It’s Ask Dr. C Time Again!

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Every so often I ask my readers to place questions in the comments for me to answer in a longer format. Meaning that while I answer comments all the time, that’s in a short format. Ask Dr. C questions are those that generally apply to many people interested in regenerative medicine. On these questions, I can dig deep! Please leave your questions where it says Post Comment, below!

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50 thoughts on “It’s Ask Dr. C Time Again!

  1. Mike Aquilino

    I have a Medicare Advantage plan that is a PPO. If I get a Regeness treatment, will it be covered by my out-of-network maximum out-of-pocket expenses (assuming the cost of the treatment is above my plan’s maximum out-of-pocket expenses)?

    1. Chris Centeno, MD Post author

      No, there is no Medicare coverage for any stem cell procedures at this point.

  2. Jeff

    In one of your earlier blogs you’ve mentioned your own treatments for spondylolisthesis, how are your treatments going and how often do you require ‘maintenance’ injections?

    I’m asking because back in October I had regenexx PRP and PL treatment for moderate herniation, DDD at L3, L4, L5 and S1. I felt great and considered it a big success. But this week I’ve had a relapse, seized up, can’t stand up straight and in lots of pain. (crooked back, I think the bulge prolapsed)

    I’m going to get a second treatment, I’ve read from you and others that the second treatment can be necessary. But I don’t think I want to be taking treatments every few months for the rest of my life. I’m curious to hear what you’d consider a nominal expectation for non surgical maintenance treatments.

    1. Chris Centeno, MD Post author

      Answered in 1/19/21 blog

  3. Breanne Wilson

    Dr. C

    For a humerus ORIF non-union, 5 months out, can this treatment be AS effective as a surgical repair? My husband is 30 and isn’t ready to have a “bad arm.” We have already been seen in Tampa and he IS a candidate. I know this is an oddly specific question, but you’re booked up for virtual visits until March. It’s like fate that you posted this topic today. I’ve probably read 15 of your articles, I’m down a rabbit hole. And I’m going to keep trying to find info in your blog while I eagerly await your reply!

    Breanne Wilson, RN

    1. Chris Centeno, MD Post author

      Breanne, I would have to see the images to be sure, but yes, non-healing bone fractures have been healed using an injection of bone marrow concentrate since the 1980s. This technique usually works and is less invasive than a surgical bone graft. Having said that, much depends on the details. If you want to send your husband’s images to [email protected] (my office email), I would be happy to take a look.

  4. Laura

    Is there any success with a complete radial transection of posterior horn of medial meniscus at root with stem cells? I was treated in VT 2 yrs ago with stem cells and moved to FL and treated in Sarasota with PRP x 2 but I still can’t walk normally. I have almost full range of motion but straightening leg hurts to walk and sleep. If I have surgery I know I will develop rapid arthritis and need a knee replacement. I am 51 year old RT and prior to CrossFit injury very active and now can’t work or even exercise except yoga. Feeling stuck and wondering if a second round of stem cells could possible work this time?

    1. Chris Centeno, MD Post author

      I would need to review your case via telemedicine to comment.

  5. Sheryl Brannan

    Is lordosis reversible? First caused by 2nd hip replacement because orthotic is too long and pushes right hip and buttock upwards. Currently it has worsened by Abdomino Phrenic Dyssynergia – a contracted lowered diaphragm pushing abdominal contents outwards and downwards affecting pelvic floor muscles. I have been working on this for 20 months to no avail but I also feel that if ‘repaired’ my back will still be in severe lordosis. Walking is extremely painful with lower back pain. I try to ‘pelvic tilt’ when standing and walking but visually my side view does not look any different and it too is painful trying to hold that position. The pain is relieved when I sit. I have not visited a chiropractor for this as I don’t believe they can do anything as previous visits for other things were a waste of time and money. I have been seeing an osteopath for this APD, also named Functional Gut Brain Disorder and she is working on my psoas to stretch them. Can you please advise? Thank you.

    1. Chris Centeno, MD Post author

      While we may be able to help the back pain and any instability, we likely won’t be able to get rid of the lordosis if that’s caused by a hip prosthesis that’s too long.

  6. Dave Smith

    Dr. C you written several blogs on bacterial infections and their impact and contributions to joint health and inflammation. I’ve got a lot of things going on with my hips and L5/S1 spondylolisthesis but I also am diagnosed with Lyme disease and I am having a tough time discerning my next treatment priority. Since Lyme has no known cure, only holding it in a kind of remission; would you consider a deep dive or series on Lyme impacts, like you did with Covid.
    Sometimes I feel I’m making good progress with the treatments I’ve receive from you, but then have inflammation flare ups and have concerns the Lyme is negatively impacting my treatments. You’ve spoken before about poisoning of joint chemistry so I’ve wonder if this might be the case for me.

