Tracking Pain – With A Journal©

While each person’s experience with Osteonecrosis is different, I want to make sure you have the right information and support you need to live life your best life in spite of osteonecrosis.

There are ways I was able to control my pain, lower overall inflammation in my body which helped my pain.

Also did you know that for many people statins helped as well?

It was time I stopped just being a patient , and I became an advocate and patient leader. It was time to take a personal approach to my health many doctors didn’t understand how I felt, some often seemed as if I was exaggerating or making it up.

This pain wasn’t in my head, and if anything I’m downplaying my pain vs telling you doctors how terrible it is on a constant and daily basis.

Let’s face it when we have chronic pain we don’t always want to cook all day . But I found out trying to save time and energy by grabbing a pizza or burger isn’t helping my pain.

The more junk fats like fast food, processed garbage I removed from my life over time the better I was feeling.

It’s not a cure or a easy fix.

But it’s not hard and it’s delicious.

I’m the main cook in our family. So I prepared meals that have less and no meat more often.

From meatless Monday to now meatless M-W-S

And it was a great success , soon we only ate meat or chicken 1x a week and fish 1x -2 x a week.

We did eat eggs .

Before I knew it some weeks we didn’t eat meat or poultry at all.

We did have fish like cod , tuna, haddock ,crab,shrimp or tuna steaks.

We didn’t care for salmon much.

I also started a pain journal it had what I ate- what I did – my stress level- pain level

Whether you’ve been battling pain for more than a decade or you’re just starting to deal with consistent aches pains and stiff soreness, a pain journal can help you document what you are feeling from day to day.

Your pain journal is where you write down everything relating to your chronic pain what kind of pain you have, what level of pain you are experiencing, what you were doing when you were in pain, what you ate and so on.

Chronic Pain Journal Helps

This information is useful both for you and your doctor. It can be used to help identify patterns of pain, such as time of day or level of stress, or pain triggers from certain activities.

A pain journal can also show what doesn’t increase your pain, which can help you make better decisions about how you spend your day. At the very least, it can be a good reference when memory doesn’t serve you (for example, if you’re not sure how to answer when your doctor asks if your pain is worse after lunch).

Usually pain journal are set up like this.

• Give your pain a scale rating. Most pain scales use the 0-10 rating system, with 0 representing no pain and 10 representing the worst imaginable pain. Your pain will usually fall somewhere in between.

• Use pain descriptor words. Is your pain burning? Stabbing? Tingling? Pulsating? Constant? Using pain descriptor words in your journal can help you track changes and patterns in your pain quality.

• It can also help doctors pinpoint your type of pain.

• Track the time of day pain occurs. Do you hurt more in the morning or the evening? How are your afternoons?

• Write down what you ate and drank that day. Foods and beverages may contribute to or worsen the pain you are experiencing. Jot down everything you ingested food and beverages everyday.You will see a pattern.

• Describe your mood. It’s also important to note your mental state and how you feel when experiencing pain. Are you depressed? Anxious? Fatigued? Obviously, the pain might be triggering these emotions, and your doctor may recommend you see a mental health specialist to deal with the feelings that arise as a result of your chronic pain.

• Note what you are doing when your pain begins. Did you just get out of bed, or had you been sitting for a while when your pain started? Were you exercising or overusing certain muscles in your body? Write down how you feel after activities, such as walking the dog or playing with the kids.

• Look at elements that might contribute to your pain. Think about the external factors that may add to the pain, such as if you suffer from stiff joints; does this happen when it’s raining or cold outside

• Note if you take pain medication does it help? Does it ease pain, take it away do nothing .

It seems like a lot of work but actually it takes just a few days to get it down.

And it’s a valuable tool.

Often a lot of what we eat makes pain worse. Because it causes inflammation in the body.

Basic inflammation is normal chronic inflammation is not.

©Debla2019

You are what you eat©

Finding delicious, wholesome  food is not always easy when you’re eating out at a restaurant, but it’s totally possible when you make it at home I’m Debbie a flexitarian that eats mostly plant based and I am changing my weight and improving my health.I changed my lifestyle to help lower my inflammation and control pain but i will eat fish, chicken etc….just not everyday

Not all my recipes posted are healthy I do like a good old fashioned dinner or snack now and then but its rare.

I am a patient leader advocate and home cook

I have

Avascular Necrosis-Osteonecrosis From Injury

Osteoarthritis

Inherited Blood Clot Disorder

Hashimoto Thyroiditis

http://avascularnecrosiseducation.com

https://flexitarianforlife.wordpress.com/author/chronicallygratefuldebla/

www.ChronicallyGratefulDebla.com

 

veg

 

Joint Pain

 Congratulations !  If you’re like me you are one of the 30 million adults in the United States who suffer with joint pain, you know the pain often is debilitating. It can keep you from staying active and limits your mobility and it even makes daily chores seem impossible. What you might not know is that many doctors can treat joint pain with more than just pills or surgery. Beware though some doctors will tell you about one procedure and then change it once they know your insurance example Medicare I felt one doctor thought less of me as a patient because I am disabled so he changed or tried to change the procedure. It pissed me off because I was all set to get the procedure we discussed and then he changed it.

