This comes from the pre-op packet they sent me:
Bone Marrow Draw
During the marrow draw, the medical provider places a needle in the back of the hip area to obtain what is called whole marrow (looks like thick blood). The procedure can cause soreness in the low back for several days to a week. The amount of soreness will vary, but will usually starts once the numbing medicine wears off (a few hours). Do not take a bath, sit in the hot tub, or swim for 3 days. A shower 12 hours after the procedure is fine. If you have a history of low back pain, it is common to have more soreness from the marrow draw. If you have redness, pus, fever, chills, sweats, or any other symptoms that look like an infection, please contact the doctor.
Fluid and Food Status
Air travel and change in elevation can predispose patients to dehydration. Please drink plenty of clear liquids or water 48 hours prior to and following bone marrow aspirate and blood draw (approximately 64 ounces a day). Avoid or minimize caffeinated products such as coffee or soda 24 hours prior to the procedure. Eat a full breakfast on the morning of the procedure. Avoid strenuous activity or heavy lifting for at least 5 hours after you donate blood.
On the day of your initial appointment, you will be asked to complete some paperwork. You will meet with the doctor. Please be sure to bring any pertinent or requested information, including imaging and paperwork, if not sent previously.
Steroids, NSAIDs (ibuprofen, aspirin, naproxen, COX-2 drugs such as Celebrex), certain asthma and allergy medications, statin medications for high cholesterol, as well as other medications and supplements described in the medication information sheet should be discontinued 2-4 weeks prior to the bone marrow draw through 6-12 weeks after the re-injection of cells. It is your responsibility to discuss this with the doctor who has ordered these medications for you. Please inform the doctor of all medications you are currently taking. Please review medication restriction list. Disregarding the recommended medication restrictions may significantly decrease the success of your procedure.
Approximately 1 week prior to the bone marrow and blood draw appointment, you will come in for a blood draw of a small amount of blood (6 small tubes). This will be used for an epidural in the disc area at the time of the blood marrow draw.
For the blood, epidural, and marrow draws please be sure to have eaten a light meal 1-2 hours prior to the procedure. It is very important that you drink plenty of fluids and are well hydrated prior to the procedure. If you come from a lower altitude, it is especially important to drink plenty of fluids (approximately 64 ounces a day). To have the best results from your bone marrow draw we recommend mild, low-impact exercise 2-4 weeks prior to the procedure. Eat a healthy, well balanced diet. Dieting at this time is not recommended.
The blood draw is about the same as donating blood. During this appointment, you will have blood drawn from your arm – approximately 2 cups. This is approximately the amount you would give if you were donating blood.
You will be taken back to the procedure room where you will be prepared for the epidural and bone marrow aspiration. The epidural consists of an injection to the back using cells from your blood. The bone marrow procedure will require you to have a bone marrow sample taken from the back of each of your hips (iliac crest). You will lie on your stomach on the procedure table where an area at the back of your hip will be numbed. A special needle will be used to draw marrow blood out of the back of your hip (back of the iliac crest). X-ray will be used to assure the optimum location. This will be done on both sides of your hips. If you have pre-arranged to take Valium prior to the procedure, you must have a driver with you. This will be discussed with you when you schedule your appointment. Please refer to the post-operative instructions for activities after this procedure. A pre-injection to the disc area will be performed during this appointment.
You will come back for the next set of appointments which are scheduled several weeks later. You will have the re-injection of cells and epidural using cells from your blood. Follow up epidurals using cells from your blood will be at 2 weeks and 4 weeks after the re-injection of cells. Please understand that it is not possible to make a an absolute pre-determination of the treatment plan that will be most appropriate for your condition and that only after being evaluated can the doctor determine the best plan for you.
You will be asked to remain still in the medical office for approximately 1 hour after the procedure. After the procedure you may eat and drink as tolerated. Please refer to the post operative instructions for activity after your procedures.
Myofascial Treatment: Many of our patients have significant problems with their ability to move through a full range of motion because of trigger points in the surrounding muscles. These are portions of the muscles that go off line and prevent movement. These problems tend to significantly increase forces in the areas where we want to regenerate tissue matrix. As a result, we recommend that the patient use this time to identify a good myofascial trigger point therapist and to initiate treatment before the cells are placed back. If you are in Colorado, we can take care of these needs. If you are from out of town, here are some resources on the web:
• iSTOP: IMS for Chronic Pain • NAMTPT | National Association of Myofascial Trigger Point Therapists • Guild for Structural Integration
Finding a therapist and working on eliminating these trigger points while increasing range of motion will help your chances of success.
Nutrition: We recommend that you take Collagen Type II Supplement. We offer Collagen II Joint Formula through our office. You can get this medication in the office or we can send it to you. Unfortunately, this particular brand is only available to medical professionals. Take 4 pills orally with breakfast and 4 at bedtime (without food) for the first 2 weeks after your marrow draw, and then 2 pills a day and then 2 at bedtime (without food) for the next 6 weeks. If you wish to take your own supplements, they must at a minimum contain:
• Collagen Type II (Collagen II Joint Supplement 4 pills contain 1500 mg) • Hyaluronic Acid (Collagen II Joint Supplement 4 pills contain 50 mg) • Manganese (Collagen II Joint Supplement 4 pills contain 10 mg) • Vitamin C (Collagen II Joint Supplement 4 pills contain 120 mg)
You should supplement this collagen formula with Glucosamine and Chondroitin. The dose is 1500 mg of glucosamine and 1200 mg of chondroitin daily for 2 months. You can purchase these at a drug store. We also recommend Cosamin DS as a great source of these joint supplements (see Cosamin®, Cosequin®, Dasuquin®, and other supplements for dogs, cats, horse, and you by Nutramax Laboratories, Inc. ). Realize that if you are allergic to sea food, this may be a problem with Glucosamine products. In addition, they can change your bleeding times if you on being monitored on Coumadin.
