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to your Address Book or Safe List. Learn how here. | June 16, 2011 | |  |  | Back Pain Relief from Plasma Shots | | | INFUSE Your Hair Today | | | Music Helps Hospital Patients Breathe Easier | | | Forever Young | | | Walk Your Way to a Sharp Mind | | | |  |  | |  | |
 | | Back Pain Relief from Plasma Shots One of my relatives (I won’t say who) is wimpy when it comes to having blood drawn and getting shots. But if he ever develops chronic back pain, he may want to rethink that and join the queue of patients now turning to a therapy that uses injections of a person’s own blood to promote healing. Called platelet-rich plasma prolotherapy (PRPP), the technique is safer and less invasive than surgery... and unlike nonsteroidal anti-inflammatory drugs (NSAIDs), which suppress symptoms temporarily, it can provide a permanent fix for certain types of back problems. I called Gordon Ko, MD, medical director of the Canadian Centre for Integrative Medicine, who uses PRPP in his clinical practice. He explained that PRPP is a recent advance in the prolotherapy field. In general, prolotherapy involves injecting a mildly irritating agent directly into the painful area in order to provoke an acute inflammatory response. This causes an increase in the flow of blood, nutrients and stem cells to the affected tissues, and these in turn stimulate the body to heal itself. Since the inception of prolotherapy, various substances have been injected (for instance, a sugar solution or cod-liver oil extract)—but foreign substances such as these sometimes created too much inflammation and/or caused extreme discomfort. Breakthrough: Recently, researchers discovered that better results occur when the injection consists of the patient’s own blood, because the platelets are well tolerated and excessive inflammation is avoided. According to Dr. Ko, PRPP can help cure or significantly relieve long-term chronic low-back pain for more than 80% of patients whose problems stem from injury or laxity in ligaments and/or tendons of the sacroiliac joint (where the base of the spine meets the pelvis). In addition, PRPP has been used successfully to treat other areas of the body where ligament or tendon problems lead to chronic pain, such as occurs with tennis elbow or Achilles tendinitis. PRPP injections also can help resolve muscle tears. People with certain nutritional deficiencies may need to have these addressed before PRPP can work to best effect. Patients who have a low blood platelet count, a blood-clotting disorder or an inflammatory disorder (such rheumatoid arthritis or psoriatic arthritis), or who take a blood thinner such as warfarin (Coumadin), may not be appropriate candidates for PRPP. What Happens During PRPP Treatment About one to four tablespoons of the patient’s blood is drawn and then spun in a centrifuge for 14 minutes to separate the liquid plasma, platelets and white blood cells from the other blood components. This platelet-rich plasma contains about five times as many platelets as normal blood. The platelets are the primary healers, Dr. Ko explained, because they release growth factors that promote mechanisms called the healing cascade and stem cell migration. After the patient is given local anesthesia, the platelet-rich plasma is injected directly into the painful tissues. While the number of injections given depends on the patient’s condition, a typical session would include about 10 injections. Each injection is done using ultrasound guidance to ensure exact placement of the needle, Dr. Ko said—because even a tiny slip might damage surrounding tissues, which can be very dangerous. As with any type of injection, PRPP carries a small risk for infection, bruising and bleeding. Recovery: The injection site may be painful for a few days following treatment. Acetaminophen (Tylenol) can relieve this discomfort, but aspirin and other NSAIDs (ibuprofen, naproxen) should be avoided for at least two weeks (preferably longer) because they would diminish the inflammatory response needed for PRPP to work. To reduce swelling, an ice pack can be applied for 20 minutes three to five times a day as needed. Many patients find that their chronic back pain improves after just one or two sessions, Dr. Ko said. Injection sessions typically are given two to three months apart to allow time for healing to occur between visits. Cost: About $750 per session. Since PRPP is still considered experimental, most insurance companies don’t cover it. PRPP is very specialized work that requires specific training, so Dr. Ko recommended seeking treatment from a doctor of medicine, naturopathy or osteopathy who has been practicing prolotherapy for at least 10 years. Get a referral from your primary care doctor or from the American Association of Orthopaedic Medicine (www.aaoMed.org) or the Canadian Academy of Orthopaedic Medicine (www.caom.ca)... then contact the practitioner you are considering to inquire about his or her experience. Important: After PRPP, Dr. Ko said, patients should get physical therapy to help rehabilitate dysfunctional muscles and improve core strength... but should avoid any aggressive manipulation treatment that could undo the beneficial effects of the PRPP. Source: Gordon Ko, MD, is medical director of the Physiatry Interventional Pain Clinic at the Sunnybrook Health Sciences Centre and an assistant professor in the department of medicine at the University of Toronto in Ontario. He also is medical director of the Canadian Centre for Integrative Medicine in Markham, Ontario. www.DrKoPRP.com
