Regenerative Orthopedic Options

By Shaun Lehmann, MD
Edited by Mila McManus MD

The body is designed to heal itself. As we age, our bodies start to lose the ability to focus a sustained healing response to musculoskeletal injuries. Injuries can occur from multiple sources including trauma, repetitive stresses, or medications. The body’s healing response can also be diminished due to nutritional deficiencies, hormone deficiencies, and genetic conditions.
The field of Orthopedic Medicine is rapidly changing to now include many regenerative options aimed at improving our ability to heal. We are now learning that some of the traditional ways that we have been treating musculoskeletal pain and injuries may actually be causing problems by negatively affecting the body’s ability to heal itself. Steroid injections, for example, are now showing in research to decrease the local stem cell counts and could actually damage cartilage. NSAIDS (non-steroidal anti-inflammatory drugs) also have been shown to accelerate cartilage loss.
Regenerative medicine aims to accelerate our natural ability to heal after injury occurs. The goal of regenerative therapy is to optimize the cellular environment by stimulating growth factors and repair cells.

Some of these treatments include:
Point of Care Therapies (same day procedures)

Nutritional Growth Factor Stimulation

Prolotherapy
Ozone Therapy

Personal Cell Therapy (Autologous)

Platelet Rich Plasma (aka PRP)
Bone Marrow Aspirate
Fat derived Mesenchymal cells – or VSF “vascular stromal fraction:”

Donation cellular therapy (Allogeneic)

Umbilical Allograft Cells
Amniotic growth factors
Placental growth factors

Cultured Cellular Therapies (not a same day procedure… takes weeks to grow)

Nutritional stimulation treatments such as Prolotherapy and Ozone therapy aim to focus the body’s healing energies on the location that needs repaired. They aim to wake up the body’s local healing mechanisms by refocusing and restarting the healing process. These treatments can work well as long as the body is healthy, and the repair mechanisms are in working order.

Personal cellular therapies do the same as above; however, they also bring extra cellular workers to the job site. These treatments are usually deemed stronger than Prolotherapy and Ozone and are deemed relatively safe since the workers are your own cells.

Donation cellular therapies are from a donor person, are more potent than Personal cellular therapies, and are tested for safety (e.g., viruses such as HIV, hepatitis); however, the tissues are not tested for every potential infectious disease, so there may be some theoretical risk.

Cultured Cellular Therapies are not legal to use in the U.S. at this time, but it is legal to process and store these stem cells in the United States. One has to travel to another country to have the stem cells injected or infused. Cultured stem cells can be either Personal (autologous) or Donated (allogeneic).

There is a large body of research done on the efficacy of Prolotherapy and Platelet Rich Plasma, but more is still needed. Stem cells show so much promise that they are said to be “the future of medicine”.

By Mila McManus MD|2019-02-22T08:55:43-06:00January 30th, 2019|Articles, General|

“Superb attention to my progress!”

Superb attention to my progress!

“I was referred here [TWIHW] by a friend. I was looking for the right place to assist me with improving my health and to lose some weight. This was exactly what I needed. Excellent staff! Superb attention to my progress!”

-Tony L.

By Mila McManus MD|2019-02-20T12:06:15-06:00January 17th, 2019|General, Testimonials|

Instant Pot Chicken Tortilla Soup

From Affordable Paleo Cooking with your Instant Pot, by Jennifer Robins, ©2018

Makes 6 Servings

Prep time: 5 minutes

Cook Time: 15 minutes

Ingredients:

6 cups (1.4 L) chicken broth

1 lb (450 g) chicken breast

12 ounces (340 g) fresh or high quality store bought salsa

1 teaspoon sea salt

1 teaspoon garlic powder

1 teaspoon onion powder

1 teaspoon chili powder

1 teaspoon cumin

1 teaspoon black pepper

1 cup chopped carrots

1 onion, chopped

Fresh Cilantro (optional)

Sliced Avocado (optional)

Directions:

1. Place all of the ingredients except the cilantro and sliced avocado into the stainless steel bowl of your Instant Pot and secure the lid. Close the pressure valve, press the Manual/Pressure Cook button and adjust the cook time to 15 minutes using your +/- buttons.
2. Allow the cooking cycle to complete and then quick release the pressure valve and remove the lid once safe to do so. Use two forks to shred the chicken.
3. Serve topped with fresh cilantro and sliced avocado if desired.

