Too many winter motorists seem to think that I’m out there shoveling snow away from areas of my driveway that are close to the road, making me available for their personal sport of seeing just how close they can drive their vehicle toward the gutter so that their tires can splash the melted snow up all over me.
Back in January 2017, while shoveling snow from the sidewalk and the end of my driveway, whilst having to dodge traffic once more, and in seeing a new lineup of vehicles coming north away from the traffic lights, I started walking backwards while watching closely for the next ignorant driver. That’s when my left heel caught the incline of my neighbour’s lot, making me lose my balance, and I fell right on my bad (left) hip.
Two weeks later and my hip pain was still so severe that I started to resign myself to the horrific thought of moving forward with a total hip replacement that l was told last summer that I needed. However, all I could think was, “Ewww, what would happen if once the surgery is done, and I’m back out there able to shovel my snow again, and I fall on my left hip… again?”
All I could imagine was that the big spike that gets hammered into the top of the hip bone being pushed out through my leg bone in such a fall. Needless to say, that thought frightened the poo outa’ me.
Feeling my decision was being made for me (given the amount of pain I was in), I went ahead and telephoned the office of my choice of total hip replacement doctor, who works out of Sunnybrook Hospital on Wellesley Street East in Toronto, and scheduled an appointment to see her and get this procedure under way.
Needless to say, I discussed my fears regarding any future falls with close friends. They all kept trying to comfort me with the decision they knew I was being faced with.
A few days later one friend came back to me in Skype, sharing a story he’d seen on a documentary or the news, I don’t remember which. Either way, the news clip he shared with me regarded a new treatment that appears to work for many patients, and seemingly is only to be publicized in Australia right now.
The news clip that my friend shared with me has now been removed from YouTube for whatever reason. In it’s place I offer you the following Aussie news clip:
After viewing this news clip, I got all full of hope and immediately shared this video in Skype with my brother, who holds a PhD in medical science. He and I immediately started conducting searches online from our own computers… my brother being located in the USA, and I am just east of Toronto.
From here on in my story, I will break this post down into easy to find pieces. In this way, you can leave off reading a section today and then come back tomorrow to finish where you left off… or, simply use the links below to help you find information more quickly when referring back to share what you have learned here.
What we found with our researching
Questions asked, and Answers
Do I qualify for stem cell injectons
My thoughts on this
A testimonial shared with me regarding stem cell injections
My stem cell procedure starts
Day 2, followed by one week
My second injection
First follow-up with Dr. Stoddard
Second follow-up with Dr. Stoddard
Once we had shared and read through many medical articles and videos about the success rate being seen with stem cell injections in the States, I started looking for a doctor located closer to me, hoping to find one with a great rating.
Thankfully, there is one medical rating website available online that warned readers off one doctor whose license had apparently been removed from two different states, and now it seems he has relocated to Toronto and is now offering stem cell injections. Noooo Thank YOU!
Then thankfully, I found Doctor Stoddard! His rating is very high on this same website, and the only reviews offering a one-star rating were from people complaining about dealings with the office staff.
Okay… no worries on my part… I mean, really… do I care if the office staff respond to my every whim?
My brother seconded my choice of doctor to go see about the possibility of this procedure being suitable for my situation. So the next day I telephoned Dr. Stoddard’s office and had to leave a message.
My call was answered by a really courteous lady, and I was able to learn that Dr. Stoddard does do stem cell injections on hips. I wasn’t sure because many of the reviews I read were praising stem cell knee injection procedures that this doctor had performed. Thus, I wanted to make sure before scheduling an appointment.
During the initial telephone conversation, I learned that the consultation is covered by OHIP, but I had to give the lady a credit card number in case I missed my appointment.
There are THAT many people who fail to turn up for appointments… REALLY?
Yup, apparently so!
Again… thankfully, my appointment to see Dr. Stoddard was scheduled long BEFORE the appointment I had made to see the total hip replacement doctor. This would give me ample time to make an informed decision.
In many of the medical posts and videos my brother and I went through in our initial investigation, some American doctors mentioned getting stem cells from bone marrow extracted from the hip bone. I was informed that Dr. Stoddard’s procedure uses body fat to extract the stem cells.
March 23, 2017, I arrived at Dr. Stoddard’s office for my consultation. I didn’t have to wait long before I was in to see him.
