regenerative medicine - integracareclinics.com · of regenerative medicine, which seeks to utilize...

REGENERATIVEMEDICINE

PHONE: 320-339-5017EMAIL: [email protected]

PLATELET RICH PLASMA AND STEM CELLS

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CLINIC OVERVIEW

OUR MEDICAL TEAM

PLATELET RICH PLASMA

STEM CELL INJECTIONS

PROCEDURE TIMELINE

PREPARING FOR THE PROCEDURE

AFTER THE PROCEDURE

PRE-PROCEDURE INSTRUCTIONS


WILLIAMS INTEGRACARE 02

TABLE OF CONTENTS

12 PHYSICAL THERAPY

CONTACT INFORMATION

Williams Integracare was established to combine the best elements of medicine, chiropractic, exercise, massage, manual techniques, physical therapy, and nutrition. The reason we do this is simple; our patients deserve the very best care and often that requires a unique and multidisciplinary approach to achieve a well-rounded treatment plan and optimal health. The result is ONE SOLUTION from an integrated team.

This integrated approach allows our medical team to work closely with our physical therapy department to ensure the best possible recovery outcomes for our patients.


Clinic Address:

Regen. Phone:Website:Email:Justin's Email:

100 South 2nd StreetSartell, MN 56377320-339-5017integracareclinics.cominfo@[email protected]

CONTACT INFORMATION

OUR MEDICAL TEAM


Williams Integracare offers 3 regenerative medicine specialists with experience providing platelet rich plasma and stem cell treatments. Patients have come from across the midwest to see this experienced team of professionals.

MARK HALSTROM, MD

JON SCHEER, APRN, CNP

ERIC GREENE, APRN, CNP

Mark earned his M.D. from the University of Minnesota and completed a family practice residency in the LaCrosse Mayo Family Practice Residency program. He is also a graduate of St. John’s University of Collegeville, MN. Mark joined the Williams Integracare team in March 2001, after prior work experience with the Rural Wisconsin Health Cooperative, Foley Medical Center, and other various emergency rooms and urgent care settings.

Jon earned his undergraduate degree in Biology at Southwest Minnesota State University in Marshall, MN. Later he earned a paramedic degree from McKennan School of EMS. Jon also holds a second undergraduate degree in Nursing from South Dakota State University and went on to complete his Masters as a Family Nurse Practitioner at Winona State University.

Eric initially graduated from Saint Cloud State University in 2008 with a bachelor’s degree in Biomedical Science. He again attended St. Cloud State from 2010 to 2012 and graduated with a second bachelor’s degree in nursing. After working on the St. Cloud Hospitals Neurology and Intensive Care Units he completed his master's degree at Walden University in 2016 to become a Family Nurse Practitioner.

LEARN MORE ABOUT THE STAFF AT WILLIAMS INTEGRACARE ON OUR WEBSITE:INTEGRACARECLINICS.COM/ABOUT/MEET-OUR-TEAM

PLATELET RICH PLASMA


CONDITIONS WE TREAT WITH PRP• Joint arthritis• Hip, knee, and shoulder pain• Chronic tendonitis/tendonosis in the elbow, hip, knee, foot, and ankle• Acute ligament and muscle injuries in athletes• Common sports injuries• Muscle tears• Neck and back pain• Sciatica• Fractures• Plantar Fasciitis

PLATELET RICH PLASMA (PRP)Everyone’s blood is composed of the same key components: red blood cells, white blood cells, plasma, and platelets. Platelets are the essential component that PRP therapy relies on to assist in the healing of chronic pain and injury.

Platelets are an incredible army of cells that circulate in your blood. They are primarily recognized for controlling bleeding and clotting. Additionally, platelets also release over 1,500 growth factors and proteins that facilitate wound healing and tissue repair. Platelet-rich plasma therapy works by concentrating your platelets within your blood and injecting them into injured areas. This triggers your body’s natural healing process and reduces inflammation and pain.

We process your cells right here at our St. Cloud area clinic with the highest attention to detail using a precision process. Our top tier lab allows us to isolate, concentrate and extract the best and most accurate formulation of platelets and growth factors. This is done specifically for each patient and their individual needs. We understand that joints, tendons, muscles, and nerves each require specific and unique PRP formulations for best results.PRP represents one method in the emerging field of regenerative medicine, which seeks to utilize and promote the body’s natural healing ability. Chronic degenerative diseases such as osteoarthritis, degenerative disc disease, and tendinopathy (tendonitis) now have effective surgery alternatives.

Traditional pain relief management treatments for spine and joint disease focus on the use of corticosteroids and NSAIDs – such as ibuprofen, and naproxen. These therapies can be effective for some people but they don’t address the underlying cause of a person’s joint pain and instability. Long term use of NSAIDs and cortisone injections can also be harmful to the body in many ways. PRP treatments focus instead on the healing of the affected areas and addressing the root cause of degeneration which is usually related to the instability of the area.