Both procedures were covered under Medicare so I felt betrayed as if I wasn’t good enough for the other injection.

Newsflash …..people on Medicare pay for the insurance they have. It’s not free , hell I pay more for insurance than when I was working.

But thankfully Medicare is good coverage. Low deductible.

It’s some doctors that treat you like a second class citizen.

Make sure this doesn’t happen to you.

 

Depending on the severity of your pain, injections can be another option for easing your joint pain and help to get you moving again.

Doctors use these injections to try to reduce inflammation and pain in your joints some come with side effects and some risks.

The injections range from corticosteroids, which have been around for decades, to newer ortho-biologic injections like platelet-rich plasma (PRP) , Stem Cell and placental tissue matrix (PTM)

 

You and your physician will decide which one is best based on your individual needs. The issue is finding doctors qualified to do these.

Not every injection is right for every patient, in my case I hate steroid injections, not only did it make my pain worse it also comes with the risk of developing osteonecrosis. Something I already have. I have noticed that it seems like doctors are quick to prescribe and inject steroids. I stand my ground and refuse. But that’s me.

 

So here are some facts to help you know more about the options.

Corticosteroid injections

 

Use: This injection is the first line of defense against osteoarthritis symptoms and other joint pain in shoulders, knees and hips. Corticosteroids can offer relief for two to three months, and reduce inflammatory cell activity in the joint. In some people.

Side effects and Risks : As with all injections, there’s a small chance of infection about one in 1,000 as well as Joint infection.

Nerve damage.

Thinning of skin and soft tissue around the injection site.

Temporary flare of pain and inflammation in the joint.

Tendon weakening or rupture.

Thinning of nearby bone (osteoporosis)

Osteonecrosis lack of blood supply to the bone

Raised blood sugar level

Whitening or lightening of the skin around the injection site

Cost: Most insurance covers the $100 -$200 usd cost of these injections. Your insurance provider may require that you try at least one corticosteroid injection first to see whether it works. If not, you may move on to a different therapy.

 

Hyaluronic acid injections

Use: Hyaluronic acid (HA) injections often are used when corticosteroid injections don’t work. But they usually are approved only for use in the knee.

In some instances, doctors consider an HA injection first if you don’t have obvious signs of inflammation. HA also is a better option if you have diabetes, as corticosteroids can raise blood sugar levels.

Also known as gel injections, HA injections are chemically similar to your natural joint fluid.

When you have osteoarthritis which is different than osteonecrosis lucky me I have both, the joint fluid becomes watery.

So, this injection helps to restore the fluid’s natural properties and works as a lubricant and a shock absorber.

HA is a cushion or a buffer against inflammatory cells in the joint.  In some cases, it can stimulate the knee to start producing more natural HA.” Some physicians also believe that HA helps reduce pain by coating nerve endings within the joint.

One treatment, which may consist of between one and three injections, usually offers symptom relief for four to five months, but sometimes up to one years. However, pain and stiffness will return. Most insurance companies only approve one HA injection every six months.

In knees with osteoarthritis, the joint fluid (called synovial fluid) can break down and not provide the cushioning your knee needs

Durolane

Euflexxa

Hyalgan

Orthovisc

Monovisc

Supartz

Synvisc, Synvisc-One

Depending on which type your doctor uses, you may get a single shot. Or you’ll get three to five injections spaced a week apart.

 

Side effects: There’s a 1-in-100 chance of an inflammatory reaction, The most common short-term side effects are minor pain at the injection site and minor buildup of joint fluid. These get better within a few days.

 

Cost: HA injections cost more — about $300 to $850 per injection, but most insurance companies cover the cost for knee injections.

 

 

Platelet-rich plasma (PRP) injections

Use: Platelet-rich plasma (PRP) injections can treat osteoarthritis joint pain, and are being thoroughly researched to understand their effects.

These injections use your own blood and platelets to promote healing. Platelets contain growth factors and proteins that aid healing in soft tissues. Research shows PRP injections can alter the immune response to help reduce inflammation,

Side effects: Side effects include a very low risk of infection and pain at the injection site. You must stop oral anti-inflammatory medications for a short amount of time if you get a PRP injection.

Cost: Insurance companies don’t generally cover PRP injections and you will pay between $400 and $1,300 per injection out-of-pocket.