Here are some of the questions I asked the doctor that day:
Question: Could stem cell injections cause tumours to form?
Question: Can you use the fat lump on my right shoulder for stem cell extraction?
Answer: No, because the fat on my shoulder has deformed cells. Instead, it will be extracted from my buttock (bum).
Question: Are there different qualities of stem cells; example those extracted from body fat as opposed to those extracted from bone marrow?
Answer: Basically the same, though there tends to be more stem cells found in body fat than in the same amount of bone marrow.
Question: Can I expect to be able to walk out of the clinic on my own two legs after each series of injections? (Back then, I thought there would be more than two injections.)
Answer: Yes, most patients do.
Question: Do you have a patient that you have treated that suffered the same thing as I do that I can talk to?
Answer: Yes, but I will need to ask the patient first and get back to you with the details later.
Question: How much would the stem cell procedure cost me?
Question: What is the worst that could happen with the injections?
Answer: There is a 1 in 20,000 chance of an infection developing.
Question: What is the success rate of this procedure?
Answer: My rate of success is 80% which is the reason I choose whom I will treat. I want to keep my success rate as high as I possibly can.
After answering my MANY questions, Dr. Stoddard took the CD I had brought with me that contained my most recent x-rays that had been done on my left hip, and went out of the room to review them.
Upon returning to the consultation, the doctor informed me that my arthritis is very advanced. This was shocking news to me; I had been led to believe that I had a “little” arthritis in my hip. Gee, any wonder I was so freaked out last summer when a local specialist (that I later learned is a surgeon) informed me that I needed a total hip replacement!
Dr. Stoddard went on to say that I have my health going FOR me whereas my age is not. It would have been better if I were, say, 40, but at least I’m not 80, was the way he explained it. And, the advanced arthritis in my left hip is against me. However, Dr. Stoddard stated that he felt strongly that his stem cell injections could indeed help me.
What SWEET relief … at last!
I was also informed that the final results of the procedure… whether it was successful or not… wouldn’t be known for anywhere from between three to six months.
The doctor also suggested that if I were to be driven into Toronto for the appointments that he could give me a sedative to calm my fear of needles. However, once I informed him that my friend Brian (who came with me as navigator, so I wouldn’t get lost in all the construction going on in Toronto these past few years!) and I took public transportation today, and that I was planning on doing the same for the procedure, the doctor said something like “then, taking a sedative would not be wise.”
Even though I AM a big ‘wuss’ when it comes to needles, I’d sooner take injections in the hip joint than to have the side of my hip sliced through the skin and muscles, and opened up nearly 10 inches, have my hip dislocated, the ball and stem of my left leg bone cut off, the leg bone spiked into in preparation for the final spike to fit in, then the cup area of my hip bone reamed out, a metal cup glued into the newly drilled out socket, with a plastic, ceramic or metal liner added inside the new socket, a big long spike then hammered into place in the leg bone, followed by a new ball tamped onto the spike once it is in place, and… then have the joint put back in place, muscles stitched, and skin stapled…
Don’t believe me?
Then, by all means, check out the following total hip replacement video.
Not only this… but how about the THIRD Stryker artificial hip replacement recall? Stem cells have no need of EVER being in a recall because they belong to the patient!
Now, on March 23, 2017, once I had arrived back home, there was a message waiting for me on my answering machine. Ah, yeah… I’m still using a landline because for me, cell phones are too invasive, and too expensive!
Anyway, the message was the name and telephone number of Dr. Stoddard’s patient who had had the stem cell procedure performed on his hip, and that patient was willing to speak with me. This patient told me that he is 67 and that he had two knee replacements done previously. When he was told that he needed a hip replacement, he said, “Enough”. So it seems that he looked for an alternative and chose the stem cell procedure, and he is very happy with the outcome.
He also informed me that he has told anyone who talks to him about a knee or hip replacement (and, those who will listen) to check into the stem cell procedures first, to see if that might work for them. He told me that many people have thanked him for this advice, as they were very fearful of the total hip replacement recovery time, as well as the pain they would have to suffer through.
Wow, in my books this man was VERY brave to have had not one but TWO knee replacements done… YIKES! Friends who have had at least one knee and hip replaced claim that a knee replacement hurt a whole lot worse than a hip replacement.