Each potential candidate for a PRP treatment will first have a comprehensive evaluation. It will include a physical assessment and a review of prior imaging. After this evaluation is completed we can establish an individualized treatment plan for your specific condition.

STEM CELL INJECTIONS


CONDITIONS WE TREAT WITH STEM CELLS• Osteoarthritis of the joints including hip, knee, ankle, wrist and shoulder.• Rotator cuff tears• Labral tears of hip or shoulder• Meniscus tears of knee• Spine disorders, including sciatica and degenerative disc disease• Tennis elbow/Golfers elbow• Plantar fasciitis• Other ligament or tendon tears• Muscle injuries.• Fracture repair

STEM CELL INJECTIONSEvery cell in our body first began as a stem cell, and through the process of differentiation, grew and changed into its ultimate form. Stem cells are “undifferentiated,” meaning they still have the potential to grow into any cell type in the body. Stem cells are located throughout the body in almost every organ and tissue and can change into any healthy cell in our body.

At Williams Integracare we utilize two primary stem cell therapy treatments. Adipose-derived stem cell therapy and bone marrow aspirate concentrate (BMAC) therapy. Both stem cell therapy treatments at Williams Integracare are utilizing each individual own stem cells from their body. Your specific case will determine the appropriate path for which stem cell treatment we recommend for you.

Stem cells travel to sites of injury by cell signals that attract them. Once they reach where they need to go, they dock and start repairing the injury/disease by releasing cytokines, chemokines, and growth factors so your immune system starts the injury repair.In the most basic sense, the stem cell procedure appears similar to PRP. The patient's stem cells are extracted, processed and re-injected into the area of injury.

However, the healing process that is happening at the site of an injury after a stem cell procedure is quite different. Because of this stem cell procedures are often viewed as the more powerful option and one for those with more serious cases that PRP can not treat.

Particularly for those with osteoarthritis, stem cell injections can be a valuable pain relief option for their hip, knee, ankle, wrist or shoulder.

PROCEDURE TIMELINE


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TREATMENT TIMELINEReceive an evaluation from an Integracare provider to see if your injury is eligible for a regenerative procedure. Together with the physical therapy department, the providers will be able to evaluate the severity of your injury and recommend which regenerative procedure you are best suited for.

Attend an appointment for your injection. Regardless of if you have a PRP or stem cell procedure your appointment will be 3 to 4 hours in length and involve first extracting blood or stem cells from your body. After that, you will have some downtime as our specialists process the formula before you receive the injection in the area of injury.

About a week after your injection you will begin your physical therapy treatment. This is crucial in addressing the instability in your area of injury and aiding a proper recovery process.

Six weeks after your initial injection you will have a follow-up appointment with the provider that completed your injection. This will allow you to discuss the next steps in the treatment process as you continue physical therapy. Patients who received stem cell injections rarely need a second injection while those with PRP injections may need additional injections depending on their injury.

The healing process is now already underway. Most patients begin to notice minor initial improvements in 2-4 weeks post-procedure. The entire healing process is roughly 2-3 months for PRP procedures, and 4-6 months for stem cell procedures.

PREPARING FOR THE PROCEDURE


PREPARING FOR THE PROCEDUREPreparing your body for your regenerative treatment is very important to create the best possible recovery outcomes for your procedure. The use of patient evaluations is helpful in giving patients direction in what supplements or nutrition should be focused on prior to the procedure.

Before the procedure, you will want to discuss any medications you are taking with your provider as well as stop taking all anti-inflammatory medications at least one week prior to your procedure. This includes common medications like Ibuprofen, Aspirin, Aleve, Motrin, Indomethacin, Celebrex and other similar anti-inflammatories.

PRE-PROCEDURE NUTRITION

• Drink plenty of water - at least half of your body weight in ounces.• Avoid sugary beverages and sweets.• Limit processed foods and refined grains.• Limit Alcohol.• Eat a variety of fruits and vegetables.• Aim for at least 1 serving of veggies at each meal.• Know that berries are your best fruit choice due to their low sugar content.• Limit processed meats.• Limit dairy to 2 servings a day.

• Include lots of herbs and spices (like garlic, cumin, turmeric, ginger)• Choose organic when possible.• A serving of good fat at each meal to help decrease inflammation in your body.• Avocado, nuts/seeds, olive oil, and fatty fish (like salmon) are some examples of healthy fats.• Increase protein intake to promote healing. Try to include 1 protein serving at each meal.• Eggs, chicken, turkey, wild salmon, tuna, grass- fed beef, protein powder, and nut-butters are some examples.

Proper nutrition before your procedure will make a significant difference in giving your body the added preparation it needs to receive a successful procedure. We recommend patients keep these dietary tips in mind leading up the date of their procedure. For more information on nutrition habits pre-procedure, we recommend you speak to your provider who will be completing your procedure.



