Friday, August 08, 2014

Billion Second Challenge

“Billion Second Challenge” 
How would I live if I treated every second as precious? 

This is a post about time, not regenerative medicine.

A shiny crimson card was waiting in my snail mail pile when I returned from a special birthday vacation.  I actually had to Google “AARP” to confirm the acronym stood for “American Association of Retired Persons”.  Did this new piece of bloody colored plastic mean I am now “retired”?  Or, did it simply confirm I am officially old and beyond the highly desirable 18-49 demographic?

I quickly picked a number out of the air and said to myself, I’ll make it to 85 years old.  That would mean I have about 35 years left. That is 12,775 days, 306,600 hours, 18 million minutes or about 1.1 billion seconds.  It turns out the Social Security Actuarial Life Table pegs my remaining time at 29.45 more years or about 928 million seconds.  I, therefore, averaged the two numbers and came up with about one billion seconds left on the planet.

To sharpen my time focus, I have started measuring how I spend my seconds.  Each 1000 seconds equals about 17 minutes.  Each 10,000 seconds equals about 3 hours.

Simply measuring how you spend your seconds, much like calorie counting, will alter your behavior. 

How would I live if I treated every second as precious? 

Perhaps you have more or less seconds left in your life than me.  Carefully consider how you spend them.  

I call it the Billion Second Challenge

Post suggestions about how to best spend your next hundred, thousand, million or billion seconds and please share this post with your connections.

Thursday, August 07, 2014

Golf, Back Pain and Disc Surgery

Tiger Woods had to withdraw from a golf tournament last week and is struggling as he starts the PGA championship today.  Just now, Matt Kuchar, another elite professional golfer had to withdraw from that same major tournament.

Hopefully, he won't have to have micro disc surgery.  See video of that procedure below.

The surgery can be quite successful.  We still, however, need better ways to prevent spinal disc degeneration especially in elite golfers.


Wednesday, August 06, 2014

Biologic Orthopedic Society crosses over 2500 Member Mark

The Biologic Orthopedic Society (BOS) is a group of professionals dedicated to the research and development of biologic treatments for musculoskeletal injuries and disorders.  This group has now grown to over 2500 members worldwide.  Much of the group's focus has been on the use of platelet rich plasma, stem cells and bone marrow concentrate (BMC) for tendonitis, arthritis and degenerative spinal disc disease.

The growth of the Biologic Orthopedic Society (BOS) is a testimony to the rapidly rising interest in biologic solutions to difficult musculoskeletal problems.  Significant progress has been made in terms of better published data supporting the use of biologic therapies in the last 2-3 years.  Clearly, more information and research is still needed.  As the group continues to grown, more and more connections are being made.  Ideas and projects are advancing.  All of this should give hope to those patients in search of better treatments.  Many hard working professionals are striving to deliver better biologic options.  

I'll predict within another 5-10 years, we will be staggered by how much will be accomplished.

Thanks to my many colleagues and friends within the BOS for a fantastic journey so far.

If you are a professional working in the area, please consider joining the group.  

Sunday, August 03, 2014

Hamstring Injuries Treated with Platelet Rich Plasma Return to Play Faster than Rehab Alone

Hamstring muscle injuries are very common in a variety of sports including track, soccer, football and basketball.  A recently published study in the American Journal of Sports Medicine (AJSM) found athletes that were treated with platelet rich plasma (PRP) injections returned faster to their sport when compared to rehabilitation alone.  In the study, the PRP patients returned at an average of 26.7 days compared to 42.5 days in the control group (P = .02).  (reference) This greater than two week difference in time to return to play after this common injury is clinically and competitively important.

Another recently published in the New England Journal of Medicine (NEJM) found no difference between PRP injections (2 injections spaced about a week apart) and a control group.  Interestingly, both groups in this study returned to play at 42 days, very similar to the control group in the AJSM study.  (reference)

Why are these results conflicting?

One important difference between the two studies is the type of PRP used to treat the patients.  In the study that did show a difference, white blood cell enriched PRP (leukocyte enriched PRP) was used.  In the study that did not show a difference, white blood cell  poor PRP (leukocyte poor PRP) was used.  This is a clear example of why PRP formulation matters.

The data published in elite, peer reviewed journals suggests leukocyte enriched PRP helps return athletes more than two weeks faster than rehabilitation alone after an acute hamstring injury.  No difference in return to play can be expected if leukocyte poor PRP is used in this patient population.

As PRP and other cell therapies continue to evolve, it will become increasingly clear that formulations much match indication.  Patients, researchers, and clinicians need to realize not all PRP is the same.

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