Stem cells, PRP, prolotherapy and collagen

This post is long overdue.  A fair amount has happened in the last 6 months — more in terms of things I’ve tried than actual results — but I’ve got lots to report on what I’ve learned during this time, and my plan may be more solid now.

First off, I really don’t know how much of an effect the HA (hyaluronic acid) had.  As with many things, the feelings are really subjective, and it’s very difficult if not impossible to say for sure one way or the other.  At least the scientific evidence is there that it helps with certain pathways involved in OA.  I’ve done two rounds of the Orthovisc already, and will be ordering another round soon.  The recommendation is to do a treatment course of HA no more than once every 6 months, but I couldn’t find any contraindications for doing it more frequently.

The other thing I tried since my last post was human placenta extract (HPE), specifically, Placentrex made by Albert David, an Indian pharma company.  Again, I don’t know if it did anything positive, but at least it was sterile!  I still have several vials left, so I’ll continue using it.

My injections have been very on and off, trying a combination of things for 6–8 shots and then leaving things for up to a few months.  This was mainly due to pressures and instability at work.  Things have settled down somewhat, and I’m back on track with both the hip and knee shots.

One more thing I added to the mix has been GHRP-2, on recommendation from a friend.  This is a ghrelin mimetic, and may help:

Attenuated Synovial Fluid Ghrelin Levels Are Linked with Cartilage Damage, Meniscus Injury, and Clinical Symptoms in Patients with Knee Anterior Cruciate Ligament Deficiency

It felt like I’d been on a steady course of decline, that I was getting more and more decrepit as time went on.  In fact there was one point I can recall a few years ago that highlights an issue I’ve been having.  It was while I was warming up for a ball hockey game at work, I could not stand properly upright, and had no clue why.  I didn’t remember feeling that way before, and little did I know that this particular thing would become the main symptom of my hip pain over the coming years.

On October 3, I finally got a stem cell and PRP injection in my left hip — not my worse, right hip, as my doctor felt that this treatment wouldn’t be able to save it.  But at least I wanted to prevent my better hip from getting worse.  Fat tissue was extracted from my left buttock, and the SVF (stromal vascular fraction) stem cells were prepared from this.  Following the injection, my butt was quite sore and the hip joint was stiff for several days.  For the next 3 or so weeks, I was going for physical therapy (PT) sessions at the same place twice per week, and I found these just as valuable as the stem cell shot itself.

During the first PT session, I learned some of the most important things — that my pelvis wasn’t in the correct position relative to the rest of my body, and that I had weakness in certain muscles.  I was given exercises consisting of foam rolling on my tensor fasciae latae (TFL) following by strengthening the hip abductors and glutes, and a couple of other ones.  What I had previously thought for more than a year to be a problem deep in my hip joint turned out to be my TFL!  Actually, before I thought it was a joint issue, I had thought for years that it was a tendon issue, so that part wasn’t too far off.  But during this new period of enlightenment, I learned that it was a combination of problems that could have led to the OA in the first place.  My left hip was too far forward, and right leg was too low, making it appear too long.  This caused various other imbalances, both skeletal and muscular.  Also during this time I happened to find a video on YouTube by a chiropractor, Dr John Bergman, and that validated all of this.  It’s well worth spending the time to watch all of it:

Hip problems and the ignored causes

While I was going for the PT sessions, I had washed my car a couple of times, one wash taking about 3 hours.  A day or two afterwards, my physical state had worsened — I had pain in my lower back, and no amount of adjusting my sitting position on the couch or in the car was making it better.  Just by chance, my daughter had just started going to a chiropractor due to hurting her back at school, which turned out to be the result of a misalignment in her spine caused by an injury from several years prior.  So my wife suggested that I book an appointment, and I did that immediately.

