Posts Tagged ‘PRP’

My PRP injection was a month ago, and I have no idea whether it helped at all.  It may be too soon to tell.  I had my follow-up visit with the doc last week.  I explained that the pain was worse than before and he said he was not disheartened yet, (good!) but that he definitely wouldn’t do another injection at this point (I agree).  He gave me a bunch of PT exercises..the usual lying-down single-leg raises  in all directions, (more on that in a minute), the ubiquitous ITB stretch,  and also VMO exercises..for my Vastus Medialis Obscuram..no wait, that’s not right..Vastus Medialis Oblique, that’s it.  It’s the muscle that causes that weird little bulge atop my knee in some pictures I was looking at from a couple of years ago when I was not injured.    I realize I don’t have that little bulge so much anymore, so I guess that is what the doc meant by “quad wasting.”  Apparently I must build the quads up again so they can stabilize the knee, and apparently this is the part of the quad that is suspected of failing in its knee stabilizing role.   So, I do these twice a day now, because, you know, I don’t have enough to do and need more exercises to add to my list of daily tasks.   I think I have 22 exercises per day now.  30 reps each.

But back to the lying-down leg raises.  Why do PTs and doctors always tell you to do leg raises lying down?  Because, I don’t generally run lying down, and it seems pretty easy to do leg raises standing up, in all directions, so I would think that would be even more effective.  For one thing, you’d be adding a balance component to the exercise.  And for another thing, it is much easier to find a comfortable place to stand to excercise than to find a hard surface to lie on..at least at my house and my office.  (Yes, I have a floor, but it’s not really so super sparkly clean all the time and  also whenever I lie down on it the cats come and stand on me.) I don’t know..I’m thinking I will try doing them standing up..in front of the mirror, paying attention to form…because I think that it’s better than not getting them done.

Today I ran/walked 7 miles on trail sin the Wissahickon.  Because it was a nice day.

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Well, after 5 months or so, having plateaued in my recovery, I decided to revert to my default behavior..casting about for some non-surgical treatment that sounded vaguely like it might have a scientific basis, and would be unlikely to make anything worse.  What I came up with was Platelet Rich Plasma Injection Therapy, aka, PRP.  The theory is that you centrifuge the person’s blood to produce a plasma that has a high concentration of platelets, and therefore various growth factors ..in other words..all the good stuff that promotes healing..you can then inject into the joint and it might initiate tissue repair.  It seemed to make sense, and since it was nothing but my own blood being injected, with a little tiny needle, I figured there wasn’t a lot that could go wrong.   The doctor suggested he should, at the same time, aspirate the popliteal cyst in the back of my knee, which apparently either never resolved at all, or has recurred as I’ve increased my activity level.  I hadn’t noticed it lately, but that seemed like a good idea.

So, here’s how it went.  The nurses/assistants (or whatever they were..no one ever tells you these things..) drew a bunch of blood really fast by using an anticoagulant and went off to spin it down.  Then, two doctors, a med student, and a nurse-type person assistant came in and, after numbing the area and visualizing the cyst on ultrasound, and planning their attack, stuck a needle in and aspirated the fluid, while pushing on the cyst to get it properly positioned.  The doctor told me it was dumbell-shaped and wrapped around the gastroc, but that this is not unusual.  This part produced a sudden  and very unusual-feeling pain that ran down the back of my calf,  which apparently was unexpected, but the whole thing wasn’t bad.

After that I got to flip on my back,while they injected the PRP, and I was able to watch the ultrasound.  It was interesting having a 5-person team all gathered around..it was like an episode of ‘House’.  Except that if it had been an episode of ‘House’, I would have had a seizure and the camera would have zoomed into my body to reveal that procedure accidentally released a giantic hookworm that had been living in the cyst in my knee and was now swimming directly to my heart..or brain..or both..and then they would have had to take time to randomly speculate on possible diagnoses for an hour..and well..I would have been there all day, so yeah..good thing it wasn’t House.  Anyway, the main doc warned me that it would hurt when the platelets went in, but it didn’t at all.  According to him, I am the only patient he’s had who didn’t say “Ow” at that point.   After that, they had me wait around to make sure I wouldn’t faint, and then I went home feeling fine, but with a scrip for 10 Vicodin, because doctors like to give you Vicodin for some reason.  It seemed like too much trouble to fill the prescription and go sell them on the street so I didn’t fill it.

So, the rest of the day my knee felt mildly unstable while walking, but I attribute that either to the anaesthetic or to fact that all that fluid they aspirated was exerting a stabilizing effect on my knee.  In any case, that sensation wore off  and I had no pain until today, which is 4 days post-procedure, and all I have is  soreness  below the joint line in the back and medially.        Somehow it seems sort of unrelated to the other things.  Oh well.  Anyway, I have a follow-up in roughly 3 weeks.

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