call us
888-473-2648

1990 Main Street Suite 700
Sarasota, FL 34236
941-952-3300

Regenerative Medicine Sarasota Florida & Tampa FL

Hydrocodone Rescheduling Takes Effect October 6th

HydrocodoneThe doctors at Greco Medical Group have worked diligently for many years to improve what they consider the best option when it comes to chronic pain. That option is natural, regenerative medicine.

The other most common options – surgery and drugs – sometimes cause more problems than they cure, and the drug option can be particularly harmful when addictive pharmaceuticals are prescribed.

RhuematologyNews.com has reported some important information regarding the classification of one particularly powerful, and potentially dangerous drug: Hydrocodone.

By Alicia Ault – Physicians should ready themselves now for the new set of rules expected when hydrocodone-containing products become subject to tighter regulation on Oct. 6, according to various physician groups.

After a years-long process, the Drug Enforcement Administration announced in late August that it would be moving hydrocodone-containing products from schedule III to schedule II.

That rule takes effect on Oct. 6.

After that date, physicians who want to prescribe HCPs will have to use tamper-proof prescription forms, or use e-prescribing programs. They can call in a 72-hour supply, but must follow that up by mailing the prescription to the pharmacy. Refills by fax or phone are otherwise prohibited.

Patients who are on long term HCP therapy can get up to a 90-day supply through three separate, no-refill prescriptions.

The American Medical Association, which campaigned against the rescheduling of HCPs, is now urging its members to be prepared for the changes in prescribing and work flow that will come with the new landscape.

In a fact sheet, the AMA says that physicians should try to refill prescriptions before Oct. 6, noting that these prescriptions will essentially be grandfathered in under the old rules until Apr. 2015.

The American Society of Clinical Oncology in early September also notified its members of the coming changes, and said that it, too, had opposed rescheduling of HCPs.

Many physician groups have said that moving HCPs to schedule II will not stop abuse or diversion and may hurt patients who have a legitimate need. Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said that “it’s hard to say,” whether up-scheduling will make a dent in inappropriate or unnecessary prescribing.

He said in an interview that his practice already requires patients on long-term opioid therapy to come in at least every 3 months for refills and an evaluation. Although physicians may have to change their practice schedules to accommodate refill visits, those visits are good opportunities for education and follow-up, said Dr. Blackwelder. Full Story @ RhuematologyNews.com

Dr. Jon Greco recently posted on Facebook: “Maybe we should actually treat the disease with biologics like Platelet Rich Plasma and not just the symptoms with narcotics. I guess that might make too much sense. 50% of the patients who start a narcotic are still on narcotics in 5 years! What is the cost of chronic narcotic use in terms of addiction, mental and physical impairment, and lost productivity?”

And a story related by BusinessInsider.com tells a sad story of a man who had it all and lost it all after developing a severe ($10,000 per week) addiction to pain killers:

http://www.businessinsider.com/kenny-lissak-vocativ-interview-2014-9

 

Hydrocodone Rescheduling Takes Effect October 6th

Personalized Medicine

Personalized Medicine for Astronauts, Soccer Players, and YOU.

AstronautWhat does personalized medicine for an astronaut in outer space have to do with a soccer star playing in the heart of the Amazon?  Both space and the Amazon jungle are two of the most extreme environments humans have chosen to explore.  As I was watching the early matches of the 2014 FIFA World Cup it was quite obvious that the teams from more temperate climates were having muscle and tendon injuries and electrolyte issues.  I was especially distressed by USA’s Jozy Altidore’s hamstring injury that has probably eliminated him from further play in the tournament.  Here are athletes in the prime of their life, in peak physical condition, with some the best sports medicine doctors and trainers, and they are still having problems.  We continue to push human performance under extreme conditions.  Can we do better?  Even a 1% improvement can make the difference between the “thrill of victory and the agony of defeat.”

