Stem Cells in Mexico

I traveled to Mexico in December 2023 for stem cell treatment for torn labrum in both hips and for herniated disk and facet disease in my lower lumbar. This is a journal of my experience.

My hope is that this information will help the next patient with their decision-making process. I’m no reporter or scientist. My interpretation of facts, especially science, could be inaccurate so please do your own research.

History

I’m an athlete. I’ve loved running since elementary school. I also played softball, volleyball and soccer in high school and continued with softball and volleyball into my adult years. I lifted weights and did cardio regularly for most of my life. Now in my 40s, I’m fairly fit and healthy. I ran 3-6 miles regularly until about 5 years ago when my lower back began to flare up after distance runs.

I was a regular participant at Orangetheory Fitness from 2020 until January 2023 when I realized I had gained hip injuries. This became clear when I couldn’t get out of bed one morning following class. My hip pain was so severe I couldn’t walk until the inflammation subsided days later. I suspect I was at higher risk of a tear due to my years of running but I also believe the intense rowing in the Orangetheory class and the lack of proper warm up and coaching was a significant contributor. If you Google ‘hip pain rower’ you’ll find tons of videos providing tips that I didn’t receive in class. Here’s a link to one of them.

Lesson Learned: When rowing, don’t use the foot straps to pull forward.

I have gradually lost access to the activities that I love because of pain. Since January 2023 I’ve relied on max 20-minute walks and physical therapy exercises for my hips and back. I’ve minimized physical impact, in an effort to manage inflammation, until I can find a cure for my root cause issues.

Lower Lumbar

My lower back started hurting with my first pregnancy 18 years ago. (!!!) I hurt so bad during my second and third trimesters that I couldn’t sit upright in most chairs. I’d lay face down in our condo pool, on a blow-up pool floaty, to remove the strain on my spine. This alleviated the pain at least temporarily. After giving birth, the pain decreased from a 10 to a 5 or 6 but it never went away. It stayed at that level until my second pregnancy when it jacked back up to a 10.

Over the years I saw an orthopedist who took an x-ray of my spine and referred me for MRI. I’m claustrophobic so I requested to get an Open MRI. Years later, I later learned that Open MRI can be as much as 5x lower resolution than standard MRI. Neither the x-ray nor the Open MRI produced a diagnosis.

Lesson learned: Use the highest resolution MRI regardless of fear of small spaces.

Without a root cause diagnosis, I was referred for pain management. I refuse to take any pain medication stronger than NSAIDs so I’ve been using chiropractic, massage, yoga, at-home stretching & popping, acupuncture, multiple stints of physical therapy with electro stimulation and dry needling all this time to manage the pain. That still only kept it at bay as I’d wake up everyday in pain no matter what therapy I had done the day before. I needed a more permanent solution for my back pain.

In August 2023 I began yet another stint of physical therapy. Despite being referred to PT for my hips, this particular therapist zeroed in on my back as the root cause of my overall inflammation. She prescribed traction and dry needling therapy, which both helped some. She also urged me to go back to my orthopedist to request an MRI of my lower lumbar. The second MRI of my lower lumbar in September 2023, this time in a higher resolution MRI tube, produced a diagnosis of herniated disk, facet disease and retrolisthesis. Have I had this condition since my pregnancy in 2006?

Finally with a diagnosis of root cause for my back pain, I began non-surgical interventional therapy. In October 2023 I received an injection of “2 mL iohexoL 240 mg iodine/mL; 10 mg dexAMETHasone sodium phos (PF) 10 mg/mL” with “needle position…anteroposterior, lateral and ipsilateral oblique.” The shot provided a couple weeks of relief. When the pain came back I received a second injection of the same dose. This time with “Interlaminar” approach, meaning the first shots came at my spine from the side and the second shot was straight on. The result was the same. Temporary relief, but by December 1 the pain had come back.

I consulted with a spine surgeon who told me I am not in need of surgery at this time. The surgery that I’d need (if it ever comes to that) would be fusion. He also told me that the surgery results in secondary issues since your fused spine is no longer able to move at all. Researching that surgery has me wanting to avoid it at all costs.