Which, when you think about it, it does make sense… right? Given that the entire knee joint gets cut out… literally, and replaced by a metal joint with spikes on either end that get hammered into BOTH leg bones!
Anyway, once I had spoken with Dr. Stoddard’s former patient, I was convinced to go for the stem cell treatment… especially given that I had enough funds tucked aside to cover the costs… yipeeee!
I was informed to stop ALL anti-inflammatory supplements like curcumin and Aleve, vitamin E, and the Glucosamine Chondroitin Sulfate Extra Strength supplements (that I’ve been taking for years now), three days before the procedure.
Reason being there are supplements available that the doctor wants me on for only a few months in order to encourage the regrowth of cartilage. Apparently, these things interfere with the joint healing as he wants it to… and, it is only for a few months.
On April 18, Brian and I ventured our way back to Dr. Stoddard’s office via public transportation once again. Driving to the GO train, parking what seemed like MILES away from the station, walking to the train, traveling into Toronto’s Union Station where we transferred to the subway heading up to Sheppard Avenue. Our destination was directly across the street from where we exited from the subway… 2 Sheppard Avenue East.
Arriving at the 6th floor of the building to the office of Sports & Exercise Medicine Institute (SEMI), I didn’t have to wait in the reception area very long when the doctor’s assistant came out to get me. Having arrived with a cane in hand for “in case” it is needed going home, I got up from my chair and the young lady guided me into the room in which the procedure was about to take place.
I came to my appointment dressed in my favourite “house clothes”… let me explain, stretch pants that the ladies at Giant Tiger like to call pjs ‘cause they’re so thin in the way of fabric (too cold for winter wear outside!) with lots of stretch to make them soooooo comfy… and though I’ve worn them out in public a few times before, I prefer to keep them for use around the house in case a hole appears 😉 in them.
The young lady asked me if I had come with a change of clothes, and I looked at her a tad confused saying, “Noooo, was I supposed to?”
She said that was okay and that she had a pair of shorts for me to change into; she immediately went out of the room and returned with them.
Okay, so I don’t have to be naked for this then?
Oh no, she informed me, you put on these shorts over top your underwear and the doctor will simply roll up to where he needs to be to do the procedure.
WOW! That was a relief.
LOL, I never thought to ask that question previously.
The young lady left the room to let me change out of my stretch pants and into the shorts. Once I had changed, she returned; she asked me to lie on the table while she extracted some blood. Thankfully, she was really good at extracting my blood… a one shot deal did it… pheeeew!
The doctor came in and had me roll over on my stomach, and then he proceeded to get me talking. LOL, I was shocked at what a chatterbox I became given my level of fear of the unknown, but somehow I placed my trust in this doctor… and thankfully, I honestly felt only a few tiny pin pricks every now and then while he extracted the body fat from my left butt cheek.
It was when the doctor wheeled himself, using a stool on wheels, around to my right side that I got a tad anxious, so I asked him what the heck he was doing on that side. That’s when he told me to roll over as the injection into the hip would be done from the front.
Ahhhh! I sooooo was hoping I didn’t have to SEE what he was doing and I told him that.
Dr. Stoddard told me to just look up at the ceiling, so I did.
You bet I was in a panic (LOL!), however, with all my silly dreading and fearing of the unknown, I honestly felt a bit of pressure only in my hip joint and nowhere else; I’m guessing that the pressure was being caused from the stem cells (from the body fat and blood) that were being introduced into the joint.
Not even an hour and the doctor was finished! Yeah, from blood extraction to body fat extraction to centrifuge with both to extract the stem cells… to injection number one wasn’t even an hour. Go figure… Woohooo!
As the doctor was leaving the room, he instructed me to change back into my clothes (leaving their shorts, of course) and to go sit for 10 minutes in the waiting room, and then he would be out to see me.
Dr. Stoddard kept his word and came out near the end of my 10 minute waiting time. He filled me in regarding getting the supplements before I left, and to schedule the appointment for the second injection, which was to happen in two weeks time. He also suggested that I might seriously consider being driven to the next appointment so I could take the sedative making it a bit easier on myself, so I agreed.
I really do need to be honest with you here. My fears about this procedure were totally unfounded… and I AM honestly a BIG ‘wuss’ when it comes to needles. I can’t even watch someone pretending to get a shot on TV… seriously! I always have to look away.
