Pre-Procedure Information
Medication | Nutrition | Preparation
Medication Restrictions
Based on over a decade of research Regenexx has learned that the following medications have been shown to be particular problems in our clinical experience or are suspected to be issues based on what is published in the medical research about their impacts on cells or stem cells.
DO NOT DISCONTINUE ANY MEDICATION WITHOUT SPEAKING WITH THE PRESCRIBING PHYSICIAN
Please note: Your Regenexx Physician will provide the timeline to discontinue these medications for your specific case. If you did not discuss these medications at your evaluation, please contact your Care Coordinator to see if any adjustments need to be made to the timing of your scheduled procedure.
- INHALED STEROIDS for asthma: Advair, beclomethasone, budesonide, Flovent, fluticasone, mometasone, Nasonex, Pulmicort, QVAR, etc.
- STEROID INJECTIONS like those given for knee or joint arthritis or sciatica.
- ORAL STEROIDS like Prednisone, methylprednisolone, etc.
- TOPICAL STEROID CREAMS AND EYE DROPS
- NSAID DRUGS like Aspirin, Meloxicam, Motrin, Ibuprofen, Aleve, Naprosyn, Celebrex, Voltaren, Cataflam, and others. If you think you will have intolerable pain with stopping these drugs, then please let us know. We can often substitute high-dose fish oils or the Regenexx Advanced Stem Cell Support Formula Supplement for these drugs. In fact, one of the ingredients in the New Regeneration supplement(Curcumin) was recently shown to be as effective as Ibuprofen for reducing pain and stiffness.
- STATIN CHOLESTEROL LOWERING DRUGS like Crestor, Lipitor, Mevacor, Pravachol, Vytorin, Zocor, and others. If you have a history of heart disease you must clear stopping these drugs temporarily with your prescribing cardiologist or internist.
- ACE/ARB BLOOD PRESSURE DRUGS like Lisinopril, Enalapril, Altace, Accupril, Prinivil, etc. If you’re on these drugs, consult with your Regenexx doctor and/or prescribing doctor about switching to a different blood pressure drug.
- TESTOSTERONE INHIBITORS like Proscar or Propecia. If you’re on these drugs, consult with your Regenexx doctor and/or prescribing doctor about stopping for a while.
- BLOOD THINNERS like Xarelto, Coumadin, Eliquis, Apixaban, Rivaroxaban, Warfarin. These medications should be discontinued for a time period that is approved by the Prescribing Physician.
- QUINOLONE ANTIBIOTICS like Floxin, Noroxin, Cipro, Levaquin, etc. These have been associated with tendon ruptures, so consider speaking with your doctor about alternative antibiotics.
- PROTON PUMP INHIBITORS like Aciphex, Nexium, Prevacid, Prilosec, Protonix should be discontinued unless you have Barrett’s Esophagus, in this case, please remain on your medication.
Suitable alternatives are Axid, Zantac (ranitidine), Pepcid (famotidine), Tagamet, Tazac, or Zantac. - OTHER MEDICATIONS TO AVOID Avandia (rosiglitazone Anti-Diabetic medication), Pepto Bismol (contains salicylates), Interferon (immune suppressant), Chemotherapy drugs, Erythropoietin (EPO), Human Chorionic Gonadotropin (HCG), Marijuana
Exceptions to Medication Changes
- MALE OR FEMALE HORMONE REPLACEMENT including thyroid hormones, estrogen, progesterone, testosterone, and growth hormone-like Norditropin. You should stay on your hormone therapy and just avoid abrupt changes within 1-2 weeks before or after the procedure.
- THYROID MEDICATION You may continue to take thyroid medication.
If you are taking any of the medications on the restricted list and did not discuss them with your Regenexx Physician it is important that you contact us prior to your scheduled procedure.
Anti-Inflammatory Medication Alternatives
Below are some alternatives that do not impair your healing mechanisms.
- Acetaminophen (Tylenol) Take 500mg (1-2 tabs) every 6 hours as needed for pain. No more than 6 tabs or 3000mg in a day. If you have a prescription for Tramadol, take an extra-strength Tylenol at the same time to potentiate the effects of either drug alone.
