RE: AVN Patient -- Guide me

[Guest guest]

Hi Sumit

Herewith my views:

1. Can I do sex regularly or I have to take some precautions?

Do it as regularly as you can – have fun while you can.

2. Hip exercises are advisable or not?

Probably not, if I interpreted your condition correctly. If you have been

diagnosed with AVN, and it is visible on the x-rays, and it is causing

discomfort, and it is deteriorating, it might be best not to expose this joint

to extra effort/pressure. But, please, remember, I am not a physician and my

views are layman. I have gone through similar phases as you have and with the

benefit of hindsight I would not be exercising if i were you.

3. Is swimming good for hip in my case?

Yes, I think it is, because it allows you to exercise the whole of your body

whilst applying minimal (gravitational) pressure on the bad hip joint.

4. Loss in body weight will be effective?

In a generic case I’d say definitively, the more body weight you loose the

less pressure on all joints. However, in your case (height 5’8†and weight

72 – I assume this is 72 kg) you appear to be perfect on BMI (body mass index)

scale and you should not loose any weight. If I misinterpreted your weight then

check your BMI (try google and it will give you the BMI reference formula so you

can enter these two parameters) and act accordingly.

5. Can some medicines play an important role?

A lot of members of this group swear by a supplement or other. Generally, it

seem that for some people glucosamin is helpfully in slowing down the

degenerative processes in cartilage in joints. Others take glucosamine with

chondritine (if I got the spelling right). Recently some members recommended

avosoy (which I understand is based on avocado, soy, glucosamine etc.). Most

doctors will tell you that it is healthy to take Omega 3 based oils (mostly

found in some fish). Ultimately, it seems that none of these are harmful, but

some people report stomach upsets (glucosamine) or that chondritin can’t be

effective as its molecules are to large to pass through the stomach/intestine

lining. Take your pick.

6. What is advisable in food?

Omega 3 oils. Any healthy diet should be OK. You seem to be on a healthy diet

already.

7. Is BHR(metal on metal hip resurfacing) advisable at this stage?

HAVE A CONSULTATION WITH A HIP RESURFACING OS AS SOON AS POSSIBLE. You have to

hope you haven’t left it too late. I do not know where you live, but judging

from your name you may have connection with India (or, at least be more familiar

with the culture/languages there). I mention this because hip resurfacing,

unless done on the NHS in the UK (free of charge) is cheapest in India where a

few UK-trained OSs do it privately for what I understand is a price ranging

between £1,500 and £2,500 (converted into British pounds; don’t quote me on

the price). Yesterday a member posted an article from a UK daily paper in which

it was reported that a Mr Chana – of whom I’ve heard before on this site as

one of Indian OS who appears to practice both in the UK and India (unless he has

an OS namesake there) – has patented a tool that enables him to perform

resurfacing through a minimal incision (only a few inches). In the article it

has been reported that he has performed more than 700 resurfacings and more than

1,500 THRs. I do recall that he trained with the BHR originators. Mr McMinn and

Mr .

I STRESS AGAIN, GO AND SEE A RESURFACING OS PROMPTLY.

8. Is another hip is secure or it can also suffer in future?

If your condition is due to OA (osteoarthritis) than there is a chance that it

may not affect other joints. However, given your young age, it is a

possibility. A number of members report problems with the “healthy†hip

once the “bad†one has been resurfaced. It seems that part of it comes from

years of protective posture and gait (your body shielding the “bad†hip and

exercising undue and uneven pressure on the “good†one), though I fail to

understand why it should go “bad†once you revert back to correct posture /

gait after the resurfacing (maybe one of our physician members will be able to

explain this). If, however, yours is not a case of idiopathic OA but of

rheumatoid arthritis than your are highly likely to have the other hip affected

as well.

9. How long I have to take rest after BHR surgery?

It appear to vary from case to case, as well as from the country you have it

done in and from the prosthesis you have implanted. It appears that in the UK

and in Belgium (Dr DeSmet) where BHR and CORMET 2000 implants are mostly used

you are discharged from hospital between 3 and 6 days after the op and you are

encouraged to apply full weight bearing on the operated hip from day1. A lot of

people operated in these 2 countries (and in Australia, from memory) appear to

be walking unaided from day 3 (I certainly did) to day 15. It seems to me that

in the USA the OSs take a slightly more cautious stance and ask their patients

to use walking aids (crutches or sticks) for up to 6 week (could be down to this

procedure still being investigational in the USA and the OSs there wanting the

best possible results so that resurfacing can become FDA approved;

alternatively, it could have something to do with lawsuits and indemnities that

are quite common in the USA, I understand). Most people seem to be able to go

back to work between 4 and 16 weeks after the op.

10. I am a software engineer and having 8-9 hrs of sitting job. Is it OK or I

must look for another type of job?

I wouldn’t look for another job, but would get the hip fixed a.s.a.p. I am

not certain that a sedentary job is more harmful to a hip joint with OA a job in

which your hip is constantly exercised. I’ll this one to our physician

friends to comment on.

So, good luck, and hurry up with seeing a resurfacing OS.

Dan

mobile +44 (0)7974 981-407

email <******************************> dan.milosevic@...

_____

From: Sumit AGARWAL

Sent: 06 July 2004 08:05

To: surfacehippy

Subject: AVN Patient -- Guide me

Hello

I am a patient suffering from AVN and need your advice.

The problem is with my left hip joint. The damage in femer head is clearly

visible in X-rays since last 4 years. Intially the damage was very less and

bone was in good condition. But two years later, damage increased alot.

Though no change is avescular area of femer head could be identified since

last two years.

I am 25 year old male, height 5.8 " , weight 72, tea-totaller, pure vegetarian

and take normal diet. I have consulted 5-6 surgeons in last 4-years. Some

suggested THR, some bone grafting, some suggested only exercise. Some

doctors also say that wait for the worst then go for THR. While few doctors

say that don't do any exercise. No body talks about BHR.

Till date I am not having regular pain and I have never taken a pain killer.

Sitting in Yoga position and some wide movements are somewhat restricted or

remain painfull. Also on walking long distances or after holding some weight

I realize some light pain near my hip joint that i am not able to locate

exactly.

Right now I am not doing any kind of exercise nor I am taking any medicine.

I am totally confused and not able to decide as what to do. Opinions of

doctors are themselves contradictory. Can you advise me on following issues?

1. Can I do sex regularly or I have to take some precautions?

2. Hip excercises are advisable or not?

3. Is swimming good for hip in my case?

4. Loss in body weight will be effective?

5. Can some medicines play an important role?

6. What is advisable in food?

7. Is BHR(metal on metal hip resurfacing) advisible at this stage?

8. Is another hip is secure or it can also suffer in future?

9. How long I have to take rest after BHR surgery?

10. I am a software engineer and having 8-9 hrs of sitting job.Is it OK or I

must look for another type of job?

I will be highly thankful to you if you could answer my querries and take me

out of this dilemma.

Eagerly waiting for your kind reply.

Warm regards,

Sumit Agarwal