The doctor also emphasized that I use the leg joint and not to baby it. Using the joint will help it to heal. He also asked me to not take the lengthy walk from the Oshawa GO station to where we had parked the car that morning. I assured him that Brian already stated that he would have me wait at the curb, and then he would go and get the car and come back and pick me up. This fact I shared with the doctor, and he agreed that that would be best.
By the time we left the institute, it was close to noon hour. My left hip joint started feeling a little stiff, but I was still able to walk comfortably enough. But by the time we got down the elevator and out of the building, where we had to wait for the street lights at Sheppard and Yonge to change so we could cross Sheppard, I HAD to put the cane into use. My hip started aching, and I began praying it wouldn’t get worse, while repeating to myself not to baby it.
Shortly after we got situated on the subway heading for Union Station, I started feeling my temperature rise and I got a little dizzy. As it got worse, I told Brian that I was going to pass out, and I did. I just could not stay conscious, and then I started hearing Brian fretting and another passenger suggesting that we get off the subway at Bloor for medical help.
Fighting my way back to consciousness, I was able to say, “No, I’ll be okay by Union Station.” …and then laid my head back down again.
Thankfully I regained my composure by the time the subway train arrived at Union Station, and was able to get off aided only by the use of the cane I had with me. After much walking inside Union Station, Brian suggested that he talk to a GO attendant and ask for a wheelchair. Needless to say, I gave in to that suggestion.
The GO train attendant was very kind, and she quickly emailed the Oshawa GO train station about my need of a wheelchair being made available upon my arrival.
Wow! Did I get lucky or what?
Though there was one ity-bity problem with this… a few stations away from Union Station and another passenger boarded the GO train aided by a wheelchair. When we arrived at Oshawa’s GO train station, I heard the lady passenger get all excited and say something like, “Ah, there’s my wheelchair!”
Brian looked at me shocked because there was only one wheelchair at the stop, and I whispered to him that it was okay (as the lady was far older than I), and the doctor did say not to baby the joint even if I was tempted.
Poor Brian, he felt so bad for me that once I was under way using the cane and heading for the exit (to what was several train cars away), he went back to the GO train attendant who was by then pushing the other lady in the wheelchair, and he quietly explained the issue. The attendant was horrified. It seems one of their employees never showed up for work… and… there is only one wheelchair at the Oshawa GO train station.
The attendant apologized profusely once she caught up to me in a few steps, and assured me that she would return to get me as soon as she could. I assured her that I would be fine.
By the time I had come very close to exiting the station, the GO train attendant returned with the wheelchair… and all I could think of is if I were to get into that chair for the little distance I had left to go, it would hurt me WORSE getting back out of it than if I just continued walking.
So, once again, I assured the lady GO train attendant that she was not to worry, and that the doctor had stressed to me not to baby the joint. I’m pretty sure I had finally convinced her, as she certainly looked very relieved as she went away with the wheelchair.
By 3:30pm, I just wanted the pain to stop!
By 4:30pm, I was able to get my Tylenol 3 prescription filled (Thank YOU Karen!), and I took 2 of those tablets followed by another 2 four hours later. That night I slept on the sofa in my clothes as I just wanted the pain to stop, and so changing and going to bed were the last things on my mind.
On April 19, I was getting around the house a bit easier, thanks to Tylenol 3 and the cane. By the early morning of April 20, I awoke in pain at 6:30am… I had slept through taking the 2 Tylenol 3s at 4:30am but once I took 2 tablets, I felt better as the day wore on and took the last of the Tylenol 3s at 4:30pm.
By the afternoon of the 21st of April, I found myself getting bored. Hmmm… a good sign of healing I think!
My first day of therapy was on the 26th of April, followed by a second appointment on the 1st of May, followed by the second… or, booster stem cell injection previously scheduled for the 2nd of May.
During my first visit with my Athletic Therapist Matt, he cautioned me that even if this stem cell procedure works, it does NOT guarantee that I will never need a total hip replacement in the future. I simply retorted that as long as it lasts until it’s my time to exit planet earth, I’ll be quite happy.
It was also during this appointment that I discovered that I should have been still using the cane… and not only that… but that I had been using the cane incorrectly… Really?
How to Walk with a Cane Properly
Matt assured me that many people do not use a cane properly, but somehow that didn’t make me feel any better. Not using the cane properly, I pray, will not affect my outcome from this procedure. However, only time will tell.
