## 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 hell I pay more than when I was working.

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.

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

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/

I will be posting this in my other blog section also

## Breathing and Prayer For Wellness

Are on the verge of a meltdown, your feeling an impulsive urge to yell, scream, cry,? Do you know that every time you lose your cool, you are giving away your power.  I know it’s often easier said than done But, when we react impulsively and unconsciously we become a victim of the circumstances; we become a passenger in our life rather than a driver.

When you give away your power, you become completely dependent on external circumstances to regulate your emotions. Life often becomes like a roller coaster – when things are going well, you will feel good, yet when your circumstances change, your behavior and feelings will shift.

The more emotional you feel, the less rational you’ll think Don’t try solving any problems when you’re feeling overly emotional. Distract yourself with an activity, like walking or reading, or deep breathing to help you calm down. Getting your mind off whatever is  bothering you, even for a few minutes, can help you calm down so you can think more clearly and rationally.

Learn to just…. Breathe

Anxiety, frustration and anger cause physical reactions within the body  you will experience  elevated heart rate. Shallow, upper chest breathing is part of the typical stress response. Stop and take slow, deep breaths can relax your muscles and decrease your physiological response, which in turn can decrease your emotional reactivity.

I use Dr Weil’s 4-7-8 Breathing  Dr. Weil MD 4-7-8 Breathing  after I  practiced this 2x a day after about 3 days I felt more peaceful, and after a couple weeks I felt this inner calm.

I do this even when I am not stressed, and then when I get stressed or angry I use it and it helps  calm me so much. I even use it to fall asleep, or when I am getting a medical test like an mri .

Trying to maintain complete control in everything that happens leads to increased anxiety. Efforts to manage your anxiety by trying to control everything in your environment will backfire. Attempting to control everything wastes time and mental energy.

When we are overly stressed we operate from a fight-or-flight response  your heart beats faster, your blood pressure rises, and your breathing quickens as adrenaline rushes through your body. By changing the rate, and pattern of breathing, we can change the messages being sent from the body’s respiratory system to the brain. Slow and controlled breathing can reduce the heart rate, reduce levels of stress hormones, and increase the feelings of calm and well being, bringing us back to a place that we can feel less likely to overreact.

I have Adrenal fatigue, and I was told my “fight or flight” response has been activated far too often in the past. So I am learning to relax, let go of stuff I cannot control and breathe…..I also pray I pray several times a day. I don’t ask for things I give thanks even when I am stressed, have fear, depressed, I have faith things will come to pass.

We have to learn stress will come, sometimes life is heavy and we will get over whelmed, we may get an illness, or disorder, deal\in chronic pain, or just not know how to cope in certain situations……stressing out will not solve the problem…..

#### Philippians 4:13New King James Version (NKJV)

13 I can do all things through [a]Christ who strengthens me.

### Greeting

Paul, an apostle of Jesus Christ by the will of God,

To the saints who are in Ephesus, and faithful in Christ Jesus:

Grace to you and peace from God our Father and the Lord Jesus Christ.

### Redemption in Christ

Blessed be the God and Father of our Lord Jesus Christ, who has blessed us with every spiritual blessing in the heavenly places in Christ, just as He chose us in Him before the foundation of the world, that we should be holy and without blame before Him in love, having predestined us to adoption as sons by Jesus Christ to Himself, according to the good pleasure of His will, to the praise of the glory of His grace, by which He [a]made us accepted in the Beloved.

In Him we have redemption through His blood, the forgiveness of sins, according to the riches of His grace which He made to abound toward us in all wisdom and [b]prudence, having made known to us the mystery of His will, according to His good pleasure which He purposed in Himself, 10 that in the dispensation of the fullness of the times He might gather together in one all things in Christ, [c]both which are in heaven and which are on earth—in Him. 11 In Him also we have obtained an inheritance, being predestined according to the purpose of Him who works all things according to the counsel of His will, 12 that we who first trusted in Christ should be to the praise of His glory.

13 In Him you also trusted, after you heard the word of truth, the gospel of your salvation; in whom also, having believed, you were sealed with the Holy Spirit of promise, 14 who[d] is the [e]guarantee of our inheritance until the redemption of the purchased possession, to the praise of His glory.

### Prayer for Spiritual Wisdom

15 Therefore I also, after I heard of your faith in the Lord Jesus and your love for all the saints, 16 do not cease to give thanks for you, making mention of you in my prayers: 17 that the God of our Lord Jesus Christ, the Father of glory, may give to you the spirit of wisdom and revelation in the knowledge of Him, 18 the eyes of your [f]understanding being enlightened; that you may know what is the hope of His calling, what are the riches of the glory of His inheritance in the saints, 19 and what isthe exceeding greatness of His power toward us who believe, according to the working of His mighty power 20 which He worked in Christ when He raised Him from the dead and seated Him at His right hand in the heavenly places, 21 far above all principality[g] and [h]power and [i]might and dominion, and every name that is named, not only in this age but also in that which is to come.

22 And He put all things under His feet, and gave Him to be head over all things to the church, 23 which is His body, the fullness of Him who fills all in all.

## Pain Chronic Pain

Once we accept the reality of the current moment (no matter how unpleasant it may be) for what it is, and not what we wish it were, we can turn our attention to ways to improve it. This I find true in any situation.

Living with chronic pain can throw your life upside down.

It’s hard to believe that I can and have managed my rare disease Osteonecrosis (knee) pain. And my Osteoarthritis pain.

