A Golden Era of Cell-Assisted Resilience
RJ’s Patient-Reported Outcome
Sports-related injuries, including concussions and whiplash, three failed shoulder surgeries, an unsuccessful right knee surgery, etc., retired RJ’s dream of playing Major League Baseball.
In May 2022, he exercised his Right to Try AMBROSE Cell Therapy. Seven months later, he says, “Y’all (AMBROSE) changed my life.”
RJ played baseball, football, snowboarding, and golf growing up.
“I had some concussions and whiplash from football and a few car accidents along the way.”
RJ’s shoulder issues started in high school. Initially, his doctor thought it was bicep tendonitis. “I had to take a month off every year. It never felt good.”
One issue led to another. “When I was 17, I blew out my left knee running second base. After that, it would give out a lot.” The MRI showed his femur had lengthened, but it had never bothered RJ before the spill.
RJ’s orthopedic surgeon shaved the femur down and cleaned up the knee. “After the surgery, I did P.T. My knee felt better. I could run but couldn’t walk downhill or stairs.”
Jumping ahead, before his AMBROSE Cell Therapy, RJ complained of left knee pain, clicking, and inability to walk downstairs or a hill. His right knee was symptomatic from compensating. “I could run, but it hurt,” he later said.
Resuming RJ’s story: “I went back to playing baseball. My shoulder gave out after the first couple of days.”
“Nothing showed up on my MRI and X-Ray, but I couldn’t move my arm. I went in for exploratory surgery. The surgeon found my rotator cuff and labrum were shredded.
He repaired it, but then every season, it would give out”, RJ recounted.
Doctors refer to the shoulder joint’s major tendons as the rotator cuff. Rotator cuff tears are common injuries. Advances in surgery have improved rotator cuff repairs. But failure rates remain high.
Here, RJ’s massive rotator cuff tear (MRCT) caused disability and pain. An MRCT precipitates a Spiral of Degeneration beginning with inflammation, abnormal immune response, and lack of blood flow. That leads to programmed cell death (apoptosis), scarring, and degeneration.
Unknown to many people and a key reason shoulder surgeries have such a high failure rate, the muscle around the rotator cuff shrinks, and the body replaces it with fatty tissue.
When the tendon and muscle are finally reattached surgically to the shoulder bone, the weakened muscle can’t handle everyday stresses, and the area can be re-injured.
“I tore my rotator cuff and labrum twice more, each followed by another surgery. Both surgeries failed. In between, I ripped a hamstring, broke some fingers, and fractured my hand while stealing second base,” he said.
Cortisone injections, PRP, and physical therapy failed to bring lasting relief.
In his senior year in college and after the last surgery, his baseball coach discouraged RJ from returning to the team.
Allostatic Load and Anti-resilience.
Sterling and Eyer introduced the concept of allostasis in 1988 as stability through change. From the Greek állos, “other,” “different” + stasis, “standing still.” The researchers were imparting the concept of “remaining stable by being variable.”.
Just as a sailor keeps his boat on an even keel despite choppy waters, the body’s biological systems maintain their equilibrium (homeostasis), despite being put through stress.
In contrast, allostatic Load is “the wear and tear on the body” accumulated from repeated or chronic stress. (Bruce McEwen and Eliot Stellar 1993) Sailing across tall breaking waves over and over can cause irreparable damage.
After RJ’s sports injuries, concussions, surgeries, and competitive stress, his physiologic systems were striking out. He descended from an elite baseball player to being told by his college coach that the disabled list was not a viable option.
By age 23, RJ experienced debilitating symptoms beyond losing his ability to throw with his right arm and run the bases. He stopped bouncing back. In other words, allostatic load set in.
RJ’s constellation of wear and tear complaints included:
- Right shoulder pain, decreased mobility, and left shoulder stiffness.
- Right elbow stiff, made clicking noises, left elbow stiffness though no pain, no clicking
- Bilateral arms, decreased reflexes with hammer exam
- Right knee, sharp pain with walking, early knee fatigue with running, aches in cold weather.
- Left knee clicking, popping, and stiffness from compensating
- Challenging to walk downstairs or declines.
