Amid the broad range of emotions and activities in which I'm engaging this week - a sad last week at Nokia before an exciting new start at MyStrands - I was able to schedule an appointment for my 6-month followup visit with Dr. Mishra regarding progress on the platelet-rich plasma (PRP) treatment for my right elbow. [I am very grateful for Kevin's recent comment on an earlier PRP-related post, and an email from Mark, who had commented on my first elbow PRP post - and who has since also undergone the PRP treatment - which reminded me that I needed to schedule this appointment before I leave town.]
I was not looking forward to the visit, in part because I have not been diligent in my theratube exercises (probably averaging once every three days rather than three times per day since my three-month PRP checkup), and in part because I thought that if I wasn't 100% back to normal by now, I would have to choose between surgery and living with my elbow's current status, which is probably around 90% of pre-tendonitis strength (and absence of pain).
However, my fears, as is so often the case, were unfounded - at least with respect to the latter one (I should [still] resume more diligent theraband exercising). I found out that it can take up to 12 months for the full effects of PRP to manifest themselves, so the fact I'm not completely "cured" is not surprising, and in fact, my current status, in which I rarely feel pain greater than 3 (on a scale of 10) - even after moving a humongous solid oak entertainment center from our bonus room to the garage last weekend - is a significant improvement over the last checkup.
During this visit, I was able to exert 135 pounds of grip strength with my right hand with a subjective pain level of 1 (vs. 120 pounds of grip strength with a pain level of 4 at the 3-month mark), and was able to resist attempts to pull down my upturned or downturned hand with a pain level of 1 or 0. As I noted earlier, during my first visit, I was only able to exert 65 pounds before I hit the wall (of pain) at level 9, and my resistance was lower and pain higher for the upturned hand exercise. It is relatively rare for my elbow to be sore - except after I move heavy furniture or engage in repetitive motions for extended periods.
Among the differences I've noticed in the past 3 months were:
- being able to carry around and drink from my 20-oz coffee mug with no pain
- being able to carry heavy furniture with some pain (I would not have even attempted to move the entertainment center 3 months ago)
- being able to do pushups with little pain (again, I would not have attempted pushups 3 months ago)
Dr. Mishra was actually quite encouraged - and encouraging - about my prospects for eventually regaining full use of the elbow with little or no pain! And, even better (to me), he suggested that if I have not reached that status by the 12-month mark, given the progress I've shown thus far, he would now recommend a second PRP treatment rather than PRP + surgery (which is what I thought would be the next step).
So, once again, my optimism is restored. I just did a round of theratube exercises (that makes 3x today), and will gradually start experimenting with exercising more regularly - pushups and perhaps even full-scale elliptical training (now that I'll be home - where we have a Precor FX - more regularly) - though ramping up on an [uncharacteristically] gradual slope. I will also restart my yoga practice.
I noted in my response to Kevin's comment that Dr. Mishra's PRP web page had a link to the Total Tendon Network, and that while I was excited about encountering my first Ning network "in the wild", it appeared to be a site targeting [only] tendon care providers:
This is a group of providers dedicated to improving the diagnosis, treatment and prevention of tendon related disorders.
Dr. Mishra told me that the site was, in fact, intended for both providers of treatment and patients who are receiving, or considering receiving, treatment (he said he will change the text on the login page - and said he requires login to ensure some level of quality control on this social network). I've signed up, but am still waiting for "approval", and so will report further on the Total Tendon Network during my next update ... probably around six months from now.