Compliant with HRP diet (TWIHW), Keto, Low Carb, Paleo and just plain yummy simple!

By Mila McManus MD|2022-10-10T21:54:51-06:00January 17th, 2019|Articles, General, Recipes|

Glass Straws

Who needs one? Everyone who uses plastic straws!

What the heck – REALLY?? Yes, here’s why:

Drinking daily from a plastic straw is daily exposure to toxic plastics on your lips and in your mouth, two very permeable surfaces giving entrance to the rest of your body. The more you use the same straw, wash it, drink different kinds of beverages through it, the more micro-particles of plastic are released as it ages.
Plastic straws are also in the top 10 items found each year as marine debris. During beach cleanups over the last 25 years it is estimated that over 6 million straws and stirrers have been picked up.
It has been said that by the year 2050 there will be more plastic in the ocean than fish.
Less plastic in our lives means healthier lives and a healthier world.

What’s so great about Glass Straws?

The manufacturer offers a lifetime guarantee. (see manufacturer’s website)
Made from extremely durable glass
Each straw comes with a cleaning brush
Protective carrying case available made from upcycled and/or organic fabrics
Dishwasher safe
Reusable and ecofriendly
Choose from a wide selection of diameters suitable for everything from water to smoothie’s
Choose a plain straw or one with artistic designs for personal expression.
Makes a fun and unique gift item! Valentine’s Day, Mother’s Day, Birthdays, and much more.
Handcrafted with LOVE in the Pacific Northwest (not China!)

Come by and take a look at our selection. Buy one for yourself and another one for a friend. If you purchase a straw, receive 30% off a Glass Straw Sleeve.

By Mila McManus MD|2019-01-17T13:51:27-06:00January 17th, 2019|General|

A Simple Thing, Profound Effects

Nutrition Nugget By Nancy Mehlert, MS

I wanted to remind you about a simple thing with profound effects: harmful oils in our food. In my opinion, it is one of our “big rocks” for reducing inflammation, preventing disease and improving health. Yet you may be surprised how easily they can sneak back into your pantry, cabinets and refrigerator. Strictly avoiding these has huge health benefits and can dramatically improve your lipid profile and reduce many factors for disease. Watch out especially for salad dressings, hummus, mayonnaise, chips and snacks, restaurant food and fast food. Even brands that seem otherwise cleaner or healthier can have these harmful oils. If you see the words expeller pressed in front of the oil, it is slightly less refined.

Here’s why: These oils are highly processed and damaged. Your body has no good use for them. They interfere, obstruct and cause damage. They are often stored as garbage in your fat cells. They are well documented to cause inflammation, oxidative stress, elevation of LDL cholesterol levels, harm to endothelial cells lining your blood vessels, damage to gut bacteria, DNA damage and have glyphosate residues in them which harm your gut lining and increase permeability. [i] You can see why we recommend total avoidance if at all possible.

Here are the oils to avoid:

Soybean oil
Sunflower oil
Safflower oil
Canola oil
Corn oil
Cottonseed oil
Hydrogenated oil
Refined Palm oil

Healthy oils are unrefined or gently refined without harmful chemicals such as hexane. Better choices are olive oil, avocado oil, butter, ghee, beef tallow, duck fat, cocoa butter, macadamia nut oil, coconut oil, almond oil, unrefined palm oil and palm kernel oil. Check out salad dressings and oils made by Primal Kitchen, Spectrum Brands and Chosen Foods as good examples of better choices. Your body knows how to make good use of undamaged, natural oils. There have been controversies and issues in the olive oil industry over the last decade, so our current recommendations are to stick with high quality olive oil made in the United States, Australia or Chile. Cobram Estate and Bragg olive oil are other reputable resources. Mediterranean olive oils have been found to be contaminated and blended with many of the damaged oils listed above.

Coconut Oil and Olive Oil Article

Audit your kitchen and take a simple step with profound effects for the entire family.