But the pain of spondylolisthesis somedays is truly unbearable. It can just take a fabulous day day and screw it all up.

Today is one of those days.

I try to stay busy , and positive when I really would like to go somewhere and just scream at the top of my lungs.

I don’t think my neighbors would appreciate it. So I bang away at the keyboard.

Since the weather in NE Ohio has changed I am having more and more days in pain.

And in the days when all the above hurt I’m down right miserable. Thank Hod that hasn’t happened yet , but then fall and winter have only begun….

I’m grateful today it’s just my back although it feels as if I have been kicked in my L5S1 several times.

Besides having spondylolisthesis I also for the past decade or longer been dealing with osteoarthritis and osteonecrosis since 2014.

If you don’t know what they are I will explain below.

Osteoarthritis

Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints, affecting approximately 27 million Americans. OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.

In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.

Who’s Affected?

Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes.

One in two adults will develop symptoms of knee OA during their lives.

One in four adults will development symptoms of hip OA by age 85. Lucky me I developed Osteoarthritis at age 45.

One in 12 people 60 years or older have hand OA.

Osteonecrosis What it is….

Osteonecrosis of the Knee. Osteonecrosis of the knee (also known as avascular necrosis) and if in the knee from a meniscus tear also called Ahlbacks Disease is a painful condition that occurs when the blood supply to a section of bone in the femur (thighbone) or tibia (shinbone) is disrupted.

I have Osteonecrosis of the medial femoral condyle due to a meniscus tear in 2014. Strange no one wanted to fix it or have any treatment plan.

This pain is like no other. Your area of Osteonecrosis is ice cold yet it often can feel like it was hit by a lightening bolt.

Weather plays a huge factor for me and my pain. I used to love winter now I can barely tolerate a cool fall day. I dread winter.

I get sick of being in pain. If it’s not the knees it’s back or hands it’s just enough to jack up my day or make things more difficult than they already are.

I have found that plant based lifestyle has helped my osteoarthritis and osteonecrosis a lot. I can’t understand why I haven’t lost a ton of weight though. I mean I don’t eat half the unhealthy calories I used to . But hey the doctors says it’s a slow thyroid.

I just wish these 40 lbs would come off it would also help my bones.

But maybe that will just take time.

If you haven’t tried a plant based lifestyle I would highly recommend it.

My cholesterol numbers are fantastic and all my doctors are impressed especially since I rarely need pain medication vs taking 2 a day like I did 3 years ago.

I truly believe that food can be your medicine or your poison.

The choice is yours.

I will be posting a lot of info and recipes

I don’t always eat perfect but life is about compromise and I follow a 90 / 10 rule.

It’s ok to have a cookie or small cupcake just make sure you eat as best as you can most of the time .

Living food is the way to go.

It may not take away all your pain but wouldn’t it be a benefit if it took away a lot of it ? And made it more managed?

Absolutely!!!

## My Story From The Mighty

I have a rare, degenerative bone disease called osteonecrosis, or avascular necrosis (AVN). It is a painful, debilitating disease without a cure. Many doctors don’t know how to treat it. AVN essentially cuts off the blood supply to the affected bone and the bone begins to die, becoming necrotic.

“Osteo” means bone and “necrosis” means death. It is most often found in the hips, knees, shoulders, and ankles and sometimes spine. You may have osteonecrosis in one or more bones. It can strike at any age, any gender. In people with healthy bones, new bone is always replacing old bone. This process keeps bones strong and also happens when children grow or if a bone is injured. In osteonecrosis, bone breaks down faster than the body’s ability to make strong, new bone. If you do not get treatment, the disease worsens and the bones in the joints break down. You may not be able to bend or move the affected joint very well, and you may have intense pain in the joint.

For the newly diagnosed, here is some information I hope you will find helpful. First of all, you are not alone. We know what it’s like to first hear you have osteonecrosis. I recall I was in shock the day I was told, as I never heard of the disease. I was told it was “bone death” and it seemed like I was frozen in time and disbelief when I heard these words. So what the heck does all that mean? Am I dying?

The answer is no, but one or more of the bones are.

< strong>I’m finding the new me. < strong>Stay tuned more to come …..

## Bone & Joint Action Week October 12-20

Bone and Joint Action Week is held annually October 12-20 with activities focused on disorders including arthritis, back pain, Osteonecrosis,Osteoarthritis trauma, pediatric conditions, and osteoporosis. The themes and their related activities are designed to raise awareness worldwide about prevention, disease management and treatment.

Statistics on Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)

Frequency depends on the site involved. The most common site is the hip; other locations include the carpals, talus, and humerus. In most countries, exact figures on incidence and prevalence are unknown.

One Japanese survey estimated that 2500-3300 cases of AVN of the hip occur each year; of which, 34.7% were a result of corticosteroid abuse, 21.8% to alcohol abuse, and 37.1% to idiopathic mechanisms. A French study reported AVN in 4.3% of allogenic bone marrow transplant recipients.

Race: No racial predilection exists except for AVN associated with sickle cell disease and hemoglobin S and SC disease, which predominantly are diagnosed in people of African and Mediteranean descent.

Sex: The male-to-female ratio depends on the underlying cause, although primary AVN is more prevalent in men. The overall male-to-female ratio is 8:1.

Age: Age at onset depends on the underlying cause. Primary AVN most often occurs during the fourth or fifth decade and is bilateral in 40-80% of cases. On average, women present almost 10 years later than men.

