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Bilateral AVN of the hips
ezone2 posted:
Hello I'm a 46 year old male who lives in West Central Wisconsin, I have had complications from Pancreatitis in 2006 which lasted about 9 months, went back to work and on October 24th (birthday) 2008 I was diagnosed with AML sub type Acute Promyelocytic Leukemia, during which I also contracted Tularemia in early 2011 caused by the baterium Francisella Tularensis a very rare disease here in Wisconsin, but was diagnosed after a few doctor visits and some testing and was treated promptly with no issues during my treatment of cancer.
Then being cleared to go back to work in March of 2012, I found a job and started April 30th. ( the rest of what I tell you here takes place over a 4 month period) The first 2 weeks of work went pretty well considering I was out of shape and went from being disabled to working overtime at a physical shipping and receiving job, then I started noticing hip and groin pain when getting up after resting for a moment, this pain soon went away after making a few strides (walking) and things seemed ok, I figured it was just my body adjusting to the work, during the next couple weeks the hip pain gradually kept getting worse to the point that it just wouldn't go away anymore after getting up and moving around, the pain was there all the time during movement but it much better at rest while sitting or lying down. At this point I was taking Aleve and lots of it with no relief from the pain and was now walking with a pretty noticeable limp. The pain got to the point that I had to see a doctor so I went to the local clinic on June 4th where they did X-Rays of my hips, and they told me everything looked good and wrote it off as Bursitis, and sent me back to work, and then on June 6th - only a day and a half later - I finally couldn't take it anymore and had to quit my new job, which I was only about 5 weeks into, I felt awful but what do you do? After three more doctor visits where they tried treatments of high dose Naproxen, which failed and then a treatment of Prednisone which also failed, I finally got to see an orthopedist on August 13th which at that time he pulled up the original X-Rays that were taken back on June 4th here at my local clinic and reviewed them and said "I don't know who read these X-Rays but" and then proceeded to show my wife and I where he detected AVN ( Avascular Necrosis / Osteonecrosis ) of both hips and immediately scheduled an MRI for the following day. Then later I returned for the follow up appointment with the orthopedist for the MRI results, the doctor found that both my hips are now past treatment that could reverse or stop the AVN and suggested the only fix at this point would be THR (total hip replacement) for both hips. The pain is severe in my right hip and I'm just starting to feel discomfort in the left hip, some days are better and some are very difficult I get pain in the hip, groin, buttocks, thigh, knee and sometimes into the calf, even sitting, standing and sleeping can be difficult at times, getting dressed can be joke and I walk mostly with cane and if I go to a store I use the electric carts there. The Orthopedist has set me up with an appointment on September 5th for Cortisone shots through fluoroscopy into both hips to ease my pain and we will continue these injections as needed, for as long as possible since the head of the femur has not yet collapsed and if the pain can be controlled he would like to hold out for 1 year or even more if possible, although he don't think it will go that long.
My AVN is most likely due to having Pancreatitis, Chemotherapy, and extended doses of Dexamethasone which i received during complications with Leukemia. I hope the cortisone injections work as it will be a long painful wait for new hips if they don't. I didn't write this to seek help from others although any input would be welcome, but more to inform others of my situation and share some knowledge of my experience thus far with AVN. Thanks, Jim
Bal M Rajagopalan, MD responded:
Thank you for this post. AVN of the hips can be devastating. This is not a process where we understand the progression. The preventative treatments are not predictable, such as unloading the hips and core decompression.

Good luck.
countrydarlin responded:
Hi Jim
I just had 2 TKR done in late June 2012, After all the information I received ,the hip replacements are alittle easier than the knees. You have had other complacations that would make you think twice on having your hips fixed. Just remember how your hips feel now and having them done and having all that pain fixed will be such a relief. Yes you will have pain no doubt...but it will be a healing pain that you feel ...Try the shots..see if you get any relief..then make your decision.Sit and talk with the Dr.and ask him what ever you want and make sure you understand it all. Remember you want to fix the pain and get your life back.Good luck with your shots and any thing else you plan on doing!
arbob5 replied to countrydarlin's response:
I had left THR 8 years ago, right TKR 7 years ago, and right THR 9 weeks ago. Yes, THR is much easier than TKR, but nevertheless, major surgery. My latest THR was completely different from the first one 8 years go, even tho the same surgeon did all three of my surgeries. I am just amazed at the procedure improvements now. I was in the hospital for 3 days, had in home therapy for two weeks, continued with exercises on my own and am still doing them, but not as often (instead of 3 times a day, probably once a day). I was driving in less than 3 weeks (approved by my Dr,) and if I recall correctly, it took about 6 weeks before I could drive after my first THR.

I had pain meds in the hospital right after the surgery, but I do not like the drowsiness they caused so I requested Tylenol. And that is all I took for the pain. There was so little pain to begin with, I was amazed. I am a big fan of my surgeon who, after the surgery when I told him he did a great job, he said "I've got a great team". He didn't take the kudos for himself. He's special, no doubt about it.

My point here is the hip surgery is definitely major surgery, but the latest procedures are so much quicker, easier and so much more tolerable. I am still amazed. And my family and close friends are also amazed at the difference this time around.

You will do fine, I have complete faith in that. And to be pain free is WONDERFUL. I really had forgotten what that felt like! Good luck, and have faith in your surgeon. All will go well with you, I'm quite sure of that. Keep us posted, OK?
ezone2 responded:
Well my cortisone shot gave mr good relief for about 1 month, on December 18th 2012 I recived a THR on my right hip. All is going very well and healing great. Next will be my left hip.
vargas1 responded:
arbob5 replied to vargas1's response:

Helpful Tips

I had my TKR done 6/30/15, and am back to work now. When I look back 3 mo. I can't believe how far I have come for the better. I also was ... More
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