Podcast Episode: Living With Chronic Pain

Pip: If you have ever tried to explain avascular necrosis to someone and watched their eyes glaze over, this episode is for you — and honestly, for them.

Mara: ChronicallyGratefulDeb covers a lot of ground here — chronic pain awareness, what it actually means to manage it, and what AVN treatment options are worth bringing to your doctor. Let's start with the mindset and the medicine of living with chronic pain.

Chronic Pain: Gratitude, Awareness, and the Management Toolbox

Pip: There is a tension at the center of chronic pain writing — between honesty about how hard it is and the instinct to find something worth holding onto. That is exactly the territory this segment lives in.

Mara: The post "Living a Life of Chronic Gratitude" names it directly: "gratitude is not just a fleeting emotion evoked by fleeting circumstances; it is a state of being, a conscious decision to acknowledge and appreciate the blessings that surround us, no matter how small or seemingly insignificant they may appear."

Pip: That framing matters because it is not toxic positivity. It is not pretending the pain is gone. It is choosing a posture toward life while the pain is still very much present.

Mara: Right — the post is explicit that being chronically grateful does not mean denying the challenges. It calls gratitude "an act of defiance against despair." That is a meaningful distinction for anyone who has been told to just think positive.

Pip: Which is a very different thing from deciding, daily, to look for what remains.

Mara: The companion post, "Chronic Pain Awareness," picks up the clinical side of that same reality. It runs through the full landscape — arthritis, osteoarthritis, AVN, nerve disorders, spinal conditions — and makes the point that chronic pain does not have one cause, so it cannot have one solution.

Pip: The toolbox metaphor they use is apt. Physical therapy, occupational therapy, movement, nutrition, topical treatments, medications — none of these is a cure, but together they can protect function and quality of life.

Mara: One line from the awareness post stands out as something worth taking into a doctor's appointment: it draws a hard line between pain management and disease treatment, asking both "how can we help control my pain" and "what are we doing about the condition causing my pain."

Pip: Those are two genuinely different questions, and conflating them is where a lot of people get stuck.

Mara: The post also pushes back on the zero-to-ten pain scale as the whole story — it asks whether you can sleep, walk through a grocery store, climb stairs, play with your grandchildren. Function, not just sensation.

Pip: Measuring pain by what it takes from you rather than by how much it hurts — that reframe alone is worth the read.

Mara: Both posts are doing the same work from different angles: one emotional, one clinical. Together they make the case that managing chronic pain is neither purely a medical problem nor purely a mindset problem. It is both, handled at the same time.

Pip: And knowing your actual diagnosis — what is causing the pain — turns out to be the bridge into what comes next.

What AVN Treatment Can Actually Look Like

Pip: Once someone has an AVN diagnosis, the question shifts from what is wrong to what can still be done — and the answer depends heavily on how early you are asking.

Mara: The post on AVN treatment options puts it plainly: "Being diagnosed with AVN does not mean that every patient immediately needs a joint replacement." It walks through options from 3D-guided core decompression and BMAC to hyperbaric oxygen therapy and focused shock wave therapy.

Pip: The stage of disease is doing a lot of work in that list — some of those options close once collapse has occurred.

Mara: That is the exact point the post makes. It urges patients to ask their orthopedic specialist where the AVN is, how large the lesion is, whether any collapse has occurred, and whether the window for joint-preserving treatment is still open. The November 29 Osteonecrosis Awareness Day post reinforces this — early detection through MRI is called the gold standard precisely because more options exist before the bone fails.

Pip: So the treatment conversation and the awareness conversation are really the same conversation, just at different points on the timeline.

Mara: Knowing your stage, knowing your options, and knowing what questions to ask — that is the throughline across both posts.


Pip: Gratitude as defiance, pain as more than a number, and treatment as a set of questions worth asking before the window closes.

Mara: There is more to explore here — on bone health, on navigating the healthcare system, on what life looks like on the other side of a diagnosis. We will be back with more from this site.