Risk Factors for Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)

Avascular necrosis has several causes. Loss of blood supply to the bone can be caused by an injury (trauma-related avascular necrosis or joint dislocation) or by certain risk factors (nontraumatic avascular necrosis), such as some medications (usually steroid basesd), steroid abuse in general, blood coagulation disorders like sickle cell, Factor V, FactorViii, MTHFR, eNOS and more, chemo and radiation infections in the Bone vascular issues such as vascularitis or alcohol abuse. Increased pressure within the bone also is associated with avascular necrosis. The pressure within the bone causes the blood vessels to narrow, making it hard for the vessels to deliver enough blood to the bone cells.Many deep sea divers get Avascular Necrosis from a condition known as the bends. Gaucher disease.

Progression of Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)

Hip Stages of avn-on

1-4

The natural history of osteonecrosis is directly linked to the size and level of the necrosis. Very small lesions (involvement of less than 15% of the femoral head) may resolve without any further treatment. Conversly, lesions involving greater than 50% of the femoral head progress to collapse, and ultimately require in total hip arthroplasty.

Symptoms of Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)

In the early stages of avascular necrosis, patients may be asymptomatic. However, as the disease progresses most patients will begin to experience joint pain; at first, only when putting weight on the affected joint, and eventually even when resting. Pain usually develops gradually and may be mild or severe.

If the level of necrosis progresses further and the bone and surrounding joint surface collapse, pain may develop or dramatically increase.

The pain may be severe enough to limit the patient’s range of motion in the affected joint.

In some cases, particularly those involving the hip, disabling osteoarthritis may develop.

The period of time between the first symptoms and loss of joint function is different for each patient, ranging from several months to more than a year.

How is Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis) Diagnosed?

In the earliest stages of Avascular necrosis plain x-rays are often normal. A magnetic resonance image (MRI) is the key that allows us to detect AVN at its earliest stage.

Osteonecrosis develops when the blood supply to a segment of bone is disrupted. Without adequate nourishment, the affected portion of bone dies and gradually collapses. As a result, the articular cartilage covering the bone also collapses, leading to disabling arthritis.

Osteonecrosis of the knee can affect anyone, but is more common in people over the age of 60. Woman are three times more likely than men to develop the condition.

Risk Factors

It is not always known what causes the lack of blood supply, but doctors have identified a number of risk factors that make someone more likely to develop osteonecrosis.

Injury. A knee injury—such as a stress fracture or dislocation, meniscus tear, bruised patella or combined with some type of trauma to the knee, can damage blood vessels and reduce blood flow to the affected bone.

Oral corticosteroid medications.

Many diseases, such as asthma and rheumatoid arthritis, are treated with oral steroid medications.

Although it is not known exactly why these medications can lead to osteonecrosis, research shows that there is a connection between the disease and long-term steroid use. Steroid-induced osteonecrosis frequently affects multiple joints in the body.

Medical conditions.

Osteonecrosis of the knee is associated with medical conditions, such as obesity, sickle cell anemia, and lupus.

Transplants. Organ transplantation, especially kidney transplant, is associated with osteonecrosis.

Excessive alcohol use.

Overconsumption of alcohol over time can cause fatty deposits to form in the blood vessels as well as elevated cortisone levels, resulting in a decreased blood supply to the bone.

Chemo therapy and radiation Non-traumatic osteonecrosis of bone is recognized as a potential complication in solid-tumour cancer patients receiving treatment with cytotoxic chemotherapy.

Regardless of the cause, if osteonecrosis is not identified and treated early, it can develop into severe osteoarthritis. And for some with osteoarthritis before avn the disease is even more painful.

Knee stages of avn-on

1-4

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## Basics To Use Food As Thy Medicine

The few basics you need to know to help pain management due to chronic inflammation with food .

1. Eat the rainbow: Consume 10-12 servings of vegetables each day , and make a couple of those servings fruit, if you like.

2. Cruciferous veggies such as broccoli, Brussels sprouts, cabbage and cauliflower are best.

3. Restrict dairy and grains: Eat dairy products in limited quantities. When choosing grains, stay away from simple carbohydrates with refined sugar.

4. Opt for whole grains, including barley, buckwheat, oats, quinoa, brown rice, rye, spelt and wheat.

5. Avoid red meat: Eat red meat the way most of us eat turkey right now a few times a year. Have it on very special occasions, very infrequently. Instead, include fish as the “meat” or eat vegetarian main dishes. Chicken is neutral not harmful but not beneficial in the anti-inflammatory sense.

Get down to your ideal weight; weight loss on its own is anti-inflammatory.

Get daily exercise in the form of walking.

It is the overall diet and lifestyle and not just the individual foods, that control inflammation.

“For a chronic pain patient like me who was suffering, I went slightly extreme form of the diet so that was no red meat, no flour or sugar or simple carbohydrate and no dairy.

I did that for a month.

I do eat chicken or tuna once a week now. Beef maybe every other month.

I listen to what my body is saying now.

Before I just planned dinner and we ate whatever. It was delicious then but it was all the wrong foods or to much of them and not enough good clean healthy living food.

Now we eat for life.

#EatForLife

More ways to help chronic inflammation is to exercise. I know it’s hard when your in pain. But our body’s were meant to move. We have to move.

Exercise is an added benefit, particularly if people are overweight. “If there is any extra weight, you will need to try to lose it, I’m in that boat also. I need to drop a good 40lbs . But when I was first diagnosed with all these bones issues I was in so much pain I couldn’t move. I could barely think and function.

Ultimately, what we all need to know is that inflammation comes from a biochemical reaction initiated by your immune system or wound-healing coagulation system.

