Stem Cell Therapy: A Journey, #2
After watching the stock markets implode on quadruple witching, We left my La Jolla office to drive to The Stem Cell Treatment Center on Directors Place, one block north of Mira Mesa Boulevard. Directors Place is located on the new frontage road on the east side of I805.
“We” is my wife and myself. Though stem cell therapy is considered an outpatient procedure and you are told you can drive yourself to and from the appointment, I wanted to make sure I had a backup driver.
My appointment was for 1PM. $8,000 cash. $4000 per hip. As of the date of my treatment, Stem Cell Therapy was not approved by the FDA. So it is called “experimental medicine” and is not covered by medical insurance. A hip replacement, which is approved by the FDA costs a minimum of $35,000 per hip. It is massively invasive and results in cutting the largest bone in your body and replacing it with a manufactured ball and socket. Welcome to life as a Borg.
We drove up the hill from the beach on Camino Del Oro and got on La Jolla Village Drive East. It was a judgment call to go La Jolla Village Drive or to get on I5 north and go east on Sorrento Valley Road. To my chagrin, I chose the former.
It took us 30 minutes to drive the 4 miles from my office in La Jolla to the doctor’s office. We hit every single stoplight during Christmas lunchtime rush hour. Count ‘em 17 stoplights.
The German logic embedded in the BMW navigation system proved to be maddening as we approached the stem cell center. The Prussian My-Way-Or-The-Highway algos didn’t allow me to input the exact address so I had to rely on memory to guide me in to the doctor’s office.
We parked the car, entered the lobby of the surgical building; then went up to the third floor Suite 360. Nobody was in the office except for the nurse receptionist Kathy who I had swapped emails with but had never met.
Medicine is like the Navy; Hurry up and wait. I throttled my impatience and chatted with Kathy. At 10 minutes after 1PM the entire plastics and orthopedic crews showed up. They had been shopping at Costco. They were good naturedly honest about it. They apologized for the traffic; the only legitimate late excuse in Southern California, and all was forgiven. “Andale!”
The stem cell treatment was to be performed in three parts. First was harvesting adipose tissue (fat cells) through liposuction of love handles on the upper butt area. Part two was to centrifuge the extracted 50 mL of fat to get the stem cells. Step three was to inject three vials of 1) stem cells, 2) growth factor and 3) Hyaluronic Acid. Think of the three as, the cells, their food and the molecular lattice structure for the cells to grow on.
Still waiting, I decided to take a coffee break; maybe it would counteract some of my growing impatience. It seemed to work because I was in better spirits when I got back to the waiting room. Bob the Physician’s Assistant introduced himself and told me to saddle-up for lipo.
At this point, I was the only patient in the 3000 square-foot surgical suite. Later my wife told me that after I disappeared behind Oz’s curtain for the liposuction, there was a steady stream of Baby Boomer cash buyers who came through the complex.
I followed Bob back to the treatment room where the liposuction would be performed. I left my Kindle, IPhone, wallet and car keys with My wife in the waiting room.
It turned out that Bob had been a Navy Corpsman. As an Asian American he’d spent his Navy time in Iraq and Afghanistan.
“Glad I missed Vietnam,” he said. “It was easier to be around the camel jockeys than it would have to be around the gooks.” After getting out of the Navy a few years ago, he tried pharmaceutical sales before coming back to the surgical suite.
Bob began to place me on the lipo gurney when the Plastic Surgeon, Craig, came into the treatment room. Craig explained that he was the Plastics Guy and was only going to do the lipo. When I asked where his medical offices were, he told me that he was an active duty Navy Captain stationed at the Navy Regional Medical Center in Balboa Park.
He said that in a war zone he did wound reconstruction but that most of what he did now was breast cancer reconstruction of the kind done on Angelina Jolie. I mentioned the Boat School and Craig laughed saying, “I was born and raised in Annapolis. My grandfather and uncle were Ring Knockers. I’m 47. It’s taken me 19 years to make Captain. Time to transition.”
