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
All things arthritis
Link to join The Clubhouse New spot
If you have Osteonecrosis of the knee like me exercise should and can still be a part of your lifestyle. But we must must must use caution and we just can’t go all willie nillie and do this or that on our own. We need to always first consult our ortho and then see a trained physical therapist one who understands osteonecrosis. The key is to know the right exercises and the right way to do them.
Generally, long-term exercise is safe for adults with knee pain from Osteonecrosis but as we know we can go from stage one to stage 3 in as less as weeks and as long as months even years, that’s why it’s imperative we keep in contact with our pcp and orthopedic.
Exercise when performed correctly, the right exercises can even help decrease our pain of osteonecrosis and osteoarthritis and other bone and joint conditions
It can improve our ability to carry out ordinary physical activities. We have to to keep our muscles strong as they support the joints and keeps them stabilized.
It may seem counterintuitive for exercise to decrease knee pain, because when our knees hurt we don’t really feel like exercising, but for me that’s when I have to push through because it will help my pain
But it’s helpful to understand how it works.
Exercise also improves your muscle strength. Stronger muscles are able to carry your body weight more efficiently, relieving some of the burden put on the joints.
However, performing the “wrong” exercise or using poor form may increase pain or inflict irritation to the joint.
“Pain with exercise isn’t normal,”
That said, it’s important to note that when starting a new exercise program, you may experience “muscular soreness,” which is different from joint pain.
It’s normal to experience muscle soreness fir a day or even two after exercises, when I first started a simple walking program I walked every other day. I gave my muscles a chance to rest.
I liked my PT sessions and afterwards I got the Electrical Muscle Stimulation (EMS) device which helped my muscles relax and recover.
I highly suggest a physical therapist, they will be guiding you through the process. An expert will analyze your form and make suggestions. They show you how to properly do the exercises.
You don’t want to injure something else in the process of trying to stay active.
Biking , swimming water aerobics are much easier on the joints.
Several states have officially proclaimed today as Osteonecrosis awareness day this past year a few more states came on the awareness train. And by next year God willing all 50 state’s as well as the US Virgin Islands and Puerto Rico will as well.
I will post the entire list later
But for now – Below are some posts and info
Thank you to Youngstown Ohio Mayor Jamael Tito Brown and Senator Michael Rulli and Senate President Larry Obhof
What an honor
Help me raise awareness today and please like and share this post.
AvascularNecrosis/Osteonecrosis Support Int’l
Finally Avascular Necrosis-Osteonecrosis has an official awareness date.
The date is November 29
I have been working on proclamations for several months and I am in the process of getting the awareness day Nationally recognized as well.
I’m so grateful that our elected officials took the time to talk to me.
And set a date for AVN-ON awareness
I have heard back from several officials that will also be adopting November 29 .
I have been advocating for over 5 years on Avascular Necrosis -Osteonecrosis and I am proud and grateful that our elected officials are also recognizing this awareness day.
What is a proclamation?
A proclamation is a formal way to make a public announcement or declaration. Government officials, such as mayors and state legislators, often issue proclamations to announce upcoming events or celebrations or to increase public awareness of particular issues.
I am proud to say I was issued a proclamation by my local Mayor of Youngstown Ohio
And also by Senator Michael Rulli of Ohio.
I have heard from Washington DC and it’s a longer procedure but it’s being looked at.
Right Now AVN-ON falls under the rare disease / disorder category.
In the United States, a rare disease is defined as a condition that affects fewer than 200,000 people. This definition was created by Congress in the Orphan Drug Act of 1983. Rare diseases became known as orphan diseases because drug companies were not interested in adopting them to develop treatment
Well I am hoping that now that AVN is getting recognition we can get more research to help all of us that are dealing with this painful condition.
Thank you to
Senator Michael Rulli -Ohio
Mayor Jamael Tito Brown – Youngstown Ohio
For helping us who suffer finally get the awareness day we deserve
God Bless You and Thank You.
Your eating what?
Before you take one more bite of that fast food lunch or dinner consider how it affects your osteoarthritis.
I am posting this because many with Avascular Necrosis/ Osteonecrosis also end up with osteoarthritis.
Did you know that research shows that diets high in saturated fat – found in red meat, butter, cheese, lard and processed foods – can weaken knee cartilage, making it more prone to damage.
Yep so start eating more plants
There was a study in 2017 published in Arthritis Care & Research, researchers followed more than 2,000 patients with OA for up to four years, checking disease progression and diet at yearly intervals. Participants who ate the most fat, especially the saturated kind, showed increasing joint damage, whereas those who ate healthy fats like olive oil and avocados had little disease progression.
Another recent animal study showed that it even may harm the underlying bone, according to Yin Xiao, PhD, a professor at Queensland University of Technology in Australia and lead author of a 2017 study that looked at the effect of diet on OA.
“Our findings suggest that it’s not wear and tear but diet that has a lot to do with the onset of osteoarthritis,” he says.
Blame It On Inflammation
Fat’s not the only culprit, though. Sugar, refined carbs, red meat, processed food and corn and soybean oils can spark inflammation, too. Barry Sears, PhD, a long-time researcher in inflammatory nutrition, says eating them is “like throwing a match into a vat of gasoline.”
These foods also tend to pack on pounds, putting extra pressure on stressed joints. To make matters worse, body fat, especially the kind that collects around your belly, makes its own inflammatory proteins, perpetuating the cycle of inflammation even after you’ve sworn off junk food forever.
The solution is to change the way you eat. Switching to an anti-inflammatory or Mediterranean-style diet can help you lose weight and significantly improve your joint, heart and brain health without sacrificing good taste.