 

Stem Cell Injections

The world’s most advanced regenerative injection treatments for treating knee pain due to arthritis, meniscus tears, traumatic ligament injuries, overuse conditions and other degenerative conditions.

 

Side effects : mild discomfort associated with the procedure. There is a very small risk of infection whenever aspirations and injections are performed. Nerve damage, vessel damage, and injury to other important structures are exceedingly rare

 

Placental tissue matrix (PTM) injections

 

Use: Placental Tissue Matrix (PTM) injections can very profoundly decrease the pain related to osteoarthritis.

 

These are injections of placental tissue, which is obtained after a healthy baby is delivered from a healthy mother. Research has discovered that there is a large number of growth factors in placental tissue that promote healing, Dr. Genin says.

Side effects: Side effects include a  low risk of infection and pain at the injection site. The placental tissue is “immune privileged,” which means the body would not have an adverse reaction to it.

Cost: Insurance companies don’t generally cover PTM injections; you will pay around $1,800 -$2500 per injection out-of-pocket.

 

Many of these injections often are effective in reducing or stopping your joint pain, but it’s important to remember that they may not keep the pain from returning, Dr. Schaefer says. In fact, they’re most effective when used with other therapies.

 

As a patient who has Osteonecrosis, Osteoarthritis, and other stuff I consider surgical options as a last resort only if other treatment options have failed. Unfortunately some treatments I cannot even afford to try. I wish the FDA would get a move on and approve some things so insurance companies can have this as a form of treatment.

 

 

 

 

Stem Cells

 

BONE MARROW AND FAT CELLS

The stem cells used in this point of care clinic are Autologous Cells that we take from your own body.  These cells are taken from your own Bone Marrow or Fat Cells.  The cells are your own Stem Cells and will not be rejected by your body.

Taking the Bone Marrow or Fat Cells from your body is relatively painless as a mild local anesthetic is used prior to harvesting.  These cells are processed to receive the most stem cell gain and then injected into the area of your body where you need the growth factors to go to work the quickest.  Your blood is also drawn and your platelet rich plasma is added to the Stem Cells taken from your Bone Marrow or Fat Cells to increase the activity of the growth factors.

It is important that these cells are used the day they are extracted from your body in order to insure they remain alive and active.  Our clinic does not grow extra stem cells from your Bone Marrow or Fat Cells to ensure that they are alive and active.  It is an FDA requirement that you receive your cells the same day they are harvested.

You get only the stem cells we extract from your body and there is no other manipulation used except extraction and preparation of the samples taken from your own body.  The cells are taken in a procedure that creates only mild discomfort or none at all.  Ninety nine percent of our patients experience no pain obtaining bone marrow or fat cells.

CORD STEM CELLS:

Embryo and Placenta stem cells can create certain types of cancers.  The cord blood Stem Cells should only be used if they are obtained from a healthy relative and you are a good match.  Cord Stem Cells that are used outside of the country or shipped to this country are illegal.  The FDA has found diseases in these grown cells and states that most of them are dead.  Even though the physicians supplying these Cord Cells claim they are safe to use, you should use extreme caution before considering these procedures.

ARE YOU A CANDIDATE FOR THESE STEM CELL PROCEDURES

REBUILDING JOINTS & SPINE: The Stem Cells that are obtained from your body are placed into all joints and spine to rebuild and regenerate new tissue growth as determined by the clinic physician.   There has been clinical evidence that new cartilage can be grown within your joint provided you are determined a candidate by the clinical physician.  Not all patients will be a candidate and may require joint replacement.

TORN TENDONS:  If the patients tendons are not completely torn this procedure will produce new tissue growth to regenerate torn tendons. Our clinic physician can only determine this with an initial visit and evaluation.

How Does PRP Therapy Work?

To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and through a multi-functional process separates the plasma from the blood producing the PRP. This increases the concentration of platelets and growth factors up to 500% also increasing hMSC (human stem cells) proliferation as a function of 8-day exposure to platelet released concentrations 10x. (x= increase above native levels)

When PRP is injected into the damaged area it stimulates the tendon or ligament causing mild inflammation that triggers the healing cascade. As a result new collagen begins to develop. As this collagen matures it begins to shrink causing the tightening and strengthening of the tendons and ligaments of the damaged area.

What is Platelet Rich Plasma?

Platelet Rich Plasma or PRP is blood plasma with concentrated platelets. The concentrated platelets found in PRP include growth factors among the huge reservoirs of bioactive proteins that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins increase stem cell production to initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels and stimulate the wound healing process.

PRP Regenerates Tendons & Ligaments

Tendons connect the muscle to the bone making it possible for you to do many everyday physical activities. Overuse or damage to the tendon over a long period of time causes the collagen fibers in the tendons to form small tears, a condition called tendonitis. Damage to tendons most often occurs in the knees, ankles, hips, spine, elbows, shoulders, and wrists.