- Curcumin/Turmeric New Regeneration Curcumin has been found to be as effective as over-the-counter NSAIDs for the relief of osteoarthritis pain. Patients can take 750-1500mg or 1-2 capsules 2-3 times per day in conjunction with the Liquid Stem Cell Support Formula. **If you are taking blood thinners, please discuss and obtain authorization before supplementing with Curcumin/Tumeric as it may increase the risk of bleeding.
- New Regeneration Omega-3 Two capsules provide 1000 mg of EPA and 500 mg of DHA and include lipase, a fat digestive aid to ensure maximum absorption. Regenexx fish oil products are provided in the triglyceride form (TG) and carry the TruTG seal. Take two capsules 2-3 times daily.** If you are taking blood thinners, please discuss and obtain authorization before supplementing with Fish Oil as it may increase the risk of bleeding.
- Glucosamine Building block for cartilage. Helps with mild to moderate arthritis. Take combined with chondroitin +/-MSM. Take 1500mg daily divided into 2-3 doses in a day as it may cause stomach upset if taken all at once. If you are taking the Regenexx Stem Cell Support formula you do not need to supplement with additional Glucosamine.
- Arnica homeopathic medication can be taken orally or topically. It helps with acute traumas, bruises, soreness, and arthritis. Take 2x daily for 1 week. If no improvement after 1 week, then stop.
- Bromelain A pineapple extract and a natural anti-inflammatory. As a tablet take 500mg 2-3 times daily. In capsule formulations: 2,000MCU per 1000mg or 1,200 GDU per 1000mg.
- Capsaicin Cream Made from hot peppers and decreases substance P which leads to decreased pain. Helps with pain in superficial joints and muscles. Apply a moderate amount of 0.025% or 0.075% cream up to 3 times daily. I recommend using gloves or washing hands very thoroughly after use because the cream can burn. Do not touch eyes, nose, mouth, or genitals after use as it can cause irritation and burning.
- Biofreeze or other menthol products without aspirin. Truameel cream is also ok.
Allow 1-4 weeks to notice a difference in pain for Bromelain, fish oil, glucosamine, and Tumeric.
Core-4 Supplement Package
Your Regenexx Physician may have recommended our “Core-4” supplement package. This specific combination of supplements is proven to optimize results, as well as provide anti-inflammatory support throughout the course of your procedure. These supplements can be started as soon as possible and ideally should be taken both before and after your procedure. The package consists of a 30 day supply of each of the following.
- REGENEXX ADVANCED LIQUID STEM CELL SUPPORT FORMULA: Supports healthy stem cell and cartilage production.
- NEW REGENERATION CURCUMIN: A potent anti-inflammatory that promotes stem cell function.
- NEW REGENERATION HIGH ABSORPTION OMEGA-3: An anti-inflammatory that protects cartilage and creates an environment that supports stem cell function.
- NEW REGENERATION MELATONIN: Promotes stem cell conversion into cartilage.
The “CORE-4” is available in our clinic or can be ordered online through our website.
https://newregenortho.com/products/
Medication Substitutions
Please use the following list as a guide when discussing acceptable substitutes for your blood pressure and/or cholesterol medications with your prescribing physician.
DO NOT DISCONTINUE ANY MEDICATION WITHOUT SPEAKING WITH THE PRESCRIBING PHYSICIAN
Suggested Substitutions for Cholesterol Medications (Statins)
- Pantetheine 450 mg twice daily
- Fish Oil 2-4 grams of EPA + DHA per day or NewRegeneration High Absorption Omega-3, or Omega MonoPure 1300 EC by Xymogen 2 soft gels per day.
- Zetia or Lopid (Gemfibrozil)
- Niacin may start with 1000mg at dinner. May increase to 1500mg if well tolerated. Discuss with your primary doctor. Add a small handful of nuts just prior to taking, such as 5-10 raw almonds, walnuts, or pecans, to slow niacin’s absorption in the body. Do NOT take niacin with an aspirin (as is often recommended) if you are planning a Regenexx procedure. Avoid alcohol and spicy food when taking niacin, this may worsen the niacin flush. Do NOT substitute with niacinamide or inositol hexanicotinate.