- Lower neck – intermittent numbness and radiation of numbness and tingling into the arm
- Right upper arm, numbness near upper biceps insertion, constant
- Right upper arm to fingers (middle & ring fingers), tingling, intermittent nerve pain
More concerning, RJ experienced symptoms of multisystem dysregulation:
- Vertigo, when looking rapidly with turning his head
- Daily headaches
- Sleeping 15 hours per day,
- Waking up drenched from night sweats
- An extreme tendency to fall asleep (narcolepsy)
- Chronic fatigue
In short, allostatic load was ahead 3-2 with the bases loaded in the bottom of the 9th inning. The odds were stacked against RJ Surgeries and drugs had failed him. Though recommended, RJ had the good sense of avoiding pain meds and psychotropic drugs such as Prozac, which could have worsened matters.
Fortunately, RJ had the Right to Try AMBROSE Cell Therapy.
Based on abundant literature, AMBROSE hypothesized that ADRC-based therapy could unburden allostatic load.          
Further, preeminent researchers from the Texas Heart Institute, University of Tokyo, Cedar-Sinai, and other respected institutions have published studies that support ADRCs’ potential to treat multiple chronic conditions.     
The medical team personalized the AMBROSE Master Protocol to address RJ’s unique health challenges.
- Fat Harvesting
Using minimally traumatic water-assisted liposuction technology (WAL), AMBROSE’s board-certified plastic surgeon harvested 580 ccs (19 oz) of adipose tissue. Post-procedure, RJ reported using only Tylenol for a few days.
- Spine and Joint Injections
AMBROSE relied on published research in addressing the patient’s cervical spine and diseased joints with PRP-enriched micronized fat injections.       
AMBROSE’s fellowship-trained interventional pain specialist delivered 61 precise injections under real-time ultrasound guidance into RJs:
- Inflamed cervical spine (22 injections)
- Arthritic shoulders and bicep tendons (8 injections),
- Sore elbows (3 injections)
- Painful, clicking knees (18 injections).
Seven months out, RJ is playing golf, swinging the baseball bat again, running, walking down declines, lifting weights, and coaching high school football and baseball.
As a result of compensating for his bum shoulder, his right elbow became his biggest problem. “My arm feels really good now- no pain, clicking, or stiffness.” He is throwing the baseball again, though, taking his time to rebuild his deconditioned shoulder muscle.
After his knee surgery, his knees deteriorated. He says, “Running is no problem now; The sharp pain and stiffness are gone. I can walk downstairs and hills again. My friends don’t laugh at me anymore.”
“My neck is much better. I don’t have the numbness and tingling. I don’t get dizzy when I turn it to the side. I haven’t recovered full range of motion yet – but that is getting better too.”, RJ added
- ADRC-IV Infusion
RJ received 129 million Celution™ system processed ADRCs with 92% cell viability through IV infusion.
Published research has established that the ADRC-IV infusion reduces neuroinflammation, improves blood flow, restores autonomic nervous system function, and so on. RJ’s real-world results validate the cited studies.   
As an aside, our group’s research revealed the Celution system significantly outperforms the Medikhan, Tissue Genesis Icellator, and other commercially available adipose cell processing systems. 
In line with the cited publications (and others), RJ started feeling better not long after his AMBROSE treatment.
“I don’t feel depressed like I did before. I am optimistic and have more energy. I don’t wake up drenched with sweat and only need about eight hours of sleep now. I used to sleep from 12:00 am to 2:00 pm and take an hour nap too. Now I coach baseball and football 15 hours a day.”, RJ reported.
He went back to the gym, resumed light weightlifting, and lost 15 lbs. – with no change in diet. RJ added, “I haven’t been in this good of shape for at least two years,”
RJ’s benefits signal a reduction in allostatic load and restoration of multisystem homeostasis.
RJ is not alone.
Research studies have established a direct link between increasing allostatic Load and all-cause mortality. Unsurprisingly, studies have also connected heart disease, diabetes, kidney disease, lung disease, and so on with allostatic Load. Thus, beyond RJ’s poor health, he was at high risk of getting worse at a young age. 
Today’s environmental, psychological, and lifestyle factors are accelerating the time-to-allostatic Load:
- A University College of London study reveals Gen X faces more years of ill health than Baby Boomers.
- According to a CNBC poll, nearly half of older millennials have at least one chronic disease.
- According to an American Heart Association survey, health concerns weigh heavier on Gen Z, RJ’s age group.
“The doctors and surgery center team were the best I have had. My future has gone from bleak to bright. I appreciate Matt Feshbach, AMBROSE CEO, for his follow-up and friendship. For me, AMBROSE was a grand slam.”, RJ concluded.
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