Plasma Rich Platelet injections

After making my way back to Vail to see my knee surgeon Dr. Steadman and waiting the customary 1.5 hours in his jampacked Waiting Room, I was ushered into Exam Room 1 by Chris, the nicest physician's assistant ever. Chris remembered me from my knee surgery last year and so I was lulled into a false sense of security and comfortably awaiting Steady(which is what the doctor is called by all his pro athlete patients, so what the heck I call him Steady too). Steady's tanned and smiling face soon appeared followed by one of his Fellows. Having had an MRI earlier Steady was armed with my full report and I happily hopped up on the exam table so he could examine my knee. After much discussion, contemplation and pressing on parts of my knee that made me groan in pain, Steady informed me that the patella tendon was inflamed and required PRP therapy. Great, I thought, a little ice and stretching and I'll be good to go. "What is PRP?," I inquired. To which the response was long and involved so I'll abbreviate for you dear reader; Plasma Rich Platelet therapy is a procedure where by blood is drawn from the patient, then spun in a centrifuge to separate the plasma rich platelets, and this plasma rich reduction is then re-injected into the injury site. The injury site is essentially duped into believing it has sustained another massive trauma and the plasma rich concoction then attacks the re-injured site and repairs the damaged cells. It is, as you can well imagine, seriously painful but holds the promise of long term non-surgical benefits. It would take 3-4 hours. Not wanting Steady to think less of me, I swallowed my fear and mild horror, smiled and said "Looks like I need to catch a later flight". Steady beamed with pride, his sparkling blue eyes conveying his happiness. I confessed to Chris that there may not be room on the later flight but sadly after enlisting the help of a friend and Steady's assistant Mona, my transport home on the later flight was confirmed.
That's when I met Brent, the physician's assistant for Dr. Karli who would be administering the PRP. Brent explained the procedure to me again but with great enthusiasm. Clearly the prospect of drawing my blood and re-injecting it was a good thing to Brent who is padding his resume before heading to Med School in the Fall. Brent also explained that after the procedure my knee would swell and that I was not to try and reduce the inflammation, so no ice or ibuprofen, although he would give me pain killers as it would hurt a lot for a week to 10 days. Brent said this entirely too matter-of-factly for my liking. Apparently it has to be inflamed so that the PRP will then find the injury and repair it with the regeneration of healthy cells. Sounded like a nightmare but a necessary one if I'm to return to normal activity. Brent drew an awful lot of blood, then placed it in the centrifuge which spun and spun until out came my separated plasma, platelets and blood. The plasma was bright yellow and thick.

Dr. Karli entered the room looking friendly and not a little handsome in his surgery scrubs. He explained how I had the same injury he had suffered from and was optimistic about the procedure. Note to self: beware anytime something is referred to as a "procedure". Dr. Karli positioned my knee atop a pillow so that it was bent at a gentle 35 degree angle and began marking my knee with little black x's, 4 in total and then another 4 x's along my IT Band, at the time that seemed innocuous. He then asked Brent to hand him something which turned out to be an enormous needle and asked me if I was ready. "You bet," was the best I could muster as I rested my head back between my cradled arms so I could dig my finger nails into my scalp without drawing attention. I simultaneously suck in my gut while reclining to appear as thin as possible for Dr. Karli as he proceeded. Brent stood by with a can of topical freezing agent which he sprayed on Dr. Karli's command and it was indeed freezing. Brent continued to spray and then I began to feel the bright pain of the needles as Dr. Karli liberally injected me with what was an internal freezing agent. Yes this was still just the warm up act. After my knee was frozen solid as a butterball turkey (or so I thought). WARNING: IF YOU ARE SQUEAMISH PLEASE STOP READING HERE AND SKIP DOWN TO THE NEXT PARAGRAPH, DAVID LAWEE THIS MEANS YOU. Dr. Karli then injected 4 needles with small catheters attached into each of the 4 x-marks, this was somewhere between very painful and excruciating, but I just dug my nails into my scalp and kept breathing. Once those were inserted, Brent handed Dr. Karli a long syringe filled with my Plasma Rich Platelets and Dr. Karli warned me at this point that the sensation I was about to experience would be like nothing I had felt before; this turned out to be a massive understatement. I craned my neck forward so that I could watch what was going on and saw Dr. Karli as he began to empty the PRP-filled syringe into the first catheter. I could feel immense pressure building in my knee (not a good pressure like a back rub) more like a sharp implement trying to pierce your muscle tissue, and then some of the PRP began to spout out of one of the other catheters. Brent wiped this up and both he and Dr. Karli assured me that this happens all the time. I kept digging my nails ever deeper into my scalp out of Dr. Karli's sight and upon finishing with the first catheter, Dr. Karli said to Brent, "Yup, she's tough." I was obviously overjoyed and filled with immense pride. It was at this point that Dr. Karli told me that he had done this exact procedure to himself just 12 months ago. I was duly impressed and countered with the tale of how my aesthetician does her own bikini waxing. This made both Brent and Karli take pause and concur that women were tougher and that no man would ever be able to do his own "manscaping". I'm sure he is right. 1 down 4 to go and that was just the patella tendon, we also had the 4 in the IT Band as well.
I hunkered down and we got through the rest of the procedure with only one audible articulation of pain that I just could not suppress. Dr. Karli assured me that I was tougher than most of the men he treated, especially the football players who are "babies when they see a needle." Brent concurred and we all had a controlled chuckle as the catheters were still inserted into my leg. Finally it was over, all the Plasma Rich Platelets had been re-injected into my tendon and IT Band and I was bandaged up. Dr. Karli wrote me a prescription for Vicadin which he assured me I would need over the next 24 hours. I thanked him warmly but he stopped me saying, "Thank me next time I see you when you are better." What a guy.
Brent helped me hobble down to the lobby where my driver was awaiting to take me back to Denver to catch my flight home. I shook Brent's hand and wished him luck with Med School, "you take care now" he said, and as I drove away I smiled and looked down at the knee which had already swollen to the size of a small grapefruit. "It's working," I thought, "come on platelets do your thing," and on we drove.