My body experiment: stem cell therapy

I’ve always been active. In high school, I wrestled and played soccer and lacrosse. I got into cycling and mountain biking in my early 20s, but in March 2007 at age 26, I was diagnosed with rheumatoid arthritis (RA), a chronic inflammatory autoimmune disease. I always felt worn down, my whole body ached, my hands and feet swelled, even my skin hurt. For the next decade, I lacked the strength and mobility to exercise regularly—so I didn’t.

If I didn’t make a change, I was going to die.

Seamus Mullen

The immunosuppressants I was taking for the RA made me the perfect host for infections. In March 2012, I contracted bacterial meningitis, a life-threatening infection in the brain. I realized if I didn’t make a change, I was going to die. I met with a functional medicine doctor in April 2012 and learned about how food can help minimize and even reverse disease. I eliminated sugar, dairy, grains, and refined carbs and ate more healthy fats, prebiotic foods, fish, and lean meats.

The hallelujah moment came eight months later. I woke up, got out of bed, and realized halfway down the stairs that I was walking pain-free. (I credit my dietary changes, supplementation, medication, acupuncture, and herbs with helping me heal.) Once that sunk in, I got back in the saddle—literally. I hadn’t ridden my bike in years and I still dealt with bone spurs and deteriorating joints from RA, but I was in my happy place again. Unfortunately, it didn’t last long.

The Crash

In October 2017, I was leading a five-day, 400-mile cycling tour in Italy along the Strade Bianche, those famous (and very old) white gravel roads of Tuscany. One day, I was barreling down a steep hill when my front wheel got caught in a patch of marble-like pebbles. I was thrown over the handlebars and hit the ground head first at 36 miles per hour. My head and left shoulder suffered the first blows, cracking my helmet, before I cartwheeled onto my right arm.

My doctor basically said, ‘The longer we wait, the lower your chance of complete recovery.’

Seamus Mullen

Something was seriously wrong. I knew that immediately because I could barely lift either arm. This was halfway through that day’s 70-mile ride, but we didn’t have a support vehicle with us. I had no choice but to get back on the bike, and I ended up finishing the tour. It was painful, of course, but I was in Italy. I didn’t want to miss the opportunity.

While I was there, I called Dr. Aruna Seneviratne, a surgeon I’d consulted before, to tell him about the accident. The day I got back to the US, I went in for an MRI and was told I needed shoulder surgery immediately. It was such a violent injury that the tendon had curled back into the muscle, making it difficult to reconnect the two. When tendons are severed, the tissue starts dying. My doctor basically said, “The longer we wait, the lower your chance of complete recovery.” We had to do it as quickly as possible.

My left shoulder surgery was scheduled for a week later that November, and my right shoulder 10 days after that.

What is stem cell therapy?
A stem cell is a cell in your body that can turn into other types of tissue. “It’s like a baby cell that can develop into a muscle cell, tendon cell, or bone cell,” says Aruna Seneviratne, MD, an orthopedic surgeon at Mount Sinai West Hospital in New York City. Everyone has stem cells, he says, but they age and decrease in quantity as we get older.
With stem cell treatment, doctors take stem cells that live inside you, concentrate them, and inject them into a damaged joint or tissue to promote healing, he explains.
Do stem cell treatments work for any injury?
Certain types of injuries benefit from stem cell therapy more than others, he says, like tears in the rotator cuff, a group of muscles and tendons that attach to the shoulder bone and help control arm movement. Seneviratne says these types of tendon-to-bone injuries typically heal slowly. He cites studies that have found stem cells can speed up recovery and reduce the risk of re-tears even 10 years post-treatment.
Stem cell treatment can also be helpful for knee arthritis, Achilles injuries, tennis elbow, and knee-related sports injuries (like ACL tears) in conjunction with surgery, he says.
Are there any risks of doing stem cell treatment?
“As with any injection or surgical procedure,” says Seneviratne, “there’s the possibility of infection.” Beyond that, however, there are no major risks. Still, stem cells have very specific applications so doctors decide whether to use them on a case-by-case basis.
Who is a good candidate for stem cell treatment?
Anyone interested in healing quickly, Seneviratne says. In general, the younger the patient, the better. Someone with a history of cancer likely wouldn’t qualify for stem cell treatment because there could be dormant cancer cells living in the bone marrow, he adds. Injecting those into a joint could help the disease spread.

By Paige Smith
The Stem Cell Treatments

I’d read a lot about people having success with stem cell therapy for soft tissue injuries, like in the knees. It’s being used more and more for a lot of things, even treating type I diabetes, but in many ways it’s the future of medicine. Dr. Seneviratne is recognized for his stem cell work, specifically with rotator cuff injuries. I asked him if the treatment was an option for me, and he agreed to give it a chance.