Specific foods can promote or shut down the inflammatory cycle.

For instance, simple carbohydrates like cakes,pies,sugar,chips,crisps,promote it, while good clean carbohydrates like fruits vegetables shut it down.

Don’t be afraid of carbohydrates just eat the good healthy ones 85 percent of the time then you can indulge now and then in a piece of pie.

Nutrition that supports a lifestyle rich in anti-inflammatory foods is the key to anti-inflammation and chronic pain management,

Although there are no magic foods, putting the right combination of foods into your diet can produce remarkable results.

I never knew until I took a class you should never really eat meat and potatoes together at a meal.

And it’s best to eat your fresh fruit by itself as a mid day snack.

I love many of them and eat them often and it doesn’t make my pain worse.

Nightshade vegetables are members of the Solanaceae family of flowering plants. Most nightshade plants aren’t edible such as tobacco and the deadly herb, belladonna.

A handful of nightshade vegetables, however, are edible and well-known staples in our diets, including:

tomatoes

eggplant

potatoes

peppers

All nightshade plants contain compounds called alkaloids. One alkaloid found in nightshade vegetables, solanine, may be toxic in large quantities or in a green potato. There’s no evidence solanine is harmful in typical food amounts. And solanine isn’t only found in nightshades—blueberries, huckleberries, and artichokes contain it, too.

Thanks to anecdotal evidence, nightshade vegetables have earned a bad reputation for causing inflammation in the body.

But not everyone with painful joints who eliminates nightshades from their diet experiences pain relief and some evidence suggests that the nutrition content of nightshades may help with arthritis symptoms.

According to the Arthritis Foundation, the belief that eating nightshade vegetables worsens arthritis is a myth. They claim people with arthritis may benefit from the high nutrition content in nightshades.

For example, researchers in one 2011 study found that inflammation and DNA damage was reduced in healthy men who ate yellow or purple potatoes, which are nightshade vegetables, for six weeks.

Most nightshade vegetables contain an abundance of nutrients. They’re also readily-available and easy-to-prepare. In some cases, the benefits of eating nightshade vegetables may outweigh any inflammation risk.

1. Peppers

Peppers, including bell peppers and chili peppers, are low in fat and calories.

They’re a good source of nutrients such as:

vitamin C

fiber

vitamin K

B vitamins

The capsaicin in chili peppers may relieve arthritis pain by reducing a specific pain transmitter in your nerves called Substance P. Capsaicin, which is a common ingredient in many pain-relieving creams. It may cause mild burning or a skin reaction when applied topically.

2. Potatoes

The white potato often gets a bad rap because it’s a starchy carb, but all varieties of potatoes are nutritionally-dense. They can be a part of a healthy diet when eaten in moderation and not fried or slathered in butter and sour cream.

Potatoes are fat-free and a good source of fiber. Fiber helps to keep you fuller longer so you may eat less. Since they contain sodium and potassium, potatoes also help keep your electrolytes in balance.

They’re also a good source of:

vitamin C

vitamin B6

niacin

manganese

iron

copper

folate

The healthiest potato is a baked potato. Add herbs and a dollop of Greek yogurt instead of butter and sour cream. Don’t be shy about trying different varieties, especially since pigmented potatoes may give you an anti-inflammatory bang for your buck.

3. Tomatoes

Technically, tomatoes aren’t a vegetable; they’re a fruit. They contain all four of the carotenoid antioxidants, which include:

lycopene

beta-carotene

alpha-carotene

lutein

Lycopene is the most powerful carotenoid. It’s thought to help prevent some types of cancer, help prevent heart disease, and boost immunity. Some research has shown tomatoes have anti-inflammatory abilities, although more research is needed.

Tomatoes are a good source of:

vitamin E

vitamin A

potassium

calcium

vitamin K

vitamin B

Add fresh, diced tomatoes to a green salad or make fresh tomato juice. Tomatoes are delicious in vegetable soup and chili, too.

4. Eggplant

Like tomatoes, eggplant is also a fruit. It has no fat or cholesterol. Eggplant isn’t high in any one vitamin or mineral, but it contains small amounts of most essential vitamins and minerals.

According to one 2015 study, eggplant stalk extract may help reduce inflammation. More research is needed to determine if eggplant fruit has the same abilities.

To enjoy eggplant in your diet, go beyond a fat- and calorie-laden eggplant Parmesan casserole. Instead, try sprinkling sliced eggplant with olive oil and herbs, then roasting or grilling. You can also steam eggplant, or add sautéed slices to your favorite veggie pizza.

This is not medical advice this is based on how I eat to help my pain.

As well as just a few studies showing how good food is.

## I Started To Cut Out Added Sugar & Use This: Homemade Stevia Liquid

We have to cut out all the added sugar or try to cut back at least !!

It is no secret that people today ingest far too much sugar. According to the NHS, adults should not be consuming more than 30g of added sugars per day.

But we consume 3x that amount !

It’s no wonder why were becoming fat

and unhealthy

In 1700, the average person consumed approximately 4.9 grams of sugar each day (1.81 kg per year). That’s about 1 teaspoon.

·         In 1800, the average person consumed approximately 22.4 grams of sugar each day (10.2 kg per year). That’s about 5 teaspoons

·         In 1900, the average person consumed approximately 112 grams of sugar each day (40.8 kg per year). That’s 28 teaspoons

·         In 2009, 50 per cent of Americans consumed approximately 227 grams of sugar each day – equating to 81.6 kg per year. That’s almost 58 teaspoons !!!