The chiropractor took an x-ray during the initial consultation and showed me what was wrong — my pelvis was totally messed up, which I kind of knew already from the PT sessions.  We could see the unnatural curvature in the thoracic (middle) spine that was one of the results of this, as well as the tilt in the pelvis and sacrum.  The adjustments he made in the first session alone were enough to correct much of the misalignment.  It turns out that my sacrum might have been misaligned for years, and this could have caused the weakening and overexertion of my right TFL that had been declining for all this time.  The next several sessions saw my alignment continue to hold position, and improve.

Here’s the “before” x-ray.  We won’t have an “after” one for several months, as the chiropractor doesn’t want to take another one too soon due to the radiation exposure.

Ansari_Daniel__Lumbar spine-AP_155642.jpg

This was all fantastic and almost unbelievable — everything had come together, converged into a possible cause and long term solution.  The decision to get the stem cell procedure done, the hurt back my daughter had endured and the resulting suggestion to get me to get chiropractic care, and my shear luck that the professionals I saw were just the right people I needed.  What amazing luck.

This is when I knew that the book I had all but discredited in my mind — Susan Westlake’s Hip Osteoarthritis CAN be cured — is full of useful and vital information that I need.  This book itself is validation of what I had gleaned from the PT and chiropractic sessions.  The book, the YouTube video in the link above, everything makes perfect sense now.  Attempting to regenerate cartilage in any joint without addressing everything together would not be a viable solution.  Also, you may have heard that some people that have undergone THR (total hip replacement) surgery do not get much of an improvement in their symptoms.  Almost certainly for some of them at least, they have not corrected the imbalances that possibly led to their OA in the first place.

Now with the proper framework is in place, I began injecting both knees and my right hip again in earnest.

But before I go into that, I want you to know that something else important happened — irentat contacted me a couple of months ago to say that he found what works in hips, and that it’s different from what works for knees and ankles.  Hip OA got to him too unfortunately, but never conceding defeat, he’s been using dextrose and collagen (plus the odd other compound such as MGF and IGF-1 LR3) and is saying how these are getting his hips healed.  Mind you, this is without x-ray evidence so far, but he has a lot of credibility with me so I really value his opinions.  He also told me that plain testosterone suspension works to cure knee and ankle OA (but not hip).  Hips are just plain harder to fix.  I’ll have the test suspension in my hands 8 days from now, and can’t wait to start using that in my knees.  I helped him refine his technique for sterilizing the collagen, though I’m still a little dubious on using it myself for the time being, as well as whether it can be sterilized by heat without it denaturing to gelatin.  He certainly thinks that it can survive the heat for a certain amount of time.  For now I’ll just stick with compounds that are already sterile, and bring collagen and other extracellular matrix (ECM) ingredients into the mix later if necessary.

Here’s a couple of studies with evidence that injecting components of the ECM might help with OA:

Effectiveness of intra-articular injections of sodium hyaluronate-chondroitin sulfate in knee osteoarthritis: a multicenter prospective study

Double-blind clinical evaluation of intra-articular glucosamine in outpatients with gonarthrosis

Also after the PT sessions and with my spine having been realigned, I re-introduced cardio sessions into my weekly routine.  This had been on-and-off since March, where sometimes I would feel OK in the days following the session on the elliptical machine, and other times it felt like things were getting worse.  It’s probably the latter that was occurring while my skeletal system was out of alignment, since my TFL was more sore (although I thought it was the joint, at the time) and it’s possible that my cartilage was also wearing thinner.  Right now I’ve just built back up to three cardio sessions per week, and I’m feeling just fine.  Perhaps I can continue this way and the cartilage won’t wear down any further, and I can say that my hip OA is “cured”!  Just kidding there, I wouldn’t consider it cured unless cartilage regrowth occurs.  One thing we do know, is that inactivity is bad for joints, and activity is good — we need the compressive forces to keep the cartilage in there healthy, and perhaps to help stimulate regrowth also.