During the procedures, the doctors stretched the tendons in my shoulders to reconnect them to the humerus bone and injected stem cells (which they extracted from my iliac crest, the top part of the pelvic bones) into the shoulders at every anchor point.

A surgeon extracts stem cells from Mullen's hip an hour before his shoulder surgery at Mount Sinai Hospital in New York City in November 2017.

Wherever they are, stem cells replicate and promote growth. In places where ligaments had to connect to other ligaments, they created new cells to create a stronger bond. Where tendon had to connect to bone, they encouraged the bone to grow over the tendon.

The recovery process was tough. Stem cell therapy makes recovery more painful than it would be otherwise because there’s an inflammatory response when the cells are actually growing. I was in incredible pain for the first six weeks post-surgery.

Plus, my movement was so limited for the first few weeks following surgery. My shoulder was isolated in a sling and hooked up to an icing machine that flushed it with cold water. I was immobilized for about 10 days and couldn’t lie down for the first week, so I had to sleep in a chair, and bathing was pretty much impossible.

Mullen's left arm is immobilized after receiving stem cell treatment and shoulder surgery at Mount Sinai Hospital in New York City in November 2017.

On top of that, I couldn’t use my hands for up to three weeks post-op. Since the second procedure was 10 days after the first, both of my hands were rendered useless at the same time. It's a good thing I wasn't working while I recovered.

Once I got past the six-week mark, the pain level totally dropped off and I was left with a complete anatomical repair that put me in a position to be able to properly rehab my shoulders. The doctors said my recovery went significantly better than it would have without the stem cell treatments.

The Rehab and Training

I started training with Michaelangelo Gabat, a Tier 3+ trainer at Equinox Dumbo in Brooklyn in late November 2017, two weeks post-op. We met for one-hour sessions three or four times per week.

We started small, working on upper-body mobility and lower-body conditioning and strength training. In the beginning, one of the exercises involved me standing, facing the wall with my arms straight in front of me and my palms flat against the wall. All I did was focus on contracting and releasing the scapula. Once I learned how to engage the tiny muscles in the shoulders, we added resistance with moves like isolated rows, Turkish get-ups, and bench presses.

I trained with Gabat from November 2017 to June 2018, building strength in my shoulders and working on my general fitness. Every two weeks we’d do a benchmark workout: 100 medicine ball slams, 100 jump squats, 100 battle ropes, a one-mile run on the treadmill, a 2,500-meter row on the rowing machine, and a 600-calorie burn on the Airdyne bike.

It was motivating to track my progress on the bike. On my first try, it took me 48 minutes to burn 600 calories. The last time, I did it in 32 minutes.

Mullen prepares for a back squat at Equinox Dumbo in Brooklyn in March 2018

The Importance of Nutrition

Following my shoulder surgeries, I continued to eat clean. I’m good friends with Melissa Hartwig, the co-creator of Whole30, and we talked about the benefits of the program. I basically ate Whole30 all the time and took more supplements to help me heal. I added in a high dose of vitamin C, collagen peptides, bone broth, chlorella (seaweed-based chlorophyll), curcumin (the chemical compound in turmeric), and strontium, a mineral that helps bone growth. Topically, I used arnica and comfrey root on my shoulders to reduce inflammation and promote soft tissue growth, respectively.

Learning how food can help you heal your body has led me to integrate healthier food into my professional cooking, too. I feel strongly that there shouldn’t be a disconnect between eating for health and eating for pleasure; I think they’re one and the same. I want to help illustrate that eating healthy does not mean foregoing pleasure or delicious food. When I cook for my restaurant, I avoid refined sugars and almost all refined carbs, use healthy fats and proteins, and make vegetables the true star. Think: a chicken bowl with mustard greens, kale, mushrooms, cucumber, and yuzu vinaigrette.

You can exercise a lot of autonomy over your health...a thousand tiny decisions can turn the Titanic.

Seamus Mullen

Mullen rides in San Giovanni D'asso in Tuscany, Italy, in October 2017.

Now that I’ve rebuilt my strength, I go mountain biking or cycling five to six days a week and do yoga two to three days a week. I’m 11 months post-op, and my shoulders feel amazing. As for my RA, all the biomarkers, like my white blood cell count and C-reactive protein levels, are negative after being positive for many years.

This experience has taught me the incredible importance of taking an active role in your health. I was passive for a long time. I saw myself as a sick person and thought all I needed to do was go to the doctor and take my medicine as prescribed.

But you can exercise a lot of autonomy over your health. You can’t just treat one element in isolation—you have to treat the body as a system by considering your lifestyle choices, nutrition, training, supplementation, rest, and stress levels. No single decision is going to move the needle dramatically, but a thousand tiny decisions can turn the Titanic.