Hips

My first visit to an orthopedist for my hips was February 2023. I saw this doctor multiple times between February and May that year. An x-ray rendered no diagnosis. He ordered an MRI for my left hip only. I have no idea why he only ordered an MRI for one hip because I told him I had pain in both hips. Further, he didn’t order an MRI with contrast, which I later learned is required to diagnose torn labrum. Further, I hadn’t yet learned that open MRIs delivery significantly lower resolution than tube MRIs so I got a lower resolution image. Finally, he didn’t order a lower lumbar MRI despite my telling him of my 18-year saga with lower back pain.

The outcome of that first lower resolution MRI in April 2023, for my left hip only, was “suspicious for tear of the left anterior superior labrum”. What does “suspicious for” mean and why don’t I have answers for the right hip? How does my back factor into my pain?

In May 2023, that same doctor injected both of my hips with “1cc Ropivacaine/1cc Bicarbonate/2ccDexamethasone was given under sterile technique using ultrasound guidance and a 22g x 3.5 needle.” He chose this treatment despite having low confidence in the “suspicious for” diagnosis of my left hip and no visibility to the root cause of my pain in my right hip. The shot did nothing to alleviate my pain.

Lesson learned: Specifically ask and advocate for an MRI for all areas of concern.

I left that doctor to get a second opinion in July 2023. The second orthopedist ordered an MRI of both hips with contrast (“MRI w arthrogram”). He also told me that open MRI is as much as 5x lower resolution than a regular tube MRI so I sucked it up and got a regular MRI. The outcome of my second MRI in August 2023 was “Anterior superior labrum tear” and “Degenerative appearance of the ligamentum teres” in the left hip. For the right hip I got diagnosis of “Anterior superior labrum tear.” It made sense to me that I have more than one thing going on in my left hip because it hurts twice as much as my right.

We discussed my options for treatment which included injections, physical therapy and microscopic surgery. Basically the same treatment offered by the first doctor despite having better visibility to root cause.

Both doctors dissuaded me from surgery. Labrum repair surgery involves drilling holes in your hip bones to anchor the stitches of your remaining labrum tissue to your skeleton. At my age I need all the bone strength I can get. Drilling holes into my bones is not something I’m going to agree to. Plus, at this point I’ve read too many stories of re-injuries and failed surgeries to ever consider that approach. Here’s one of many available videos which describes the hip labrum repair surgery. You can read about surgery results in many places but here’s one of the sources I continue to monitor on Facebook for Hip Labral Tear Recovery /Private Group.

Another option for surgery is total hip replacement. I'd be more likely to accept this surgery option of the two. However, given the uncertain lifetime of hip implants, I want to delay this option as long as possible. Plus, I'd need to do more research to understand if it will fully address my specific symptoms.

Stem Cells

I decided I needed to find a better solution which didn’t involve cutting into me, drilling holes in my bones or fusing my spine together. Through many hours of online research, I identified Stem Cells as a viable path. I learned that, for more than 10 years, research is being done outside of the US to use umbilical cord stem cells from live healthy births for orthopedic and other therapies. There is too much going on in this area to document here so I’ll stick with the path that I eventually chose in Central America.

Dr. Neil Riordan founded the Stem Cell Institute back in 2006. This treatment center and lab, located in Panama, has performed more than 25,000 procedures including treatment of many famous people. In addition, Dr Adeel Khan works with University of Toronto and other scientists to push the science forward. He is currently the most prominent name in regenerative therapy as far as I can tell. He regularly speaks on podcasts and posts to Instagram. He recently opened Eterna Health, with an office in Los Cabos, Mexico, but he also travels the world to treat many well-known individuals.