An anti-inflammatory diet is heavy on fruits and vegetables, whole grains, fish and healthy fats like olive oil, avocados and nuts. Poultry’s allowed now and then and you can have one glass of red wine or beer a day. Off the menu, as you might expect, are sugar, red meat, and processed foods.
What sets this way of eating apart is that it actively fights inflammation, experts say.
“There are a variety of foods in the Mediterranean diet that are high in fiber, beta carotene, magnesium and omega 3s, all of which have been found to reduce inflammatory markers in human studies,” explains Michelle Babb, MS, RD, a Seattle-based nutrition educator.
“I’ve had [arthritis] patients who have been able to discontinue the use of non-steroidal anti-inflammatory drugs (NSAIDs) as a result of transitioning to a Mediterranean diet. Some even report a noticeable difference in pain in the first week.”
Even so, changing the way you eat can be daunting.
“Don’t expect your diet to change overnight,” advises Sotiria Everett, EdD, RD, an assistant professor at Stonybrook University Medical Center in New York. “Start by looking at what you’re eating now (a food diary is a great way to do this) and identifying areas where you can improve.”
But Babb doesn’t see a problem. Her patients “really enjoy this food plan and don’t feel it’s a hardship to follow it,” she says.
She admits it takes more work and advance planning than the drive-through and recommends prepping some food for the week in advance.
I personally can agree with this as when I stopped eating so much red meat and cut out sugar and most processed junk I felt much better .
And when I eat things that are not as healthy as they should be I feel more pain.
So try a plant based diet or as they suggest Mediterranean
You will be so glad you did.
This taken from article Arthritis Foundation Blog
When you have tried everything an all non-surgical treatments stop relieving your chronic hip pain, or your pain reaches debilitating levels, hip replacement surgery may be the best option to relieve your discomfort, restore your mobility and improve your quality of life.
Hip pain due to Osteonecrosis is an increasing problem for many.
After time over-the-counter pain medications can lose their efficacy and chronic hip pain can quickly escalate often requiring prescription medications, physical therapy, and the use of canes or walkers to aid mobility.
If your pain is severe and debilitating, isn’t it time to do something about it.
Talk to your Doctor or Orthopedic because you don’t need to suffer and have a poor quality of life.
What Signs & Symptoms Indicate a Need for Hip Replacement Surgery?
Hip pain can have a number of causes, not all of which can be relieved by a hip joint replacement.
Among the listed causes of AVN are steroid use, trauma, hypertension, rheumatoid arthritis, and alcoholism, blood clot disorder, smoking, vasculitis Bisphosphonate use, Chemo or radiation or it could be idiopathic, meaning no cause can be determined. Certainly Napoli has had his share of wear and tear, being a catcher.
For instance, constant or long-lasting stiffness in your hip joint can be a sign of rheumatoid arthritis while pain that centers in the buttocks region and radiates down the leg may be related to sciatica.
However, many cases of hip pain and discomfort are directly related to your hip joint.
Symptoms and signs that it may be time for hip replacement surgery include:
• Mobility issues, especially if your level of mobility progressively worsens
• Persistent or recurring pain, swelling or discomfort in your hip
• Hip pain that worsens during rainy weather
• Inability to sleep due to hip pain and discomfort
• A “grating” feeling in your hip joint
• Increasing difficulty in climbing stairs or getting in and out of cars, bathtubs, and chairs
• OTC medications no longer effectively manage your hip pain
If you have any or all of these symptoms, talk to an orthopedic surgeon about the possible need for hip replacement surgery.
How Is a Diagnosis Made?
To determine if you are a good candidate for hip replacement surgery, you will need a thorough examination by an experienced orthopedic surgeon. This examination will include:
• A complete medical history evaluation, including any previous injuries or illnesses that could be contributing to your pain
• A physical assessment to determine your range of motion, pain level and the strength of your affected hip
Your orthopedic surgeon may also order additional medical testing, including MRIs and X-rays. If your surgeon decides that the next step is hip replacement surgery, be sure to discuss any questions or concerns you have about the surgery or recovery from hip replacement surgery.
What Do You Need to Know About Hip Replacement Surgical Procedures?
Potential candidates for hip replacement surgery need to know that the surgery is a time-tested procedure that has been used successfully for more than four decades to relieve chronic hip pain and improve both flexibility and mobility. More than 300,000 Americans opt for hip replacement surgery each year to rid themselves of hip pain and improve their quality of life.
Total hip replacement surgery, or total hip arthroplasty, uses a ball and socket prosthetic joint to replace your damaged one. Special metals, such as cobalt-chromium and titanium, and polyethylene plastics, are used to make your prosthetic joints. These materials are safe for use inside the body and are extremely durable and long lasting.
The procedure for your total hip replacement surgery will most likely include the following steps:
1 Separating your femur from your hip socket
2 Removing the damaged ball from the femur
3 Removing your damaged bone and cartilage
4 Inserting a metal shell into your pelvic bone socket and using bone grafting material to secure it
5 Completing the artificial socket by adding the plastic liner
6 Preparing your femur to receive the metal implant
7 Placing the metal implant into the hollowed end of your femur
8 Attaching a metal ball component to the stem
Hip replacement surgery is a very effective procedure, and most patients experience a dramatic reduction in pain and improvements in their mobility and stamina. With the proper recovery procedures and physical therapy, you should be able to enjoy walking, swimming, biking and other low-impact activities without impediment.
If you can no longer bare the pain or have problems walking talk to your ortho about your options.
We’re praying for you
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.
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.
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
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.
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%.
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.
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
Shoulders & Elbows
Wrist & Hand
Knee & Lower Leg
Ankle & Foot
Fingers & Toes
Important Videos Everyone Should watch on Biologics
Scientific Papers on Research of Stem Cells
I will be posting this in my other blog section also