When I got the stem cell with PRP injection in early October, and a follow-up PRP “booster” shot just 3 days ago, the doctor used an injection site more medial (towards the centre of the body) than what I had been using.  I was determined to replicate it.  That evening I performed an ultrasound (US) examination of the area on both hips to try to locate the site, and after over an hour, I had found it.  Two days ago I got ready for the second in a series of injections into my right hip, this time combining 5 mL of 50% dextrose, 10 IU of hGH, some BPC-157, and about 2 mL of 0.9% sodium chloride solution (saline).  This idea was from an article in the Journal of Prolotherapy:

Hip Arthritis Prolotherapy Injection Technique

I didn’t use lidocaine in the IA injection, as I fail to see why it’s necessary — it doesn’t do anything to promote regrowth as far as I know.  My dextrose solution has a pH of 4-point-something and I was a little worried that the whole injection would be too acidic and cause problems (synovial fluid has a neutral pH), but fortunately I didn’t encounter any negative consequences.

Getting the dextrose solution divided and dosed appropriately was a whole problem unto itself.  Here is the product I used:

https://medimart.com/product/dextrose-injection-abboject-lifeshield-pre-filled-syringe-dextrose-50/

The problem with this is that it’s meant as an IV drip.  One can’t just take out a portion of it using a syringe like one can from a vial.  Here’s what I figured out, after examining the instructions and thinking about it for a while:

  1. Got some sterile empty vials (5 mL size), each one to hold 5 mL of the dextrose solution.  Since the dextrose is single-use only, rather expensive, and not bacteriostatic, I would apportion the dextrose into the vials and freeze them.
  2. Emptied a few vials of bacteriostatic and sterile water, which I would inject the dextrose solution into.  After emptying them, I try to create as much a vacuum in them as possible by using a syringe.
  3. The dextrose syringe had a couple of ways of getting the solution out — one with the built-in 18 G needle, and the other with a Luer lock attachment.  First I tried using the needle, but it turned out that it wouldn’t extend past a certain point, and the needle wouldn’t reach the vial.  So I attached a 25 G needle using the Luer lock.
  4. I was then able to inject all of the dextrose into two of the emptied water vials.
  5. Next, I withdrew 5 mL of the dextrose solution from those vials, and filled each sterile empty vial with it, then equalized the pressure in them by just sticking the needle without a plunger through the rubber stopper.
  6. The 5 mL-apportioned vials could then be frozen for use at a later point, without worrying about bacterial growth.

Now that I had the injection mixed and ready to go, the timing was pretty bad as my wife had gone on the phone and wasn’t going to get off it any time soon.  I’d always wanted to try doing the entire injection alone, and this was going to be it.  I always do the initial skin anesthetic shot myself, but nothing afterwards as I’m always holding the US scanner and ensuring that I can find the needle as it goes into the joint.

This time, I put in the deep anesthetic using the layer-by-layer technique that I explained to my wife.  No problem there.  I waited 5 minutes for it to kick in fully, then went for the spinal needle.  No pain with that going in, though I had to push it in pretty hard and wasn’t expecting that.  I started the needle without the US transducer in place, following the line from the points I had marked as I always do, a little away from the top and the bottom of the US probe.  Then I put the probe in place, and watched the path of the needle — I had no trouble locating it.  I was a little worried at one point thinking that I was looking at the femoral NVB (neurovascular bundle) and that the needle might hit the nerve, but once it got there and went through that part of the image, it was all fine.  I got the target site, which was closer to the main problem area of the hip, so to get the injection done there was probably better.  My wife came along to do the actual injection while I took a video of it as I often do, to make sure I can see the effusion develop as the solution is plunged in gradually.  That validates the intra-articular placement.

Finally, I need to mention some evidence that dietary habits can influence the progression of OA:

Sulforaphane represses matrix-degrading proteases and protects cartilage from destruction in vitro and in vivo

One of the best sources of sulforaphane is broccoli, so make sure you eat sufficient quantities of it regularly!  Brussels sprouts and cabbage (and other cruciferous vegetables) are also good sources.

