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Thread: Installment 63 - Ask the Doctor with Dr Alan Kadish

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    Default Installment 63 - Ask the Doctor with Dr Alan Kadish

    About Dr Alan Kadish

    Dr. Alan Kadish is President of World Stem Cells.Dr. Kadish is a researcher/clinician who has actively been involved in protocol design and implementation in the stem cell field for a number of years. His firm, World Stem Cells LLC has been utilizing cutting edge integrated therapeutics for a number of disorders specifically, autoimmune, neurological, opthalmic and orthopedic issues with documented objective findings.

    Dr. Kadish
    800-234-1693
    USA & Canada only
    800-234-1694 FAX
    drk@WorldStemCells.com

    Q & A
    Q: I would like to ask Dr. Kadish if he had success treating peripheral neuropathies due to nerve trauma & infection (abscess)? If so, what type of stem cells (manipulated or non-manipulated) & number of treatments on average?
    A: We have had successes treating peripheral neuropathies. Primarily we see PAD, diabetic neuropathies and of course those caused by CMT and other neuromuscular disorders. When you consider nerve trauma and post infection this is a very different issue vs. PAD/DN , which are based on vascular and inflammatory considerations. For trauma based PN one would need to evaluate individually and determine the areas resources (vascularity/intact tissue/etc.) and results of the damage still present. As an example, highly fibrotic tissues may pose a complete inability to achieve proper tissue penetration of any cellular components. As a note, doing stem cell therapy with any active infection, is contraindicated.

    We utilize bone marrow based stem cell primarily, but not exclusively. Our treatment protocols consist of stimulation, stem cell collection, use of growth factors, ancillary agents and expanded cells injected both locally and systemically, for treatment of our neuropathy patients.

    There are a number of problems with selective manipulation of the cells, in this disease entity. Typically there are multiple medical issues present including vascular, neurological and excessive oxidative loads in the tissue. It's more appropriate to use a broad range of growth factors and cell types to address these mechanisms.

    To assess your specific situation I would encourage you to go to our website at www.worldstemcells.com and fill in the form, on the left, indicating you would like a free consultation. We will contact you and make arrangements for a review of your medical records and have our team assess your condition and potentials for stem cell therapy.

    Q: A few months ago I submitted my saliva for a DNA test to 23andme.com. My test results indicated that all but one of my telomeres were longer or average compared to other people my age. Are different functions in our bodies regulated by specific telomeres? If so, how can I tell identify them?
    A: In the anti-aging aspect of medicine your results are an overall good sign and dependent on the specific SNMP you can infer some information that will direct you toward a better outcome. A single affected telomere may or may not cause a specific response. Consider that the one area many be reproducing at a different rate and the shorter telomere will not necessarily affect the functionality, over time. To appreciate the whole picture one needs to clearly evaluate the results of the test, as a whole. An excellent resource on this question is Dr. Pollard, at 23andme.