Suggested Substitutions for Blood Pressure Medications (-Prils)
- Hydrochlorothiazide (HCTZ)
- Calcium Channel Blockers (CCB’s)
- Maxzide
If the above medications are not sufficient or not tolerated, then a Beta Blocker can be used. Please avoid ACE inhibitors and ARBs
Other Recommendations for High Blood Pressure
- Ground Flaxseeds 2-3 tablespoons per day (average 15/7 drop in blood pressure)
- Hibiscus Tea Two cups of strong tea using a total of 5 tea bags in the morning (4-6 point drop in systolic blood pressure)
- Nitrate Rich Vegetables Arugala, Beets, Basil, Beet Greens, Swiss Chard, Cilantro, Rhubarb. Eaten daily can reduce sodium intake to <1500 mg per day.
TO HELP MANAGE BLOOD PRESSURE WITHOUT THE AID OF A PRESCRIPTION, WE RECOMMEND THE FOLLOWING DEVICES:
- RESPERATE is the only non-drug product cleared by the FDA for lowering blood pressure. It can be found at www.resperate.com/shop
- ZONA is a device proven to safely improve cardiovascular health using an easy to perform, non-invasive isometric therapy. It can be found online at www.zona.com
Nutrition
GENERAL RULES: For best possible outcome and post-procedure comfort
- Eat plenty of vegetables and fruits, whole-grain foods, and protein foods
- Choose protein foods that come from plants more often
- Choose foods with healthy fats instead of saturated fat
- Limit highly processed foods
- Prepare meals and snacks using ingredients that have little to no added sodium, sugars, or saturated fat
- Choose healthier menu options when eating out
- Make water your drink of choice. Replace sugary drinks with water. If you like soda, try naturally flavored carbonated water with no artificial ingredients or sugars
- Read food labels. Be aware that food marketing can influence your choices
FATS: The type of fat you eat over time is more important for health than the total amount of fat you eat
- Foods containing healthy fats: nuts, nut butter, seeds, avocado, fatty fish, extra virgin olive oil, avocado oil
- Foods containing higher saturated fat content: fatty meats, high-fat dairy products, some highly processed foods,
some tropical oils such as palm oil and coconut oil, coconut cream, most fried foods - Try different types of fatty fish such as trout, salmon, herring, mackerel
- Make your own salad dressing with olive or flaxseed oil. Add balsamic, rice wine or other kinds of vinegar. Flavor with lemon juice, Dijon mustard, garlic, and herbs
AVOID PROCESSED FOODS: when cooking, people may use highly processed foods for convenience and to save time
- These types of food products include: prepared sauces, ready to eat soups, ready-made dishes
- Make your own versions of these foods or replace them with healthier options
ADD FLAVOR: When you cook at home, you can decrease the amount of salt you use by adding herbs, spices and
seasonings. Your taste buds will adjust to less salt in your food
- Instead of using pre-seasoned foods, salt, gravy, or sauces, enhance the flavor of your food by adding: citrus,
flavored vinegar, fresh or dried herbs, and spices
HEALTHY COOKING METHODS: Baking, grilling, steaming, stir-frying, and sautéing
GRAINS: Choose whole grains only and avoid large quantities. Read labels carefully, even when advertising “whole grains”, most products mix with refined and processed grains (eg. “enriched wheat flour”).
- Try a variety of different grains: quinoa, amaranth, spelt, whole wheat, buckwheat, barley (if not gluten sensitive), oats, etc.
SUGARS: Avoid ADDED Sugars (raw or white sugar, brown sugar, coconut palm sugar, molasses, agave, corn syrup, fructose, maple syrup, honey, etc.) and fruit juices - Avoid artificial sweeteners: sucralose (Splenda), aspartame (Equal and Nutrasweet), saccharin (Sweet ’N Low)
- Natural sweeteners – ok to use in small quantities: Monk fruit. Stevia, sugar alcohols (erythritol, xylitol), raw honey
Physical Activity
It is advised that you increase aerobic activity, targeting a minimum of 150 minutes (or 2.5 hours) per week. The chosen activities should not worsen pain in the areas for which you seek treatment. For treatments involving the lower extremities, low-impact exercises are best; examples include walking, elliptical, aquatics, or biking.
NOTE: We would like you to say as active as you can comfortably, before and after your procedure. Our general rule is to participate in an activity to your comfort level without exceeding an additional 2/10 on your pain scale.