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 | | Music Helps Hospital Patients Breathe Easier Years ago, my premature, two-pound newborn daughter needed a ventilator machine because she couldn’t breathe on her own... and I swear that she seemed to take comfort when I sang to her. Now a new study supports the idea that patients on mechanical ventilation—who often experience major distress, anxiety, discomfort, fear and a sense of isolation—can be soothed by music. I contacted study leader and music therapist Joke Bradt, PhD, of Drexel University. She explained that the research team looked at data from eight different clinical trials involving a total of 213 hospitalized patients who were receiving mechanical breathing support along with standard care. In seven of the trials, certain patients listened to prerecorded music using headphones... in one trial, a trained music therapist played live music. Findings: Compared with patients who received standard care alone, those who listened to music showed reduced heart and breathing rates (suggesting a relaxation response) and reduced anxiety. Surprisingly, most trials did not specify the music used other than to mention general styles, such as classical or easy listening. Researchers point to a need for additional studies involving greater numbers of patients and more specificity on types of music. Meanwhile, if a loved one is on a ventilator, Dr. Bradt recommended consulting with a music therapist if one is available... otherwise, select music that you know the patient loves. For relaxation purposes, choose slow music that has no sudden changes in tempo or dynamics. Avoid music that may evoke strong emotional reactions in the patient (such as memories of a loved one who passed away). If the patient is alert, frequently check in with him or her regarding the music selection and volume—for instance, ask for a thumbs-up or thumbs-down signal, Dr. Bradt said. Important: Medical personnel also should monitor the patient’s physiological responses to the music to make sure that all is well. Source: Joke Bradt, PhD, MT-BC, is a board-certified music therapist and an associate professor in the department of creative arts therapies at Drexel University in Philadelphia, and leader of an analysis of eight studies.
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| | | Walk Your Way to a Sharp Mind We all want to know what steps we can take to protect memory and thinking skills as we age. Now data from an ongoing study suggests that one effective strategy is, quite literally, to take steps—in other words, to walk. Background: Mild cognitive impairment refers to problems with thought processes, language, memory and judgment that are worse than typical age-related changes. More severe is Alzheimer’s disease, a progressive and irreversible disease that destroys memory and cognitive skills. About half of people diagnosed with mild cognitive impairment eventually develop Alzheimer’s. New research: Participants included 426 seniors. At the start of the study, 299 of the seniors were healthy, 83 had mild cognitive impairment and 44 had Alzheimer’s. Researchers monitored how far participants walked each week... did 3-D MRI scans to measure changes in brain volume (decreases indicate that brain cells have shrunk or died)... and analyzed results of exams that track cognitive decline over time. Findings after 10 years: To maintain brain volume and slow down cognitive decline, healthy seniors needed to walk an average of about six miles per week... those who had already had cognitive impairment needed to walk about five miles per week. Bottom line: Walking cannot cure Alzheimer’s disease, but it can improve the brain’s resistance to this devastating condition. So start taking those steps today! Source: Cyrus Raji, MD, PhD, is a physician-scientist at the University of Pittsburgh and coauthor of a study on walking and cognitive decline.
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 |  | |  Tamara Eberlein, the editor of HealthyWoman from Bottom Line, has been a health journalist for nearly three decades. An award-winning author or coauthor of four books, she is committed to helping other women in midlife and beyond live healthy, fulfilling lives. Her latest book is the updated, third edition of When You’re Expecting Twins, Triplets, or Quads (HarperCollins). She is also the "chief health adviser" to her husband of 26 years and three college-age children. | |  | | Bottom Line Publications | 281 Tresser Boulevard, 8th Floor | Stamford, CT 06901
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