Besides taking the usual supplements (glucosamine, chondroitin, fish and cod liver oil), I’ve also been consuming more of the “fermented K super foods” — kefir, kombucha, sauerKraut, and kimchi — it helps for the last one that my wife is from a Korean background.  As a developed society, fermented foods are rarely consumed, and adding these to ones diet is crucial to maintaining good gut health, which leads to a host of other health benefits.

That concludes the long awaited update.  Now it’s time for my foam rolling and hip and posterior chain exercises before I retire for the night.

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Change-up time

It’s been almost 2 months since my last post—a few weeks longer than I had thought.  Because I’d been using this blog to keep track of my injections, I almost lost track of what shot # I’m up to in my right hip; I needed to count my spinal needles to be sure.  I took a little break, feeling that things were not really improving, and improvements I thought I had before could have been psychosomatic.  I needed a little “reset”.

However, during that time, I reloaded on pentosan polysulfate (PPS – Teofarma brand from Italy), doing 1 shot per week for 4 weeks.  From now on it’s once monthly.  Again, the improvement from that might be real or perceived, but let’s say it’s a good safety measure just in case it’s helping.

The count is now 16 shots in the right hip (and paused at #4 in knees).  The last one was a combination of Orthovisc (high molecular weight hyaluronic acid, aka HA) and GH.  I recently obtained the latter from GoldPharma, via a Berlin pharmacy.  It’s a treatment course of 3 shots, spread one week apart, and one isn’t supposed to repeat the treatment for at least 6 months.  (I need to find out the reason for that.)  I didn’t feel like the stanozolol was helping much—if at all—and decided to keep things simple for this round.

We know that HA has been used as a viscosupplement in OA joints for a while now, though it’s not been proven to change the course of the disease.  I’m hoping that combining it with GH will improve the odds, as this study on rabbits yielded positive results:

Additive Effects of Intra-articular Injection of Growth Hormone and Hyaluronic Acid in Rabbit Model of Collagenase-induced Osteoarthritis

Of course, I’m not implying that what works in rabbits will work in humans, but what I’m doing is experimentation anyway.

There’s also evidence that HA combines well with PRP for treating knee OA:

Clinical effectiveness in severe knee osteoarthritis after intra-articular platelet-rich plasma therapy in association with hyaluronic acid injection: three case reports

Here are some more studies concerning HA for the treatment of OA:

Intra-articular use of hyaluronic acid in the treatment of osteoarthritis

Symposium: evidence for the use of intra-articular cortisone or hyaluronic acid injection in the hip

Viscosupplementation in the hip: evaluation of hyaluronic acid formulations

As you can see, HA could work to help with lubrication, as well as potentially modifying the progression of the disease when used in combination with either GH or PRP.

I had been advised by a friend to try Hymovis, a new high molecular weight HA formulation.  However, for this treatment course I chose Orthovisc due to it more closely matching what was used in the studies, and because of me combining it with GH and not relying solely on its lubricating action.  Orthovisc was probably also easier for me to obtain.

During my visit to the hip resurfacing specialist in February, he told me that my condition was bone-on-bone, and that I was a suitable candidate for this surgery—I’m the ideal height (5′ 9″), age (46), and the outcome tends to be better for males, especially in terms of lifetime of the device before revision surgery becomes necessary.

I’m really trying to avoid a hip resurfacing operation; here are some good studies I found regarding this:

Hip resurfacing: expectations and limitations

Outcomes after metal-on-metal hip resurfacing: could we achieve better function?

The results from second study above are particularly worrisome:

Overall examination was satisfactory with few complications. High functional levels were reported… For 25%, outcome was poor with persistent pain, reduced hip flexion (mean, 94.46 degrees +/-12.7 degrees ), decreased strength (P<.001), restricted walking, and functional limitations.

This is rather different than we are led to believe from the surgeons themselves, or from other studies for that latter.  It’s a good enough reason to avoid the surgery at some (but not all) costs!