Ligaments are composed of collagen fibers that hold one bone to another, stabilizing the joint and controlling the range of motion. When a ligament is damaged, it is no longer able to support the bones in the joint, which often leads to pain symptoms. The instability causing the pain in your joints does not always show up on high tech imaging equipment. Through a thorough neurological and orthopedic evaluation Dr. Baum can determine which ligaments and tendons are unstable due to injury, wear or tear.

Tendons and ligaments have a poor blood supply and they do not usually heal from damage. Combined with the stress of day-to-day activities tendons and ligaments become inefficient causing degeneration of the joint which leads to chronic pain and weakness. Patients who experience chronic pain may not even remember when the injury occurred.

How Does PRP Compare With Cortisone Shots?

Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but may not provide long term healing. PRP therapy is healing and strengthening these tendons and ligaments and in some cases thickening the tissue up to 40%.

Treatment Plan

PRP injections with guided ultrasound can be performed on tendons and ligaments all over the body. Cervical, thoracic and lumbar spine, degenerative disc disease, arthritic joints shoulder pain, hip pain, and knee pain, even the smaller joints of the body can all be treated effectively with PRP. Dr. Baum will determine whether prolo solution, Platelet Rich Plasma or a combination of both will be the most effective form of treatment for you during his initial consult and evaluation.

Frequency Of Treatments

While responses to treatment vary, most people will require 3 to 6 sets of injections of PRP. Each set of treatments is spaced 4 to 6 weeks apart.

Is PRP Right For Me?

If you have degenerative spine or joint disease, a tendon or ligament injury, laxity or tear and traditional methods have not provided relief then PRP therapy may be the solution. It will heal tissue with minimal or no scarring and alleviates further degeneration and builds new tissues. There will be an initial evaluation with Dr. Baum to see if PRP therapy is right for you.

What Can Be Treated?

Platelet Rich Plasma injections helps regenerate all areas of the body including the cervical, thoracic and lumbar spine, wrists, elbows, shoulders, hips, knees and ankles as well as tendons and ligaments all over the body.  Dr. Baum is one of the few physicians performing PRP procedures to all areas of the spine.  Our clinic treats patients with sports injuries, arthritic and degenerative joints and degenerative disc disease. More specific injuries including tennis elbow, carpal tunnel syndrome, scoliosis, ACL tears, shin splints, rotator cuff tears, plantar faciitis and iliotibial band syndrome may all be effectively treated with PRP.

What Are The Potential Benefits?

Patients can see a significant improvement in symptoms as well as a remarkable return of function. This may eliminate the need for more aggressive treatments such as long-term medication or surgery.

Special Instructions

You are restricted from the use of non-steroid anti-inflammatory medications (NSAIDs) one week prior to the procedure and throughout the course of treatments.

Initially the procedure may cause some localized soreness and discomfort. Most patients only require some extra-strength Tylenol to help with the pain. Ice and heat may be applied to the area as needed.

How Soon Can I Go Back Regular Activities?

PRP therapy helps regenerate tendons and ligaments but it is not a quick fix. This therapy is stimulating the growth of new tissue requiring time and rehabilitation. Under Dr. Baum’s supervision patients will begin an exercise program immediately following the first procedure. During the treatment program most people are able to resume normal activities and exercise.

Platelet Rich Plasma (PRP) Matrix Graft by David Crane, MD and Peter A.M. Everts PhD

PRP application techniques in musculoskeletal medicine utilize the concentrated healing components of a patient’s own blood—reintroduced into a specific site—to regenerate tissue and speed the healing process

PRP INJECTION APPLICATION SITES

Spine

Cervical/Thoracic/Lumbar/Sacral

Shoulders & Elbows

Wrist & Hand

Hip/Pelvis

Knee & Lower Leg

Ankle & Foot

Fingers & Toes

Arthritic Joints

Osteoarthritis

Some Osteonecrosis

 

Information

http://www.prolotherapy.com/PPM_JanFeb2008_Crane_PRP.pdf

https://drjamesbaum.com/wp-content/uploads/stemcells2002-0109.pdf

 

Important Videos Everyone Should watch on Biologics

https://drjamesbaum.com/2013/07/the-science-of-mesenchymal-stem-cells-and-regenerative-medicine/

 

Scientific Papers on Research of Stem Cells

https://drjamesbaum.com/stem-cells/scientific-papers/

knnz

I will be posting this in my other blog section also

Guest Speaker

Tonight the support group I started

Avascular Necrosis/ Osteonecrosis Support Int’l has a guest speaker

I can’t wait to hear Dr. Michael Mont discuss Osteonecrosis and Joint preservation

More to come ……

He discussed Osteonecrosis and the 3 decades he has been treating it.