Recently I spoke with Michael Schmidt, PhD who co-authored the article “Personalized medicine in human space flight: using Omics based analyses to develop individualized countermeasures that enhance astronaut safety and performance”.  It isn’t light reading, even for a medical doctor like myself.  Essentially the authors are saying that we are emerging into a new era of personalized medicine that takes into account the differences in our physiology and individually tailors our medical treatments.  This Soccer Playernew paradigm is especially important in extreme conditions as space flight or even playing soccer in the Amazon. Obviously I am more concerned about medicine than sports, but professional and collegiate sports are billion dollar industries providing entertainment, jobs, and education.  What are the practical applications of personalized medicine for professional athletes as well as everyday people?

In the new field of Regenerative Medicine, we utilize Platelet Rich Plasma (PRP) derived from the patient’s own blood.  We isolate and concentrate messengers (growth factors and cytokines) from each individual patient’s  blood.  These messengers work with our own stem cells and regenerative cells to expedite healing.  For example, Cristiano Ronaldo, arguably the best professional soccer forward in the world, has a patellar tendon injury that may be interfering with his play in the World Cup.  Greg Simony, an extreme triathlete who swims, bikes, and runs with disabled athletes for the Care2Tri charity (www.care2tri.org) had the same injury.  This injury usually takes months to get better with the standard therapy of rest, ice, and non-steroidal anti-inflammatory medications. I injected him with Cytokine Rich Plasma (CRP), our own purified and proprietary form of PRP.   Three weeks later he ran a full marathon.  Rich Lomas, another local runner and fundraiser for the Phelan-McDermid Syndrome Foundation (www.phsf.org), has been suffering for the past 2 years with osteoarthritis, cartilage tears of both knees, and recurring back pain from lifting his disabled son.  With the help of CRP injections and his orthopedic surgeon, Rich is running again and training for the Boston Marathon.  The most exciting use for CRP is to postpone or prevent knee replacement surgery.  We have many patients whose knees are “bone-on-bone” and were told over 5 years ago they needed knee replacements.  Today they are pain free and mobile without prosthetic knees.

For more information about any of these treatments or a free on-line consultation, please go to www.kneepainflorida.com or call 941-952-3300.

 

Personalized Medicine

What is regenerative medicine and what can it do for us?

If the human body is nothing short of miraculous, then why is it so hard to believe that the answers to many of our medical problems are already within our own body?  Unfortunately we take the healing power of our body for granted until we are sick or falling apart from the passage of time.  We have come to rely on medicines and surgery to fix everything.  Yes the advances in medicine in the last hundred years have been fantastic but they still pale in comparison to the complexity and marvelous nature of our body’s own healing and self-regenerating capacity.

We are now on the cusp of changing this current paradigm.  Isn’t it much better to take care of, fix, and hold onto the amazing body we already have been given?  Isn’t it best to look inside us at our own fantastic repair and regenerative capabilities? There is hope in the emerging field of Regenerative Medicine.  According to the National Institute of Health,  “Regenerative medicine is the process of creating living, functional tissues to repair or replace tissue or organ function lost due to age, disease, damage, or congenital defects. This field holds the promise of regenerating damaged tissues and organs in the body by stimulating previously irreparable organs to heal themselves.”  The most exciting and promising treatments for the future will be non-fetal or non-embryonic stem cells for growing new tissues and organs.

So what can Regenerative Medicine do for us now?

We can use messengers that tell our own stem cells and regenerative cells to go to work.  We have stem cells for almost ever tissue in our body, for example stem cells for skin, stem cells for bone and cartilage.  We have the same number of stem cells in us now as we did when we were younger.  They just don’t work as well as they did when we were younger.  The messengers that stimulate our own stem cells are in the form of growth factors and cytokines that are present on the platelets of our own blood.  We can isolate them, concentrate them, and inject them under ultrasound guidance to where they are needed most.   This Platelet Rich Plasma (PRP) has been used for almost 3 decades in dentistry, cardiothoracic surgery, and orthopedics. Not all forms of PRP are alike and not all forms of PRP give great results.  At Greco Medical Group (GMG) we use an advanced, purified, and proprietary form of PRP called Cytokine Rich Plasma (CRP).  It is all-natural, made by you, for you.  No drugs are needed.

