Saturday, April 30, 2011

Autologous Conditioned Plasma (ACP) Injection

Autologous Conditioned Plasma (ACP) Injections or also known as Platelet Rich Plasma (PRP) Therapy is a promising new treatment promoting natural healing.

Components of our blood
(picture courtesy of Mr.Google)
It has been used in numerous cases, mostly by athletes, to enable them to shorten their recovery time without ill effects and get back to their game.

ACP have been used for the treatment of difficult chronic Tendonitis around the hand and foot, muscle healing, knee Osteoarthritis and ligament tears, to name a few. These types of tissue have limited blood supply so they heal slowly. So by using ACP, it speeds up the recovery. This treatment concept is also used in the dental and also animal veterinary sector.

(picture courtesy of Mr.Google)
This treatment approach gives patients opportunities to heal without surgery and the right treatment for those who would want to avoid the knife.

What is ACP ?
ACP is the concentrated platelet rich plasma solution formulated by taking the patient's own blood and spinning it in a centrifuge, thus separating the blood components. Red blood cells, white blood cells and platelet rich plasma. The plasma is reinjected into the injured part. The plasma contains concentrated platelets that release certain growth factors that initiates and accelerates healing. Growth factors play a central role to stimulate local tissues to heal an injured area.

The components of our blood can be seen after the spinning process in the centrifugal machine.
(picture courtesy of Mr.Google)

The usage of the patients own blood makes this way of treatment safe as it eliminates any chance of rejection response and minimizes the probability of an infection.

A special syringe is used for this treatment. Its unique double syringe design allows for convenient and safe handling, as the whole preparation process takes place in a closed system.

The ACP Injection should be given under sterile condition, so an OT (Operating theater) would be best. The whole procedure takes up to about 45 minutes to withdraw, process, and reinject the blood back to the patient.

The process:
A small amount (@10ML) of blood is withdrawn from the patient himself.

The blood is then spinned in a centrifugal machine for 5 minutes. This separates the red and the white blood cells leaving a solution containing the concentrated plasma.

The special centrifugal machine used for ACP
(picture courtesy of Mr.Google)
The double syringe design
(picture courtesy of Mr.Google)
This separated plasma solution is then injected into the injured part of the patient.

The patient may be asked to come for a follow up or checkup a few days after the injection, to check the injured areas healing.

* Promotes natural healing
* It's safe and no ill effects
* Avoids operation and further complications of an operation
* Does not involve putting foreign chemicals in the body
* It offers a solution to accelerate the healing process and shorten healing time

The number of times one has to take this injection may vary upon the seriousness or severeness of ones injury. The doctor is best consulted for these inquiries.

Scientific proof has unequivocally demonstrated drastically improved bone and soft tissue healing using ACP injection therapy.

(Video from Mr.Google)

This treatment therapy is more common in Europe. In Malaysia, this treatment trend is something new. Its being used to facilitate the healing process in the orthopedic sector and some others. As for hospital that can't afford to buy the centrifugal machine, they have private health care companies provide the facility.

Consult your doctor. If you opt for ACP treatment, these two painful methods may be avoided.
(picture courtesy of Mr.Google)
Information and pictures I used, to refer in my post are not entirely mine. I googled Google for more details and shared some of them here. I only have the experience of going through this treatment, which I have already written about in my earlier post. Check it out HERE.

Mr.Google; and others recommended by Mr.Google. My credits to them all.

Monday, April 25, 2011

Learning To Walk Again

In case your wondering whats with my post title today. Well...
I mean it literally! ~ I am learning to walk again, step by step..

Okay, okay, maybe you should read up on this first ------->> Brief Flashback . It'll give you an idea of what i'm talking about.

So did you read it? Well thats just what happened. I wrote that letter to the News Straits Times a few weeks after I was discharged from the hospital.

Left: That's almost similar to my X-RAY result; Right: A clean fracture like I had
(picture courtesy of Mr.Google)
After taking the X-RAY and deciding not to do an operation, the orthopedic doctor had me wear a full cast (made of fiber glass) and send me home after 2 days at the hospital. For the 1st three months, I was in full cast and used my crutches to move around at home.

Long leg cast or full cast
(picture courtesy of Mr.Google)

My long leg cast
(picture courtesy of ME.. ;p)
And now after 6 months, the doctor had my cast removed and said I don't need it anymore. Yay!! It was such a relieve although I still have to use my crutches for support. I am very happy (did I mention VERY happy? just making sure, haha..).

You might be wondering why it took me 6 months before I could have my cast open, right? Well thats cause I didn't have any operations to put in a plate or to fix an aerial on my leg. Mine was a clean and closed fracture, so I just had a fiber-glass cast instead and waited for it to heal on its own. My bone did grow but at a very slow rate. So I had to go through a small (well that's how the doctor categorized it, small) procedure called Autologous Conditioned Plasma (ACP) injection to help speed up the recovery. It cost us RM 650 per injection, as it required a specially designed syringe to withdraw the blood and separate the plasma.