He answered a lengthy Q and A from several members.

He prefers to preserve the joint so we discussed CD(core decompression) it’s success and failure rates, surgery

He is doing a second Q and A

June 19,2018

Avascular Necrosis / Osteonecrosis Support Int’l.

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

Non -Surgical Treatment’s of Avascular Necrosis – Osteonecrosis

Non -Surgical Treatment s of Avascular Necrosis – Osteonecrosis

If osteonecrosis is diagnosed while damage is limited to a small area of bone sometimes doctors can try PRP injections, A2M injections, or Stem cell injections which is said to be the gold standard of injections.

I will get into those treatment options another day . And it may also be effective in up to stage 3 of AVN-ON but the faster you get it treated the better the outcome. It also depends on how you got your avn that will determine the outcome.

Let’s be real here

Avascular Necrosis –Osteonecrosis can be incredibly painful. And only those who have it understand the pain.

Medication to treat osteonecrosis may not be effective in people who have medical conditions that require treatment using corticosteroids, immunosuppressant medications, or chemotherapy. These medications may counteract osteonecrosis treatment.

During treatment with medication to stop the progression of osteonecrosis, your doctor monitors bone damage by taking periodic images of the affected bone for six months to a year or more. Some doctors may also recommend using crutches or a brace to remove stress from the affected bones.

As the bone starts to heal, physical therapy can help you maintain joint mobility, strengthen muscle groups that support the joint, and make changes to the way you walk to protect the affected bones.  If the disease does not progress and putting weight on the joint becomes less painful, nonsurgical treatment may be all that is needed to recover from osteonecrosis.

Bisphosphonates

Bisphosphonates are prescription medications that reduce bone loss by destroying cells that contribute to the degeneration of bone. This helps preserve healthy bone tissue.

Your doctor may recommend that you take this medication by mouth or injection for six months or more, depending on the size of the osteonecrosis lesion or lesions and whether symptoms improve during the first six months. If an injected form of medication is prescribed, your doctor may give the injection in his or her office or show you how to administer your injections at home. Some bisphosphonates are taken by mouth or injection once a week or once a month, others less frequently.

Your doctor will continue to evaluate the effectiveness of treatment, using periodic X-rays or MRI that can reveal changes in the bone’s health. The doctor also looks for signs of side effects from bisphosphonates, which may include bone fractures outside the affected joint, and conducts regular blood tests.

Long-term use of bisphosphonates should be monitored by your doctor.  And also may cause avn-on in jaw if you need on going dental work.

Nonsteroidal Anti-inflammatory Drugs

Bone loss due to osteonecrosis may be painful, especially in the hip and knee joints, which bear much of the body’s weight. Nonsteroidal anti-inflammatory drugs, or NSAIDs, sometimes work by reducing inflammation in the soft tissues surrounding the joint, relieving pain and swelling. These over-the-counter pain relievers include ibuprofen, naproxen, and aspirin. It may help in the short term but again talk to your doctor.

Long-term use of NSAIDs can cause side effects, including upset stomach or ulcers. If joint pain persists for more than a month, talk to your doctor before continuing use.

Statins

Statins are medications that lower cholesterol levels by reducing the amount of fatty substances called lipids in the bloodstream. If statin’s remove lipids from blood vessels leading to a diseased bone, more blood can reach the bone, allowing it to rebuild bone tissue. This may slow or stop the progression of osteonecrosis.

Statins can cause liver abnormalities and muscle damage, so your doctor takes your overall health and medical history into consideration before prescribing them for long-term use.

Medical Marijuana

No other pain relieving medication is less toxic than cannabis, even aspirin or Tylenol. This is why cannabis as medicine can be an excellent choice for pain.  A proper cannabis recommendation requires more than just a few minutes of a doctor’s time, and includes information on cannabinoid content, strain selection, and delivery methods. If you’re not getting this information from your doctor, you’re not getting a real cannabis consultation and are missing information on the full value and healing potential of the plant. Cannabidiol, a nonpsychotropic component of marijuana, may enhance the healing process of bone fissures, according to a new study.

CBD oil is an entirely different compound, and its effects are very complex. It is not psychoactive, meaning it does not produce a “high” or change a person’s state of mind. Instead, it influences the body to use its own endocannabinoids more effectively and can ease pain.

Pain medication  

Most pain medications for bone cancer are taken by mouth, in pill or liquid form. If swallowing is difficult, pain medication can also be delivered through a patch placed on the skin, an injection,talk to your doctor or see a pain management specialist if needed . No one needs to suffer in pain

Physical Therapy

When prescribed in addition to medication, physical therapy may slow down the progression of osteonecrosis and provide some pain relief. During the early stages of treatment, if the disease has affected the hip or knee, physical may suggest using crutches or a cane to help you move around without putting any weight on the affected joint.

