PLATELET RICH PLASMA THERAPY: FIVE WEEKS

Week five and time to visit the ankle Doctor for a checkup. He questioned me closely about how long I was non weight bearing on the ankle and how long I wore the ankle brace after going off crutches.

Then he yanked and twisted and poked my ankle to see if and where it hurt. The bottom line is that it still hurts some but not as much as it did before the procedure. I told him that I have not yet done any exercise on it such as swimming or exercise bike. He said I could start that stuff but not to do any running or elliptical etc. Still no golf until February 1.

We talked about what is next from a treatment perspective. He still thinks it will get better to some degree. The main problem is getting my foot in a position with orthotics so that it does not put strain on the tendon. Well, no luck there. He asked if I had done the orthotic at his office and I had. But, I said that I gave up on the adjustments after two tries.

He didn’t want me to give up and even said that further adjustments were on him. Did I have the orthotic with me, he asked. I got them out of the car. He looked at them and said that he agreed with me; they were not right and he would get the adjustments made. I am waiting on a call in a couple weeks.

So, I am going to make my own adjustments to existing pairs of orthotics and off the shelf inserts. I think I have enough knowledge to cut and paste pads etc to make something that works. That is my project for this weekend. No, I am not a podiatrist but did sleep in a Holiday Inn last night!

Bottom line is that the ankle is better and will keep getting better the more I can get the foot in the position that does not strain the tendon. The sooner the better on that. I can actually tell if a shoe or orthotic or insert irritates or makes it feel good.

Another appointment in February.

PLATELET RICH PLASMA THERAPY; FOUR WEEKS

Yes, it has been four long weeks of being on crutches (three weeks) and wearing the ankle brace and or walking boot (one week). I have missed some good golf weather and golfing experiences with my golf buddies. In addition, I have missed swimming and working out.

On the plus side, I have gotten some books read and many office and home projects attended to. Everyone has been very nice to me, wife included! In fact, she has gone beyond the call of duty by attending to my needs. I owe her big time.

The ankle is feeling better each day. I am now wearing shoes but no brace or walking boot. It seems like I can walk and move around better as times goes on. I am not trying to push it by doing a lot of motion exercises however. In fact, the Doctor told me not to do any of that.

I go back for my five week appointment next Wednesday and I will do a report at that time. I am hoping to get the go ahead to swim, lift weights and ride the exercise bike. He has already told me not to swing a golf club until February. If the ankle gets well, I can deal with that.

PLATELET RICH PLASMA; DAY FIVE

Today was the first follow-up visit with the Doctor. It was scheduled for 1:10 PM. However, this turned out to be the day from Hell! Do you want the whole story?

Here we go. I woke up this morning around 4 AM with a pounding pain in my left upper jaw. The culprit was the second from the back molar. Very sensitive to touch; even if my tongue touched it. Hurt a lot.

I did have a dental appointment scheduled for Tuesday but seeing how today is Monday, I wasn’t going to make it until then. So in addition to going the foot doctor, I got a root canal today as a bonus. Now the tooth hurts a lot still from all the drilling and Novocain shots. So when people say “that was as much fun as a root canal” they mean that it really was not much fun. No kidding; I am lying in the chair stiff as board waiting on the pain come. That my friends is stress.

Back to the foot doctor. He took the bandages off and guess what? I had thought he did about 4 injections. Well, there are nine little holes with scabs where the injections went in. This is in addition to the three holes where the nerve blocks went in. My lower ankle looks like a pin cushion!

The prognosis is to stay on crutches for another one to three weeks; as long as I can stand it. Further, he gave me a walking cast to wear from now until one week after I give up the crutches. Then, I can start swimming and doing the stationary bike. No elliptical or treadmill machines however. Upper body weights will be ok then as long as I am sitting down.

The bottom line question for me was: when can I swing a golf club? Bottom line answer was February one; my birthday. What a present that will be! So no golf from November 10 to February 1; basically three months. Since it took me about a year and a half to get here, I guess that is ok.

More entries to come later; tune in on the same channel.

PLATELET RICH PLASMA THERAPY; DAY THREE

Dear Diary,

This is the third day after the procedure. I am still on crutches; yes, I know the Doc told me I would be on crutches for two to four weeks. But, it seems like a long time since Wednesday! I am pretty bored actually. The main problem is not being able to be outside and enjoy this beautiful fall weather we are having.