On May 2, having arrived by car driven by my cousin Gord for my second appointment with Dr. Stoddard, I have to admit, the prescription meds that I was given to sedate me suuuuuure did a great job… except when it came to drawing blood from me. Though I could have cared less because I was soooo relaxed; looking back, I feel sorry for the doctor’s assistant (I’m guessing she is a RN) because she had such a tough time getting the little blood needed for the booster shot extracted from me.
The second hip joint injection went off without so much as a hitch… and, walking was soooo much easier; though it was a bit painful for a few days, the pain was nowhere nearly as bad as it was after the first injection.
My therapist had warned me not to do anything until my leg joint felt better after the booster shot. So, it wasn’t until Thursday, May 4, that I started back at the exercises and stretches my therapist had instructed me to do. On May 8, I returned to Matt’s office for my third round of therapy.
Being analytical, I asked Dr. Stoddard why I was to stop taking all anti-inflammatory supplements. Here is what he shared with me, “The main problem with antiinflammatories is that they block inflammation, and not that they affect blood flow. Inflammation is a healthy body process needed for healing. This is the biggest reason I want people off of them.”
Later on, I got wondering that if [nonsteroidal] anti-inflammatory meds restrict blood flow, is THAT really healthy for an arthritic joint? For those of you who are every bit as inquisitive as I am, I offer you the following post to help explain this best: http://www.madsci.org/posts/archives/1999-10/939735545.Me.r.html
As further evidence that anti-inflammatory meds can interfere with stem cell injections, I offer you the following linked information: http://jamanetwork.com/journals/jama/fullarticle/2626573 [Triamcinolone is a “steroid” anti-inflammatory agent. Injecting this into the knee of people with arthritis (as a means to control inflammation and pain) didn’t help the pain and actually made tissue loss worse, making this another good reason not to use any anti-inflammatory agents while doing stem cell treatment.]
So as not to bore you further regarding my therapy, I will just say that exercises are being added gradually so as not to overtax my left hip joint. Also exercising and stretching my right hip with the same exercises and stretches are done in order to maintain a healthy balance.
Come July, I have my first follow-up appointment scheduled with Dr. Stoddard, after which I will be back here to update this post and let you know how things are progressing. Until then… stay happy and healthy.
Following are other pain relief reviews I have shared here:
- Treatment for Lower Back Pain
- A Device to Relieve Back Pain
- Natural Anit-Inflammatory to Relieve Joint Pain
- Computer Desk Chair to Relieve Lower Back Pain
UPDATE: 26 May 2017
Since my therapy on the 23rd of May, I have noticed a substantial increase in the range of motion of my left hip when doing my daily routine of exercises and stretches. However, my issues with piriformis syndrome (due to a workplace injury) has been interfering with my ability to walk comfortably these past few days so I have been doing my 20 minute walk (increases by 5 minutes every 3rd day) indoors. I am determined to be out walking normally around the block with my Simona by the end of June.
UPDATE: 02 June 2017
During my therapy on the 29th of May, I was told that it is now okay for me to resume hanging upside down on my inversion table for 10 minutes (relieves the pain from piriformis syndrome), walk around the block and then resume the hour and a half exercising and stretching routine I was doing previous to my injections.
So far so good. I’ve been able to walk the block every day since Monday’s therapy. Though I have noticed a time or two where I was walking with my left foot toed in slightly. An old habit I automatically do as my lower back pain becomes worse. Seems the worse my lower back pain the worse my left foot becomes toed in.
Can only imagine that a total hip replacement would make my lower back pain worse, as I would NEVER be allowed to hang upside down on an inversion table ever again. The local specialist I saw last summer asked me why I’d want to hang upside down. His retort was “only bats hang upside down”. Quit obvious he’s never had a patient suffering piriformis syndrome before. Funny the pain is NOT.
UPDATE: 29 June 2017
Saw my GP (General Practitioner) on the 21st of June, asking to see a neurologist and when he asked why, I explained that I’m tired of my back pain causing my left leg to hurt like it has been doing. It has actually felt though I was going to lose my balance at times.
Anyway, after much discussion my doctor sent me for an ultrasound as he explained that this leg pain is NOT due to back pain. Huh! And here it was previously assumed that it was my hip that was causing this pain. With THAT issue well on it’s way to being healed… I figured it HAD to be the piriformis syndrome causing the pain… but NOPE!