    Q: My 7 year old child has cerebral palsy. Please, if you can provide me some details of the type of SCT procedures you normally perform for someone like my son, and what is the estimated amount of stem cells that can be infused?
    A: A good starting point would be our website information at: www.worldstemcells.com/ Here you will find information including some of the current research on CP. We are going to post the results of one of our adult (25 yr old) CP patient who has made a video documentary on his experience of the stem cell process.
    His changes were evaluated by a panel of physicians in the US and then repeated after 6 months. His response was substantial and has continued for the last year during our evaluation of his updates. Changes include his ability to live with less pain, more range of movement, better mental clarity, and a host of other measurable positive objective changes. I would encourage you to contact us and we will let you know when his video becomes available. To give you a feel for the many changes seen I've posted his 6 month update, post treatment at the end of this answer.
    Let’s address the cell numbers issue. This is a misunderstanding on the part of many patients. Unlike hair transplants the number of cells is not what determines the outcome of the therapy.
    It is a gimmick used by some groups to make you think that you’re receiving a substantial treatment. The real issue is not by any means exclusively the number of cells that determine the patient’s success or failure. Cell viability (number active) is by far more important coupled with the issue of growth factors.
    To really appreciate the, “rest of the story” I would encourage any consumer to look into the paracrine effect, which may be the equal in importance of any cell numbers or even viability consideration. The work on the growth factors effect on allowing the cells to really engage and remain on the affected site of the diseased tissue is critical for a good response. At World Stem Cells we use growth factors with all our patients.
    Interestingly this effect is now becoming the new cookbook in stem cell differentiation, for all stem cell researchers. There are a number of commercial firms selling specific factors or mechanical means to make specific cells. The problem is our bodies do not contain isolated single cell types, but rather multiple cell types are the requirement for good tissue integrity and response.
    Millions of cells with low levels of viability are a waste and give the patient nothing. At World Stem Cells Clinic we count your cells and measure the viability levels in our laboratory. You’re given this information both before and after we expand the cells and know what cell number and viability were found and used in your treatment. Our typical patient received multiple millions of cells. Even our older patients generate the high cell numbers, along with viability, after stimulation and proper preparation for stem cell therapy.
    So as a consumer I would encourage you to not get hoodwinked by a numbers game. Instead consider the whole procedure. Our experience seeing patients ranging from 4-86 years of age and now going into our 5th year, clearly has shown that all patients given adequate preparation and stimulation can achieve multiple millions of active cells.
    Unedited e-mails:
    From: Tony
    Subject: 6 month update...
    Date: June 19, 2012 6:01:51 PM CDT
    To: Dr. Alan Kadish
    Reply-To: Tony A

    Hello, Dr. Kadish.
    I'd like to give you an (overdue) update:
    - I've been attending physical therapy once a week. As a result, I am able to move more freely and confidently.
    - My routine now includes ankle weights and a medicine ball.
    - I can quickly snatch something off the floor and stand back up without any balance issues (this is completely new).
    - I feel my recall has improved quite a bit.
    - With stretching at physical therapy, I have a much greater range of motion (I can now touch my toes).
    - I'm down to 155lbs, from nearly 170lbs (at its peak).
    - I fall very little these days.
    - I actually shift my core AND feet to correct an imbalance rather than falling -- unconsciously (new behavior, started a couple of months ago).
    - I was able to take shifts during Comicon carrying a 25lb backpack filled with water-bottles without any of the issues I used to have. After 4 days of attending, I was only as tired as my friends-- not more tired, sooner. The only soreness I felt was in my feet (and a little in my back), but a night's rest really helped. I took few breaks and had to rest very little.
    And here's some other news:
    - I'm at the end of the rewrite process for a screenplay of mine (with assistance), which will be looked and critiqued by someone with a lot of Hollywood experience.
    - The documentary is back on route, with interviews to be conducted in July (no hard date for completion yet). We had to remove the EEG from the overall results, as they could not get the machine functioning within a reasonable time frame and it was delaying the documentary.
    I hope all is well.
    Antonio


    Hi Dr. Kadish,
    I want to update you on my progress since my treatment in mid February. (2012)
    While still in Cancun I experienced very early sensations in my feet. The sensations covered everything from pin-prick pain, to muscle throb, to sensations of touch and movement. It was like my brain/spine was sending signals to my feet that my feet was having trouble understanding the message. Also, the numbness in the soles of my feel seemed to be less.
    Since Cancun I have been on a regimented stationary-bike and balance ball exercise program. My strength is increasing. My walking has improved, better some days than others. I need to learn how to walk again. The muscle memory that goes into walking without thinking is slowly returning. The one area that has not improved as must as I would like is my stamina. I cannot walk more than 100 - 150 feet and my legs (especially the right leg) screams out in pain like I had just ran a 200 meter race. For reference, my left leg has always been stronger than the right leg. On the exercise bike I can pedal harder with the left and observe the left leg tires out first.
    Every other measure of my physical health is very good (heart rate, blood pressure, weight, down ~ 12 lbs.) except for my blood-sugar. It remains stuck in the 150 region and none of the medicines I have tried (2 so far) seem to help.
    I believe that my low testosterone might be the culprit. I'm scheduled to see my Wellness Doctor next week.
    72 years ago I out grew my tricycle. I have asked for a new 3-wheeler for my up coming birthday. I hope to increase my workouts with a new toy. My balance might be good enough for my current dirt bike, but I could get myself in a difficult situation, so the 3-wheeler should be the safe and sane answer.
    Progress is very slow, I'm still using my braces in my shoes and my cane. The cane is more of a confidence crutch than a needed support device. Most of the time I walk without the cane around the house.
    If this was a baseball game, I believe I am around first base. Whether I will improve enough to get all the way around to home plate is very much in doubt at this time. I intend to get there, but this soon to be 75 year old body does not take orders very well.
    That is all for now. I will keep you updated as things change.
    Gary


