At the moment I’m waiting on my shipment of dextrose and isotonic sodium chloride before I can do the injections. I have sterile water vials that I was originally intending to use to dilute the D50, but I’m no longer sure if that will be useful. Correct me if I’m wrong, but the dextrose prolotherapy works by being hypertonic and causing the cells to burst, causing inflammation and, after time, healing. What I’ve read is that prolotherapists who don’t use a compounding pharmacy dilute their dextrose in 0.9% NaCl (or lidocaine solution which I don’t have). The pure sterile water I have would be hypotonic though. If I mix that with the dextrose, would it be less effective? I have 24 10mL vials of sterile water without any additives, bacteriostats, or NaCl. If I can make use of them it would be convenient.
I have heard about the east coast and west coast styles of prolotherapy, and Dr. Hauser’s “comprehensive Hackett-Hemwall prolotherapy” technique. From those videos I see Dr. Trister palpates and identifies the bones of the wrist and, like you said, sort of feels where the bone ends and where the fibro-osseous junction of the ligaments are. Whereas Dr Hauser described his injections as “rows” of injections that cover the whole area. I can see the solution under the skin covering pretty much the whole wrist area.
The buckshot approach seems more appropriate to my wrists considering the widespread damage they have and the duration of the injuries. But my book describes the location and markings of each ligament… Buuut, the book seems to miss certain areas the buckshot approach covers, such as the transverse metacarpal ligaments.
I’m drawn to doing the buckshot, but I am a bit scared of hitting structures like nerves or arteries.
What is the worst that could happen if I inject like that?
I am going to inject myself with one hand. That’s another thing that I suppose limits me from Dr. Trister’s approach. But, with markings, I don’t think I’d need my other hand anyway. All the videos of Dr. Hauser I’ve seen, he only seems to use one hand.
I think my family and friends would think I’m crazy if I asked for help with this. : /
Thank you SO much for all this help you’re giving me!
I can’t give you advice on your first point simply because I don’t know. I would have to dig a little deeper to find an answer. I do know that the dextrose NaCl mix is used successfully. Actually because of the hyperosmolarity any stray bacteria gets killed.
Do whatever’s suits your style best. I would also have opted for the buckshot-style if I were in your shoes.
What happens when you hit a nerve: PAIN! the chances of neurological damage is low IMO. The worst think I think transient stuff, I really don’t expect long term defects. you are dealing with a needle here, not a scalpel so cutting nerves through is almost impossible.
Arteries: I wouldn’t start poking around in the big arteries like carotids, femoral, popliteal, brachial,… hehe
In the wrist you’ve got the radial and ulnar artery you should steer clear of. If you hit them: you’ll maybe get some internal bleeding, no biggie, may even help healing, assuming you stopped your bloodclot medication of course!
Caution: some patients get dizzy and some even pass out from the treatment. Not because of the pain but because of the vasovagal reaction of the body. Be sure to sit down and pause if you are feeling light headed.
extra info: don’t take antiinflammatories (NSAID), use paracetamol instead (does that have the same name in the us?), don’t apply ice use heat instead. After a few days of pain, stiffness, soreness, immediately start rehabbing the wrist. I don’t have a good protocol for you but I bet you can find something on the internet as well.
I think you are brave to attempt this by yourself.
Just for a disclaimer: I’m not a medical doctor, I’m a medical student in my internships. the education i’ve had in prolotherapy is mainly self-taught, also I’ve been taught injection techniques by various “godfathers” in the prolotherapy world. I’ve also worked with a doctor as his assistant who does a lot of cortisone shots so I’ve seen a lot of injections and a lot of what has to be done around it. I promise you that everything that I’ve advised you to do is what I would do myself and is true to the practical reality. The only reason I dare to give you this information is that I think that you are smart enough not to screw it up.