Hitting the Nuclear Option: Autologous Blood Injection

Five months into my current calf injury, I finally went with the nuclear option: an autologous blood injection (ABI).

What does that mean? That means that yesterday a doctor took a vial of blood from my own arm and injected it right back into my leg, using an ultrasound to get the needle exactly into the site of my tear.

My doctor recommended a similar procedure, a platelet-rich plasma injection (PRP), months ago. Back in February, when I had an ultrasound to show that my calf still hadn’t healed, she said a PRP injection could speed healing. Unfortunately, the cost deterred me: $1,000 out of pocket. Ouch. The alternative was to continue to rest and let it heal on its own.

When I got the results of my third ultrasound at the end of April, I was heartbroken. Ten additional weeks of rest failed to heal my soleus strain. And not only that, there was minimal progress since my last ultrasound in late March.

At the point, the doctor said that this strain was beyond unusual in the rate of its healing highly recommended going forward with an injection. Five months should be more than enough time for the body to repair itself. Fortunately, this time my orthopedic doctor also offered an alternative to the very costly PRP injection.

The orthopedic practice had just hired a new physician who would do an autologous blood injection on site at half the price of a PRP injection. ABI is exactly the same as a PRP injection, she said, but instead of spinning my blood to extract the platelets, the doctor would simply inject my whole blood back into the wound. This sounded promising, but I wanted to do some research first.

Honestly, the research in this area generally isn’t very conclusive. There haven’t been any large-scale, randomized trials to prove the efficacy of these kinds of injections (hence why the cost is so high—insurance companies won’t cover it). The anecdotal evidence in favor of these treatments is encouraging, however. Many athletes have returned to competition sooner thanks to these injections, or so the story goes.

My main concern was to be sure I wasn’t doing myself a disservice by opting for the cheaper ABI procedure versus the PRP injection. But many of the studies I found showed no meaningful difference between the efficacy of the two procedures (example one, example two). Granted, almost all the studies relate to treating tendons, not muscles.

Still, the logic of the whole thing makes sense. By injecting my blood directly into the site of my injury, the procedure is doing two things. First, it is provoking an inflammation response—the body’s natural healing response—at the exact place that I need it, but without causing further harm. Second, it’s ensuring the presence of plenty of blood—an essential component to that healing process—is on hand when the healing begins.

Don’t get me wrong, $500 is still nothing to laugh at, especially when planning a wedding, but when compared to $1,000 it seems like a deal, especially when looking at the research.

Luckily (?), my treatment yesterday just so happened to coincide with my very last student loan payment (hooray!). And, as it turns out, my monthly student loan payment was exactly $500. That means this treatment will essentially be like one additional loan payment. (Just when I thought I was done…)

The procedure itself wasn’t bad. I definitely freaked myself out a bit by reading a lot about it. Honestly, the worst part was withdrawing the blood from my arm—or arms, since the doctor collapse the vein in the first arm he tried. That didn’t feel so great, because they were using a pretty big needle.

Putting the blood into my calf wasn’t so bad, though, because they put a local anesthetic in the calf before they began. I definitely felt a quick, sharp pain when the blood first entered the injury site, but it was over before I knew it. I also knew the doctor had to move the needle around a bit (my research was very thorough), but again, I didn’t feel that thanks to the anesthesia.

At home last night, after the anesthesia wore off, the area was pretty tender. Walking to bed, I found I couldn’t bend my knee while walking. My body just wouldn’t let that happen. And I had to sleep with a pillow under my knees to keep my lower calf from touching the bed as I slept, but it wasn’t too bad.

Today, I’m still very tender, but walking better. Of course, I’m trying to avoid walking at all. After all, yesterday, the doctor basically re-triggered the acute phase of my injury, so today is all about rest. When I first injured myself, I didn’t take it seriously and I never really rested. I won’t make that mistake again.

I have a follow up appointment, where the doctor will do another ultrasound, on June 5. Fingers crossed!