We wonder why we’re sick! And living with chronic pain.

I mean it’s in everything. From Cookies where we expect it to me to tomato sauce and yogurt. Things you never would expect to have sugar and it’s causing us to be fat and unhealthy and full of inflammation.

I’m trying to cut out added sugar and it was very hard.

Once you get past a few weeks you will feel better.

Food tastes better also and coffee does to .

I do use hazelnut coffee mate . And I’m not going to lie I still will eat a couple chips ahoy thin cookies or a mini cupcake or two now and then.

But I am really trying to get off the sugar. I have to admit it’s harder than when I stopped smoking.

I have learned through my herbology classes how to make my own liquid stevia.

And it’s helped me cut back a lot on the sugar. I just can’t drink things like tea without some sweetness in it.

So now actually make my own Stevia extract and dilute it, and other Stevia liquid flavor it etc..

I learned a lot in the herbology classes I take.

I buy all my herbs from mountains rose herbs.

I also just put the dry leaves in a beverage hot or cold.

I stopped buying Stevia at the store.

Also raw honey is good to use as a substitute.

Anything processed with a strange chemical or an artificial ingredients added is never good.

You can use fresh stevia leaves as a sweetener in beverages, such as tea and lemonade, or in sauces. A few fresh stevia and mint leaves make a great herbal tea when steeped in a cup of boiling water.

Add fresh stevia leaves to beverages or foods as a sweet, edible garnish. Although the fresh leaves are less sweet than dried leaves, they’re still much sweeter than sugar. Taste-test your beverage before serving to ensure you don’t over-sweeten your drink.

Use dry stevia leaves to make a powdered sweetener. Bundle and hang fresh stevia plant stems upside down in a warm, dry location until the leaves are thoroughly dry, then strip the leaves from the stems.

Fill a blender, food processor or coffee grinder to half full with dry leaves and process at high speed for a few seconds.

Store the powdered sweetener in an airtight container. Use the powder in recipes that call for a sweetener, but make adjustments in the amount used due to its dense sweetness.

A general rule of thumb is that 2 to 3 tablespoons of stevia powder equals 1 cup of sugar.

Use dry stevia leaves to make a syrup for sweetening beverages, sauces or other syrups. Add one cup of warm water to one-quarter cup of fresh, finely crushed stevia leaves.

Put the mixture in an airtight container and allow it to set for 24 hours before straining the leaves from the mixture. You can cook the strained mixture on low heat, reducing it to a more concentrated syrup. The syrup should last for several years, if kept in an airtight container in your refrigerator.

Things You Will Need

* Blender

* Measuring cups

* Strainer

* Airtight container

• Glass amber color and dropper

I also make my own liquid stevia extract for baking etc…

Stevia extract recipe.

Vodka

Organic Stevia Leafs Dried

Glass mason jar

Fill a clean glass jar 1/4 to 1/3 full with stevia leaf. Cover the herb with vodka and pour to the very top. Allow to steep for 24-48 hours, taking care not to let it extract any longer than that to avoid bitterness. Strain and bottle it in a dark amber glass dropper bottle.

Vanilla Stevia Extract Recipe

Chop 1 vanilla bean and add to strained stevia extract. Allow to infuse for 2 to 6 weeks. Strain and bottle it in an amber bottle with dropper.

Lemon Stevia Extract

Fill your jar 1/3 full with organic lemon peel

Cover completely with strained stevia extract.

Allow to infuse for 1 to 4 weeks, tasting along the way. Strain and bottle in amber glass bottle with dropper

HOW TO USE HOMEMADE STEVIA EXTRACT

Add 1-2 drops to your favorite beverages (I especially love using homemade stevia extract to sweeten my coffee or tea!) A little bit goes a long way, so start with small amounts.

I found I had  to use a bit more of my homemade stevia to get the desired level of sweetness, as compared to the store-bought stevia I’ve tried.

But I think the sweetness will depends on how long you heated the extract and how many leaves you used.

This is a Stevia Plant.

Your dry stevia leaves can be used to make a healthy syrup for sweetening beverages, sauces, or even other syrups. A teaspoon of stevia syrup is as sweet as a cup of sugar.

Take 2 cups of warm water and add it to half a cup of dried stevia leaves.  Put the mixture in a glass jar and let it steep for 24 hours. Strain the leaves from the mixture.

Cook the strained mixture on low heat, reducing it to a concentrated syrup. The syrup should last for at least a year if kept in an airtight container in your refrigerator.

Conversion chart

1 cup of sugar is equal to – 1 teaspoon of stevia leaf powder or 1 teaspoon of stevia extract.

1 tablespoon of sugar is equal to – .25 teaspoon of stevia powder or 6-9 drops of stevia extract.

1 teaspoon of sugar is equal to – a pinch of stevia powder or 2-4 drops of stevia extract.

Stevia is becoming a popular plant and is readily available at most local nurseries.

If grown inside or outside it will flourish.

Thankfully it has few pests and is easy to grow and preserve.

Now that you know how to use it, you be adding stevia to your garden or window seal.

Another Recipe

Extract

With Alcohol cooked off.

• 1 glass jar with a tight fitting lid

• Dried Stevia leaves. They can be crumbled, chopped or powdered

• Vodka or Rum

Using a ratio of 2 parts stevia to 3 parts liquid, place one cup of stevia in the jar and cover it with 1.5 cups of alcohol.

Shake the mixture well and let it sit for no more than 36 hours. (it will become bitter if you steep it longer than 36 hours) Strain through muslin or a coffee filter and pour the tincture into a dark colored bottle.

