not to mention the high medical costs.]

4th- I was given a script for Tylenol with Codeine, given crutches, and told I could walk on the leg but only slightly touch the ground (no full pressure on the leg for 24 hrs), and also told to use the cruise all the way home, then was sent on my way!
I stopped at a CVS pharmacy down the road, which thankfully had a drive-thru, put in the script, and was told I'd be notified via text on my cell phone when it was ready. The novacaine was wearing off quickly, but it was just a very slight dull ache and seemed completely manageable without medication.

I hadn't eaten, so I went into a Panera Bread right next door and got something to eat. By the time I finished eating, my script was ready.
I left immediately for home, stopping only once on the Turnpike rest stop to use the facilities.
My knee was achy, and although the pain was manageable, I would have rather not been driving. But, it was completely do-able by myself!
I arrived home, and my family was waiting to help me get in the house. I had prepared ahead--had my pjs laid out, meals made ahead, blanket and such brought downstairs, so I just plopped on the couch, realized how much my knee was hurting, but promptly feel asleep without taking anything and slept like a baby that night!
(I had missed all the calling hours for my father-in-law today, which saddened me, as my family told me of all the people who came. I would have loved seeing everyone, but if I had cancelled this pre-treatment, it would mean postponing the entire procedure for at least 3 months or longer. Dr Shiple is one BUSY doctor!).

------------

Wed, May 16th: I woke up pain free! However, my knee was quite stiff and swollen. I had to stay on the crutches today, so off to the 1pm funeral I went, hobbling along. 

Funeral, cemetery, dinner afterward, and by later afternoon, my knee was slightly sore from being stiff, but also from hobbling around. I also had a headache, so I went home and slept for several hours. I felt quite a bit better.

------------

Thursday, May 17th: I was able to ditch the crutches and went to work today. I have to walk quite a bit around school, but I was careful to put my leg up when I could. My knee was still ever so slightly stiff and swollen, but other than that, my day was just as normal as usual. I had a massage and pedi after work, so I was able to relax and put my leg up, which was nice. I started doing my exercises as ordered by the doctor. I was supposed to bend my leg all the way possible to get it moving and flexible. I think it helped to decrease the stiffness.

------------

Friday, May 18th: By today, I was able to bend my leg all the way back at the knee, and felt 100% again. The pain of the torn meniscus was still there, but any pain or stiffness from the procedure was gone!

------------

Sunday, May 20th: Jeff and I left for Philly. We were able to do some sightseeing (Liberty Bell, Freedom Hall, etc), and also got some good food!

My husband, Jeff, standing next to Benjamin Franklin's grave.

Me standing in front of Liberty Bell. I thought I was smiling, but I didn't realize how anxious I was about the knee procedure til I looked at this picture!

I discovered a FAN--TAS--TIC vegan restaurant called Blackbird Pizzeria! It's just a short walk from the Liberty Bell, and if you go, try their Cubano---ohhhh YUMMM!

Jeff got an authentic Philly Cheesesteak sandwich at Geno's. We went back to our hotel room and I tried to sleep!

------------

Monday, May 21th: Jeff and I arrived at Dr Shiple's office in time for my 9am appointment, for the actual stem cell procedure! Here's a step-by-step of what happened:

(If you watch this video, you'll see a patient lying on a table getting the stem cells taken out from their back, then injected into their knee. This is exactly what I experienced. The video also explains some things about the procedure)

1. Blood was taken from my arm, as last time, and the platelets spun out.
2. I was put onto the table face down, much like getting a massage. My lower back was numbed, and what is considered the most painful part of the procedure was started: Dr Shiple inserted a longer needle into my iliac cavity (basically, it's the hip bone area closest to the spine) in six different spots. There was slight pressure as the needle was pushed into the bone, then slight pressure as he drew the marrow out, but I had absolutely NO pain, which I was SO thankful for!
3. He then drew out some fat from my lower back/hip with a very small liposuction needle. I begged him to use a larger one and take more fat off, but he just wouldn't do it (hehehe!). The fat was going to be inserted into my knee, along with the stem cells, in order to hold the herniated meniscus in place.
4. I was then turned over onto my back while the stem cells and fat were prepared. My knee was well numbed with novocaine, and, using ultrasound, Dr Shiple then injected all the stem cells, platelets and fat back into my knee. He had to inject it into 3 different areas around the knee: the arthritis area, the ligament, and the meniscus. Apparently, the most sensitive vein in our body is located on the  inner side of our knees, because even numbed, I DID have some discomfort when he injected in that area, as before---ouch!!
5. With all the injections done and bandaids put on, I was fitted with a brace. I again hobbled out of the office on crutches, only this time I was ordered to keep my foot completely off the ground for 48 hrs.

Jeff was now put in charge of driving, as the doctor had warned me ahead of time that I shouldn't attempt driving this time, and that I should get home asap (same as last time). We went to the CVS pharmacy down the road and got a prescription filled for something stronger than the Tylenol 3 I had gotten last time. Jeff also got me something from Panera Bread (I wanted to stay sitting this time!)-- I had been too nervous to eat on this morning, so by now I was ready to get something in my stomach!