So, after a few more shots of HA/GH, what will I do?  I’ve got an consultation appointment booked with a BMAC stem cell doctor for May 1, during which I’ll explain what I’ve been doing and whether he thinks his clinic can help.  I’ll request before/after x-rays of any of his patients for evidence that stem cells can work in some hip patients before I’ll consider that as an option, as it would be rather expensive.

Besides that, I have PRP (I also found a nearby clinic that does the shots for a decent price) to try, and finally, if all else fails, BMP-7.  I don’t hold too high hopes for that either, given the results from FGF-18, but I need to exhaust all the options.

Various musings

Current status: 11th shot in hip last week on Wednesday, and 3rd shots in knees last Sunday.  Overdue for hip shot this week (I was too tired yesterday evening).

There was a lot of back and forth on concepts in the past few weeks.  First and foremost, these have been caused by me getting fresh X-rays a few weeks ago, and comparing them closely with what I had a year ago, and from August 2016—I also obtained the August X-rays about 4 weeks ago.

I could not discern any visible difference in the minimum joint space width (JSW) in the right hip.  This isn’t particularly good news, as I believe Dr Dunn (www.iagh.com) got increased JSW in a matter of months.  Well, he also says he achieves < 50% success rate in hips, so perhaps it doesn’t always work out well for his hip patients.

What I was trying to figure out from the latest X-ray was, if new healthy cartilage were to form, how it would “fit” in the joint space, given that there is so little space in the narrowest area.  I’ve highlighted this here.right_hip_201702

You can see that the femoral head cannot shift downwards or inwards due to the topology of the structures.  I had some discussion with my colleague about this and he indicated that bone remodelling would need to occur for the upper gap (i.e. cartilage) to be able to increase in that area.  I would imagine that this wouldn’t happen too quickly, and could take several or even many months.

Just by chance, I found a fantastic resource very recently, a presentation by Dr Dunn from 2012:

Developmental Healing of Cartilage—Uses Growth Hormone to Recapitulate the Cascades of Development to Regenerate Articular Cartilage

Not only can we see there the kind of results he gets with his hip (and knee and ankle) OA patients, he also gives information on dosages that he uses for hips (10 mg, which is 30 IU, or more).  In addition to his high-level explanation of the science of how GH works via prenatal soft tissue healing, he describes his experiments on rabbits where GH caused the cartilage layer to grow twice as thick as the control group, and the following key point which likely addresses my concern above:

The upper layer of subchondral bone dematurates and returns to its earlier cartilagenous state, a form of rejuvenation.

I believe this is the bone remodelling that needs to occur.  It seems that in successful outcomes, Dr Dunn has been able to achieve this within months, although in this presentation, I cannot see the dates properly on the before/after hip X-rays to determine any periods.

Interestingly, Dr Dunn doesn’t believe that either PRP or prolotherapy regrow cartilage.  This is in contrast to the results that irentat achieved, where he claimed that prolotherapy helped—although he also used GH.  I would hazard to say that he has a vested interest in making such statements, and given all the positive research going on in these areas, I cannot trust him in regard to this.

Dr Dunn also says the following:

I A injections of pure IGF-1 cause retinal damage and permanent blindness.

It might be good that I haven’t included IGF-1 in my concoctions!  I wonder what the mechanism of this could be, since IGF-1 cannot travel straight from the joint to the eye—it would need to get systemic first.  There are lots of people injecting IGF-1 into their bodies, and I’ve never read of any eye problems, so this statement seems rather odd.  Either these people are getting bunk IGF-1 (quite likely), or IGF-1 doesn’t have this effect, or a combination of the two.  Nevertheless, I hadn’t been planning to use pure IGF-1 anyway, since one of the major effects of GH is to increase IGF-1 levels.