Rare Disease Awareness Day -2026 Osteonecrosis

Living With Osteonecrosis: My Story & Why I Advocate

Today is Rare Disease Awareness Day, and for me, this is deeply personal.

I live with osteonecrosis in my knee — a condition that changed the entire course of my life.

But my journey with chronic pain didn’t start there.

I was first diagnosed with osteoarthritis in 1995.

Then spondylosis in 2010.

And in 2014, after a medial meniscus tear, I was diagnosed with osteonecrosis in my knee — the condition that ultimately led to my medical disability.

I am definitely no stranger to pain.

My journey began in 2014 with what seemed like a routine knee injury. Something painful, yes… but manageable. Something that would heal with time.

But it didn’t.

Instead, that injury disrupted the blood supply to the bone in my knee. Over time, the bone began to deteriorate — leading to osteonecrosis, a disease where bone tissue dies due to lack of blood flow. What started as a tear became a life-altering diagnosis.

A Lifetime of Living With Pain

For decades, I have lived with chronic musculoskeletal conditions that affect how I move, how I function, and how I experience daily life. Pain isn’t something that visits occasionally — it’s something that has walked beside me for years.

Osteoarthritis brought joint degeneration. First, I had it in both knees, then part of my spine, then both hands both feet.

Spondylosis affected my spine and mobility. I then was diagnosed with spondylolisis due to bilateral pars fracture and after a couple years spondylolethesis as my spine slipped.

And osteonecrosis added another devastating layer, impacting my knee and ultimately my independence.

These diagnoses didn’t just affect my body — they reshaped my entire life.

The Impact on My Life

Living with multiple chronic conditions means constant adjustments:

Pacing my energy Planning around pain levels Managing mobility limitations And coping with the emotional toll of invisible illness

You can look “fine” on the outside while fighting a battle inside your bones every single day.

Why I Continue to Advocate

Because I know what it means to be dismissed.

To be misunderstood.

To have pain that people cannot see or measure.

I raise awareness so that others living with osteonecrosis, osteoarthritis, spondylosis, and other chronic conditions feel seen, heard, and believed.

And I will keep advocating — not just for myself, but for every person who wakes up each day in pain and still keeps going.

I am definitely no stranger to pain…

But I am also no stranger to resilience. 💜

http://www.joint-purpose.com

Do you or a loved one have Osteonecrosis?

If you or a loved one needs moral support while living with or caring for someone with osteonecrosis (also known as avascular necrosis), we invite you to join our Facebook support group. Please remember that this is a safe space for support and encouragement.

Important Guidelines:

  • You must answer all the questions to join the group.
  • We have a zero-tolerance policy for spammers or individuals posting inappropriate content, including any form of advertising or fundraising, such as GoFundMe campaigns.
  • We value all our members privacy and we do not email members of our group 
  • Any negative or unrelated comments will not be tolerated.

Break the rules once, and you will be removed from the group.

If you’re genuinely seeking support related to osteonecrosis, we welcome you to join us!

https://www..facebook.com/groups/deadbonediseaseavN/

Selecting between an Orthopedic Surgeon and a Rheumatologist for Your Musculoskeletal Pain

Selecting between an Orthopedic Surgeon and a Rheumatologist for Your Musculoskeletal Pain: A Comprehensive Guide


Choosing between an orthopedic surgeon and a rheumatologist can be a pivotal decision when seeking treatment for musculoskeletal pain. Usually we also may need a referral from our PCP.

Understanding the differences between these specialists and the conditions they treat is essential for effective pain management and recovery. In todays blog post we’ll delve into the nuances of orthopedic surgery and rheumatology, helping you make an informed choice regarding your healthcare needs.