    1. Chris Centeno, MD Post author

      The best we can do for Lyme is to add in doxycycline to our injections.

  7. james auchincloss

    Severe traumatic anterior dislocation of my right shoulder years ago has resulted in subluxation of the shoulder and chronic hand pain due to nerve compression (Thoracic Outlet Syndrome). The pain is reduced with PT, including manual adjustment, stretches, and some exercises, but it never goes away completely. My question: Can orthobiologics help seat and stabilize the shoulder joint to diminish shoulder subluxation?

    1. Chris Centeno, MD Post author

      This was covered on the 1/25/21 blog post.

  8. Doug Atkins

    Are the FDA’s “More Than Minimal Manipulation” as well as “Homologous Use” standards truly scientific guidelines in what defines a drug? Or are these standards more administrative conclusions or FDA created concepts on their part?

    1. Chris Centeno, MD Post author

      All good questions with no real answers…

  9. Daniel McMahon

    I had a stem cell procedure on my arthritic ankle in November 2019 at your Sarasota office and a follow up PRP treatment in June. Everything was great until recently when my ankle became sore and weak again. Will I need to get annual PRP treatments or other stem cell procedures regularly in order to keep the ankle functioning and pain free?

    1. Chris Centeno, MD Post author

      I don’t know your situation, so that’s something you need to discuss with your treating physician.

  10. janat vanmeter

    What is you opinion for cold laser treatment for low back pain? Well any arthritic joint pain.

    1. Chris Centeno, MD Post author

      I have some patients that have liked it, others that have said it did nothing.

  11. William Wertman

    Hi,
    I am a Regenexx patient. I have had both knees done with the stem cell procedure and my neck done 2 times with platelet lysate. All being successful with the exception of my last stem cell procedure in my right knee, however, I am still hopeful because the procedure was only done 3 weeks ago. My question, following your article on How Stem Cells Get to Where They Need to Go. Hoe do stem cells or any cells for that matter exist and flourish in avascular tissues like knee cartilage, menisci and spinal discs?
    Thank you,
    Bill

    1. Chris Centeno, MD Post author

      Replied in Jan 26th blog post.

  12. Rich Aiello

    I have arthritis in both knees and valgus in the left knee, can stem cell help me.

    1. Chris Centeno, MD Post author

      Likely, but a telemedicine consult would be a great way to find out for sure.

  13. Bill

    I had stem cell and platelets with Regenexx. Left knee 2 years ago and right knee 4 weeks ago. Both treatments were beneficial. I noticed in both procedures my knee became VERY stiff after the procedure for several weeks. I am actually starting to be concerned because it has been 4 weeks from my last treatment and I can’t get past 90 degrees of flexion in my right knee. Prior to the stem cells and platelets I had full ROM in the knee. Should I be worried?

    1. Chris Centeno, MD Post author

      Yes, I would definitely bring that up with your treating physician.

  14. Patricia Trumble

    Can PRP and or stem cell be beneficial in improving ROM in calcified Bursitis in a shoulder

    1. Chris Centeno, MD Post author

      Yes, usually

  15. Nancy Gelardi

    I had an invasive back surgery back in 1998. Two bars on each side. Done well but now I am experiencing pain down the back of both legs especially the left. I opted for an epidural shot as I don’t want any more surgery
    Advised that they go through the side to straighten the bars. What are the chances of putting back the cells that are now being narrowed. I had a stem cell on my right shoulder in 2000.

    1. Chris Centeno, MD Post author

      Not sure what you’re asking?

  16. David James Slagter

    For over 35 years, I’ve had continuous pain in my lower back. My 4th and 5th lumbar is the problem. It started because of a series of accidents with injuries to my lower back. ChiroAdjustments not helpful, adjustment does not hold more than one day. Is there an effective stem cell treatment available to help with my condition? Thank you for your advice!

    1. Chris Centeno, MD Post author

      That sounds like instability, so if that’s the case then yes. However, a telemedicine visit would be a good next step to get the imaging we would need to make that disganosis.

  17. Russ Delaney

    My cervical spine has been a problem for years. I had a major head on collision in 1980 which probably has a lot to do with it. Recently I’ve been getting worse and I’m experiencing a sensation on my neck’s right side when I sit at my desk and look at the computer screen with my hit tilted slightly backward, it feels like a buzz or quick vibration as though it were bone on bone. The question I want to ask is if there is a pinched nerve or some type of interference with a nerve due to cervical issues can this effect the area of my glute on the same side(right)? My glute and slightly above is feeling weak and slightly painful when I been down to pick up objects and has been staying around for longer than I would think if it were some type of strain. So, bottom line can cervical issues effect the glute muscle in any way?