On another note, I purchased Susan Westlake’s book, Hip Osteoarthritis CAN be cured, just to absorb everything I possibly can that may be useful.  I skimmed through it but haven’t read it in detail yet.  One of the salient points I got from there was that she insists that you must not continue with competitive sports, since those place supraphysiological stresses on the joints that cause the most damage to cartilage.  Instead, she says, you should do controlled workouts where you are not subjected to unpredictable movements.  Another point that I need to reconfirm is that I couldn’t find any X-rays, either before or after her “cure”.  Thus I need to be skeptical of her claim, and my current stance is that she may not have actually cured anything, just delayed or prevented progression of the OA.  This would be a significant achievement in itself, but it hardly lends credence to her claim.  Honestly, if she had really cured herself, don’t you think she could have resumed competitive sports?

In my case, I may have muscle imbalances either that caused my hip OA, or that my hip OA is causing.  Since I have studied 3 sets of X-rays over the past year or so, as well as my MRI’s, I can see that JSW is my problem, and I don’t believe that correcting any imbalances will be enough to restore cartilage.  Perhaps other people can still benefit from the techniques that Westlake lays out.

Westlake also believes heavily in joint distraction being a contributing factor to her “healing”.  See this proposal paper:

Cartilage regeneration for treatment of osteoarthritis: a paradigm for nonsurgical intervention

I had also been of the mindset that sleeping in certain positions can relieve certain stresses on my hip cartilage and allow for better regrowth.  Whether or not this is true is still up in the air, but in the same presentation, Dr Dunn states the following:

The addition of joint distraction has not improved the results when used together with IAGH injections.

So whether or not it helps, it feels better to sleep in certain positions, so I’ll continue to do it.

Winny to the rescue

Since my last post I’ve done a few more shots, and had a slight change of plans.  The original plan had been to do 8 shots in each hip, continuing with hGH + BPC-157.  Since the OA is more severe my right hip however, I decided to stop at 6 in the left, which will allow me to allocate more to the right, and go up to 9.

If you can recall from one of my earlier posts, I mentioned a user irentat on the Knee Guru forum who made great progress in treating himself for his bone-on-bone ankle OA.  I wanted to send him a PM there, so I registered.  Unfortunately that site doesn’t allow you to PM anybody until you reach 20–30 posts, and I didn’t feel like contributing there.  But at least I was able to do a little research and see what he’d been posting there.  I’m glad I did, because I gleaned a few useful nuggets that I’ll share with you here.

Firstly, he suggested to somebody in a thread that 15 IU of hGH was enough for a knee, given weekly, after that person indicated that they were planning on going all the way up to 40/45, or something like that.  His belief was that using a lower dosage but going for a longer treatment regimen would be more beneficial .  That got me thinking that I could probably get away with 20 IU in my hip instead of the 30 IU I’d been using, and the plan changed again, allowing me to stretch out my current batch of hGH to 11 weeks total for the right hip.

Irentat was a true pioneer.  He’s not a doctor, but studied for years before getting treatment, and came to the conclusion that you need to start injecting yourself (perhaps learning by observation from some paid doctors’ visits) if you want real recovery, as you need a lot of injections over maybe 1–2 years for it to be effective (it would be too expensive otherwise).  He started off with paid treatments, then took over after a while (I believe), and said that he did around 40 injections for his left and right ankles combined, and achieved enough recovery to be able to run again.

Irentat also felt that Dunn has higher success rate in ankles (followed by knees, and lastly hips) because it’s easier to keep the weight off them. Not sure I agree with that, but I hope he’s wrong! It’s practically impossible for me to keep the hip from contacting the low-to-zero cartilage spot. Just bending forward causes contact.

Unfortunately his last post on that forum was around 2012 IIRC, with the admin shutting down any further discussions—which is, I believe, why he stopped posting there.  That board’s admin no longer allows people to discuss self-treatment.

