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This is an email journal of K.H., 68 Y/O

Initial Intake: 12/17/13

Karen is a very pleasant 68-year-old female who is here today accompanied by her husband, Bill, for evaluation of her chronic right knee pain.
She reports that she has had “flareups” in the past year. Each flareup last about 7 days and includes significant increase in pain and swelling and give way. She uses a walker during these episodes. She reports that she has had episodes of buckling and falling to the ground due to the pain.

She reports that she has increased problems with sloped or uneven walkway’s as well as trouble going downstairs. She notices that her thigh muscles have been getting weaker and that her knee seems to be chronically swollen. She ices regularly which does help. She denies any locking.
she presents to clinic today with an MRI report (no actual images available today) indicating:

Maceration of the lateral meniscus with lateral displacement. Truncation of the medial meniscus with possible mucoid degeneration. Strain of the lateral collateral ligament. Subarticular edema in the lateral femoral condyle and medial femoral condyle with osteophytosis laterally. Chondrolysis of the lateral compartment. Mild chondral lytic changes in the medial compartment. Chondromalacia patella with irregularity of the hyaline articular cartilage of the lateral facet:

Conclusion: Abnormal menisci with severe osteoarthritic change of the lateral compartment and chondromalacia patella.
The patient reports a history of DVTs and has been found to have a factor V Leiden deficiency and a lupus anticoagulation issue. She is on Coumadin and keeps her INR at about 2.4. We did discuss the possibility of needing to discontinue Coumadin for 4-5 days if we proceed with a stem cell procedure.

Treatment:

1/20/14 – Pre-Injection Prolo Therapy

1/21/14 – SD Procedure

1/23/14 – SCP/PL Post Injection

 

 Updates:

Dear Dr. Cohen:  Here is an update to my Jan 21, 2014 stem cell procedure

Feb 10, 2014

#1  No sensations behind my knee cap

#2  Fewer sensations on right side of knee, very faintly

#3  Went grocery shopping for 1 hour, my shin started to ache (1-10) =2. I quit, went home, and used the thermo-pad.  The discomfort went away and NEVER returned.

#4  When walking down the steep ramp at the office, I lost my grip on the walker and put full weight on my right knee.  My knee cap immediately hurt=3. The pain lasted for the 4 remaining steps with the walker down the ramp.  Then on the flat ground, the pain went AWAY FOR GOOD.

 

Feb 18, 2014

#1  It has been 4 weeks today since my procedure.  When I got into bed tonight my right leg FELT whole, solid, and strong just like when I was young. I noticed that my right leg moved just like my left one.  It felt like my right leg was ONE COMPLETE UNIT.  It was NOT flopping apart anymore with 2 sections (like a puppet) going different directions with pain.  It is so great NOT to feel BROKEN anymore!

#2  I’m driving 15 miles to my other office and back with no problems.

#3  I can go up on my tippy-toes (to reach something up high) and my knee does NOT hurt.

 

 Mar 1, 2014

#1  At our home, I walked down the steep 12’ ramp outside our door-just to see if I could.  NO walker, just my brace = NO PAIN!!!

I was so HAPPY!!!  I’m not really exercising yet.  I will do that after my knee heals.  I am loosing some muscle tone, but I can regain that again with some work.

Dr. Cohen, I feel so THANKFUL to you and the entire staff at Health Link Medical Center.

Karen Hay

 

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