    On Jan 17, 2013, at 2:24 PM, Gary B wrote:
 

    I had expected that the stem cells deposited through my body would all be fired up or die off after a few months, so physical changes would be in a period of less than 6 months after the procedure. Too my surprise I seem to be experiencing more sensation in my feet as time goes on. The progress is slow, but seems to be ongoing. Getting the proper exercise to build upon this emerging functionality remains a challenge. 

> I'm pleased with what is happening and hope it continues. It have purchased two more leg braces that provide support to the shin and the outside of the shin area. The Orthopedic guy said the support to the back of my calf area was really not necessary, it is the muscles on the outside of the shin, above and below the knee that need help. Balance is my biggest problem now, and these new braces could make a difference based upon my a limited in-office demonstration.
> 
> That is all for now.
> 
> Gary

    Q: At times I get too much O2 and have to desaturate. What causes this? (Patient has COPD).
    A: Due to your COPD you may be utilizing excessive oxygen. This can lead to both hypercarbia (increased CO2) and respiratory acidosis. You will need to see your pulmonologist to evaluate your partial pressures and confirm an appropriate oxygen flow rate. You can read about this condition in more detail at AHRQ. This is essential for your condition to prevent a potentially life threatening situation.

    Q: What is your protocol for CMT (Charcot Marie Tooth Disease)? What types of results are you seeing and are multiple treatments most likely needed?
    A: I would start with a review of our CMT page and if you contact us we have CMT newsletters that will be of interest to you as well.
    Our protocol for CMT uses a number of approaches to address this disorder including stimulation, growth factors, cell expansion lumbar and IV placement of the cells, along with physical therapy and other stimulation for the purpose of making certain that the maximal engraftment takes place. We also evaluate other potential factors that will have a long-term effect on re-myelination and inflammation. Please keep in mind that all patients have a specific individual protocol based on our physician’s conferences, at World Stem Cells Clinic meetings, following a review of your medical history and examination.
    Our CMT patients have been both type 1 and type 2's and range from 14 to mid 80's years of age. Results have varied from moderate to truly amazing. The typical responses we see include return of some sensation in the legs, typically leading to better balance, some muscle regrowth, increased energy and a better overall quality of life. I would refer you to one of many of our follow-up patient responses. (below)
    Since many people ask, "how long will the therapy last" , a quick look at the second follow-up e-mail, from Gary at the 1 year point is instructive. Many of our patients have had long-term changes similar to Gary’s. We are finding that the consistency is dependent on many factors and feel strongly that the use of many inputs, including physical therapy, vitamins and other medical considerations make for major positive changes.