The ultrasound technician ended up calling in a doctor (not mine) and he explained to me what they were seeing. When I got up from the table, I was allowed to see the ultrasound images. One of the images looked to have an object the size of a walnut sitting on what I was told is a vein deep inside my leg (the calf of my leg).
This doctor asked me for the name of my GP explaining to me that he was going to have me sent for an MRI. He even informed me that an MRI may not be able to tell them any more than the ultrasound… and then my GP informed me that “it has to come out.”.
Needless to say, he got no argument out of me on that fact. I’m looking forward to a pain free walk once again. Hmmm… extensive walking is off my daily routine for the time being.
UPDATE: 19 July 2017
Saw Dr. Stoddard on the 17th of July for my 3 month check up and, after checking my leg joint, he agrees that my range of motion has in fact been increased, though he said he’s hoping for more improvement yet.
One disc in my lower back is causing some of my leg pain; the pain that has been causing my left leg to literally collapse lately. The MRI that was done on the 13th has only served to prove what the lump in the calf of my left leg is NOT… it is NOT a cyst nor a fatty tumour. What the specialist THINK if COULD be is a plexiform neurofibroma.
All I can think of is… can you imagine the agony I would be in right now (given these other 2 issues) if I had of opted for a total hip replacement? YIKES!
Oh! I was allowed to get back to taking my curcumin, vitamin E and Glucosamine (pictured above) as of yesterday. Had forgotten to ask sooner. Took 2 capsules of curcumin about 11AM yesterday and was able to sleep pain free WITHOUT Tylenol Extra Strength… YIPPPEEE! I have also promised to NEVER EVER take Aleve again because of what has been discovered, confirmed and shared here: http://www.madsci.org/posts/archives/1999-10/939735545.Me.r.html
Thankfully my hip joint issue is being resolved … now for the OTHER two issues. Aging SUCKS!
UPDATE: 21 August 2017
Saw my Athletic Therapist today and he assures me there is quite a good improvement on my range of motion in my left hip joint now. And thankfully, I was able to report that for two WHOLE days now… no excessive pain from the piriformis muscle. Daily exercise regimen is to continue… and… I’m only to call for an appointment with him if/when excessive pain returns. YIPEE!
UPDATE: 20 October 2017
As promised, here are the results from my final follow-up appointment with Dr. Stoddard. He informed me that my score has risen from 49% (meaning I was in need of a total hip replacement) to 74%, which is about a 95% improvement, and an excellent response to the stem cell injections (YIPEEEE!)… AND… most importantly… “at this level most people feel that they do not need a joint replacement!”…that’s ME!
My range of motion has improved more (though only slightly, I’m HAPPY with any improvement like this) since my Athletic Therapist noted the improvement back on 21st of August. However, I am still having some issues with muscle pain radiating from my lower back down the front of my left leg. A MRI for my back has now been scheduled to determine what is causing this pain.
The final results from my appointment with my neurologist on October 5th confirmed the lab report for the MRI that was performed on my lower left leg. Dr. Pirouzmand informed me that I have a neurofibroma in my lower left leg.
This tumor has literally wrapped itself around the main nerve and cannot be removed safely… thus it is inoperable. As the doctor noted, it looks like beads (see MRI view below) with the biggest bead in the middle. Now I tell friends and family that it looks like I have a beaded necklace in my leg with the biggest bead in the center.
I DO hope this post serves to encourage those diagnosed as being in need of a total hip replacement, to at LEAST explore your options. Just because a total hip replacement is free (which is REALLY is NOT free!) does NOT mean it’s the ONLY option… nor the best option for YOU!
Please… at the VERY least go to a stem cell injection specialist (Dr. Stoddard comes WELL recommended for those close to Toronto, Ontario, Canada!) for your “free” consultation.
I’m rolling my eyes as I type “free” because far too many here in Ontario think that treatments covered by OHIP are free when they are far from free. Those of us who have jobs and or businesses ALL contribute to that insurance; its just that MOST of us don’t SEE a field stating “OHIP” on our pay cheques like we do with unemployment insurance, etc.
Credit for Header: image by © Krishnacreations | Dreamstime.com – Stem Cell Photo