A firsthand experience with stem cell treatment in pitching arm
The Bartolo Colon story has intrigued me since it first broke in May. Colon is a former AL Cy Young winner whose career seemed to be lost but who is now pitching effectively again for the Yankees at age 38. I did more than raise an eyebrow when I heard that his incredible comeback was aided by a relatively unknown stem cell procedure. As an injured pitcher who is also 38, I had to know more. It didn't take long for me to find Colon's doctor, Joseph Purita of The Institute of Regenerative and Molecular Orthopedics in Florida.
I spoke on the phone with Dr. Purita's medical assistant, Jeremy Carreno, and he walked me through the procedure, the science and the benefits. Carreno asked me to send my medical records, which included radiology reports from 2009 and 2011 MRIs on my left shoulder. I knew I had a rotator cuff tear and also one in my labrum. I pitched with the tears in 2010, eight months after I originally suffered the injury, but it wasn't feeling right this year.
This wasn't a quality-of-life issue for me; my arm was fully functional and feeling pretty good. My injury was manageable. I could play catch with my son and throw batting practice. I just couldn't crank it up in the low 90s anymore, and if a minor medical procedure could help me do that again I wanted to give it a shot.
Dr. Purita reviewed my records and said I was a good candidate for the procedure. He said my shoulder wasn't nearly as damaged as Colon's. My next decision was weighing the cost versus the reality of me ever pitching again professionally. The usual cost is $4,800 for everything. That includes drawing stem cells from my fat and bone marrow and re-injecting them into my shoulder plus 2-3 rounds of platelet rich plasma (PRP). The entire process would take 9-12 weeks, depending on how much time I took between PRP sessions; a minimum of four weeks is recommended each time.
That price was better than the $7,500 I was quoted from a different doctor last year. His process was somewhat similar to what Dr. Purita does but instead of immediately injecting me with my own bone marrow and fat stem cells on the same day, the other doctor harvests them for approximately a month first. Manipulation of stem cells is frowned upon by the FDA and considered much more risky. Dr. Purita believes he has the more effective, safer way of executing stem cell and PRP therapy.
The price was justifiable but Dr. Purita gave me an even better deal knowing that treating professional athletes was good exposure for his business. I made my appointment for mid-July, booked my flight and was soon in Dr. Purita's office in Boca Raton, Fla.
Dr. Purita's office is like any other doctor's office you'd expect to see in South Florida; I was the youngest person in the waiting room by 40 years. After my initial consultation with Dr. Purita I was brought down to the third floor, where the 4-5 hour process began.
The first step was to draw the fat. Dr. Purita was concerned that I didn't have enough, but then he grabbed my love handles and said, "Oh, here we go." I lay on my left side while the fat was extracted from my waist, 5-6cc. It was relatively painless. An anesthetic was administered and I only felt an occasional slight prick or burn.
Dr. Purita left after the fat was drawn. I waited about 20-30 minutes in a waiting area and they went back to start the bone marrow extraction process.
This is slightly more intimidating but is not what you think. In this process, a hole is not drilled into the bone but rather a soft spot is found and bone marrow is drawn with a needle. After anesthesia, Dr. Purita put a sizable needle in me and then told me I'd feel some tapping. He literally used a small hammer to tap into the left side of my lower back. There was practically no discomfort at all.
During my phone consultation the topic of HGH had come up, and it came up again when I arrived at Dr. Purita's office (I didn't initiate either conversation). It was made clear to me that while they usually administer a small dosage of HGH in the procedure, they do not do so when treating athletes.
I prodded Dr. Purita just to try to learn more about the advantages of mixing HGH with stem cells and PRP. He told me the IGF-1 in synthetic HGH helps stimulate the stem cells and helps the cells to do their job better. The amounts used are so small that the suggestion that HGH is performance-enhancing in this instance is absurd.
Dr. Purita actually brought up former big leaguer Andy Pettitte, who admitted using HGH in 2002 to help recover from an elbow injury. He said in a case like Pettitte's, HGH therapy made perfect sense. There is no performance-enhancing involved, just an aid in injury recovery.