    1. Chris Centeno, MD Post author

      Yes, irritation of the spinal cord due to a disc bulge or arthritis in the neck could cause all of these symptoms including your glute.

  18. Janice Cook

    The results of an MRI of my knee show that I am a candidate only for partial or total knee replacement. Minor surgery to repair meniscus won’t help. I am a 69 yr old woman, and evidently my hard cartilage is eroded from arthritis and there is bone on bone. I also have a root radial tear of the post horn meniscus. I find it difficult to walk, and my knee unstable. My quality of life has really deteriorated and I have a lot of pain. Can your procedure help me avoid the inevitable, and if so, what are my expectations.

    1. Chris Centeno, MD Post author

      Yes, we can likely help with this type of procedure: https://regenexx.com/blog/is-injecting-the-bone-in-knee-arthritis-the-new-standard/

  19. Stanley Tucci

    I am about to have PRP for my left knee at Regenexx Sarasota. My daughter wanted to know if Regenexx can treat ankylosing Spondylitis.

    1. Chris Centeno, MD Post author

      Not usually

  20. Larry Duffy

    I hope you will allow me the opportunity to seek an alternative to reverse shoulder replacement. At 85, I am concerned that the surgery may be to taxing on my body. The surgeon I am working with is rated in the top 27 in North America and does only shoulder and elbow procedures.
    a little over 2 years ago, I had stem cells injected in both shoulders using PRP as the delivering fluid.(?). Well, deterioration has progressed since then and the pain is a pretty constant 10. The muscles down my arm pain tremendously and are now to the elbow consistently. I ? if there is any procedure that I might pursue prior to giving my consent to move forward with surgery. I, most likely, would have already had surgery but I suffered a heart attack on August 30, 2020 with stents being placed in early October, 2020. Everyone elected to delay surgery due to blood thinners, etc. etc. I have been an email subscriber to your site for over two years. I did not elect to come to DEN for treatment because you were only using bone marrow stem cells and after years of prednisone, etc. I did not feel I could handle the bone marrow procedure. I appreciate you listening to me. If it sounds like a plea, It Is. Thank you, Larry Duffy

    1. Chris Centeno, MD Post author

      Larry, I think the next step is a telemedicine visit so I can see if we can help.

  21. reginald edwards

    Dr. C, Would you recommend P-Shot?

    1. Chris Centeno, MD Post author

      No

  22. Mike Figolah

    5 months ago I received platelet injections to 3 levels of my neck by Regenex Chicago. I couldn’t be happier with the customer service and results. Prior to the injections, I was in 8 of 10 pain at some point almost every day. For a few months my pain decreased to a 1 or less, but now I’m at a 3 or 4 every few days. However, the pain is not quite the same as before and I notice my neck and shoulders are stiff. I think that my pain is now coming from the maya fascia tissue. My doc is also thinking the same, but he doesn’t treat that. I can’t find anyone other than chiropractors. Any thoughts on my next steps?

    1. Chris Centeno, MD Post author

      I would need to perform a telemedicine visit to figure out what’s up, so best to go back to your local Regenexx doc.

  23. Beatrice Smith

    I fell 1year ago and in September I had knee surgery to repair my meniscus but instead it was removed because the damage was not repairable mainly because surgery at the time that I needed it was not an option due to restrictive surgery because of COVID-19. Now I am told that I need a knee replacement which I dread having done. My knee is swollen all of the time and in pain. I have had 6 X-rays showing that I have severe arthritis and bone on bone because of The removal of the meniscus. Also an MRI was done.

    1. Chris Centeno, MD Post author

      This is a common issue post meniscectomy that we treat all the time with a stem cell procedure.

  24. Cynthia Mettler

    I have spinal stenosis in my cervical C4,5,6 and L 3,4,5. Wouldn’t that contribute to constipation and liver/organ function? My MRIs are on file with Regenexx.

    1. Chris Centeno, MD Post author

      No, the medications patients frequently take are a bigger issue in causing these medical problems than the stenosis.

  25. Heidi M.

    Any thoughts on the Covid-19 vaccine and if it could potentially affect an upcoming stem cell harvest in a negative way? Same question for getting Covid-19, how long would a person need to wait and recover before they could consider doing a treatment to ensure high stem cell numbers?

    1. Chris Centeno, MD Post author

      No issues with vaccine timing and these procedures. You should be fully recovered from the clinical disease of COVID-19 before getting any procedure. If you’re just positive for COVID, then you need to wait 10 days to 2 weeks.

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