To remove the alcohol: once the 36 hours are up, simmer the mixture on low heat for 30 minutes, stirring regularly.

Be careful not to boil.  When it cools, strain and bottle as above.

This mixture should be kept in the refrigerator, where it will store for six months.

.

.

## People With Chronic Pain Are Suffering While Addicts & Junkies Are Being Coddled.

What does it say when heroin and opioid addicts are given better treatment than a person living with chronic pain?!

Now please don’t go thinking I lack compassion and am being cruel honestly it’s not my intention.

But I am sick of hearing about the opioid crisis every day, especially when

they throw chronic pain sufferers in the same category as a junkie!

News Flash ……….Were Not

Or a person that is suffering with cancer. I just don’t understand it.

Yes I understand that their is a problem in this country with some abusing drugs whether prescribed or illegal.

But not everyone falls into that category.

Why are so many Doctors,Pharmacies, Government Officials patient profiling?

We as a society look down on racial profiling, gender profiling but why is it ok to patient profile?!

Thank God I have an excellent family doctor.

Many people in government and now pharmacies don’t make their job any easier.

In fact they make it hard for decent doctors who don’t over prescribe and patients who don’t abuse drugs or who don’t doctor shop.

All the red tape they have.

Now we have government and pharmacies in our doctor patient relationship.

Telling the public that they will now be limited and controlled on how much medication they receive and that their legitimate diagnosed ongoing pain doesn’t matter.

But we care more about addicts & junkies who choose to shoot heroin over and over again. They choose that life !! Chronic pain suffering is not a choice it’s many individuals reality.

Many people myself included suffer from several painful chronic conditions.

NSAIDS don’t do crap for the pain I feel most days . I have tried many of them. And sometimes the pain medication takes the edge off so I can get things done. No one wants to be in pain. My body has less pain so I can then function more.

But I find that taking CuraMed Curcumin helps me more than a rx for an NSAID.

So I limit my own use of rx pain meds.

And most people I know don’t want to have to take a pills to have pain relief.

But we will,when we need to.

NSAIDs will for some It really depends on your pain and your condition or disease.

Some of the conditions I have Osteonecrosis for one is rare. And has been said it’s second in pain to bone cancer.

More on Osteonecrosis below.

I bilateral pars fracture in L5S1

Lumbar spondylolysis this is a condition in the lower back where there is a defect or fracture in the part of the vertebra known as the pars interarticularis. The pars interarticularis, also known as the isthmus, is a segment of bone that connects the facet joints at the back of the spine. It is a small, thin part of the vertebra that has a poor blood supply, which makes it susceptible to stress fractures. No NSAID can help this. A pain pill barely helps but at least it helps somewhat.

Fractures of the pars interarticularis, known as spondylolysis, usually occur at the L5-S1 level,and rarely at L4-L5 or higher. They can occur on one side of the vertebra or on both. Lucky me mine is in both sides L5S1

SPONDYLOLYSIS

A pars fracture is also known as a stress fracture, or as spondylolysis. Spondylolisthesis is often the result of spondylolysis. In non-medical terms, this means a stress fracture causes the forward slippage of a vertebral body. The stress fracture occurs through a fragile part of the vertebral bone called the “pars” and is often broken on both sides. The fracture may be the result of a direct trauma, by a focused strain usually from athletic activity, or from a genetic weakness in this area of the bone. This is a thin bone that can break with repeated use; imagine a paperclip that has been bent over and over and finally breaks.

Spondylolysis sometimes causes spondylolisthesis, which it did in my case.

This is when one vertebra slips forward on the vertebra below it.

Symptoms include a deep painful constant ache in the lower back, pain that is worse with movement, and tightness in the hamstrings. If the vertebral slippage is severe, nerve roots can be compressed.

The pars functions as a bony hook and when fractured the posterior support for the vertebrae is broken. It can cause a forward slippage with time. Which mine has about 22 -25 percent.

I also have Spontaneous Osteonecrosis of the Knee, also known as Ahlback’s disease is the result of vascular arterial insufficiency to the medial femoral condyle of the knee resulting in necrosis and destruction of bone. It is often unilateral and can be associated with a meniscal tear.

Osteo means Bone Necrosis means

💀

No orthopedic wants to fix it, trust me I have been to more than 5 but less than 10 for their professional opinions

The stem cell procedure is 8 to 10kusd insurance doesn’t cover any part of stem cell injections that can actually help save the bone.

All the orthopedic doctors I seen said to wait until my knee bone crumbles and collapses and then they will saw out the old bone and give me an artificial knee.

I don’t know about you but to that is totally unacceptable!

A TKR Total Knee Replacement and PKR Partial Knee Replacement-cost 30-40,000usd some places more.

Your basically sawing off the patients bone and replacing it with fake parts

Vs using the patients own stem cells to help heal their own body.

For much less money.

It’s a no brainer

And I also have Osteoarthritis NSAIDs will help this but so does my CuraMed Curcumin so I take that instead.

Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints, affecting approximately 27 million Americans. OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.

Who’s Affected?

Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes.

One in two adults will develop symptoms of knee OA during their lives.

One in four adults will development symptoms of hip OA by age 85.

One in 12 people 60 years or older have hand OA.

So if you add all these together my bones are jacked.

And yet the government wants me to suffer?

Now I will say

I don’t like pain pills I do need them occasionally it’s nice to know that if I need one or for pain I won’t have to jump through fire to get them.

