Avascular Necrosis

If you read my title and say what?? You aren't alone. When I was first told I had Avascular Necrosis I said the same thing. Those who know what I am talking about I am sorry, especially if you are not a doctor. Most people who know what it is are either a doctor, or someone who has had it themselves. Which sucks.

I go and read all I can on it sometimes. I want to share an article I found tonight, but in a bit. First for those who don't know what it is, I will explain and tell you of my journey of getting Avascular Necrosis.

In Dec 1999 I came down with pnemonia. No big deal right? Well it was to me, because I have Asthma. Within 3 hours of having issues breathing I was in the hospital, and within 20 mins of being in the hospital I was in ICU. I won't go on and on about my hospital stay. But I was in there 10 days, out for 3 and back in for 5 because I then had Influenza A.

But, in the hospital is where my journey started. I was put on prednisone *a steroid which helps people who have asthma, amoung many others* prednisone itself is the devil. For those who have taken it know what I mean. If you google side effects you will find a page, if not 2 of side effects.

Anyway, one side effect I have never read only when you google prednisone is Avascular Necrosis. I took prednisone till around March 2000 I believe it was. Have to ween yourself off of it because it's so nasty. So finally around March I was off of it. So I took it for about 3 months, maybe 4.

Around June of that year I started having bad left hip pain. Bad... I mean bad. When people asked me how it felt I told them it felt like my hip was just going to break off. I serisouly thought it would. So I went to the doctor. He thought it was something else, I don't think we did an xray then. But I went to physical therapy in August to help it.... never felt better.

Kept getting worse so in October of 2000 I went back to the doctor. he took an Xray and saw nothing, but sent it someplace else to get looked at. Came back there was something there. A really small thin black line... what did that mean?

So I had an MRI and talked to a doctor named Jeffery Nassif. I have to tell you, Dr Nassif is not only a good doctor, but a weird, funny doctor! OMG... at first my mom and I were looking at each other like WTF?

So anyway, we went in and I was told I needed surgery. I was like okay, what are you going to do? He said drill a hole in your hip to relieve the pressure on the joint. The prednisone had cut off the blood supply to my hip and basically my bone was dying. The hole in my hip would relieve pressure and hopefully the bone would start growing back.

So I asked when. He said ASAP and you need to be on crutches now until the surgery and can not put ANY pressure on it, otherwise we can't do the surgery and will have to do a full hip replacement. He then told me that the surgery is a temp fix and I will need a hip replacement in the future. But couldnt' say when, could be 2 years, could be 15 years.

So I get in for surgery in 2 weeks. He drills a hole in my hip and I am on crutches still for like 6-8 weeks. No work, no driving, nada. Oh and drilling the hole in my hip, the medical term for it is Core Decompression.

So we get another MRI months later and it looks like the bone is growing back a bit. The pain goes way down. I mean on a scale of 1-10 my pain at first was like a 20! It was bad. Then it went to a 2-3 depending on the day.

So then 3 1/2 years, after I was told I had Avascular Necrosis, November of 2003 I was having so much pain again, and I was so limited in what I could do. I had 2 small boys at this time and it was getting hard to play with them.

So I went back to the doctor who told me we would only do a hip replacement if the pain was so bad I couldn't handle it... then I we would wait a bit more. Or if my hip was about ready to fall off. Well I told him the pain was bad, but it was limiting what I could do in my life.

So I had a full left hip replacement in Jan 2004... I got me a Ceramic hip! Whoo hoo... lots of time sitting around, laying around... it was bad. Now it's 2+ years later and sure I still have some pain, some stiffness, but my hip squeeks from time to time. Mostly when it's cold outside. I am sure people look at me funny, especially when I tell them it's my hip.

So anyway, that is my story. Oh, and by the way, when I was told I had Avascular Necrosis and had the Core Decompression I was 24, and I was 28 when I had my hip replaced. A lot of the nurses couldn't believe it, and remembered me when I came back for the 2nd surgery. Everyone was amazed at why I had Avascular Necrosis and that I had my hip replaced so young... I won't even tell you about the classes I went to, no one besides me was under the age of 60-65!

I wish I had pictures of my hip before I had any surgery and then before I had my hip replacement. By the time I had my hip replacement a good chunk of my hip joint *the ball part* was gone.

So the articles, I will link it and then below it quote the parts that intrests me:

http://healthlink.mcw.edu/article/926046182.html

Steroid Medications: Corticosteroids such as prednisone are commonly used to treat diseases in which there is inflammation, such as systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, and vasculitis. Studies suggest that long-term, systemic (oral or intravenous) corticosteroid use is associated with 35% of all cases of nontraumatic avascular necrosis. However, there is no known risk of avascular necrosis associated with the limited use of steroids. Patients should discuss concerns about steroid use with their doctor.
Doctors aren't sure exactly why the use of corticosteroids sometimes leads to avascular necrosis. They may interfere with the body's ability to break down fatty substances. These substances then build up in and clog the blood vessels, causing them to narrow. This reduces the amount of blood that gets to the bone. Some studies suggest that corticosteroid-related avascular necrosis is more severe and more likely to affect both hips (when occurring in the hip) than avascular necrosis resulting from other causes.

The first part I bolded: Well I would say I am a case of limited use of steroids and having avascular necrosis.

The second part: Yeah, that is what I am worried about, especially since once every couple years I have to take the steroid again because of issues with my asthma. They also worry about my shoulders.

Treatments
Appropriate treatment for avascular necrosis is necessary to keep joints from breaking down. If untreated, most patients will experience severe pain and limitation in movement within 2 years. Several treatments are available that can help prevent further bone and joint damage and reduce pain.

Of course my sever pain and limitation in movement took just 3 months to show up.


Here are a couple other articles on it:

http://www.twbookmark.com/books/68/0446679771/chapter_excerpt18500.html