Preparation
Fasting is required for 3 hours prior to the following appointment types:
- Bone Marrow Aspiration
- Mini Lipo Aspiration
- Some Cervical Spine Procedures (if indicated by your Regenexx Physician)
- Any procedure in which NITRONOX is used
You should fast from food 3 hours prior to each one of these appointment types. Avoid caffeine and hydrate with 48-64 oz of water per day for three days leading up to your procedure appointments. Being well hydrated will benefit your blood draw and bone marrow aspiration appointments.
Lab Work
Our medical team will check your hemoglobin levels before your procedure.
In some cases, your Regenexx Physician may request a copy of your most recent blood work or order a CBC for you.
Imaging
If imaging is ordered for you our staff will obtain authorization from your insurance provider, if required, and submit the order to the imaging facility. The imaging facility will contact you directly once they have received the order and authorization to schedule your imaging appointment. To keep things on schedule We do ask that you contact us if you do not hear from the imaging facility in a timely manner. Imaging should be completed a minimum of 3 days prior to your procedure date. It is recommended that you request a copy of the disk for your records, and bring the disk with you to
your procedure.
Regenexx Registry
In the upcoming days/weeks leading up to your scheduled procedure, you will receive an email from the Regenexx Registry asking you to complete your pre-procedure survey. The registry collects anonymous, non-identifying outcome data. This registry data available at Regenexx Outcome Data.
Please be sure to complete your registration and pre-procedure survey prior to the day of your first scheduled procedure appointment. Your participation is greatly appreciated. Please note, this email does not come from our office, and if you have any questions you can contact the registry directly at [email protected]
Regenexx Medical Travel Concierge Service
Each of our patients has access to a complimentary medical travel concierge service that provides discounted rates for hotels close to our clinic locations. This service is beneficial for patients who may need to travel a distance or prefer the convenience of being close for the days of their procedure. For our Regenexx Corporate Self-Insured patients, please contact [email protected] to see if you have additional benefits through Regenexx Travel.
For Rates Visit Regenexx Travel
Medication | Nutrition | Preparation
Medication Restrictions
Based on over a decade of research Regenexx has learned that the following medications have been shown to be particular problems in our clinical experience or are suspected to be issues based on what is published in the medical research about their impacts on cells.
DO NOT DISCONTINUE ANY MEDICATION WITHOUT SPEAKING WITH THE PRESCRIBING PHYSICIAN
Please note: Your Regenexx Physician will provide the timeline to discontinue these medications for your specific case. If you did not discuss these medications at your evaluation, please contact your Care Coordinator to see if any adjustments need to be made to the timing of your scheduled procedure.
- INHALED STEROIDS for asthma: Advair, beclomethasone, budesonide, Flovent, fluticasone, mometasone, Nasonex, Pulmicort, QVAR, etc.
- STEROID INJECTIONS like those given for knee or joint arthritis or sciatica.
- ORAL STEROIDS like Prednisone, methylprednisolone, etc.
- TOPICAL STEROID CREAMS AND EYE DROPS
- NSAID DRUGS like Aspirin, Meloxicam, Motrin, Ibuprofen, Aleve, Naprosyn, Celebrex, Voltaren, Cataflam, and others. If you think you will have intolerable pain with stopping these drugs, then please let us know. We can often substitute high-dose fish oils or the Regenexx Advanced Stem Cell Support Formula Supplement for these drugs. In fact, one of the ingredients in the New Regeneration supplement(Curcumin) was recently shown to be as effective as Ibuprofen for reducing pain and stiffness.
- BLOOD THINNERS like Xarelto, Coumadin, Eliquis, Apixaban, Rivaroxaban, Warfarin. These medications should be discontinued for a time period that is approved by the Prescribing Physician.
We recommend refraining from blood donation for 2 months prior to and 2 months post-procedure.
If you are taking any of the medications on the restricted list and did not discuss them with your Regenexx Physician it is important that you contact us prior to your scheduled procedure.
Anti-Inflammatory Medication Alternatives
Below are some alternatives that do not impair your healing mechanisms.