ACP injection procedure
(picture courtesy of Mr.Google)
I had to go for ACP injection once a week, for 3 weeks. It was painful but I managed to bare it as I thought 3 painful injections are way much better then having to undergo an operation. The injections had to be given in a sterile environment so they did it in the Operating Theater (OT).

It was a new and spooky experience for me but thank god its just for an injection and not an operation. Being wheeled into the OT in a wheelchair was really nerve wrecking especially the 1st time. It was damn freezing once inside the OT and i was practically shivering away as they had asked me to undress earlier and only wear a patients gown. But then the nurses and doctors inside there were used to it already.

Inside the OT, it was almost similar with what we see in movies.. operating table in the middle, big round lights above, screens here and there and nurses in aid to the doctors.

Inside the Operating Theater
(picture courtesy of Mr.Google)
For the 1st injection I was really really nervous, not knowing what to anticipate or how painful it would be. The doctor did explain the procedure to me earlier but still I couldn't help being nervous. I was not given any anesthetic or pain killer (it was not required for this procedure), so I was aware of whatever was going on around me.

The whole process usually took about 45 minutes to one hour. For the 2nd and 3rd injection I was not as nervous as I already knew the routine and was not scared anymore. My doctor was really cool and good to me all the time. He even talked and joked with me in the OT and he would tell me when he's about to poke me to withdraw blood or when he was going to inject me, so I'd be prepared. He would ask me to take in a deep breath and .. OUCH!.. he poked me already.
And it hurts.. 
It would continue to give a mild pounding pain and later some soreness for about 24 hours following the injection.

My leg with half cast
(picture courtesy of ME again.. ;p)
I didn't have to wear the full cast anymore after the injection procedure. They reduced it to a half cast (till below my knee) which was much more easier to move about with. 3 weeks after my last injection and we could see that the results were pretty encouraging. There were new bone growing at the fractured part. It was good news for me. At last all that waiting was starting to show some positive results.

If I had went through the operations it might have healed a little faster but the doctor advised me against it as those procedures have their own complications like infections and others. And I really really didn't want to go through any operations. I didn't want to have my leg cut open and sewn back together with a metal inside, holding my bone together. It'd be there in my leg for the rest of my lifetime unless I undergo yet another operation to remove the metal plate. Na'ah..

Thank god all went well and all is well now.

Stages of bone fracture healing
I am now in between stage 3 and 4 of healing. Bony callus have formed but they are not hard enough yet.
(picture courtesy Mr.Google)
What i'm very excited about is that, today, for the 1st time since I was injured, I walked up the stairs using both my legs with the support of one crutches on my right and holding the railing on the other side after sooooo long. Yay!! It did take me quite some time to reach upstairs but it was worthwhile. Hahaha...

For those who are experiencing anything similar to I'd say go for the ACP injection method. Talk to your orthopedic doctor if you can avoid going through operation to put in a plate or an aerial.

Well that's all for today.. toodles.. =)
Take care guys..

p/s: Fiber glass cast is lighter and more costly then the usual cast made of Plaster Of Paris (POP).

Credits to: Mr.Google and for the pictures. They helped me describe easier.

Monday, April 11, 2011

Caring Malaysians: Kindness helps ease pain

WHO says Malaysians are not caring? I wish to relate an incident where total strangers came to my aid and where hospital staff performed their duty efficiently.
I met with an accident on the evening of Oct 12 in Seksyen 17 of Shah Alam. I was riding pillion on a motorcycle.

Several passers-by rushed to our aid. My friend suffered bruises while I could not move my leg. These kind people moved me from the road to the pavement and called for an ambulance.

The ambulance arrived, and my friend and I were taken to Tengku Ampuan Rahimah Hospital in Klang. 
The doctors and hospital staff attended to us immediately. An X-ray was done and I was told that I had sustained a clean and closed fracture of the tibia and fibula on the right leg. I was warded in Ward 4B.

The specialist on rounds the next day advised a full cast, preferably a fibreglass cast. This was done.

The doctors and staff at Ward 4B took good care of me. When I complained of pain in the heel of the left leg, the doctors arranged to have a foot X-ray done.

I was discharged on Oct 14.

Although it was a painful experience, the doctors and staff made it very much less so by their kindness and good advice.

Just before being discharged, the physiotherapist came over and showed me how to use the crutches correctly. I was also shown the proper way to climb the stairs as I live in a double-storey house.

I would like to thank all the passers-by, of various ethnicity, who came to help my friend and I. I would also like to thank Dr Thirumal, Dr Gurjit Singh, Dr Ahmad Fahmi, Dr Prakash, Dr Siva, nurse Jivia, Puan Zaleha, several others whose names I can't recall, all staff on duty at the emergency ward on Oct 12, the doctors and staff at Ward 4B, the physiotherapist and the pharmacist who brought the medicine over to my bed before I was discharged.

I had heard stories about government hospitals being a bad experience, but my experience at this hospital has proved otherwise. And the accident has also shown me how kind Malaysians can be. Thank you, everyone.

Balakong, Selangor
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