You may use crutches or a cane for six weeks or more, depending on your age, the location of the lesion, and the severity of the disease. This gives the lesions time to heal and may prevent further joint damage.

Rehabilitation experts also offer heat and ice therapy, which may provide temporary pain relief deep within the joint, as well as acupuncture and acupressure, in which very thin needles or massage are used to stimulate blood flow and reduce inflammation.

After you can put weight on the affected joint without pain, physical therapists can customize a routine of simple, low-impact exercises to maintain range of motion in the affected joint as well as build strength in muscles that surround and support the joint. For example, stretching exercises and movements such as leg lifts or squats can prevent the joint from becoming stiff.

In addition, adding exercise such as tai chi or  or my favorite is  qi gong ,  or using a stationary  or recumbent bike  another favorite of mine or add swimming to your regular workout routine can help you maintain flexibility in the joints without putting too much stress on the bones. These exercises may prevent the disease from limiting your ability to walk and participate in everyday activities. They also improve blood flow throughout the body, which may help the bone heal more quickly.

A physical therapist can also help you alter the way you walk to avoid limping or putting too much stress on the affected joint. This helps ensure that you are able to use the joint without feeling pain for the long term.

The duration of physical therapy varies depending on the location of a lesion and how quickly your body responds to medication and physical therapy. After four to eight weeks, your therapist and physician assess your progress and determine whether additional treatment is required.

The most important thing you can do is have a good ortho , talk to him or her openly and honestly about your condition, your pain, your limitations etc…. together you can work together to find the best treatment plan for you . And also remember if you are unsatisfied you can always get a second opinion and or new ortho.

All content found on this Website, blog,, including: text, images, audio, or other formats were created for informational purposes only.

The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Never disregard professional medical advice or delay in seeking it because of something you have read on this website,blog,page.

If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

I do not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on here .

Reliance on any information provided by this website , blog is solely at your own risk.

I discuss and educate.

I tell my story.

National Orthopedic Societies By Country

I talk so many people around the world with Avascular Necrosis/ Osteonecrosis so often it’s sad because they struggle to find qualified doctors and surgeons knowledgeable about the disease.

I also here in the USA found it hard to find doctors who are not just educated in avn but really know about it and have a true interest in helping their patients.

The only I have spoke with are listed in my list for USA doctors.

I am working on a world wide list.

Here is also great information on orthopedic societies by country.

Deb

They are in alphabetical order.

National Orthopedic Societies By Country

Argentina

Asociación Argentina de Ortopedia y Traumatología (AAOT)

Australia

Australian Orthopaedic Association (AOA)

Austria

Österreichischen Gesellschaft für Orthopädie und Orthopädische Chirurgie (ÖGO)

Bangladesh

Bangladesh Orthopaedic Society (BOS)

Belgium

Société Royale Belge de Chirurgie Orthopédique et de Traumatologie (SORBCOT)

Belgische Vereniging voor Orthopedie en Traumatologie (BVOT)

Orthoweb

Bolivia

Sociedad Boliviana de Ortopedia y Traumatología (SBOLOT)

Bosnia and Herzegovina

Orthopaedic and Traumatology Surgeons Association of Bosnia and Herzegovina (OTSABH)

Brazil

Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)

Bulgaria

Bulgarian Orthopedics and Traumatology Association (BOTA)

Canada

Canadian Orthopaedic Association (COA)

Chile

Sociedad Chilena de Ortopedia y Traumatología (SCHOT)

Colombia

Sociedad Colombiana de Cirugía Ortopédica y Traumatología (SCCOT)

Croatia

Croatian Orthopaedic and Traumatology Association (HUOT)

Czech Republic

Ceská Společnost pro Ortopedii a Traumatologii (CSOT)

Denmark

Dansk Ortopaedisk Selskab (DOS)

Ecuador

Sociedad Ecuatoriana de Ortopedia y Traumatología (SEOT)

Egypt

Egyptian Orthopaedic Association (EOA)

El Salvador

Asociación Salvadoreña de Ortopedia y Traumatología (ASOT)

Estonia

Estonian Association of Traumatology and Orthopedics (ETOS)

Finland

Finnish Orthopaedic Association (SOY/FOA)

France

Société Française de Chirurgie Orthopédique et Traumatologique (SOFCOT)

Germany

Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC)

Berufsverband der Fachärzte für Orthopädie und Unfallchirurgie e. V. (BVOU)

Greece

Hellenic Association of Orthopaedic Surgery and Traumatology

Hong Kong

Hong Kong Orthopaedic Association

Hungary

Magyar Ortopéd Társaság (MOT)

Iceland

Icelandic Orthopedic Society

India

Indian Orthopaedic Association (IOA)