The goal of injecting Mesenchymal Stem Cells "MSC" is to stimulate our own bodies to regenerate tissue. These cells, donated from healthy births, act as supporting cells that promote the expansion of other stem cell types. The FDA in the States allows MSC to be sold and injected to patients. However, it does not allow for the expansion of those cells. The FDA views expansion of Stem Cells to be creation of a drug and thus not approved for therapy in the US. As I understand it, we want the cells to be expanded because this process increases the likelihood of success by increasing potency of the stem cells prior to injection.

There are many healthcare providers in the States who will draw and then inject our own bone marrow aspirate concentrate "BMAC" stem cells back into our bodies. This approach is well meaning as some say fluid containing cells taken from bone marrow is the preferred source of stem cells for orthopedic injuries because of improved focus of the stem cells toward skeletal healing. However, using old cells from an old (>20 year old) person also has drawbacks and leads to questions of potency and effectiveness.

With my basic understanding, I chose to go with expanded MSC and focused on Central America, specifically Dr Riordan and Dr Khan. I also included a couple of clinics in the US for comparison.

Stem Cell Consultations

I scheduled five free consultations with doctors in Panama, Mexico and the United States. The only consultation I had to pay for was with Dr Khan. I spoke with representatives of Stem Cell Institute (Panama City, Panama), Regenamex (Puerto Vallarta, Jalisco, Mexico), PRMedica (San Jose del Cabo, Los Cabos, Mexico), Eterna Health (San Jose del Cabo, Los Cabos, Mexico), Riordan Medical Institute (Southlake, TX), and Innate Healthcare Institute (Scottsdale, AZ). They each accessed my x-ray and MRI images via Dropbox.

I documented all of the conversations. I was surprised at how different their therapy protocols were. Without a standard, these doctors are left to experiment and tweak their individual protocols based on their own individual studies and whatever feedback loops they choose to rely on. Some partner with research labs. Some were merely a customer of those labs and nothing more. Guidance from online sources directs us to only trust those providers who partner with a research lab.

I also collected personal stories of experience, research and related news from members of Facebook groups like Stem Cell Healing, Recovery & Regeneration, Stem Cell Institute Panama treatment progress and experiences, Stem Cell, among others. I researched the labs providing the cells to these service providers thinking quality, potency and reliability of the cells are really the key to a successful outcome.

My trust ultimately relied on collecting numerous data points and triangulating what was likely to be the most successful approach for me.

Stem Cell Institute (PAN) said they would inject MSC to my SI & Hip Joints as part of their “osteoarthritis protocol.” They source their cells from MediStem Panama, the lab and research arm of Stem Cell Institute. Their process to collect, grow, culture, screen, and expand the cells takes 3.5-4 months. They recommend reduced activity for 1-month post-procedure with no specific PT required. I was told I’m relatively young for this treatment with most patients in the protocol being in their 60’s.

Regenamex  (MX) planned to do a “blocked facet application” with injections to spine. I was told my degenerative, osteo problems were the “low hanging fruit of the stem cell industry.” Standard protocol for IV drip is 3-5M MSC stem cells/kilo of body weight. My range would be 189 to 300 M depending on my preference and budget. They recommend 50M stem cells per direct joint injection. Stem cells are sourced from CBCells.

PRMedica (MX) planned to inject 50M MSC stem cells + 1ml of exosomes in each hip, the disk and facet joints. They also included a number of supporting therapies. These included ozone therapy, hyperbaric oxygen chamber, NAD+ therapy, and take-home supplements. Plus a stem cell booster implant in the abdomen to “slowly release nutrients and cells to activate the body's stem cells and hasten the healing process.” This consisted of my own PRP mixed with placenta in powder form. They source their stem cells from Regene Globe.

Eterna Health (MX) offered MSC stem cells + exosomes to heal the tear which “responds well to stem cells” and “based on your MRI we are very confident we can fix it with one round of injections only” and “95% of people get relief from one shot.” For my back they would inject to the disk. They said the dexAMETHasone that I had previously had injected in my spine helps with stem cell viability. The procedure would be performed at PRMedica in an operating room which was custom built for Eterna Health. I’d need to wait 4-6 months for tissue regrowth. There will be special PT for the spine, nothing for hips. They also source their stem cells from Regene Globe.