[i] https://articles.mercola.com/sites/articles/archive/2019/01/07/replace-dangerous-oils-with-healthy-fats.aspx?utm_source=dnl&utm_medium=mail&ut…

By Mila McManus MD|2019-01-17T13:35:31-06:00January 17th, 2019|General, NANCY’S NUTRITIONAL NUGGET|

“Do Yourself A Favor”

Do Yourself A Favor

“I have been a patient at TWIHW for several months now. I love that Dr. McManus treats each patient as an individual – there’s no cookie cutter formula or one-size fits all solution used in her practice. Instead, she’s committed to finding answers to my very complicated, very individual, and very long-standing health issues. Most of the doctors I’ve seen get frustrated and throw their hands up, not knowing what to do next. But, I know Dr. McManus has a variety of ideas about my treatment that we’re trying in a systematic and thoughtful way. After each visit, I get a written summary from Dr. McManus about what we discussed, as well as next steps. I’ve never experienced this level of communication with a health care professional. The staff at TWIHW are top notch as well – incredibly friendly and personable while being professional and compassionate. Tami, Diane, Nancy and Kim make every visit something I look forward to and even enjoy. If you’ve been on the fence about trying all that TWIHW has to offer, do yourself a favor, and take that step toward better health now, so you can start the New Year off on the right foot.”

-LG

By Mila McManus MD|2019-01-17T14:12:16-06:00January 4th, 2019|Testimonials|

Viracid & WholeMune *

Viracid, by Ortho Molecular Products provides support for immune challenges and can be taken to immediately boost the immune system or for immune maintenance. Viracid strengthens immune function and helps to maintain normal inflammatory balance. Viracid has a powerful combination of key nutrients and botanical extracts which significantly boost immune cell function including antibody response, natural killer (NK) cell activity, thymus hormone secretions and T-cell activation. Viracid boosts immune defenses by providing nutrients such as L-lysine, vitamins A and C, pantothenic acid, B₁₂, and zinc. Also included is a synergistic blend of botanical extracts including black elderberry, astragalus, echinacea, and andrographis, all of which have been used traditionally for their clinically effective immune-modulating properties. This supplement comes in a convenient pill pack to have handy at home or in travel, when you feel like you may be coming down with something.

WholeMune, by Orthomolecular Products is used to prime and mobilize key immune cells and protects against immune challenges resulting from ongoing stress. Wholemune is formulated with Wellmune WGP®, the most well-researched, single beta-glucan, proven in human trials to prepare and protect the immune system form repeated and ongoing stressors. Wellmune WGP® is a highly purified, yeast -free beta glucan extract derived from Saccharomyces cerevisiae. It is standardized to contain 75% pure beta-glucan and is considered the most effective single nutrient to naturally prime immune cells. Wholemune increases immune vitality and mental clarity as well as protects against exercise-induced stress.

For information or to purchase, visit our office or call 281-298-6742.

*Information taken from Ortho Molecular Products, Product Info Sheet/pdf.

By Mila McManus MD|2019-01-05T10:08:00-06:00January 4th, 2019|Articles, General|

Seared Scallops with Arugula Pesto

Adapted from Cooking From Scratch from PCC Community Markets

Makes 4 Servings

Ingredients:

4 cups baby arugula (about 4 ounces)

4 tablespoons pine nuts, toasted

1 clove garlic

1 tablespoon freshly squeezed lemon juice

½ ounce (3 tablespoons) grated Pecorino Romano sheep cheese

¼ cup extra-virgin olive oil

Sea salt and ground pepper

1 pound scallops

1 tablespoon ghee

1 tablespoon butter

Directions:

1. In the work bowl of a food processor, combine the arugula, 3 tablespoons of the pine nuts, garlic, lemon juice, and Pecorino; pulse about eight times, until everything is chopped. With the machine running, drizzle in the olive oil until smooth. Season to taste with salt and pepper; set aside.
2. Rinse the scallops, pat them dry with paper towels, and season them generously with salt and pepper. In a cast-iron or stainless-steel sauté pan over high heat, heat the ghee and butter until they shimmer, then place the scallops in the pan so they are not touching. Don’t touch them again until you are ready to flip so that a golden crust forms, about 1 ½ to 3 minutes on the first side. Gently flip them over and cook for an additional 30-90 seconds. They should have a golden crust on each side while the centers remain slightly translucent. The scallops will continue to cook a little once removed from the heat.
3. Spread the pesto on a plate, top with the scallops and sprinkle with the additional 1 tablespoon pine nuts and serve immediately.