Iran

Iranian Orthopaedic Association (IOA)

Ireland

Irish Orthopaedic Association

Israel

Israel Orthopaedic Association

Italy

Società Italiana di Ortopedia e Traumatologia (SIOT)

Japan

Japanese Orthopaedic Association (JOA)

Jordan

Jordan Orthopedic Association (JOA)

Korea

Korean Orthopaedic Association (KOA)

Kosovo

Kosovo Society of Orthopaedics and Trauma Surgeons (KSOTS)

Lebanon

Lebanese Orthopaedic Association (LOA)

Lithuania

Lithuanian Society of Orthopaedics and Traumatology (LSOT/LOTD)

Luxembourg

Luxembourgian Society of Orthopaedics and Traumatology (SLOT)

Macedonia

Macedonian Association of Orthopaedics and Traumatology (MAOT)

Malaysia

Malaysian Orthopaedic Association (MOA)

Mexico

Sociedad Mexicana de Ortopedia (SMO)

Montenegro

Association of Orthopaedics and Traumatology of Montenegro (AMOT)

Morocco

Société Marocaine de Chirurgie Orthopédique et de Traumatologie (SMACOT)

Netherlands

Dutch Orthopaedic Association (NOV)

New Zealand

New Zealand Orthopaedic Association

Norway

Norsk Ortopedisk Forening (NOF)

Pakistan

Pakistan Orthopaedic Association

Paraguay

Sociedad Paraguaya de Ortopedia y Traumatología (SPOT)

Peru

Sociedad Peruana de Ortopedia y Traumatología (SPOT)

Poland

Polskie Towarzystwo Ortopedyczne i Traumatologiczne (PTOiTr)

Portugal

Sociedade Portuguesa de Ortopedia e Traumatologia (SPOT)

Puerto Rico

Sociedad Puertorriqueña de Ortopedia y Traumatología (SPOT)

Romania

Societatea Romana de Ortopedie si Traumatologie (SOROT)

Russian Federation

Association of Orthopaedists and Traumatologists of the Russian Federation

Saudi Arabia

Saudi Orthopaedic Association

Serbia

Serbian Orthopaedic Trauma Association (SOTA)

Singapore

Singapore Orthopaedic Association (SOA)

Slovakia

Slovenská Ortopedická a Traumatologická Spoločnosť (SOTS)

Slovenia

Slovenian Orthopaedic Society (ZOSZD)

South Africa

African Orthopaedic Association (SAOA)

Spain

Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT)

Sweden

Svensk Ortopedisk Förening (SOF)

Switzerland

Société Suisse d’Orthopédie et de Traumatologie (SSO/SGO)

Taiwan

Taiwan Orthopaedic Association

Thailand

Royal College of Orthopaedic Surgeons of Thailand (RCOST)

Turkey

Turkish Society of Orthopaedics and Traumatology (TOTBID)

United Kingdom

British Orthopaedic Association (BOA)

United States

American Academy of Orthopaedic Surgeons (AAOS)

Uruguay

Sociedad de Ortopedia y Traumatología del Uruguay (SOTU)

Venezuela

Sociedad Venezolana de Cirugía Ortopédica y Traumatología (SVCOT)

Legg-Calve-Perthes Kids Avascular Necrosis

What is Legg-Calvé-Perthes disease?

Legg-Calvé-Perthes disease (LEG-cal-VAY-PER-theez) is a problem in the hip. It is often called Perthes disease.

Legg-Calvé-Perthes disease occurs when blood temporarily stops flowing to the ball (femoral head) at the top of the thighbone that fits into the hip socket. If the bone does not get enough blood, it dies. The bone collapses and becomes flat. As a result, the ball no longer moves smoothly in the hip socket.

Over the course of several months, the blood supply comes back to the bone. New bone cells gradually replace the dead bone. This process may take 2 or 3 years.

The disease can occur in both hips, but usually not at the same time.

Children with Legg-Calvé-Perthes disease may develop arthritis early and lose some movement in their hips.

Legg-Calvé-Perthes disease in children

Although any child can get Perthes disease, boys with the disease outnumber girls 4 to 1. Usually, they are thin, wiry, very active boys who are smaller than others their age.

Perthes disease usually develops when children are between the ages of 4 and 8. But children as young as age 2 and as old as age 12 can develop the disease.

Symptoms

Signs and symptoms of Legg-Calve-Perthes disease include:

• Limping

• Pain or stiffness in the hip, groin, thigh or knee

• Limited range of motion of the hip joint

Legg-Calve-Perthes disease usually involves just one hip. Both hips are affected in some children, usually at different times.

When to see a doctor

Make an appointment with your doctor if your child begins limping or complains of hip, groin or knee pain. If your child has a fever or can’t bear weight on the leg, seek emergency medical care.