Riordan Medical Institute (USA) planned to extract my bone marrow, spin it and inject it back. They planned to combine my bone marrow with umbilical cord tissue allograft which has not been manipulated or expanded. Injections of bone marrow to both hips along with hyaluronic acid as well as injections to facet joints and paraspinal tissue. They said the Dr. would follow up at 2 weeks post procedure to check on me and that specific physical therapy would be prescribed after treatment. I can go back to my normal routine the next day except no heavy lifting or hard pounding. Blood flow is good for the hip.

Innate Healthcare Institute (USA) They recommend 300M stem cells over 3 visits (75M hips, 25M low back each visit). They indicated their cells are expanded in their Arizona office which went against my research on FDA constraints. They combine stem cells with dextrose prolotherapy to draw stem cells to the injured area. Recommended activity post-procedure is 50% capacity for 2 weeks. Their cells are sourced from the University of Tampa.

My Stem Cell Treatment

I selected PRMedica in San Jose del Cabo, Los Cabos, Mexico based on a combination of reputational research, personal testimonials, published articles, lab selection, and budget. If not for budget I would have selected Dr Khan at Eterna Health but alas money is a factor for me. Because Dr Khan operates out of PRMedica and because they source their stem cells from the same lab, this gave me the confidence I needed to go with PRMedica.

Treatment was delivered over the course of a week. I booked lodging for my husband and me near the clinic at The Westin Los Cabos Resort Villas – Baja Point which I highly recommend. The clinic sent a driver to pick us up each day for treatment.

On Monday my blood was drawn, spun to get PRP, combined with placenta in powder form, and injected into my abdomen. I also met with Dr Victor Ocegueda to discuss my treatment plan. He gave me an ozone injection in my hips and back. This treatment was intended to provide immediate relief but it seemed to have no effect at all. The injection in my abdomen left the injection site (just below my belly button) tender for the rest of the week.

There was no treatment on Tuesday so we went to Cabo San Lucas and took a whale watching tour.

On Wednesday I spent an hour in the hyperbaric oxygen chamber and received NAD+ therapy via IV.

Thursday was the big procedure day. First they drew my blood to get more PRP. My PRP + Exosomes were added to the MSC stem cells for the four injection procedures in my hips and back. Dr Andres Terreros performed the procedure. My pain was managed the entire time with local anesthesia. I left the clinic feeling loopy and dizzy as the lidocaine entered my bloodstream. That feeling passed within a few hours. I went to bed early that night.

On Friday I spent another hour in the hyperbaric oxygen chamber and received NAD+ therapy via IV.

I woke up on Friday morning with a deep purple bruise where the stem cells had been injected to my left hip. More concerning was the fact that my left leg felt longer than my right leg when I walked. I can only surmise this was due to the added fluid in my hip. The feeling has since subsided and I am walking normally. Besides that, I felt pretty unchanged when I left Mexico.

One Month Post Procedure

Now 1 month out, I feel pretty good. No quick fixes. My expectations have been set to expect results in 3-6 months. From reading message boards I’ve found that some stem cell recipients feel a result as soon as 60 days. I’m patient and I feel fully satisfied with my decision to give stem cells a try. The mental boost is substantial, to know I’ve taken steps to address issues that have been bothering me for quite some time. My alternative is surgery and no one wants that.

Post procedure care from PRMedica is not offered. To be fair, I wasn’t promised any post procedure care during in their sales process. I was not given any specific physical therapy instructions so I’m creating my own program based on the many PT stints I’ve been through previously. I’m walking up to 20 minutes at a time with little to no pain and doing back and hip mobility and strengthening exercises to keep blood flowing to the area. What I’m doing feels good and it feels like the right thing to do.

Given that my left hip was the worst of the two, the closest to needing replacement, I’m really interested to see what happens with it. At this point in my recovery, I can say that both my right hip and my lower back feel pretty good. My left hip still does have some issues but it seems like it’s getting better not worse.

This is my experience so far. I will post updates.