“Amen Brother,” I replied. “I did 4-Westpacs when Hong Kong, Olongapo and Singapore were full of the wildest women on the planet.” “I love you, no shit. Buy me a drink!” Bob chimed in. The three of us erupted in laughter
With the testosterone at the appropriate level, I took off my old topsiders and laid face-down in my navy blue sweats on the gurney. Bob asked me to pull the top of my sweats to mid chest and pull down the bottom of my sweats to the bottom of my butt cheeks.
I had met Craig last week at the pre-op conference. As we chatted while Bob prepped me for the liposuction, Craig told me that in order to comply with all regulations, he would take a leave day to perform the lipo on a specific patient group. This was why the stem cell treatments were scheduled for all patients only twice a month on Fridays. The scheduling allowed Craig to take a leave day, perform a couple of dozen liposuctions, make more money in a day then he made in a year as a Navy captain and then go back to his work at Navy regional medical center Balboa Park.
As a Bob draped my butt, Dr. Craig explained what was going to be happening during the liposuction.
He said the most painful part of the procedure was going to be the process where numbing solution was injected into the fat to be removed. He then proceeded to numb the skin in a dozen different places on both sides of my upper butt just below my belt-line.
Next was injecting the numbing solution into the fat … and he was right. The injection of the numbing solution was painful. My body jerked involuntarily in spite of my trying to remain relaxed. I was aware that the jocular talk had tapered off as I focused on the task at hand; trying to play the Terminator without flinching..
My mother was a Registered Nurse. Early on I realized that medical personal never use the word “pain.” Instead, the euphemism “discomfort” is substituted.
I can imagine the field hospital scene at the Battle of Gettysburg. A young soldier whose leg has been shattered by gunfire, is brought into the surgical tent. The drunken butcher who is going to amputate the leg, asks 9-men to hold the patient down because there are no anesthetics. Even the whiskey has run out. As the doctor picks up the bloody saw and positions himself to hack off the offending limb, the terrified patient looks up and whimpers, “Doc, is it gonna hurt?” … and the doctor says, “Son, you’ll just have some discomfort.” …. as piercing screams fill the air … fade to black.
So there was some discomfort; uncomfortable but not unbearable as the area was numbed. Then two small vertical incisions, about ¼ inch in length, were made on each side at the top of my butt cgurney and the lipo began.
Liposuction consists of ramming a hollow tube, called a cannula, back and forth through your fat. The dislodged fat residue is then sucked out of the area. There is nothing delicate about this process of having a foreign object jammed in and out of your body. The motion is the same as that you would use when shooting pool. But unlike shooting pool, the doctor is putting his back into this effort. This “rammin’ and jammin’” was done in silence as the banter gave way to the very physical task at hand.
There is discomfort. But anesthetics do a remarkable job. The occasional pain spike caused my body to jump but Craig was responsive saying, “We won’t go there again” as he rammed and jammed in another direction. He worked a fan shaped area on both sides of my upper butt. When he was done with the left side, he immediately went to work on the right side. In a few short minutes he was done.
He then asked if I was interested in seeing the 50 ml cylinder of extracted fat cells. I was interested. It looked like a cigar size syringe full of pink Smoothie from 7/11..
After 20 minutes of which included prep, the lipo and post lipo wrapping, I was back on my feet and in the waiting room.
Kathy, the reception area nurse, told me that it would take an hour for them to centrifuge the fat cells and extract the stem cells. She recommended that I leave the office and kill an hour with a cup of coffee. She gave me a $20 Starbucks Gift Card and recommended that I drive down the hill to the Scranton Road Shopping Center on the North East corner of I 805 and Mira Mesa Boulevard. Kathy recommended that we be back in the office at 3:30. So at 2:30 PM we left, drove down the hill and got some Christmas cookies and hot chocolate at Starbucks.
The shopping center is adjacent to the infamous red “Dog Dick’ sculpture that is in front of the San Diego Tech Center building. The sculpture was erected in the mid 1980’s. It used to be easily seen from I805. Now you have to be on Scranton Road to see it. But there it is. “Dog Dick” reigns supreme in its turgid 100 feet of .fire-engine-red glory; pointing at the sky awaiting the Mother of all Bitches.