Causes

Legg-Calve-Perthes disease occurs when too little blood is supplied to the ball portion of the hip joint (femoral head). Without an adequate blood supply, this bone becomes unstable, and it may break easily and heal poorly. The underlying cause of the temporary reduction in blood flow to the femoral head is still unknown.

Risk factors

Risk factors for Legg-Calve-Perthes disease include:

• Age. Although Legg-Calve-Perthes disease can affect children of nearly any age, it most commonly occurs between ages 4 and 8.

• Your child’s sex. Legg-Calve-Perthes is up to five times more common in boys than in girls.

• Race. White children are more likely to develop the disorder than are black children.

• Family history. In a small number of cases, Legg-Calve-Perthes appears to run in families.

Complications

Children who have had Legg-Calve-Perthes disease are at higher risk of developing hip arthritis in adulthood particularly if the hip joint heals in an abnormal shape

If the hip bones don’t fit together well after healing, this can cause the joint to wear out early. Hip replacement surgery eventually may be required.

In general, children who are diagnosed with Legg-Calve-Perthes after age 6 are more likely to develop hip problems later in life.

The younger the child is, the better the chances for the hip joint healing in a normal, round shape.

Avascular Necrosis – Rare Disease-Disorder©

Rare Disease

Approximately 15-20,000 New cases if Avascular Necrosis are diagnosed each year.

Treatment can often help, but this condition can’t be cured.

The earlier the stage of your diagnosis and the sooner you get treatment.

The better the outcome.

A Chronic condition : can last for years or be lifelong

Avascular necrosis is associated with trauma to the bone or joint, clotting disorders,long-term steroid use and drinking too much alcohol.

It’s most common in people between the ages of 30 and 60 and often affects the hip.

Avascular Necrosis can happen in any bone but the most common are

Hip

Knee

Ankle

Shoulder

Early stages of Avascular Necrosis may be symptom-free.

You may not even know you have it until you start to experience pain.

The affected joint may hurt when weight is put on it or even when lying down.

Treatment includes physical therapy, surgery, prp and or stem cell injections and medications.

 I am working every week writing to Senators asking for an awareness day.

I know they are busy but I am confident it will happen eventually.

I write them because when you have a rare condition, there isn’t much research being conducted and sometimes I feel like myself and my group are the only ones raising awareness.

So if I have to be the one to plow through and get proclamations in every state.

Let the writing begin

God Bless you all and wishing everyone a pain free day

Deb Andio

©Debla2018 text and art 2014-2019

The Journey Begins©

Thanks for joining me! Avascular Necrosis is a long crazy road……road

I am adding this specific blog site to dedicate it to all that suffer from avascular necrosis and so they can get education information and resources that may help them along the way.

This site is never intended as medical advice its just to educate it is not to diagnosis

FDA Disclaimer: The advice & statements on this blog have not been evaluated by the Food & Drug Administration. Any information on this blog is not intended to diagnose, treat, cure, or prevent any disease.

Copyright

No part of this publication shall be reproduced, transmitted, or sold in whole or in part in any form, without the prior written consent of the author. Any content on my blog whether it be pictures or text, may not be republished or distributed, for financial gain or not, without written permission of the author.

Always talk to your primary care doctor.

If you have Avascular Necrosis and need a great support group join – you are required to answer a few questions

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

Good company in a journey makes the way seem shorter. — Izaak Walton

I forgive but won’t forget

I forgive you….For showing me who you really are.

On one hand, I get it. Who would want to deal with this? Who would want a friend that plans to go to lunch then changes their mind because the pain in their body is just to much that day.

Who would want to hang out with a friend who’s bones always hurt and was afraid to make plans , because they didn’t want to let you down if their body was in pain again.

If you don’t want to talk to me for a while to focus on your own issues, or just to unwind and be alone for a while, you are entirely valid and you don’t have to justify that to me. Trust me I understand

On the other hand, some of you really hurt my feelings. When you needed me before I had my health issues I was always there for you. I’d pick you up late at night if you drank to much, I’d take you shopping when your car was in the shop. Make you soup when you were sick.

You hurt me by leaving me when I needed you most.

You hurt me by making me feel like my condition is to much for you to bear than it is for to live with.

You hurt my feelings by making me feel alone, different and excluded when all I wanted was to feel included and just the same as everybody else.

Maybe I should be thanking you instead of feeling a bit sad.

I thank those of you who went about leaving with human decency, for being honest with me, and for admitting that your own issues are the priority for you, as they should be.

I thank you for taking time away from me to focus on yourself and work on your own health. I thank those of you who went about it in a rude way for you revealed your true colors to me, and I feel relieved I don’t have to waste each other’s time.

Finally, I thank those of you who have never left. Those of you who are still here, calling me , asking me to get coffee etc….