For the past couple of weeks I’d been spending time researching more about hGH on another forum (Meso).  So many people are using UGL (underground lab) hGH coming out of China, it’s fascinating to learn what kind of things are going on.  Much of this GH is bunk, meaning it’s biologically inactive, underdosed, or both.  There is much discussion on different providers of this UGL GH, and on testing.  Even if the GH is 98% pure, for example, it might still be inactive due to it being made incorrectly.  Apparently there are only a few licensed GH manufacturing labs in China, and these are known.  It takes an investment of $10 million or so in equipment in order to manufacture it according to spec, and requires teams of people to maintain and work the equipment.  However, technology has advanced a lot in the last few decades, and it seems to be a fact that there are groups in China that are not in possession of such expensive facilities, that are still capable of producing quality GH.  The best seem to be TP’s (The Provider) black tops.  Nevertheless, since we’re injecting this GH into our joints, I would never take the risk of UGL GH, since we never know the conditions that it was produced in, and it could cause severe damage from infection.  Naturally, pharma GH is what you should strive to obtain.

img_20170110_095925I was elated when my Desma Winstrol (stanozolol) finally arrived in the mail the other day.  It took several weeks to make it all the way from Greece, and that was by air mail.  I’d been quite worried that it wouldn’t make it past customs, so this was a fantastic piece of good fortune.

I was too tired to use it on the day it came, so I delayed my hip shot by a day so that I could add it to the cocktail.

First I needed to figure out how to divide it into appropriate dosages, since 50 mg per 1 ml vial would be far too high a dosage, given that the dose for Sungate in horses is 5 mg for a medium-sized joint, and 1–2.5 mg for smaller joints.

Here’s what I came up with.  I withdrew the Winstrol from one vial using a 23G 1″ syringe, and injected it into a sterile empty 5 ml vial (see photo on the right).  img_20170111_214858Next, I injected 4 ml of bacteriostatic water into that vial, making the total 5 ml.  This would make it much easier to measure out into the 1″ TB syringes (the same ones I use for knee shots) that you can see in the background.

By my calculations, 250 mcg of that solution would contain 2.5 mg Winstrol, and 500 mcg (0.5 ml) would contain 5 mg Winstrol.  Because the TB syringes are 1 ml, it’s easy to accurately withdraw these amounts.  I planned do to a mixture of knee and hip injections  with these amounts in the coming weeks, and allocated the 5 ml total solution amongst these.  After loading one of these two amounts into the needles, I put the needles into a hard plastic container and froze them.  Winstrol is in aqueous solution, and bacteria tend to grow there more than oil-based solutions.  We can’t take the risk of such contamination in our joints—even though I mixed it with bacteriostatic water, I’d still rather be safer, hence the storage in the freezer.

The right hip injection last night was #7, and consisted of hGH, BPC-157, and 5 mg stanozolol.  It went well again—intraarticular placement was easy to achieve and confirm with the ultrasound scanner, and I watched as the nice effusion formed from 9 or so ml of solution that was injected.

This evening I put 2.5 mg of Winstrol into each knee using the TB syringes—these went without a hitch.  Indeed, I barely felt anything from the needle going in.  Finally, my knees are undergoing treatment.  I’ll also be able to resume treatment on the left hip, with just Winny for now, this weekend.

Not a great week

So far we’re up to shot #4 in both hips; the right was done yesterday.

I haven’t been posting frequent updates here, simply because things don’t happen very quickly with joints, even when they’re being treated.  And sometimes, with the intuition that the healing tissue is fragile, you need to do things that might affect it negatively.

Last week there was a fair amount of snowfall, and I did what I really wasn’t looking forward to—shovelling.  That’s something that I knew would make the joints feel worse, and I was right.  It’s hard to gauge whether the treatment is working well when something like this happens, but there are certain indications I can go by.

Firstly, sitting in a chair especially while driving a car, puts my hip in a restricted position that has been slowly but steadily making it feel worse when moving my thigh left and right—it’s more of a soreness rather than acute pain, thus it’s quite tolerable for me.  I think there’s still some joint space where the top of the femur hits the acetabulum, and I dread to think what the pain would be like if it went right down to the bone.  The good news is that this is one indicator that has been improving, even after the snow shovelling.  After yesterday’s shot, things continue to improve in this area, and  I think this will go on for several more days.