After sitting out in front of Starbucks enjoying the 70 degree weather, we drove back to the surgical center.
We arrived back in the surgical office at 3:30PM. I was met in the waiting room by the orthopedic surgeon, Dr. Pete, who was going to perform the stem cell injections. My wife again sat in the waiting room while I was ushered into the treatment room which was located across from the nurses station. After a quick introduction, Pete disappeared after turning me over to Bob for prep.
When I entered the treatment room, I noticed that there was an intravenous drip (IV drip) set up next to the treatment gurney. Bob commented that my stem cell count was about 85 million cells which was the upper end of the norm. Bob asked me to lay on my back on the gurney. The IV drip contained saline solution. Bob told me that treatment now included a systemic injection of a portion of the stem cells through an IV drip back into the patient’s body. He said that this had reduced or eliminated a variety of aches and pains in patients that had received it. This was good news. Self-medication continues to recede. “Fire when ready Gridley!”
As Bob searched for an appropriate vein in my left arm, I told him that my veins rolled. As a blood donor I’d gotten in the habit of telling the help because my rolling veins had been problematic. On more than one occasion I’d had to stop some dullard who confused vivisection with medical care, as they continuously tried to harpoon my rolling veins. Eventually I began to address all medical technicians as Doctor Moreau whenever I sat down and began to roll up my sleeve to give blood. Many times the technician would disdainfully tell me, “I’m not a Doctor.”
But Bob was the real McCoy. His aim was true and in no time my own stem cells were coursing back into my body on the IV drip. When the injection was done, Bob removed the needle from my left arm, and put a bandage on the spot. Then the door opened and Pete came in.
While Bob prepared the sonogram transducer with KY and positioned the screen, Pete explained the injection procedure. He showed me the three vials and explained that the largest containing the stem cells would be injected first, followed by a smaller volume of growth factor and a third volume of hyaluronic acid aka “rooster comb.”
The procedure was similar to the cortisone injections that I’d previously had. With me lying on my side, the Doc selected a spot directly above my hip joint. Then an aerosol can of numbing solution was sprayed on the point of entry for the 4-inch hollow needle. The Doc drove the needle straight down into the hip joint while Bob sprayed the impact zone with the local anesthesia. Once the needle had been guided into the joint using the sonogram, the stem cells were injected with Dr. Pete looking at the sonogram display and injecting the cells into specific areas of the hip joint. On my left hip this was a slow and painful process as he moved the needle around within the joint. I could feel the stem cell solution going into my joint and the resulting pressure of having the area around the hip joint expanded by fluid. The stem cells were followed by the growth factor and then the hyaluronic acid.
The process for my right hip went much faster. Pete again drove the needle straight down into my hip joint. He then injected the entire stem cell solution quickly without having to work the needle. Next, as he injected the growth factor and hyaluronic acid, he explained that my left hip had been “dry.” Injecting the left hip had been more painful and had gone more slowly because there was little natural lubricant in the left hip joint.
My right hip, however, was full of fluid because it was more inflamed. This is consistent with what I had experienced since my last Cortisone shot 90 days ago. I went into that Cortisone shot with my left hip more painful than my right. I came out with my right hip more painful. It has subsequently remained more painful. Uh …. I mean there had been more discomfort!
The stem cell injection procedure from beginning to end took half an hour from the moment that I walked in and lay down on the gurney until I got back up and was escorted out of the room by Bob.
When I left the treatment room, Pete, Craig and Bob were all standing at the nurses station. I stopped for a moment to thank them. They asked what I did for a living. When I said that I owned a wealth management firm, they began talking about the venture-capital opportunities available in the stem cell space in San Diego.
My wife and I left the Stem Cell Center at 4:15PM with a Vicodin script. We drove straight to Ralphs Pharmacy to get it filled. Sorry Charlie, Pete had mis-dated the script 12/19 instead of 12/18 so the pharmacy wouldn’t fill the script. The pharmacist wouldn’t give the script back to us so we were stuck with having to come back after midnight to pick it up.
I just laughed. Thank you God for all my blessings!