Platelet-Rich Plasma Centrifugation Changes Leukocyte RatiosTheodore E. Harrison, Jannice Bowler, Todd N. Levins, K. Dean Reeves, An-Lin Cheng
Published: April 13, 2021 (see history)
In this study, we looked at what happens to the white blood cells during centrifugation. In our first study we observed that there seemed to be a swing from the "heavier" denser white blood cells to the "lighter" white blood cells. While we don't know what effect this has for your PRP results, we do know that some of these "lighter" cells act as scavengers cleaning up debris and removing the more inflammatory white cells, as well as stimulating the "rest and repair" aspect of the immune system. This may explain some of the healing mechanisms that happen after your initial PRP inflammation has settled down.
Prolotherapy is such a wonderful treatment. It can make a big difference to pain reduction and to correcting instability in the body. It is a privilege to be on the teaching team heading to Calgary in September, Covid-precautions permitting, to train 20 physicians from across Canada. We hope this will lead to easier access to prolotherapy for more people, as more physicians become proficient in the treatment :-)
Toronto and the CAOM
I have recently attended the annual Canadian Association of Orthopaedic Medicine conference, this year held in the big TO. As usual there were some excellent presentations and workshops, and I left feeling inspired and privileged to be working in musculoskeletal pain management. There was a lot of focus on nutrition: so much of pain can be attributed to the foods we eat! Also there was an excellent talk on genetic testing - knowing one's genome can help tailor treatment very specifically and even prevent certain problems/diseases from occurring. I presented a workshop on the hydrodissection of peripheral nerves using 5% dextrose under ultrasound guidance, along with a colleague, Dr Jag Gupta. This was well-attended, showing the interest in treating neuropathic pain without using drugs which have many side effects (aka brain fog). Dr Gordon Ko organised a terrific conference and I hope to incorporate new pearls of wisdom into my practice!
Back Pain and Exercise
University of Alberta Pain Certification
David and I have enrolled in a recent pain management certificate program at the University of Alberta. We never stop learning! Things have certainly changed since we were undergraduates. Over the next couple of years we'll be participating "virtually", attending "e-classes" and online lectures, submitting assignments electronically, searching virtual libraries and accessing a wealth of material, adding citations with a computer-generated program that automates the process so quickly, and best of all, able to enjoy Victoria instead of the frozen north!
Here are the doctors, nurses and volunteers who headed down to inject prolotherapy in Honduras this year. It was my third opportunity to work in Honduras, where we helped many hurting people at clinics in 3 small towns there. It is such a privilege to do this, teaching, learning and helping. My lecture there this year was on wrist prolotherapy - we take it in turns to present topics. The Hackett Hemwall Patterson Foundation is such an excellent teaching organization based in Wisconsin, where we meet up with good friends that we have made from different countries. In addition the foundation also sends down an Ear, Nose and Throat team as well as a Varicose Vein and Ulcer team. What a difference they make!
This is an important topic of interest to all physicians: that we should strive towards evidence-based medicine whenever possible. For this reason we have reorganized our website with a page dedicated solely to worthy studies, rather than include them in the links page. We encourage you to visit periodically as we add new studies when they become available.
The CAOM holds annual conferences in Regenerative Medicine and this year we met in Vancouver. It is always stimulating to listen to excellent speakers in the field, meet old colleagues and new, and exchange information that makes all of us better practitioners. This year we heard an excellent talk on nutrition and its importance by Dr Aileen Burford-Mason - this will have its own blog entry. In addition we had workshops on prolotherapy, platelet-rich plasma and ultrasound-guided techniques. Erik Ouellette, well-respected prolotherapist from Ontario gave a great lecture on injecting the shoulder, and followed up by doing just that. Physicians presented new research studies, some so new they haven't been published quite yet, and our North Vancouver colleague Dr Helene Bertrand discussed her positive shoulder prolotherapy study which has been accepted for publication. Kelowna physician Dr Francois Louw piqued our interest with favourable early trends in his TMJ (jaw) pain study. We came away tired but grateful to belong to such a good organization.
Neurokinetic Therapy certified
In April's blog I described Neurokinetic Therapy - a system of muscle testing and correcting imbalances. David and I are now officially level one certified in this technique and you will notice us incorporating NKT as a helpful method of honing in on the cause of pain. Always good to have an exam over!
Ultrasound training: Toronto
Jannice is a family physician with an interest in the treatment of pain. Anything to help the process is added to this blog.