- Acetaminophen (Tylenol) Take 500mg (1-2 tabs) every 6 hours as needed for pain. No more than 6 tabs or 3000mg in a day. If you have a prescription for Tramadol, take an extra-strength Tylenol at the same time to potentiate the effects of either drug alone.
- Curcumin/Turmeric New Regeneration Curcumin has been found to be as effective as over-the-counter NSAIDs for the relief of osteoarthritis pain. Patients can take 750-1500mg or 1-2 capsules 2-3 times per day in conjunction with the Liquid Stem Cell Support Formula. **If you are taking blood thinners, please discuss and obtain authorization before supplementing with Curcumin/Tumeric as it may increase the risk of bleeding.
- New Regeneration Omega-3 Two capsules provide 1000 mg of EPA and 500 mg of DHA and include lipase, a fat digestive aid to ensure maximum absorption. Regenexx fish oil products are provided in the triglyceride form (TG) and carry the TruTG seal. Take two capsules 2-3 times daily.** If you are taking blood thinners, please discuss and obtain authorization before supplementing with Fish Oil as it may increase the risk of bleeding.
- Glucosamine Building block for cartilage. Helps with mild to moderate arthritis. Take combined with chondroitin +/-MSM. Take 1500mg daily divided into 2-3 doses in a day as it may cause stomach upset if taken all at once. If you are taking the Regenexx Stem Cell Support formula you do not need to supplement with additional Glucosamine.
- Arnica homeopathic medication can be taken orally or topically. It helps with acute traumas, bruises, soreness, and arthritis. Take 2x daily for 1 week. If no improvement after 1 week, then stop.
- Bromelain A pineapple extract and a natural anti-inflammatory. As a tablet take 500mg 2-3 times daily. In capsule formulations: 2,000MCU per 1000mg or 1,200 GDU per 1000mg.
- Capsaicin Cream Made from hot peppers and decreases substance P which leads to decreased pain. Helps with pain in superficial joints and muscles. Apply a moderate amount of 0.025% or 0.075% cream up to 3 times daily. I recommend using gloves or washing hands very thoroughly after use because the cream can burn. Do not touch eyes, nose, mouth, or genitals after use as it can cause irritation and burning.
- Biofreeze or other menthol products without aspirin. Truameel cream is also ok.
Allow 1-4 weeks to notice a difference in pain for Bromelain, fish oil, glucosamine, and Tumeric.
Core-4 Supplement Package
Your Regenexx Physician may have recommended our “Core-4” supplement package. This specific combination of supplements is proven to optimize results, as well as provide anti-inflammatory support throughout the course of your procedure. These supplements can be started as soon as possible and ideally should be taken both before and after your procedure. The package consists of a 30 day supply of each of the following.
- REGENEXX ADVANCED LIQUID STEM CELL SUPPORT FORMULA: Supports healthy stem cell and cartilage production.
- NEW REGENERATION CURCUMIN: A potent anti-inflammatory that promotes stem cell function.
- NEW REGENERATION HIGH ABSORPTION OMEGA-3: An anti-inflammatory that protects cartilage and creates an environment that supports stem cell function.
- NEW REGENERATION MELATONIN: Promotes stem cell conversion into cartilage.
The “CORE-4” is available in our clinic or can be ordered online through our website.
https://newregenortho.com/products/
Nutrition
GENERAL RULES: For best possible outcome and post-procedure comfort
- Eat plenty of vegetables and fruits, whole-grain foods, and protein foods
- Choose protein foods that come from plants more often
- Choose foods with healthy fats instead of saturated fat
- Limit highly processed foods
- Prepare meals and snacks using ingredients that have little to no added sodium, sugars, or saturated fat
- Choose healthier menu options when eating out
- Make water your drink of choice. Replace sugary drinks with water. If you like soda, try naturally flavored carbonated water with no artificial ingredients or sugars
- Read food labels. Be aware that food marketing can influence your choices
FATS: The type of fat you eat over time is more important for health than the total amount of fat you eat
- Foods containing healthy fats: nuts, nut butter, seeds, avocado, fatty fish, extra virgin olive oil, avocado oil
- Foods containing higher saturated fat content: fatty meats, high-fat dairy products, some highly processed foods,
some tropical oils such as palm oil and coconut oil, coconut cream, most fried foods - Try different types of fatty fish such as trout, salmon, herring, mackerel
- Make your own salad dressing with olive or flaxseed oil. Add balsamic, rice wine or other kinds of vinegar. Flavor with lemon juice, Dijon mustard, garlic, and herbs
AVOID PROCESSED FOODS: when cooking, people may use highly processed foods for convenience and to save time
- These types of food products include: prepared sauces, ready to eat soups, ready-made dishes
- Make your own versions of these foods or replace them with healthier options
ADD FLAVOR: When you cook at home, you can decrease the amount of salt you use by adding herbs, spices and
seasonings. Your taste buds will adjust to less salt in your food
- Instead of using pre-seasoned foods, salt, gravy, or sauces, enhance the flavor of your food by adding: citrus,
flavored vinegar, fresh or dried herbs, and spices
HEALTHY COOKING METHODS: Baking, grilling, steaming, stir-frying, and sautéing
GRAINS: Choose whole grains only and avoid large quantities. Read labels carefully, even when advertising “whole grains”, most products mix with refined and processed grains (eg. “enriched wheat flour”).