What pisses me off is that junkies od get free narcan over and over often it takes 2-3 doses to revive them. And yet even faced with death they still don’t learn.

And go right back to it knowing it will either kill them now or later. More free narcan and hey we’ll pay for you to go to rehab as well.

And I can’t get insurance to even pay anything towards stem cell injections, that could possibly get me off disability and back to a career in eye care that I loved.

People in chronic pain want their lives back. We would gladly give up all medication to live and function pain free or even with less pain.

We become so used to our pain being a 5 that in days it’s a 3 we feel fabulous, where you may be on the sofa in pain at a level 3 we’re rejoicing. But pain level 7-8 and beyond are sometimes there also and we are down.

I wish the insurance companies would get on board with stem cell injections and Prp injections it can help so many.

So we can’t get the treatment we want because it’s so expensive and not everyone can afford the injections.

Because there is no payment plan.

For pain I take CuraMed Curcumin 1x a day.

5000 iu vitamin

1000 mg krill oil

300mg Coq10

Now and then I will take a pain pill.

It’s a blessing when my knee and back don’t hurt. But usually the back always hurts somedays a lot more than others.

I just think it’s a disservice for people with pain , constant legitimate pain to have to suffer.

I see junkies get free narcan,free rehab yet a girl in my bone disease support group who wants to live and us fighting every day to live has to pain for chemo.

It’s wrong.

## Blogs

I think I will be starting a new blog just for recipes

Opinions? I really want your opinions

Since I am a health leader and advocate who lives with several chronic conditions

Should I focus on just that or have a mix

## The Beauty And Pain Of Autumn

Autumn (British English) or fall (American English) is one of the four temperate seasons. Autumn marks the transition from summer to winter, in September (Northern Hemisphere) or March (Southern Hemisphere), when the duration of daylight becomes noticeably shorter and the temperature cools down considerably.

Fall is a season for balancing light and dark, letting go, and accepting the impermanence of things.

My body seems to know that bad weather season is coming, with summer on the way out and fall on the way in the bone pain goes crazy from mild to intense to unbearable all in a 24/48 hrs time frame.

I was hoping to live in Florida by now.

But with one set back after another since December 2016 husbands heart attack and stents.

2017 my stress test, echo , Mri’s and umbilical hernia surgery I wonder will we ever get to Florida.

Seems like there is always something and I’m not talking small somethings, they are always big intense stressful something’s.

I miss my family , I am so tired also of the pain that will come daily from mid fall until mid spring. I am sick of pain, I’m not ready for it again.

It hurts the soul always being in pain. Day in and day out pain. It’s overwhelming sometimes. It’s depressing some days.

So I have my granddaughters bedroom a mess it’s loaded with boxes.

Donate

Keep

Purge

Why do we really keep papers,paystubs etc 7-10 years? It’s crazy. Hopefully my husband gets a move on before I do it haha.

What’s bothering me is that little movement causes painful stiffness and just overall poor mind body health. I like to move about. No I can’t hike like I used to. Maybe some day.

Big movements are good, like walking in the sunshine ,or a stroll in the park to sorting through a pile of books (as long as they aren’t too heavy.)  And the problem is that I just don’t have enough of these big movements to keep my joints happy.  I’m home a lot these days, the colder it gets the more I’m stuck in doors, meaning the more pain I have.

I can ride my recumbent bike and do some small chores staying useful without using up too many of my spoons.

Typing on the computer or reading or watching tv isn’t my thing especially when that’s all there will be to do.

So good luck during the changing of the seasons

At least it’s pretty.

## Walk To Be Spontaneously Happy

Walking is an ideal daily exercise for a wide variety of reasons – including its beneficial impact on body, mind and spirit!

Walking as a way to get daily exercise, it can help strengthen major organs in the body, promote bone density , boost the immune system, lead to a more positive outlook and more.

If your new to exercise always clear it with your doctor. Don’t over do it. Gradually build up to it.

I gave bone problems Osteonecrosis,Osteoarthritis and Spondylolisthesis. I was told to limit my weight bearing but just standing is weight bearing, and then one doctor told me exercise all I want it will help your knee collapse faster !! WTH needless to say he was fired.

But I do need to move.

I started out with 10 minutes after a couple weeks 15 minutes snd so on.

Some days I can walk 40 minutes other days 15 depends on pain level.

When I’m in a lot of pain which usually comes with winter and cold months.

I ride my recumbent bike at least 15-30 minutes a day.

But walking clears the head, gets us in touch with nature it gets me from a funk to happiness

Spontaneously Happy

I used to love winter now because of my bones I really dread it.

If you can’t walk , if in a wheelchair or scooter getting out in nature is still good for the soul.

Photos and Video I took in Millcreek Park in various locations of park .

I really miss hiking : but for now walking will do.

## From Optometric Tech /Optician To Professional Patient & Patient Leader

If you have a chronic condition or illness you may already know and understand what it feels like to be a professional patient.

Between the physical pain and symptoms and emotional symptoms, the constant doctor appointments in search of that one person knowledgeable enough to help vs refer you to yet someone else and the numerous tests and procedures (not to mention having to keeping track of all of it & all the bills that go with it ) having a chronic condition can become a full-time job and to be honest it’s more exhausting than a good day’s work.

Speaking of work.
You may find yourself needing to cut back on hours at work , go to part time or stop working altogether.

Although this may be a necessity for you and your health, other people don’t always understand why you’re not working.
They may have these crazy misconceptions that you’re now somehow slower , lazy on vacation or lucky not to have to go to work .