    Q: You have a background in naturopathic medicine and from what I have read, you integrate a number of therapies into your protocols. Do you believe that this integration of a combination of different therapies is overwhelmingly more beneficial to patients than stem cell treatment alone? And if so, why?
    A: My background gives me the appreciation of the concept that isolation, with a single treatment in this case stem cells, is but one part of the process needed for health restoration. I firmly believe and the literature supports the contention that our complex bodies are never influenced in the vacuum of a single component.
    An excellent example, in the stem cell industry, is the use of growth factors coupled with stem cells, which is essential for good engraftment and differentiation. For those inclined to go into the current state of the art, look at the term paracrine effect and it becomes obvious why a whole body effect is essential.
    A good way to grasp the idea of the complexity of the body and it's essential need for multifocal approaches can be had if one considers the body as being similar to your car. Without all 4 wheels you're not going to go far. The motor may indeed run and the lights can function, but as a whole the car is far from fully useful.
    Naturopathic medicine is for some misunderstood. I think the best way to describe the integration at WSC is we take the scientific basis, look at the whole patient and then ask a key question….. how did the patient get into their current state of affairs.
    Take a gardening approach to setting the conditions for a great crop. You first need to check the soil, moisture, and other factors to set the stage for optimal germination and growth of the seeds (Stem Cells) , before planting.
    Now let's consider a patient with Parkinson's disease. If you look at the published literature carefully it has been seen as an environmental disorder, for years. If you choose to solely address the cellular damaged area or simply replace the dopamine loss the patient will continue their decline. The “soil” needs amendments and other changes to give good results.
    Most patient's we see have been experiencing the results of multiple systems no longer adequately functioning. Would you only replace one bald tire ? Of course not, if you had options.
    The essential philosophy of Naturopathic medicine is that it is encompassing of all that medical science has to offer. Our training is identical in the areas of basic sciences and conventional medicine, with the key being the additional training in many medical aspects of life style, along with the use of nutrition, botanicals, vitamins and minerals, from a therapeutic consideration.
    Naturopathic physicians do use conventional approaches, when appropriate, including prescriptions, surgery and many other conventional procedures including, physical therapy, respiratory therapy and a host of other interventions.
    When you couple these means with a scientifically based personally tailored aspects including: nutrition, vitamin or other nutrient needs, life style considerations, from exercise to toxic exposures, your get the rest of the story. With the advent of stem cell therapy you now have a very potent and accessible means of positively influencing many diseases.
    Obviously stem cell therapy is as natural as it gets. Consider that in many published stem cell expansion solution protocols you will now commonly find such items as vitamin C, along with other amino acids , etc.. The same internal environment is essential for our cells in the lab.
    Clearly in the last 30 years medicine has now embraced and verified the scientific validity of most natural approaches to health. It's become more of a conventional approach to embrace vitamins, nutrition, life style and many other natural therapeutics. This is and has always been the bedrock of Naturopathic practice. There should be no different in the stem cell field.
    To amplify the concept let’s consider another aspect of Naturopathic therapeutics. A good physician recognizes the importance of seeking to balance the hormones in our patients. This equilibrium of interacting endocrine functions sets the stage for literally every process in our bodies, from repair to cellular replacement to the speed of our metabolism.
    We frequently find our patient’s anabolic (building) hormones to be out of balance. Here is another excellent common sense piece of the puzzle that needs to be present in cell medicine. Consider that the typical "older" male patient has experienced a decline in his naturally occurring levels of testosterone. This hormone is critically importance to create an environment for proper cell development.
    I’m certain you can see from these examples the obvious need to get the whole picture to maximize cellular therapy. This is a critical difference in getting some results vs. maximizing the potentials to get superb responses.
    All patients deserve to receive their optimal potentials.
    I contend that if our real intent is to achieve the best possible health ....... it's clear giving the maximal amount of opportunity to the patient, in total, is just plain good medical practice.

    Q: What kind of treatment do you recommend for ulcerative colitis?
    A: As I started to answer this question I realized that this is an excellent example of a disease that need much more than a prescription answer.
    Ulcerative colitis requires a complete workup, which would evaluate the irritants (physical, bacterial, viral, gut contents), immune function, hormone levels, and genetic aspects, along with life style considerations.
    From a stem cell prospective, at World Stem Cells, we have had the opportunity to see major changes in colitis symptoms and findings by using a combination of therapies. Long-standing fistulas and areas of ulceration have repaired, along with a return of proper bowel function. Keep prospective that UC is a systemic disorder. The gut is the focus, but the overall inflammatory cascade affects the whole body. Please see my answer above.
    Clearly stem cell therapy has a major impact on the chemistry of inflammation and directly on healing areas in the gut. When combined with proper evaluation and treatment, of underlying causes, is a very powerful force for repair and proper function.