- Try a variety of different grains: quinoa, amaranth, spelt, whole wheat, buckwheat, barley (if not gluten sensitive), oats, etc.
SUGARS: Avoid ADDED Sugars (raw or white sugar, brown sugar, coconut palm sugar, molasses, agave, corn syrup, fructose, maple syrup, honey, etc.) and fruit juices - Avoid artificial sweeteners: sucralose (Splenda), aspartame (Equal and Nutrasweet), saccharin (Sweet ’N Low)
- Natural sweeteners – ok to use in small quantities: Monk fruit. Stevia, sugar alcohols (erythritol, xylitol), raw honey
Physical Activity
It is advised that you increase aerobic activity, targeting a minimum of 150 minutes (or 2.5 hours) per week. The chosen activities should not worsen pain in the areas for which you seek treatment. For treatments involving the lower extremities, low-impact exercises are best; examples include walking, elliptical, aquatics, or biking.
NOTE: We would like you to say as active as you can comfortably, before and after your procedure. Our general rule is to participate in an activity to your comfort level without exceeding an additional 2/10 on your pain scale.
Preparation
Fasting is required for 3 hours prior to the following appointment types:
- Mini Lipo Aspiration
- Some Cervical Spine Procedures (if indicated by your Regenexx Physician)
- Any procedure in which NITRONOX is used
You should fast from food 3 hours prior to each one of these appointment types. Avoid caffeine and hydrate with 48-64 oz of water per day for three days leading up to your procedure appointments. Being well hydrated will benefit your blood draw and lipo aspiration appointments.
*Fasting is NOT required for a standard blood draw/platelet procedure unless otherwise directed.
Lab Work
Our medical team will check your hemoglobin levels before your procedure.
In some cases, your Regenexx Physician may request a copy of your most recent blood work or order a CBC for you.
Imaging
If imaging is ordered for you our staff will obtain authorization from your insurance provider, if required, and submit the order to the imaging facility. The imaging facility will contact you directly once they have received the order and authorization to schedule your imaging appointment. To keep things on schedule We do ask that you contact us if you do not hear from the imaging facility in a timely manner. Imaging should be completed a minimum of 3 days prior to your procedure date. It is recommended that you request a copy of the disk for your records, and bring the disk with you to
your procedure.
Regenexx Registry
In the upcoming days/weeks leading up to your scheduled procedure, you will receive an email from the Regenexx Registry asking you to complete your pre-procedure survey. The registry collects anonymous, non-identifying outcome data. This registry data available at Regenexx Outcome Data.
Please be sure to complete your registration and pre-procedure survey prior to the day of your first scheduled procedure appointment. Your participation is greatly appreciated. Please note, this email does not come from our office, and if you have any questions you can contact the registry directly at [email protected]
Regenexx Medical Travel Concierge Service
Each of our patients has access to a complimentary medical travel concierge service that provides discounted rates for hotels close to our clinic locations. This service is beneficial for patients who may need to travel a distance or prefer the convenience of being close for the days of their procedure. For our Regenexx Corporate Self-Insured patients, please contact [email protected] to see if you have additional benefits through Regenexx Travel.
For Rates Visit Regenexx Travel