Orthopedic Surgeon vs. Rheumatologist: Which Specialist to Choose?
When deciding between an orthopedic surgeon and a rheumatologist, several factors come into play. Let’s explore the distinctions between these medical professionals and the conditions they specialize in treating:

Orthopedic Surgeon:
Orthopedic surgeons focus on diagnosing and treating physical ailments related to the musculoskeletal system. Consider consulting an orthopedic surgeon if you experience:

  • Pain resulting from a physical injury or trauma
  • Weight-bearing discomfort (e.g., knee pain, foot pain, during certain movements)
  • Osteoarthritis or joint degeneration
  • Persistent joint pain unresponsive to conservative treatment
  • Need for joint replacement surgeries, particularly in hips and knees

Rheumatologist:
On the other hand, rheumatologists specialize in systemic inflammatory disorders affecting the musculoskeletal system. It’s advisable to seek a rheumatologist’s expertise if you exhibit symptoms such as:

  • Joint or muscle pain accompanied by systemic manifestations like fatigue, fever, or rashes
  • Non-traumatic joint pain or stiffness
  • Pain affecting multiple joints simultaneously

Diving Deeper: Orthopedics and Rheumatology Explained
Understanding the scope of orthopedics and rheumatology provides insights into their respective areas of expertise:

Orthopedics:
Orthopedics encompasses the diagnosis and treatment of musculoskeletal conditions, including bones, muscles, ligaments, and tendons. Orthopedic surgeons specialize in:

  • Identifying structural abnormalities and injuries within the musculoskeletal system
  • Performing surgical interventions to address fractures, ligament tears, and cartilage damage
  • Providing non-surgical therapies like physical therapy, injections like cortisone, prp, stem cell, prolotherapy and medications for pain management and rehabilitation

Rheumatology:
Rheumatology focuses on diagnosing and managing rheumatic diseases, which involve systemic inflammation and immune dysfunction affecting the musculoskeletal system. Rheumatologists are adept at:

  • Conducting comprehensive evaluations and diagnostic tests to identify underlying inflammatory conditions
  • Prescribing disease-modifying medications and biologics to alleviate symptoms and prevent disease progression
  • Collaborating with other specialists, including orthopedic surgeons, for integrated care in complex cases requiring surgical intervention

Orthopedic Treatment vs. Rheumatological Management: A Comparative Analysis
The treatment modalities offered by orthopedic surgeons and rheumatologists differ based on the underlying causes of musculoskeletal pain:

Orthopedic Treatment:
Orthopedic interventions primarily target structural abnormalities and injuries within the musculoskeletal system. These may include:

  • Surgical procedures such as ACL reconstruction, joint replacement surgeries (e.g., hips, knees), and arthroscopic interventions
  • Non-surgical therapies like physical therapy, corticosteroid injections, and orthotic devices for functional support

Rheumatological Management:
Rheumatologists focus on managing systemic inflammatory conditions through targeted medical interventions. These may involve:

  • Pharmacological treatments such as disease-modifying anti-rheumatic drugs (DMARDs), biologic agents, and corticosteroids to suppress inflammation and modify disease progression
  • Multidisciplinary approaches integrating medication management, lifestyle modifications, and supportive therapies for holistic care

Making an Informed Decision: Factors to Consider
When determining whether to consult an orthopedic surgeon or a rheumatologist, consider the following factors:

Identify the Root Cause:
Evaluate whether your pain stems from a traumatic injury, structural abnormality, or underlying inflammatory condition.

Assess Additional Symptoms:
Take note of accompanying systemic symptoms such as fever, fatigue, or skin changes, which may indicate an underlying rheumatic disease.

Seek Specialized Expertise:
Choose a specialist whose skills and experience align with your specific condition and treatment needs.

Emphasize Early Intervention:
Prioritize timely evaluation and intervention to prevent disease progression and optimize treatment outcomes.


Remember choosing between an orthopedic surgeon and a rheumatologist depends on the nature of your musculoskeletal pain, underlying conditions, and treatment goals.

By understanding the roles and expertise of these specialists, you can make an informed decision to address your healthcare needs effectively. Remember, early intervention and personalized care are key to achieving optimal recovery and enhancing your quality of life.

Shining Light on Avascular Necrosis-Osteonecrosis Awareness Day: A Call for Unity

As we approach November 29, a day etched on our calendars as Avascular Necrosis-Osteonecrosis Awareness Day, the enthusiasm is palpable. Originating in states like Ohio, Pennsylvania, Iowa, Georgia, and Tennessee, and several other states this day has grown beyond its regional roots, capturing hearts and minds across the nation. A celebration of resilience, unity, and the strength of those battling this rare disease, the journey has just begun. We still have many states that have yet to recognize this awareness day.