Those of us with chronic conditions know, this is so wrong .
And we need to say this for those who don’t understand what we feel or go through. Maybe then people will be less judgmental.

So here is what most people don’t know or understand about not working due to chronic condition or illness.

I personally would much rather be at work.
People look so surprised when I tell them that, some act as if I’m off on some luxurious vacation.
They have no idea that I’m probably home.

So yes, I’d rather be at work because being at work means I’m healthy again.

Logically I know that one good day doesn’t mean I have to ability to hold my full time job again , but its nice to hope I will be back to work someday.

I wish people knew how much I miss my job. I stayed far longer than I should have and probably did more damage to my knee than I needed to, because it was such an important part of my life.

I lost 90 percent of my social life when I left my career and now being at home mostly all day every day is incredibly isolating, not to mention how guilty you feel not doing your part. Every day I hope that I’ll be able to work again someday soon , there are only so many episodes of a tv show a person can watch , I am writing a book and I do take classes.

I fill out paperwork constantly new doctors , more questions than answers.

Researching new treatments and the cost only to find great new Like about stem cell injections helping my Osteonecrosis but then being let down seeing that it’s 5-10k and never covered by insurance.

Then the frustration and sadness sets in because I live in America and I paid into Medicare and my share of taxes. And yet the government continues to hold up proven treatment that could help tens of thousands and yet some countries allow the cost of stem cells for their patients.

I also think many people see me and because I wear a little makeup and curl my hair, I think she doesn’t look disabled or ill. They don’t see me on the days I can barely move .
The days I need help going to the store because it gets so cold in the winter here in Ohio I am literally like concrete and in a great deal of pain.
Thank God Giant Eagle grocery store has a new shop for you curbside express.
You will be utilizing it this winter.

I try to be positive even when I’m in pain. I have a disease that is called Osteonecrosis due to trauma to the bone which has left me with a lack of blood supply to the knee.If you don’t have AVN/ON you won’t ever understand my pain.
I also have Spondylolisthesis L5S1 spine issues.
And Osteoarthritis another painful bone condition then add Spondylolisthesis,Hypothyroidism and Rosacea to the mix

Even though I get disability I do feel guilt now and then. I feel like I’m not contributing financially to my marriage and to be honest I miss working and making my own money.

My husband reminds me that he loves me and I would be doing the same for him if it were reversed and he’s right.

Being home all the time can be really lonely. If I had the energy and the physical stamina to be out and work, everyday life would be more fun again.

The isolation from limited human interaction is challenging so I started to take a few classes here or there, attend a seminar for this or that and meet new people. I’m going to be a health coach.

I find things to keep me and my mind busy.
I have a support group for Osteonecrosis.

I find that the spondylolisthesis is the more st painful of the few conditions I have, and the pain from Osteonecrosis is being managed mostly but it has its flares.

Osteoarthritis the stiffness is really indescribable.

But I make my own pain rubs and herbal remedies you can find many in this blog. But more will be in my book.

I wrote a booklet about the Avascular Necrosis/Osteonecrosis
And I blog and I’m writing a regular ebook and it should be completed by the end of the year.

I would love to find a decent work from home job.

Trust me, I would love to hold down a regular job in the optical field again.

No one realizes that a job does more for you than just pay your bills. It is part of what gives you self-esteem.

People always want you to be there for them, but are they ever there for you? Most of the time no.

I’m bored out of my absolute mind. I loved working and until my pain got bad, my job actually took my mind off it for the most part.

So next time you see your friend or family member that’s on disability don’t envy them.

Maybe remember to call them a little more often.

And let’s hope someday the government will help people get their life back by adding stem cell injections to all forums of insurance.

## Vegetarian Lettuce Wraps

Vegetarian lettuce wraps with tofu and mushrooms.

194 Calories
Makes 4
Ingredients:
3 tablespoons hoisin sauce
3 tablespoons reduced-sodium soy sauce
2 tablespoons rice vinegar
1 teaspoon sesame oil
2 teaspoons canola or grapeseed oil
1 (12- to 14-ounce) package extra-firm tofu (do not use silken)
8 ounces baby bella (cremini) mushrooms, finely chopped
1 (8-ounce) can water chestnuts, drained and finely chopped
2 cloves garlic, minced
2 teaspoons freshly grated ginger
1/4 teaspoon red pepper flakes (omit if sensitive to spice)
4 green onions, thinly sliced, divided
8 large inner leaves romaine lettuce (from a romaine heart) or butter lettuce leaves
Optional for serving: grated carrots, additional red pepper flakes

Directions:
In a small bowl, stir together the hoisin, soy sauce, rice vinegar, and sesame oil. Set aside.
Press the tofu between paper towels to squeeze out as much liquid as possible. Refresh the paper towels and press again. Heat the 2 teaspoons canola oil in a large nonstick skillet over medium-high. Once the oil is hot, crumble in the tofu, breaking it into very small pieces as it cooks. Continue cooking for 5 minutes, then add the diced mushrooms.

Continue cooking until any tofu liquid cooks off and the tofu starts to turn golden, about 3 to 5 minutes more.

Stir in the water chestnuts, garlic, ginger, red pepper flakes, and say half of the green onions and cook 30 seconds more.

Pour the sauce over the top of the tofu mixture and stir to coat.

Cook just until you hear bubbling and the sauce is warmed through, 30 to 60 seconds.
Spoon tofu mixture into individual lettuce leaves.

Top with remaining green onions, grated carrots, and additional red pepper flakes as desired.
Eat immediately.