Note: Save extra pesto in the refrigerator for up to 1 week or frozen for up to 1 month. A perfect toss with spaghetti squash or other spiralized vegetable or served with roasted chicken or white fish.

By Mila McManus MD|2019-01-05T10:03:41-06:00January 4th, 2019|General, Recipes|

Boundaries

This is a quote that I have found helpful in my journey and relationship with food and myself. It has helped me to:

see boundaries as a way to love myself and know who I am and who I don’t want to be.
get comfortable reaching for a longer perspective, rather than be overcome with short term gratification.
be courageous and set some reasonable and needed boundaries for my life without concern for what others may think.

I hope you will take some time to read it a couple times, maybe even out loud. May you find in it a nugget of encouragement or help for you or someone you love.

Boundaries

“Boundaries, in a broad sense, are lines or things that mark a limit, bound, or border. In a psychological sense, boundaries are the realization of our own person apart from others. This sense of separateness forms the basis of personal identity. It says what we are and what we are not, what we will choose and what we will not choose, what we will endure and what we will not endure, what we feel and what we will not feel, what we like and what we do not like, and what we want and what we do not want. Boundaries, in short, define us. In the same way that a physical boundary defines where a property line begins and ends, a psychological and spiritual boundary defines who we are and who we are not.” Dr. Henry Cloud, Changes that Heal, Zondervan Publishing House, 1992.

May 2019 be a year of greater health, better relationships, meaningful work and daily gratitude.

Peace be with you.

By Mila McManus MD|2019-01-04T11:57:20-06:00January 4th, 2019|General, NANCY’S NUTRITIONAL NUGGET|

Neurofeedback Changes Your Mind, Literally!

Written by Guest Contributor:

Spring Hill, MS, LMFT, LPC

Individual, Couples, Family Counseling

Neurofeedback Services

Have you ever felt like “if I could just relax instead of being anxious, depressed, or distracted I would enjoy life more?” Well, you’re not alone. The brain controls everything we do in our lives from relaxing, to sports activities, to writing this article. Specifically, it is our brain waves that control what and how we think, how we feel physically, mentally and emotionally, and how we behave with others.
If our brainwave distribution becomes out of balance (much like our hormones), symptoms may result, such as anxiety, depression, lack of energy, foggy thinking, etc. Neurofeedback is a non-invasive, pain-free computer-based technique which retrains the brain to produce brainwave patterns that are beneficial to better functioning. When the electrical system (brainwaves) is modulated through Neurofeedback, the brain becomes more flexible, calming the brain and helping the client to have better control of their emotions, feelings and thoughts. The results of the brain changes are enduring, unlike medication.
What does a Neurofeedback session look like?
• During a session a cap with sensors is placed on the head to monitor the brainwave activity, much like the electrical activity you see when having an EKG. (There is NO electricity going into the head)
• This activity is displayed onto the therapist’s computer monitor. On a separate screen, the client plays a video game or watches a movie that is generated using their brainwave activity.
• Each time a healthy brainwave is achieved, the client is rewarded via graphics and auditory sound. As healthier brainwaves are achieved, a healthier state of mind (e.g., focused, relaxed, less anxiety) is learned.
Neurofeedback is a safe, long-lasting, drug-free alternative to treating symptoms including:
• Focus/Foggy thinking/Cognitive Processing
• Anxiety/Panic Attacks/ Obsessive thoughts, Compulsions
• Depression
• Sleep issues
• Pain
• Other Conditions and Symptoms
The overall goal is to help the client manage their symptoms and improve their performance in whatever area of life they desire such as school, work, or relaxation. For more information regarding neurofeedback contact Spring Hill at shill1@springhill4counseling.com or call 713.927.5093.

By Mila McManus MD|2019-01-04T12:17:21-06:00January 4th, 2019|Articles, General|

About Mila McManus MD