Secondly, when I’m training with free weights in my basement, it was becoming increasingly bothersome to bend down to pick up the plates off the floor to load onto the barbell on the power rack.  Since starting the injection regimen, this has also notably improved.

These are two things that are not psychosomatic in my opinion, unlike the back-and-forth feelings of supplements working and then not working, then going off them for a while because you think they’re not effective, and starting them up again and believing in them again.  This happened to me with some supplements, such as Celadrin.  I think it’s still a good supplement (try breaking open a capsule if you have those, and rubbing the contents around the joint), but in the long run it wasn’t really making a difference in terms of disease progression.

For the last two injections (#4 in both hips), I decided to throw another compound into the mix, one which I’ve known about for a long time, but I wanted to give the hGH some reinforcement now that the FGF-18 part is over and done with.  Enter BPC-157, a healing peptide.  BPC stands for “Body Protection Compound”, and BPC-157 is a partial sequence of this; it is a natural peptide found in human gastric juice.  Chances are that you wouldn’t have heard of it, since it’s not patent-able by big pharma, being natural.  Anyway, this is from a recent study on it:

Pentadecapeptide BPC 157 enhances the growth hormone receptor expression in tendon fibroblasts

…pretreatment with BPC 157 can no doubt enhance the effect of growth hormone in a dose- and time-dependent manner.

In the authors’ conclusion:

This study demonstrated the promoting effect of BPC 157 on tissue healing is potentially associated with the increased expression of growth hormone receptor in tendon fibroblasts. This finding also suggests a different way to promote the tissue healing by increasing the expression of growth hormone receptor to promote the beneficial effect of growth hormone in terms of enhanced proliferation. In addition, the amount of growth hormone used can theoretically be reduced and also the cost of therapy. BPC 157 may play an important role in promoting tendon healing and potential clinical usage in the future is expected.

Sounds pretty fantastic, eh?  If you search for it on the interwebs, you’ll find a ton of references to people using it for healing their injuries and speeding up post-surgery healing.  They use dosages anywhere from 250 mcg to 700 mcg per day.  So even though the above study implies that you can use a much lower dosage to get an effect, I figured why not, I’ll use 1 mg in each injection combined with the hGH.

Today my right hip continues its apparent recovery.  I haven’t used diclofenac in 2 weeks now, so there’s no chance that any of these effects are left over from it.  If the BPC-157 is doing what it hopefully should do according to this study, then it will accelerate the healing process by making the hGH more effective, as well as possibly acting via other pathways.

I’m not so sure how well my left hip is doing, as the last couple of injections there didn’t go so smoothly.  For some reason it’s much harder for me to locate the proper target site with the ultrasound scanner, and the markings at the top and bottom I made with the permanent marker are just the non-optimal result of using the scanner a few weeks ago.  I’ll need to find a better site next time by moving the top and/or bottom marks one or two centimetres left or right.  The femoral head/neck junction just doesn’t appear as easily as for the right hip, the result being that we weren’t absolutely sure that we hit the target.  Add in the fact that the 3″ needle went all the way in both times—unlike on the right side—that raises some doubt.  At least I didn’t get the GH sides, which may be a good sign that the injectate went into the joint capsule.  What I think really happened was the needle went in at a different angle relative to the bony structures, which is why it went all the way in.  Thus the solution should be to move the marking(s) so that the ultrasound transducer is placed and oriented more appropriately.  Easier said than done!  I also think that the “bony landscape” is just different on that side.

The title of this post implies negativity and there were indeed some periods of it, but overall things have been progressing rather well and the positive appears to be prevailing.  This is only week 4, and any reversal of the disease process that may be occurring will likely also be a slow process.