My Cup Runneth Over

You will be reading this in December, but as I’m writing, Thanksgiving is just around the corner and I find myself so immensely grateful for where I am in my life – family and career – that I can literally feel the last half of the old Bible verse, Psalm 23:5 in every fiber of my being;  ”…. my cup runneth over.”  My life is overflowing not only because I am busy but with blessing.  Blessing in spite of or even because of adversity.  Adversity invites us to grow.  We however have to accept the challenge and then do the work. 

About this time last year I made an intentional shift to do exactly that.  I accepted a position that Dr. Lizbeth Roy, DO of StudioPRP had been offering me for a long time;  I had been afraid to take it.  I embraced more fully the medical school oath of Docere (Doctor as Teacher).  Only this time not in a doctor to patient role, but as a doctor to doctor role.  If you follow any of my work outside of the articles I write for Southeast Living Magazine, then you know that I have limited my practice to Regenerative Medicine.  While I’m still in clinic seeing patients three days a week, I spend a great deal of time as a guest lecturer for medical education groups and teaching hands-on courses to providers wanting to learn to use PRP (Platelet Rich Plasma) in orthopedic, aesthetic and sexual health & wellness applications.  Guess what?  I’m actually really (really) good at this.  Trust me, it has taken me a long time to be able to say that out loud, let alone write it.  The thing is, I never believed it when other experts would say it about me; I had to start saying it myself to literally create new neuro-pathways in my brain for how I self-identified. 

As I began to see myself as excellent in my trade and my skill set, I actually got even better!  More exciting than simply moving into a new job position or title, I re-awakened what I believe is probably my greatest skill – connecting.  When I took the Gallup Clifton Strength Finder test last spring, what they call “Woo” was in my top 5 strengths.  The basic characteristics of “Woo” are social intelligence, instinct, influence and integration.  I genuinely like to connect with people and I decided that instead of simply connecting with anyone and everyone, I was going to deliberately seek out people striving for excellence in specific areas and willing to push me to up-level in my family and professional life.  I started practicing the fine art of saying “no” to people and opportunities that did not share my code of ethics or commitment to growth.  I also found myself saying “yes” to some of the people who have been in my life for a long time, and I needed to more fully acknowledge how they were really winning at life and could challenge me to do the same.  Some of these friends and colleagues literally make it possible for me to be who I need and want to be.  My tribe is everything.  It’s growing and I’m constantly in awe at the value I get to bring and caliber of people I get to be with. I actually feel, not that I’m a completely different person, but that I am more fully aware of my deepest identity, the “me” that has always been there and I’m finally allowing myself the freedom to live into my potential.

So as you approach the end of the fall season – I urge you, just as leaves fall to the ground, let all that does not serve you being your highest self, do the same.  Death and decay are a vital part of the natural order and cycle of life.  This season of decomposition creates the rich compost that gives new and vibrant life in the spring.  Embrace this winter as a time of cultivation for what spring has to offer! For me, I’m already seeing glimpses of the growth I’ll need to prepare for; most of that involves my teaching of PRP.

Regenerative Medicine and use of Platelet Rich Plasma is one of the fastest growing medical industries.  It is also one of the most unregulated.  So I’m going to share just some of the basics with you so that you can be a discerning consumer if searching for these services.  Platelet Rich Plasma involves a simple blood draw which is then spun down in a sophisticated centrifuge at a specific rate and time in order to separate the red blood cells from the plasma.   Many people offering PRP stop after this first spin and simply use the plasma.  Please know that this is NOT true PRP.  It is a nice growth factor treatment, but in no way rises to meet the most accepted clinical and research based definition for PRP.  If you read the published scientific reviewed research articles on PRP you will find that PRP is supposed to contain a minimum of 1 million platelets per ml of plasma to be true PRP.  So just know that not everything that is called PRP is actually true PRP.  Many systems claim to be able to take a small blood draw to concentrate the platelets; again simple math shows this to not be possible.  It actually requires an easy but significant draw, processed in a double spin (the double spin is a critical step) to have enough platelets to concentrate into solution to get anywhere from 5x-7x baseline platelet counts.  The far majority of regenerative medicine research shows that this 5x-7x baseline has to be met to elicit the most profound regenerative effects.  Anything less, is like I mentioned before simply a growth factor treatment that in my opinion does very little for the cost of the treatment. Ironically, higher levels are not better!  The other thing I commonly see not meeting standard is the lack of activation or early activation of platelets.  Think of a platelet as a nice juicy grape with that skin holding in all the sweetness.  That grape needs to be burst to taste the juice and likewise the platelet has to be activated to release the growth factors and cytokines and other cell signaling molecules in order to work.  But if you activate too early then by the time you inject the PRP into the treatment area no more cell signaling happens or not enough to mount a robust response.  If you do not activate at all, then a simply hypodermic injection is not enough trauma for the body to self-activate the platelets.  PRP works because of a process called degranulation.  If that doesn’t happen, you do not get the regenerative effect intended.  This brings up another very important point that will feed the conversation into the topic of stem cells and biological allografts being used in the market.  This too is a service fraught with extremely poor quality control, mis-nomenclature and out right lies.  PRP works because of cell signaling.  Even stem cells and biological allografts work because of cell signaling.  Injecting or infusing even your own autologous fat or bone derived stem cells does not work the way most people are sold.  There is absolutely a place for them in Regenerative Medicine and they can have incredible benefit – just be aware that is certainly a “buyer-be-ware” market.  Honestly, I frequently meet and train practitioners who have been providing services they thought were genuine because they believed the sales rep who sold them their centrifuge and trained them in the process.  There was no mal-intention, simply lack of full education.  Dr. Lizbeth Roy, DO has used and compared nearly every program and device for PRP available on the market and a few years ago put out a great webinar explaining all of this in easy to understand but more complete detail.  You can watch it on the PRP Science you-tube channel.  It is called PRP 101 and can be found at: https://youtu.be/o2N9ZWJS-ko

There is so much more to effective PRP and I’d love to have you follow me on social media as I share more. A new website will be up at the beginning of the year too.  I’m excited to continue sharing and teaching practitioners to do this work well, and I also want to make sure my community of patients is just as well informed to choose regenerative medicine treatments that can actually deliver what they promise.