Since you have a tissue matrix problem and we want to support healthy maintenance of this tissue matrix, you should be on these supplements long-term.
Inversion Table: Please discuss with the doctor recommendations regarding the use of an inversion table – both prior to and after the procedure. Here is one resource with information: http://www.inversion-table- direct.com/?utm_source=Google_AdWords&utm_medium=Keywords&utm _term=Inversion+Tables&utm_campa ign=10087960#
Helping Cells Grow – Blood Flow: You will be asked to use an infra-red unit while you’re sitting at work or home after the re-injection procedure. You should be instructed on how to use this unit on check out. Use up to 30 minutes twice a day for 6 weeks. Please be cautious not to exceed 30 minute intervals! Infra-red units are available for purchase at Thermotex - Thermotex Heating Pad - Thermotex Infrared Heating Pad Platinum. They are available in several sizes; please review what would be appropriate for you.
Post-Op Instructions for Disc Procedure
Immediately After Your Cell Transplant Procedure
Activity: The goal is to allow the stem cells to attach and then to protect them while they differentiate into disc tissue matrix. For this reason, you’ll be asked to keep remain as still as possible for 30-60 minutes after the procedure. Do not take a bath for three days, but a shower 12 hours after the procedure is fine.
1st – 3rd Day: For the first day, you should limit activity. If you have post-op soreness this may be easy to do, as your body does this to reduce pressure on the area to allow healing. Avoid all contact sports as well as jogging, running, or sports that involve impact on the spine.
4th Day - 2nd Week: You can start to walk normally, no more than 30-60 minutes a day. Avoid all contact sports as well as jogging, running, or sports that involve impact on that spine. Bike riding is fine as are stationary bikes, elliptical machines, and swimming.
3rd-6th Week: Avoid all contact sports as well as jogging, running, or sports that involve impact on the spine. You can walk as much as you like. Bike riding is fine, as are stationary bikes, elliptical machine, and swimming.
After the 6th Week: Start integrating back all desired activities, adding back 20% per week. For example, if you were used to running 10 miles a week, you would start at 2 miles a week, then the next week add back another 2 miles, and so on...
If recommended, continue traction 3-5 times a week for 4-6 weeks after the stem cell re-injection.
Medications: You can’t take anti-inflammatory drugs such as Motrin, Alleve, Ibuprofen, or similar NSAID’s. These need to be avoided for 6-12 weeks after the procedure. In addition, any other drugs you have been asked to avoid, should also be stopped for the same time period. Please review the Medication Restriction sheet sent previously. Most statin cholesterol lowering drugs will move stem cells toward producing bone, which is not what we want here, so these need to be avoided for 6-12 weeks. Steroid medications (such as steroid based asthma inhalers, oral steroids, or steroid injections into a joint) will dramatically impair stem cell function, so these are to be avoided as well.
Pain: If you have pain from the procedure, this should resolve within the first 1-3 weeks. If it does not, contact your clinic doctor. During those 3 weeks, take your post-op pain medications. If you need to get more post-op pain medication, please contact your clinic doctor. Tylenol is acceptable to take as well.
Alcohol and Marijuana:
Alcohol can have profound negative impacts on stem cell function, so this should be avoided for the same 12 weeks. A glass of red wine or white wine with dinner is not a problem, but more than that could pose a risk to the cells. Cannboids such as Marijuana can also promote bone formation over tissue matrix (not what we want in this case), so should be avoided.
Complications: Call your clinic doctor if you have excessive swelling, fevers, chills, sweats, local hardness, redness, or pus at the injection site. Please contact us if you have any concerns about infection or any other concerns.
Taking Medications to Help Disc Nutrition
We'd all accept at face value that if you wanted seeds to grow into healthy plants, the quality of the soil would make a difference. The same holds true for placing stem cells into your low back discs. Research has shown that one medication in particular may help improve the nutritional environment in the low back discs. This medication is ********. In higher doses than we prescribe for discs, it's used for high blood pressure or in patients with stroke or brain injury.
NOTE: They also gave me a HUGE list of medications I shouldn't be taking. I erased a few details given that they may be proprietary to their procedure.
They also sent me some paperwork that i'll be filling out and sending in, alongside payment instructions and an invoice, which I'm supposed to pay a small deposit of when I schedule the appointment. The rest is due in parts during each of the sessions.
I also assisted to one of their webinars.. Dr. Centeno answered everyone's questions thoroughly. I can't imagine all the time these guys are putting into this clinic, especially with the amount of misinformation online.
It seems the procedure is being perfected. Also, it seems that they have had some problems with some patients before, especially with adverse reactions to certain medicines. In any case, I'll be giving it a try and you guys can follow the whole thing..
Wish me good luck!