I can get around pretty good but the problem is that I can’t take anything with me. For example, want to take a drink from the kitchen to the den? No can do. Want to take a book from the den to the bedroom to read at night? No can do. I have to have someone help me do little things like that. In my case, it is my lovely and devoted wife. She is being very nice to me and I will owe her big time when this is all over.

I also need help taking a bath. The doc said no showers since I am not to stand on the ankle and have a wrapping on it. But, something has to give. I mean the body odor can become pretty bad to me even if it is my own smell! So, we put a trash bag on my lower leg and put a bungee cord around it to keep the water out. Then I sit on the side of the tub and swing my legs around and lower myself with both arms. After that, we just soap and rinse like you would when normally taking a bath.

We went out for lunch yesterday and a friend took me out to lunch the day before so I am getting out a bit. Thank goodness the weather is beautiful and not rainy or anything like that. I am getting to read some books and catch up on the magazines. At church we are “reading the bible in 90 days” so I have caught up on that as well.

So, it is not all bad and I hope that the procedure actually works and the ankle gets healed up! Further, that my wife still loves me when it is all over.

I go back to the Doctor on Monday so another entry in the journal will come out then with an updated prognosis.

PLATELET RICH PLASMA THERAPY

This past Wednesday I had the injection. What is it? PRP is a relatively new therapy for repairing connective tissue in the body. The blood is drawn from the patient; put in a centrifuge and all but the platelets and plasma are separated out. This is what is injected into the wound. It is supposed to promote quicker healing of the damaged area.

In my case, I have had an inflamed tendon for about one and half years. It resulted originally from playing tennis. I knew that something happened when it happened. But I kept on playing. The next morning my ankle hurt like a sprain or maybe it felt like I jammed it.

So, I quit playing tennis but kept on playing golf. If you are a golfer, you know that golf puts a lot strain on the left side; in particular the knee and the ankle. I am such a dummy. If I had just taken a month off from every activity, maybe all this would have been unnecessary. We will never know however.

A year and a half later, I still am not playing tennis and cannot walk the golf course anymore; I have to ride. Even then, after playing my ankle hurts.

I have been reading about the PRP therapy and it seems to get good results. However, it only seems to be done in CA and FL for the most part. It was hard to find a Dr. in this area who does it. The orthopod that I was seeing for my ankle said it was too experimental and they don’t do it. I think maybe they just aren’t on the leading edge of medicine.

I did hear about a Podiatric group here in Richmond that is doing it. Made the appointment and yes, I was a candidate. The tendon was inflamed in several places and PRP might help. There are no guarantees. And guess what, my insurance company will cover the process! How about that! I guess my orthopod needs to catch up if even the insurance companies are covering the process! I will be on crutches for “two to four weeks”. Holy Cow Batman; that is going to be hard to do. But, sometimes the pain is worth the gain so let’s do it is my attitude.

They do this in the outpatient operating room. I had mine at Johnston Willis Hospital. Everyone there was professional and personable. Just a great experience.

If you want the gory details here they are. First I was given three or four numbing shots in my lower leg above the ankle. That hurt quite a bit. Simultaneously blood was taken from my arm. Then about 20 minutes later I was wheeled into the operating room. The Doc came in with the platelet rich plasma and started giving me the shots. Normally, it is one injection. However they had done ultrasound in the office the day before and had determined that I had about a 6 to 8 inch area of inflamed tendon. This time he gave me about 4 injections of the PRP. Each time he stuck me, he would wiggle the needle and moving it about to get the stuff all over. On about the second or third shot, it hurt and hurt a lot. Then he gave me more numbing stuff. So the last couple shots didn’t hurt but I was expecting it to. Thus my body was a stiff as a board waiting on the pain to come from each shot.

Finally it was over. Really only took about 20 minutes although it seemed longer.

Now it is Friday and I go back for followup visit Monday. I hope to get the wrapping off and get instructions as to physical therapy, activity etc. I don’t expect to be playing golf again until January; tennis a little later. Walking I would hope would come sooner rather than later.

I will put out a report after the visit Monday.