Greco Medical Group uses CRP for arthritis, chronic pain, and sports injuries.  But some of the best results with CRP are with knee pain treatment for Osteoarthritis (OA).  OA of the knee is a progressive condition that wears away the smooth cartilage cushion in the joint.  Like almost everything else in our body, the cartilage is constantly being broken down and rebuilt.  Unfortunately in OA the cartilage is being broken down faster than it is being rebuilt.  Early in the disease process, the OA patient may just describe their knees as feeling tight and stiff.  As OA progresses, there is pain, inflammation, and destruction of the joint.  As time goes on, they may only feel pain after excessive activity.  Then the treatment is rest, ice, and acetaminophen.   Acetaminophen is a very safe and effective medicine if taken correctly.  As OA progresses the pain gets worse, more frequent, and occurs with less activity.  Non-steroidal anti-inflammatory drugs (NSAID’s) such as over the counter Advil and Aleve or prescription drugs such as meloxicam are usually the next step. This is where it gets scary.  Did you know that in 1998 The American Journal of Medicine stated:

Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for non steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone.”

Time and OA march on leading to more pain, more joint destruction, and consequently less mobility.  At this point, OA patients are forced to cut back their activities and exercise.  This downward spiral continues with weight gain, deconditioning, and possibly diabetes.  All of these can make OA worse.  What’s next?  The present standard of care is steroid and hyaluronic acid shots (Synvisc, Hyalgan, Orthovisc).  Steroids are a temporary fix and can be harmful to the knee cartilage. Hyaluronic acid can help in the short term and in a limited number of people.  Typically, narcotics are prescribed for pain management until the patient is ready for surgery or if they aren’t candidates for surgery.  Narcotics can cause constipation, impaired mental status, impaired driving and addiction. The most important point about knee pain treatment for OA is that none of these treatments change the course of OA and eventually there is no other option but knee replacement surgery.  Many things influence how fast this occurs such as body weight, family history of OA, diabetes, and prior surgery or trauma to the knee.

We believe now with the use of CRP we can change the course of Osteoarthritis. We can offer an alternative to knee replacement.  Two goals for treating OA of the knee are to decrease or eliminate knee pain and maintain mobility.  We don’t just mask the pain.  We eliminate the pain by cooling down the inflammation and actually initiating and accelerating the healing process. About 90% of the patients that we treat with OA of the knees are successfully treated with CRP.  The younger the patient and the earlier the stage of OA, the better the results with CRP, however, we have many patients in their 80’s who have done well. The ultimate goal is to avoid knee surgery and keep your own joints (hardware) by growing new cartilage.   At GMG we believe we can accomplish all these goals with CRP treatments.  Talk is cheap but all one has to do is listen to our patients.  (link to testimonials) We have numerous patients who were told by their orthopedic knee specialist they needed knee replacement surgery because their knees were “bone-on-bone.”  Five years later after using our CRP treatments these patients continue to be pain-free and active with their own knees.  Even if we are just prolonging the time until surgery is needed, technology in regenerative medicine and prosthetic joints will probably advance tremendously in that time. We are already making great strides with fat transfers and bone marrow aspirations, which contain an abundance of stem cells.  The FDA currently doesn’t allow true stem cell treatments in the United States but research continues and the future is very bright in Regenerative Medicine.  At Greco Medical Group we aren’t sitting around watching and waiting for things to happen, we are making it happen.

“An ounce of practice is generally worth more than a ton of theory.”

E.F. Schumacher

 

What is regenerative medicine and what can it do for us?