In the spirit of reflection and progress, let’s take a closer look at what Avascular Necrosis-Osteonecrosis is and why it deserves the spotlight. Osteonecrosis occurs when the blood supply to a bone is disrupted, leading to the death of bone tissue. While it can affect anyone at any age, the rarity of this condition often results in delayed diagnosis and limited awareness.

Imagine a disease that doesn’t discriminate by age, gender, or background—a condition that can strike unexpectedly, altering lives in its wake. Avascular Necrosis-Osteonecrosis fits this description, emphasizing the importance of education and advocacy. It’s crucial to understand the pain that accompanies this condition. The affected bones, deprived of essential blood supply, lead to excruciating pain, impacting mobility and quality of life.

This awareness day isn’t just a commemoration; it’s a call to action. The commendable efforts of states like Ohio, Pennsylvania, Iowa, Georgia, and Tennessee have set the stage for a nationwide movement. Proclamations have been issued, voices have been amplified, and the journey towards recognition has begun.

As we celebrate the strides made, it’s essential to acknowledge the work that lies ahead. Advocacy is a journey, not a destination, and the goal is clear: to have all 50 states recognize and celebrate Avascular Necrosis-Osteonecrosis Awareness Day by 2024. This ambitious vision requires a collective effort.

To our esteemed congressmen, senators, and the President of the United States, we extend an invitation to join us in this noble cause. Avascular Necrosis-Osteonecrosis doesn’t discriminate based on political affiliations, and neither should our pursuit of awareness. We implore you to consider the impact of this rare disease on your constituents, urging you to champion the cause for an awareness day in every state.

It’s not a daunting task; it’s an opportunity for bipartisan collaboration, demonstrating a commitment to the health and well-being of the American people. A simple proclamation can go a long way in raising awareness, fostering empathy, and providing support to those affected by Avascular Necrosis-Osteonecrosis.

In the coming year, let’s collectively work towards making November 29 a day of national significance. Together, we can ensure that the stories of those touched by Avascular Necrosis-Osteonecrosis are heard, recognized, and celebrated from coast to coast. The journey has just begun, and with your support, we can light up the map with awareness, compassion, and unity.

Sincerely

Deb Andio

Founder

Avascular Necrosis-Osteonecrosis SuppooInt’l

http://www.avascularnecrosiseducation.com

“Like the majestic Phoenix that rises from the ashes, those of us living with Osteonecrosis are on a journey of resilience and hope. As we continue to advocate for awareness, we believe that our Awareness Day will soon shine worldwide, illuminating the path for understanding, support, and compassion. Together, our voices will soar, echoing the strength that lies within each of us.”

Join my new Clubhouse Room

All things arthritis

Since late stage Osteonecrosis leads to severe osteoarthritis I feel they are under the same umbrella although different in some ways and the same in other ways.

Link to join The Clubhouse New spot

https://www.clubhouse.com/room/wg5c5DG1G8iDl6pVd:EBeGc6yiEqlOHOXuTQYzP18p7uhtKpCBSkfvsgL7w-U?utm_medium=ch_room_pt&utm_campaign=YEvlhG2P4LoHYqbG1UhgLw-488396

Poor Diet and Being Overweight doesn’t help Osteonecrosis

I lived for 20 years with osteoarthritis but nothing was as scary and painful as my Osteonecrosis diagnosis. I gained a lot of weight because I. Oils no longer work and I won’t lie I stuffed myself with food to comfort myself. I went up to 293 lbs. I can’t believe I let myself get that big. Something had to change because I was too fat for a joint replacement and honestly I didn’t want one. So I had to do something, so I changed the way I ate I noticed a great improvement. People thought I was crazy but I had less pain.

I didn’t quit everything cold Turkey. I did stop smoking cold Turkey best decision I ever made.

