Please Pass the Dextrose!

I have tried everything, I think, short of amputation to try and relieve the pain I had been experiencing in both my shoulders over the last couple years. I have tried pain relievers, I have tried acupuncture, I have tried physical therapy, I actually had surgery on my left shoulder in late 2018, all to no avail. Then on my last physical therapy appointment I had a few extra seconds to look at a peer periodical with an article touting PRP, or Platelet Rich Plasma. This is a procedure where they draw some blood from you, spin it in a centrifuge thingy and then inject the plasma into the affected joint. And this made me wonder, since I have been an avid blood donor for a couple decades that blood flow to these extremities might be a concern. It then made me wonder if these injuries might have transpired when I was a pint low, with less blood (and oxygen) reaching the area making them more susceptible to injury. I have been met with mixed reviews from the professionals I have asked about this theory. Some said mostly not, a few said, "Eh, maybe." I did not donate blood at all last year, and I have not suffered any further tendon or ligament injury. But I am a firm believer in donating blood, especially after our wonderful daughter almost died in 2019. Yeah, the morning of our son's wedding I was informed that she had just miscarried.  Planned Parenthood also had called stating that it might be an ectopic pregnancy.

I apologise for the previous run-on paragraph from hell which should have been five. The back-end here at blogger has changed it's format a bit, and this post has been in editing mode for months. So somehow a whole bunch of programming gobbligook gets magically inserted here and there and if you fuck with it, run on paragraphs occur. Or possibly worse. I dunno. We'll see.
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. Pregnancy begins with a fertilized egg. Normally, the fertilized egg attaches to the lining of the uterus.  But apparently sometimes it likes to go a wandering.

An ectopic pregnancy most often occurs in a Fallopian Tube, which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Sometimes, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina.

An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.

She should have gone to the hospital then, but she and me decided we didn't want to put a shroud over the her brother's wedding.  So she was going to stay the course and then go to the hospital first thing in the morning.

The wedding went absolutely fabulously, as did the reception. It was at the after party when she collapsed, her boyfriend and cousin rushing her to the hospital. 

Fate was on her side.  The visiting ER doc at our little country hospital happened to be a crack OB/GYN from San Diego who had experienced ectopic pregnancy fallout before.  Nine units of blood and three units of plasma later my daughter was still alive.  A smaller person would not have survived.

So there's that.  I donate blood to get my BP checked for free.  Plus they're always nice (I think they have to be) and you get free treats.  Who knew the exercise would actually save lives?

As I was still shoulder floundering, my lovely wife turned me on to a local doctor who worked non-surgically with connective tissues.

Great guy, but he does not take insurance, at all.  So after my first $275.00 visit, I decided to talk with my GP about it all.  And he referred me to Mountain View Rehabilitation and Dr. Tracy Hoag 530-477-0893

Can you tell I'm a fan?

On my first visit I was wearing my Gwar t shirt, a group I would hardly go see but whose t shirt I semi-sardonically wear.  (I now request t shirts from our daughter when she goes to a show and we baby-sit.)  Anyway, Dr. Hoag recognized the group/shirt and we cracked up about it all.  If you're not familiar with Gwar, check out the link above.

Anyway, on my first visit (covered entirely by Medicare and the extras part alphabet whatever I now pay extra for) we covered the basics (besides Gwar) and then she did an ultrasound on both shoulders.  From looking at the ultrasound screen and from having me do certain movements she surmized I was having trouble with the supraspinatus tendon in both shoulders.  Since both long head biceps tendons have ruptured, this would mean there's extra pressure on whatever is left.  I guess.

I can semi-understand surmising a diagnosis based on certain movements, but I don't know how anybody can tell anything from an ultrasound screen.  To me it looks like you're searching for a sand dab in the middle of the Sahara Desert, or a frog in a swimming pool full of dill pickles.

On my second visit. per our treatment plan, we began a little Prolotherapy, which is a bit different than Platelet Rich Plasma therapy.  It is also a heck of a lot cheaper and wahlah, it is also covered by Medicare!  Just what is Prolotherapy?  Let's have a look see:

Prolotherapy is an alternative therapy that can help repair ligaments. It’s also known as regenerative injection therapy or proliferation therapy.

This treatment is meant for injured joints and connective tissue. It’s also used to treat some people who have conditions like arthritis, whiplash, and degenerative disc disease. Prolotherapy can treat a number of areas of your body, including your back, neck, knees, shoulders, hips, pelvic floor, and hands.

Prolotherapy is considered safe for most people. However, only smallTrusted Source studies have been conducted about its overall effectiveness.

Prolotherapy typically costs between $400–$1,000, depending on the clinic and the part of the body that’s treated.

Prolotherapy involves watery injections to relieve pain from affected joints. These injections typically contain natural substances like dextrose, saline, and sarapin, in addition to a numbing agent like lidocaine. This treatment is unlike platelet-rich plasma injections, which require stem cells from the person undergoing treatment. It’s also unlike steroid and cortisone injections.

Your doctor will make the injection to a very specific, targeted area in the injury site which triggers your body’s healing response. This leads to the growth of new, healthy ligaments or tendon fibers. As a result, you may experience reduced pain and stiffness and improved strength, function, and mobility of the joint.

Multiple treatments can be used to continue to stimulate growth of new tissues.

I was pretty excited about starting this therapy, very hopeful that it would work.  But thirty days later my shoulders were the same.  When I went in for the second injection, it was decided I would have an MRI done to find out exactly what was going on.  

I was also informed that Ibuprofen could inhibit the effectiveness of the dextrose.  And since Ibu-800's are one of my go-to's for  old man back, I said, "Oh."

So I stopped eating IBU-8's and then a week or two after the second injection I thought I felt maybe I was getting a little more pain free movement within my shoulders.  By the time I went in for my third injection I could do circular movements with both arms pretty much PAIN FREE.

I might be able to golf again.  Maybe even toss a ball around.  It's. Been.i>YEARS! 

Oh, and by the way, the MRI listed full-thickness tears in both my supraspinatus tendons, among a couple other less painful items in both shoulders.

Dr. Hoag was dead on with her diagnosis without having the aid of an MRI.  She is the real deal.  

Apparently there are not a lot of doctors out there offering this kind of therapy and having insurance pay.  Most of them are cash only, and with each injection running somewhere between $200-$500 that can add up.  I have not paid a dime, except for insurance premiums.

If you are suffering from any kind of joint pain I highly recommend looking into Prolotherapy.  If you are local, I highly recommend Mountain View Rehabilitation. Dr. Hoag has unfortunately left, but I am now seeing one of the main dudes, Dr. Joel Richnak. He's a whiz at non-surgical orthopedics. It took him a visit or two to catch up with me. I went in to see him about a trigger finger, but both shoulders, my right ankle, and left thigh/hamstring also needed attention. We're now on track and hopefully, hopefully I can start swinging a golf club again. And I will also be back here at the keyboard a little more often. The crowd-funding for our invention did not go as planned, so we are back peddling a bit and are now looking at simply marketing the patent(s). And then maybe go golfing. Look for Pura Vida-Resort'n Done Right shortly!