    Q: Do you believe that age is a major factor in the success of a stem cell transplant? If someone is elderly would it not be better to get umbilical cord stem cells or fetal stem cells rather than using their own?
    A: Great question and one we field often. We at WSC have seen patients ranging from 4-86 years of age. Curiously even some of the elderly have had remarkable cell counts and tremendous levels of viability. It appears from my reviewing the many 100's of patient records that it may be more a factor of type of disease, intensity and duration along with their response to stimulation. Is it receptor sites, the sensitivity to stimulation or a combination of the multiple inputs we use to treat our patients’, who knows ? What I would tell anyone is that the fact that you’re still functioning, bodes well for your response to stem cell transplant.
    I hesitate to recommend the fetal cells for many reasons. With the newest advent of DNA/SNPMs testing I would ask you to consider who’s DNA do you want commingled in your body ? After ~ 10 year of looking at the first and second generation of testing it becomes a scary affair when you realize that NO individual has the ideal unadulterated perfect expression.
    To add to my pause, having been in this industry going on 5 years, I see too many laboratory shortcuts to make me feel that I would trust that an allogeneic addition, to my patient’s disease profile, is not coming from the cells being introduced. There is no way to cost effectively check for more than the obvious bad players, including hepatitis, HIV, some viruses, etc.. To complicate the issue no consistent regulation is in place to insure a wider evaluation of all samples, for other diseases. Add to this the fact that in some countries we have higher prevalence of certain disorders, such as Chagas disease in Latin and South America. These diseases are not required nor being checked by many groups.
    There is a new technology that can effectively evaluate for > 3000 bacteria and 2000 viruses, using partial DNA fingerprinting. I think most folks are going to be very concerned with what we will find. Remember that the highest numbers of issues with stem cell therapy, from allogeneic sources, has been CMV (Cytomegalovirus). Not a death sentence, but not something we want our patients getting from what should be a positive health enhancing treatment. I look forward to the use of other means of therapeutic sources as a "better idea" once we can be certain that patients are indeed getting what they paid for and nothing else.

    Q: How long does a patient need to stay in Cancun to have treatment? Do you treat them in a clinic or at a hospital?
    A: Most patients spend 5-7 days with us at the World Stem Cells Clinic. This allows us the opportunity to provide a comprehensive approach and extensive medical therapeutics. We have developed longer treatment times when additional aesthetic or otherwise more complicated situations are present. Our approach is an individualized format determined after medical evaluation and conversations with our patients.
    Patients are typically seen in an outpatient setting and many of our procedures are done in accredited operating rooms. Hospital options are available and used dependent on our patient’s condition, the disorder and intensity of the disability. For those patients we will use one of our affiliated hospital facilities.

    Q: Is there a certain window where children who suffer from autism or cerebral palsy for instance have a better chance of getting improvements from stem cell therapy? In other words, is the younger the better or is it best to wait until they might develop more on their own and then have stem cell treatment when they are able to travel and tolerate the treatment more easily.
    A: Let me answer by stating unequivocally that our experience with children, which is a very large part of our clinic population, there has never been an issue with tolerance. We use a number of pediatric specialists on staff for many of our procedures and they are parents.....and “get it”. For younger children we find that going the extra distance to make them and their family feel comfortable and even entertained, within a medical setting, is doable.
    I do believe that we have a golden window for both ASD and CP patients. It appears that when our neurological and musculoskeletal systems are influenced earlier we have a greater capacity to make the substantial positive changes we are seeking.
    Keep in mind that the nervous system is now not considered fully formed, till we are between 21-23 years of age. Yes, it continues to evolve but the major amount of plasticity is no longer present. So the sooner you receive treatment, for your children, the higher the potential for more change.
    It costs nothing to find out if we can assist your child. Go to the “request a free consultation form” and we will evaluate and determine the potentials for making the changes your child deserves.
    Last edited by Jeannine; 10-03-2013 at 04:36 PM.
    Still Pioneering
    Had UC treatment April 5th, 2007
    Had autologous treatment March 19, 2010
    Had bone marrow and adipose stem cell treatment (autologous) June 16, 2010

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