I added more plants raw and cooked and lessened the meat intake. I started out having meatless Monday Wednesday and Friday soon it was meatless Saturday also.

I cut out 85% of all the crackers and cheese puffs all the stuff that we love but know it’s not real food. When I wanted chips I made a baked potato or a baked sweet potato. When I wanted chips and dip I made my own bean dip and hummus and dipped peppers, celery and sometimes a few crackers. I wasn’t perfect but I really began eating to live not living to eat.

My cholesterol dropped to fantastic numbers I went from total cholesterol of 210 to a total of 172 in a matter of months then down to 158. My good cholesterol went from 38 to 60. So I was on the right path. It wasn’t easy, it still isn’t easy because let’s face it junk food is every place. My next post I will post about how to eat healthy at fast food restaurants and yummy food fast that’s healthy!!

I became a flexitarian meaning I ate mostly plant based and once a week ate chicken and fish. Backed or grilled .

Good bye to greasy fried food, I also cut out 80 percent of processed junk .

Stopped all cola and sugary drinks I never was much of a pop drinker.

Many thought this was crazy and would not do much. But it did.

Then in 2019 there was a study that also confirmed similar findings .

I got off blood pressure medication and my bones didn’t feel like a tourniquet around them.

I also with the ok if my Ortho started taking Cureamed curcumin 375 1-2 times a day for 2 weeks then just once a day. It seemed to help my pain and thinned my blood some. So if you take blood thinners don’t just try this.

Always talk to your doctor before doing anything new.

Fast forward to 2022 thank God still no joint replacement (knee)

Below is some info on poor diet and obesity is not good for Osteonecrosis. Actually obesity and poor diet cause our body to have more inflammation and that gives us more pain. And can lead to many things.

So see a nutritionist get your diet in check and if you are a compulsive overeater go to some OA meetings , see a counselor what ever it takes to reclaim your health.

I lost about 95 lbs regained 16 during covid lock down. But back on track in May 2022 I am hoping by May 2023 I am at goal weight of 145 -150 lbs. it’s not easy and the older I get ( soon to be 60) the harder it is to lose especially when you have bone and joint issues.

But trying and still no joint replacement.

If you have a problem with food like binge eating, or just an unhealthy relationship with it check out https://oa.org/

See link on study below.

Click to access 1100002678220.pdf

5 years of pics

Avascular Necrosis-Osteonecrosis Awareness Day 2021

Hard to believe another awareness day has arrived.

It’s been a struggle and challenge to get all 50 states to issue a proclamation: but being persistent is becoming rewarding. We now have about 1/2 the USA on board as 29 November being AVN-ON

To all those living with Osteonecrosis like myself, know I will not give up until every state has issued the proclamation.

We live with pain and uncertainty every day. But I assure you I will not give up until it’s recognized in every state.

Happy AVN-ON Awareness Day.

Wish you all a pain free day

Avascular Necrosis Mask

Many requested masks as so many cannot find them , so I contacted a local shop in my area and we made these two designs. The mask are washable

I don’t get paid anything for or a portion of the masks just doing this as a way to help those wearing a mask support the cause of Osteonecrosis aka Avascular Necrosis.

If you wish to purchase here is info. And they ship worldwide

They are closed on Sundays and Holidays

Afterburner FX

3600 Schotten Road

Hubbard Ohio 44425

3305347653 phone

Afterburner FX

Mask design

@Debla2020

Thank You Arizona

The good news keeps rolling in

Rare Disease Day is February 29 usually 28 on non leap years.

So as you know I have been working very hard on November 29 being National – Avascular Necrosis Osteonecrosis awareness day and all states have come on board so far but still waiting to hear from maybe 10 states.

They are doing all they can. And I am so pleased many states have issues proclamations for November 29 and many still are in the process.

Today The State of Arizona sent a proclamation for rare disease awareness we got the entire week February 20-27

And they will also be recognizing November 29

So blessed.

Hard work pays off

Thank you State of Arizona

Deb Andio

Founder Avascular Necrosis Osteonecrosis Support Int’l

#Osteonecrisis #AvascularNecrosis