As I sit here funneling as much food into my mouth as I can (like I have been at every meal lately due to my raging appetite), I decide I have to finish typing up these notes once and for all. I become determined and nothing (not even the lure of chocolate) will stop me.

These are some questions I was intrigued to hear answers to. I got those answers from Dr. Ashish Verma; anesthesiologist, partner to Dr. Geeta Shroff, and the kind of physician who will always take time out of his day for you, if you simply ask.

Here are his explanations in (my) laymen's terms. I've chosen to share our conversation on this blog because I think it will help people who are willing to consider this, gain more insight. Thank you Dr. Ashish and Dr. Shroff for your amazing work which I’m blessed enough to be a part of.

Any reference to "stem cells" in this post are made in relation to embryonic stem cells.

Q: What types of stem lines are being created?
Types of stem cells include: Neuronal (nerves), hematopoietic (blood cells), muscle stem cells, insulin producing stem cells and cardiac stem cells (created sparingly). Most people require a combination of these. Hematopoietic is necessary for the successful function of all of these because these are the “food” for all the other stem cells. All types of muscle, tissue, nerves, etc. need healthy blood cells to carry nutrients and help them grow and survive.

Q: How many stem cells are in each intramuscular injection or IV?
There are from 1-80 million (depending on patient and method of administering them). A spinal procedure dose (most commonly used for spinal cord injury patients) contains approximately 50 million.

Q: What percentage do you think reach the target area with each method (intravenous, intramuscular and spinal procedures)?
This is still an area of learning. They don’t know exactly how many reach each area with the different procedures because there is no precise way to measure at this point. They do believe though, that IV has a better overall distribution than intramuscular because it is carried throughout the whole system by the blood. However, a localized effect is important in something like muscle atrophy, where the stem cells also can benefit from being injected into a certain target area.

Q: Which type of patients generally show the quickest or most progress?
Spinal cord injuries and static diseases seem to have the most progress. Anything that they don’t have to fight the decline of is the best scenario. Generally speaking, when spinal cord injury patients arrive, they are at a place where it will stay that way as far as their injury. So, they can focus on trying to get improvement. Same goes for any disease completely under control. For neurodegenerative diseases or ones that are not controlled, it creates a seesaw battle to try to get ahead.

Q: Can we have an example of how it works for diabetes with multi-organ involvement (meaning it has affected other organs aside from just the pancreas)?
Type 2 diabetes is when there is either damage to pancreas and the cells are not creating insulin; or someone’s body is producing insulin, but there is an autoimmune factor attached that is making it not work properly. Stem cells are working both ways from what they see. People that start with less insulin production in the beginning are taking longer to start producing the right amount, but are still showing improvement. The patients with the autoimmune factor where their body just isn’t using it properly are getting off insulin very soon, sometimes in one or two months time. The patient is able to overcome the autoimmune factor and have their own insulin work just like before the process kicked in. Many people don’t get diabetes until later in life (say 40 years old, which is likely when the autoimmune factor was triggered), but that doesn’t mean it wasn’t there lying dormant the whole time. The stem cells help to reverse it back to that state by making everything work properly.

Q: How about autoimmune diseases?
In autoimmune disease, there is a factor added onto your own cells whereby body is rejecting them. Stem cells are replenishing them and changing them from cells with the autoimmune character to normal cells. It’s working very well in autoimmune diseases by repairing dysfunction at the problem area.

Q: What is the biggest challenge you face as far as acceptance? Politics, egos, etc.?
They feel its only a matter of time before it’s accepted. All of the people involved in this decision making are not thinking from patient's point of view. Many terminal or incurable conditions have treatment option with risks involved, and in some, only about 5% of people are benefited (and there are so many side effects). But, they are approved anyway. So, why aren’t stem cells being approved? They are confident that when it's accepted, it’s going to change the face of medicine.

Q: How did you get involved in this?
He was the anesthesiologist working in In Vitro Fertilization labs together with Dr. Geeta Shroff. He gives full credit to her for thinking of and embarking on this journey with money from her own pocket. They used only surplus discarded embryos which would have been thrown away anyway. Storing embryos is not that common in India. It’s a costly affair and patients here don’t want to use eggs from the same cycle twice. They would rather do another cycle to retrieve new eggs. All stem cells now are taken from a single embryo and used for many, many patients. Side note: IVF cycle costs about $1 lakh ($2,500-$3,000 U.S.) in India.

Q: What about rejection and tumors? There is so much talk about it....
It is explained in simple terms, which make complete sense. Let’s take a surrogate situation for example. A couple cannot have a baby of their own so they require a surrogate mother to carry the baby for them only. You have one egg, one sperm and then an embryo from that union that is implanted in another woman’s uterus. The mother can be blood type A and the father blood type B. The person carrying could be anything. It’s all working with no testing before they do it for compatibility. This concept can be used to understand how embryonic stem cells don't cause tumors and rejection in humans. With embryonic stem cells, you have an egg and sperm that created an embryo from which the cells were extracted and put into another human (the surrogate of the stem cells). The person receiving stem cells acts like a surrogate and doesn’t reject the embryo or suffer from tumors. This can help the world see that although this requires labs of high sophistication, it can be done without as much money as is being poured into it. The goal of Nu Tech is to make it available at pharmacies for patients to prevent the progression of their diseases or help in regeneration.

Q: How can stem cells be used to help stabilize terminal progressive diseases?
With these types of diseases, there is continuous degeneration. You have to replace number of dying cells with the same number of regenerating cells, and if that can happen, it will remain static. If you have more of a number regenerating than dying, you will see improvements. It’s basically just mathematics. However, they need time from patients. If someone is going downhill very quickly, it’s hard to help since the stem cells work over time. They need enough time left in a disease to be able to allow the cells to grow and grow into their full function.

Q: What are some of the subtle signs it’s working (even things a patient may not realize)?
It's key for patients to be very aware of what they are suffering from and what is going on with their body. They don’t have tests to say its working in the body. One example of how they can tell something positive is happening is for example -- sweating in a paralysis patient. Most of them cannot sweat because of damage done to the autonomic nervous system (which controls this). So, they cannot just be looking for their legs to move. They have to look for things like change in other abilities too because that kind of stuff will come more quickly.

Q: I know I have to treat my stem cells like babies, feeding them, giving them lots of rest, etc. How long will I have to take precautions with my body like I’m pregnant?
The first nine months are the most important, just like with pregnancy. After that, the cells will continue to develop for approximately five years. The nervous system isn’t fully developed in a child until five years of age so that’s how long it should be “babied” for best results.

*Watch video of Dr. Ashish answering a couple of extra questions:

Dr. Ashish Verma speaking of Nu Tech's first patients

Dr. Ashish Verma explains an aspect of healing