How We Can Change our Country's 'Sick Care' System

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Interviewer: Let's talk about another service that you offer here, prolotherapy [SP], can you explain exactly what that is? 

Dr. Joel Baumgartner: Yeah. Prolotherapy is kind of the God Father of regenerative medicine.

Interviewer: Okay. 

Dr. Joel Baumgartner: Prolotherapy, you could trace it back. There's studies back in the Lansing General Medicine back in the 1960's on chronic low back pain. Prolotherapy kind of started because people would have like a shoulder dislocation and there's nothing you can do. So, they'd go in there and they start injecting things around that shoulder trying to get that shoulder to stabilize. Well, back in the 60's and 70's people are crying of low back pain. They go in and inject different things into the ligaments of the low back to try to get the body to repair those ligaments. 

What they found is the most basic form of prolotherapy is injecting a concentrated form of dextrose into a ligament, tendon or joint. Now, dextrose is just a sugar molecule, so it's very safe. It's less side effects than a Jolly Rancher, but what it does is the dextrose stimulates and actually is an irritant. So, when if I inject dextrose into one of my ligaments, it causes that to be very irritated. It's actually an irritating solution. The body sense that. Oh, there's an injury going on there. I've got to go back and repair it.  

The dextrose kind of acts as a kind of pseudo injury. It makes the body think something's going on. The body then sends healing cells to that area to start repairing it. What happened after we started doing prolotherapy, we'd biopsy people's tendons and ligaments, look inside their joint and we found that after doing prolotherapy there's higher rates of growth factors in that area. There's higher amounts of stem cells concentrated in the area of the prolotherapy. 

We found that all the prolotherapy is doing is stimulating the body's own healing response to go back and repair that area. So, prolotherapy was the trampoline for higher injection like a PRP which is platelet rich plasma and then the newest one now is the stem cell injections.

Interviewer: Okay. So, who would be someone that should look at prolotherapy? What kind of injuries or conditions are we talking about?

Dr. Joel Baumgartner: So, prolotherapy is good at stimulating repair of ligaments, tendons and cartilage. So, for example, somebody has knee arthritis where they're losing the cartilage in that knee and those tendons and ligaments are getting loose and allowing all that grinding to take place, they'd be a great candidate. Same way with chronic low back pain where they've got discs that are bulging because nothing's stable back there. Things are shifting. 

The shifting's causing grinding of the joints in the low back which is causing arthritis. That arthritis is then putting pressure on those nerves causing a pinching to the nerves. They're a great candidate because prolotherapy can go back and stabilize those structures that are causing things to break down. When you stabilize structures, it reverses that damage and makes it last longer. 

Interviewer: So, you mentioned PRP as another example. What is that exactly? What's that stand for again?

Dr. Joel Baumgartner: PRP stands for platelet rich plasma.

Interviewer: Okay. 

Dr. Joel Baumgartner: It's a little bit of a higher end, maybe a little bit sexier version of prolotherapy. With PRP, we actually will draw your blood and we have found through science that in the blood are circulating things like platelets and growth factors and stem cells that are circulating in our blood. So, we do is we draw the blood. We go to our lab and we separate out of the blood all the platelets, all the things that help the body repair. We take out all the red cells and the other things that don't help the body repair. 

We concentrate that down then I would inject that little slur of healing cells back into my hip if I have hip arthritis, into my knee if I have knee arthritis, into my rotator cuff tear if I have a rotator cuff arthritis. We use things like this ultrasound machine right here to guide those injections down to those tears or deficits would fill in the gap of those healing cells and just basically put the healing putty that heals that body back together in that area. 

Interviewer: So, you're using your own body's repair mechanism?

Dr. Joel Baumgartner: Yes.

Interviewer: Okay. 

Dr. Joel Baumgartner: Yes. 

Interviewer: So, let me play devil's advocate a little bit. Why isn't the body taking care of it on its own? Why do you have to intervene then to do that?

Dr. Joel Baumgartner: Yeah. So, the question is why do the arthritis in the first place, why my rotator cuff tear in the first place. There are a few different reasons. One thing for example, rotator cuff is you know, I fell with my outstretched hands and boom I ripped my rotator cuff. Unfortunately, that super (?) tendon as we age has a pretty poor blood supply and the only way that things can heal is by blood getting delivered to that area sending nutrients, sending healing cells there to heal. 

Usually when you injure yourself, your body is going to go back and try to repair that. So, when I ripped my rotator cuff, it bleeds a little bit. Blood goes there and it may repair at 30% or so. 

Interviewer: Mm-hmm.

Dr. Joel Baumgartner: Same thing. I sprained my knee. Oh, man I just sprained that thing. It's really loose. It's law. It hurts and I (?) for about three or four weeks and it goes back and tries to repair, but might only repair at 50% if it's as strong as it was before.

Interviewer: Mm-hmm.

Dr. Joel Baumgartner: The problem is now I'm left with a knee that it's been vulnerable, it's been injured. I tried to heal, but didn't heal at 100%. So, that's where the prolotherapy, the PRP or the stem cells helps because we can go back in, (?) micro injury that place, get the body to go back and repair the rest of the 50%.

Dr. Jamie Wright discusses the problems with the country's health care system. He discusses why we are in the trouble we're in and how it might be turned around. He also discusses the patient's role in the health care system and how that, too, can be changed.

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