Jeff drove me home right away. Since he didn't like going by way of Scranton, he decided to go over to Harrisburg, then up 15 thru Williamsport and on home that way. My husband is not a fan of driving, so he was more comfortable going this route. The only problem is that it took a good hour longer. My knee was hurting a lot, lot, LOT more than last time, and I just wanted to get HOME!!! After only a few hours into our drive home, I was forced to take some Tylenol 3. It helped slightly, but only lasted about 1 hr tops. During that time of slight relief, I somehow managed to hobble into the Starbucks in Williamsport to use the facilities, but that stop, plus a quick one for gas, were the only stops we made, thankfully.

Jeff did great driving, and we finally arrived home early evening (the whole procedure in the office took about 3 hrs), and as before, I had prepared meals, had the sofa and everything I'd need ready. I plopped on the couch, propped up my leg, and couldn't focus on anything except how to get relief for the throbbing pain in my knee!

I was nervous about taking the stronger pain med that was prescribed, so I had tried to get by with only the Tylenol 3. It was only afterward that I realized I should have taken the stronger meds!

I finally fell asleep around 1 in the morning. I woke up around 6am, took another Tylenol 3, then fell back asleep for a while.  When I woke up mid-morning, my pain was gone! Dr. Shiple said it was quite unusual for a person to be pain free less than 24 hrs after the kind of procedure I had. I was grateful I wasn't the norm!

I stayed off my leg for 2 full days (Tues and Wed) as directed. By Tues afternoon, I realized I had developed bad blisters around the bandages that were put on over where each needle had been inserted. I had to leave my brace off a few hours at a time, plus applied some Tea Tree Oil in order to help the skin heal.
Dr Shiple figured it was an allergic reaction due to the combination of the topical antiseptic he used and the bandaids. The antiseptic was not betadine; rather, it was a newer type of antiseptic that doctors feel works better. The bandaids were just normal ones, of which I've never had an allergy. Dr Shiple said for the next time, he'd use betadine so as to avoid this problem in the future.

------------

Wednesday, May 23rd: Noontime marked 48 hrs that I was supposed to be off my leg. By 3pm, I decided to finally ditch the crutches. It felt weird trying to walk after 2 days of not putting my leg down! I didn't stay on my feet for very long, as my knee was still a little stiff and swollen, so I took it easy the rest of the day.

------------

Thursday, May 24th and beyond: I started bending my knee and walking as directed by the doctor. Instead of the usual rest after traditional surgery, this procedure requires the patient to start moving as much as possible. They want the stem cells to know, thru the exercise and movement, as to what they are supposed to do and become (re-grow the meniscus, repair the ligament and bone, etc).

By the end of the week, I was back to normal in every way, except my knee was still slightly stiff and swollen. The swelling was actually a good thing, believe it or not! I was instructed not to take any kind of anti-inflammatory, since they actually want inflammation in the joint! The inflammation brings blood to the area, which aids the stems cells and platelets in the healing process. Our bodies are amazing things in how they work! I'll never look at inflammation as a bad thing again!

The swelling continued for several months, and more so included my foot/ankle. Dr Shiple said this is normal, since gravity is at play here. But again, the sign of swelling was a good thing....it meant there was still inflammation in my knee, and that the stem cells had more of a chance to 'do their thing.'

------------

Wednesday, May 30th: I left for Philly once again and stayed overnight in a hotel in Quakertown, Pa.

------------

Thursday, May 31st:  I walked around downtown Philly a little more in the morning, went to Blackbird Pizzeria again, then off to Dr Shiple's office for my 1pm post-treatment appointment.

By this day, I was feeling great--my knee hadn't been stiff for probably 3 days, the blisters were almost gone from the allergy, and the pain from the meniscus tear didn't seem as bad as before. 

My back, where they took the stem cells, was still tender. That continued to be tender for almost a month after the procedure. It never was painful, nor did it hurt to sit; but it was tender to the touch, which was completely understandable. It was also bruised, along with my knee--also to be expected from such a procedure. The bruising eventually went away and never caused any problems.

My arm had bruised quite badly from the stem cell day procedure, but was because pressure wasn't applied long enough to the vein after they took blood. So for today, they took blood from my other arm. My veins apparently aren't as good as my right arm, as they had to use the ultrasound to get into the vein. Once in, the red stuff flowed well--blood is amazing stuff, I tell ya!

Today's post-treatment procedure was an exact duplicate of my pre-treatment, except he only had to insert the platelets into the outer part of my knee, not the inner part where it hurt so bad last time. I was SO grateful! The post-treatment was necessary as it was sort of like the 'fertilizer' to help the stem cells grow and repair the meniscus and ligament.
He said my knee looked great--the fluid was staying down and everything looked as it should. I was instructed to wear the brace as long as possible, to walk, bike, swim, and just plain move! I had brought my crutches with me, hobbled out after the procedure was done, and drove home.

This time, I wasn't in any real pain, just some slight discomfort, so I took the opportunity to stop at my niece's house near Binghamton, which was on my way home. It was a real treat, as she fed me (she eats the way I do--a higher raw, vegan diet), and I got to spend a few hours with her, her husband, but especially my grand-niece and nephew!

I again had to stay off my leg for 24 hrs, but then I could resume normal activity, and by Saturday, I was walking, cleaning, and doing all my normal activities. The swelling continued (not a bad thing, remember), I did the exercises as recommended by the doctor, and I settled in for the next 2 1/2 months,  praying that I'd get good news on August 15th, when I was due to go back for a checkup.

And that's where I'll leave you for this post. My next post will be the big drum roll with the results, so be sure to tune in!!