PRE-PROCEDURE INSTRUCTIONS• Discontinue any NSAIDs (i.e. Ibuprofen, Aspirin, Aleve, Advil, Celebrex, Naproxen, etc) 1 week before your PRP treatment date and for 1 week after.• Stop aspirin containing medications 1 week before your treatment. Baby aspirin is OK to continue unless otherwise stated by your provider.• Stop antiplatelet agents (Plavix, Ticlid) 1 week before your treatment with prior approval from your provider.• Stop Coumadin (Warfarin) 5 days before your treatment with prior approval from your provider.• Do not smoke or drink 5 days before your procedure.• Hydration is very important for proper plasma levels. Please ensure you are drinking at least 64-84oz of water daily starting 1 week before your procedure date. • Eat a light meal and drink a glass of water prior to your blood draw time. Eat a snack and drink a glass of water prior to the PRP injection during your “down time.”• Nutrition is also very important. We suggest eating a diet high in fresh fruits, vegetables, and lean meat. Avoid processed and fast food. For further recommendations, talk to your provider. • Plan on visiting a Physical Therapist before your injection and also 7 days after your injections unless told otherwise by your provider. You will want to schedule 2-3 visits so a professional can follow your progress while you are in the healing phase.• Your provider may recommend a specific brace for your procedure. This will be discussed with your regenerative team and physical therapist.

AFTER THE PROCEDURE


AFTER THE PROCEDUREHow you handle the recovery steps after your procedure is crucial in receiving the best possible outcomes from your injection.

When can I return to regular activity?

Patients should rest for the first three days following their procedure and limit their movement. By the third day, patients can begin to move the limb/joint through its full range of motion without resistance.

It is a good idea to act on the side of caution and avoid activities that cause a high impact on the joint for up to 6 weeks after the procedure. However, during this time biking, elliptical machines, and swimming can be great options to continue activity while limiting the impact on your joints.

When do I start physical therapy?

It is recommended patients start physical therapy about a week after their initial injection. This can be completed right here at Williams Integracare.

What medications will I be taking?

Even after the procedure, it is recommended you continue to follow the nutrition recommendations on page 8 of this booklet. Tylenol can be taken to relieve pain, but other anti-inflammatories like Ibuprofen, Aleve, Aspirin, Celebrex, Indomethacin and other similar medications should be avoided for at least one week. Additional pain medications may be prescribed to you, but this is rare.

Will I need to set up another injection?

As mentioned previously, those who receive stem cell injections rarely need another injection. However, those receiving PRP injections often need multiple injections as time goes on. It is often best to see the progress that comes with the first injection before setting up another injection, which is often months later.

POST-PROCEDURE INSTRUCTIONS


POST-PROCEDURE INSTRUCTIONSThe injection you receive is designed to strengthen weak ligaments, heal damaged tendons, and/or treat arthritis pain. It does so by causing inflammation at the site of injection. You will feel a certain degree of soreness during injections and for a period of 4-5 days afterward, on average. This soreness can be described as tightness or pressure in addition to pain and discomfort. Most describe the pain as “achy, stiff, tight, or tender.” This is NORMAL and EXPECTED. The discomfort will gradually subside over the next few days. Pain levels vary depending on the patient, the area treated, and the condition.

• If needed, we recommend patients use Tylenol or Tylenol Extra Strength for pain relief after treatment. At times, other medicines and pain relief techniques can be used for specific purposes. These options can be discussed with your provider. • Again, do not use any NSAIDs (i.e. Ibuprofen, Aspirin, Aleve, Advil, Celebrex, Naproxen, etc) for 1 week after your injection.• If absolutely needed, you may use ice only on the day of your injection. After that, we recommend heat only for pain relief. Ice restricts healthy inflammation from occurring, which is the opposite of what we want happening at the site of injection. • Do not smoke or drink for 5 days after your procedure. • For the first 2 days, keep activity minimal and rest as much as possible. On day 3 move the limb/ joint through its full range of motion without resistance. You will have received a set of instructions with specific exercises if you worked with our Physical Therapists. Formal Physical Therapy should start at 1 week after the date of your injections. • Keep track of your symptoms in a log.• You will visit with your provider 6 weeks after your procedure.

PHYSICAL THERAPY


THE IMPORTANCE OF PHYSICAL THERAPY

OUR PHYSICAL THERAPY TEAM

BRIANNA HOFFARTH, DPT JENNIFER GARDING, DPT DOMINIC TURNER, PT

You will begin physical therapy around 7 days after your procedure. This is a crucial component of your recovery as you build your strength back. This will help address the instability of the area treated as your body is going through the healing process.

The unique nature of having regenerative procedures and physical therapy available in one location allows for unparalleled communication between providers. The close working relationship established between our medical and physical therapy staff creates more frequent updates and improvements to your care as you progress.

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