I found it interesting though that he said to some degree PRP therapy does something very similar to HGH. PRP is a process that essentially separates your blood, leaving part of it extremely strong. This stronger, platelet-rich plasma contains your own IGF-1 and helps heal an injury, just like HGH. It's all a very fascinating and natural use of your body to heal your body.
The World Anti-Doping Agency was skeptical at first, but has since stated that PRP treatment is not performance-enhancing as long as it is not administered with HGH or IGF-1 injections. As of Jan. 1 the agency has cleared PRP.
Once all my liquids were extracted, it was time to spin them. At 2,000 RPMs, my blood, fat and bone marrow were placed in a centrifuge for 13 minutes. This was the process that isolated the platelets.
After he took the containers out, Jeremy examined them and said, "Wow!" He told me I had a lot of usable stem cells. He said on average most people produce about 60 percent of what I produced. He said genetics and healthy living contributed to this.
We were getting closer to the final injections, but the second-to-last step was loading the bone marrow, blood and fat into syringes and putting them under an LED light. This light is apparently the latest and greatest thing in stem cell therapy.
The way it was described to me, this LED light kick-starts the cells. Each syringe was under the light for 20 minutes. Once those sleepy cells were awakened they were ready to be injected into my shoulder and become tiny miracle workers.
Because I am a producer of strong bone marrow and stem cells, there was a lot of liquid in each of the syringes. This was the most uncomfortable part of the day. Dr. Purita used a low radiation X-ray machine while injecting me. This machine could be moved around as he worked, and the images were in real time on two monitors above me. It helped him to find the most effective location for me to be injected. The injections came in my labrum first and rotator cuff second. More pinches and pricks, slightly unnerving but very tolerable.
The tightness and soreness in my shoulder was almost immediate. It was reminiscent of the PRP I had a year and a half ago but not nearly as bad. Dr. Purita believes he has the most advanced PRP system in the United States.
My arm was in pain the rest of the day and the flight home was pretty uncomfortable. The PRP intentionally inflames your muscles and tendons, and because your arm is inflamed you can't take any anti-inflammatory medicines for 2-3 days. As a pitcher, you know your body well and a handful of Advil would have hit the spot after the procedure, but also would have defeated the purpose.
I had been training and strengthening my shoulder for over a month before the treatment. That program will have to slow down a little because of the soreness, but to maximize the effects of this procedure I have to keep exercising. I'm hoping to be back in full training mode in a few days.
By all accounts I've read, Colon really dedicated himself during the time he had the procedure and that was just as essential to his successful comeback as was the therapy itself. Dr. Purita said Colon was pitching six weeks after the procedure.
I was given a host of natural supplements to take over the next couple months that will also help the stem cells do their work: Shark liver oil, L-Arginine, Melatonin and a product called Stem XCell. Dr. Purita ran these by the Major League Baseball Players' Association to make sure they were OK to take.
Certainly I hope this procedure gives me the results I'm looking for and a chance to do what I love again. But bigger than that is the future of stem cells in sports medicine. I'm fascinated when I think about what's going on in my shoulder right now.
I asked Jeremy if he thought this therapy could be used proactively. After a few years of professional baseball, all pitchers have tears in their arm to some degree. When I had my first MRI, Dr. James Andrews told me I had a rotator cuff and a labrum tear, but that the labrum tear had been there for years. I was amazed by this; I'd been pitching full speed for years with a torn labrum.
I wondered if after a long baseball season, stem cell and PRP therapies could be given to seemingly healthy pitchers to strengthen weakened and slightly torn ligaments and tendons. My thought was that they would decrease the chances of a pitcher getting seriously hurt. Jeremy said, "You know, that's a pretty good idea."
We'll see. It'll be pretty difficult to convince a healthy pitcher to intentionally inflame his arm and make it hurt temporarily because he'll be better off in the long term. In one form or another, though, you have to believe stem cell and PRP therapy is about to go mainstream in sports. It will take some more research and open-mindedness on the part of those who make decisions, most notably league commissioners and team doctors. It will also take time, but progress always does.