Posted in Avascular Necrosis, Awareness, covid19, Osteonecrosis

Many asked to get them for awareness so here they are

Osteonecrosis Avascular Necrosis Awareness

Masks and where to find them.

Afterburner FX

Hubbard Ohio

Or

Afterburner FX

I make nothing off of their sale just want to do my part to get awareness masks out there.

They are washable

## Official Proclamation Avascular Necrosis -Osteonecrosis Awareness Day is November 29,2019 and every year after.

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 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

and

Mayor Jamal Tito Brown – Youngstown Ohio

For helping us who suffer finally get the awareness day we deserve

God Bless You and Thank You.

## Having A Rare Condition Stinks: But Being A Patient Advocate Is An Honor

Here’s what really stinks about having something that is called a rare disease/disorder

First you probably won’t find it in any regular medical textbook or learn about it in detail in any medical school.

Really ? Trust me I have looked I stumble on a paragraph here and there, but even it stinks as it lacks real information ,studies.

Secondly you probably won’t find any books you can buy that really tell you about your condition:

So I wrote a booklet it’s about 15 pages and I’m in the process of making it larger.

And ya know what really stinks is –  good luck finding a support group in your local home town.

I’m trying to change all that. I will get into that later.

And because you gave is a condition that in not that known , heard of  or taught about , what stinks is it can take many years before even figuring out what is the cause of this condition.

So it will be classed as idiopathic – There may be years of pain low moderate and severe possibly, possibly blood samples, many doctors that don’t listen to you or that just don’t believe you’re in pain , test after test referral after referral and many give out these clueless stares at you on behalf of specialists before even being diagnosed with a rare disease.

You know they are probably thinking why was I the one to get this patient…I can’t help them he’ll I don’t even know what they have or how they ended up with it.

Because your disease/disorder is rare, you just cannot be an average patient getting treatment or physical therapy.

Usually you end up playing the role of doctor and educator when visiting family or friends hell even seeing some healthcare professionals.

Sure you’re grateful for any opportunity to educate and raise awareness yet it becomes so damn frustrating when you see a medical professional and it appears you know more than they do.

Which brings up the next issue that stinks  – finding a good educated medical professional who knows, really knows about your condition and has actually treated more than a handful of patients in their entire career and one that doesn’t just try to use you as an experiment unless I want too.

Or worse just dismisses you and your concerns and questions.

What I also find frustrating and this really stinks are the doctors that are closed minded, just because they don’t know or understand my condition they are not open to alternative or newer forms of treatment.

I mean it’s not like they are paying for it. Nor did they look any of the research up that I have mentioned or left for them on more than one occasion. They even have the nerve to get passed off when you say you want and will try something new.

There are many things that stink about having a rare condition : But there is  the one thing  that doesn’t  stink about being rare …..  It’s the community we have.

I have a FB support Group for Osteonecrosis- and there are only approximately 12-15000 new cases a year in the USA diagnosed and 50,000 worldwide.

Because we are rare, we stick closely together. My rare  community  is fantastic— both patients and loved ones are fantastic and like our own family— they are the glue that helps me and others when we feel pain, become overwhelmed or just suffer the loss of our mobility, our career because of the condition, a significant other leaves us because they cannot take always seeing many of us in pain or unable to work.

I never planned on starting the support group but after all the things I came across when I was diagnosed I wanted others to have a place of hope, education and information and FB gave me that platform.

Our group now has a booklet we give free to all new members its mailed to them worldwide:

We have a Nationwide Directory with doctors that are educated and experienced in treating Osteonecrosis and some help find out the cause. Our group is working on a worldwide directory as well.

We have guest speakers (orthos, naturopaths, doctors that preform prp and stem cell injections)

I am very proud of our group.

So what is Osteonecrosis you ask?

#### Osteonecrosis

Osteonecrosis, also known as avascular necrosis (AVN), aseptic necrosis or ischemic bone necrosis, is a disease resulting in the death of bone cells. If the process involves the bones near a joint, it often leads to collapse of the joint surface and subsequent arthritis due to an irregular joint surface. The exact cause is unknown.

Osteonecrosis usually affects people between 30 and 50 years of age; about 12,000 people develop osteonecrosis each year in the United States. 50,000 worldwide.

Osteonecrosis affects both men and women and affects people of all ages. It is most common among people in their thirties and forties. Depending on a person’s risk factors and whether the underlying cause is trauma, it also can affect younger or older people.

My very 1st blog post –  Why I became an Advocate and Patient Leader

There is also a link to the booklet in the above post

Link To Avascular Necrosis Osteonecrosis Info AvascularNecrosisEducation.com

I am honored that people actually nominated me for the Wego health awards .

I am up for a few awards from WEGOHealth for my advocacy and there are so many amazing advocates I am blessed to be among them.

Thank You

Deborah L. Andio

wwwChronicallyGratefulDebla.com

Posted in Avascular Necrosis, Awareness, Osteonecrosis

## Could use your assistance

I need you to help me get to my goal

Link For Petition2Congress To Make October Osteonecrosis Awareness Month

I have started a petition to get the rare disease Osteonecrosis recognized by asking for an awareness month week or day. If they won’t allow a month.

I could use as many supporters as possible to help me and share this.

No money at all is needed.

I hope you will help me raise awareness

Take Action: We Need Osteonecrosis Awareness To Have The Month Of October to Recognized & raise awareness #Osteonecrosis #AvascularNecrosis please help and sign and share

Link Petition2Congress For Awareness Month Request – Osteonecrosis

Or copy and paste

https://www.petition2congress.com/ctas/osteonecrosis-awareness-month-october

To President Donald Trump, The U.S. House and The U.S. Senate
We, the patients of a rare disease called Osteonecrosis respectfully ask the United States of America in this petition to the US Congress to pass legislation to establish and recognize October as Osteonecrosis Awareness Month in the United States.
The people of the United States are called upon to observe the month of October with appropriate educational and awareness opportunities, and recognition.
With hundreds of thousands of US residents suffering from this disease and more being diagnosed everyday , there is a need for this community to have an active voice and recognition.
It is happening in all age groups from child to elderly

Osteonecrosis, also known as Avascular necrosis (AVN), aseptic necrosis or ischemic bone necrosis, is a disease resulting in the death of bone cells. If the process involves the bones near a joint, it often leads to collapse of the joint surface and subsequent debilitating often crippling arthritis due to an irregular joint surface.

Although it can happen in any bone, osteonecrosis most commonly affects the ends (epiphysis) of long bones such as the femur (thigh bone). Commonly involved bones are the upper femur (ball part of the hip socket) the lower femur (a part of the knee joint), the upper humerus (upper arm bone involving the shoulder joint), and the bones of ankle joint. The disease may affect just one bone, more than one bone at the same time, or more than one bone at different times.
Osteonecrosis can cause severe pain and disability. Early diagnosis and early treatment may improve the outcome.
Osteonecrosis may result from use of glucocorticoid (sometimes called corticosteroid) medicine or from drinking too much alcohol but there are many causes and also some that are unknown.
Though osteonecrosis can occur in almost any bone of the body, the hips, knees,ankle and shoulders are the most common sites affected.
The cause and treatment for osteonecrosis of the jaw differs from that for osteonecrosis found elsewhere.

The most common causes of osteonecrosis are:

Serious trauma to bone or joint (injury), which interrupts a bone’s blood supply
Corticosteroid medications (such as prednisone, cortisone or methylprednisolone), mainly when a high dose is used for a prolonged period of time
Excess alcohol consumption
Systemic lupus erythematosus

Other risk factors for osteonecrosis include:
Decompression disease (also called the “Bends” that can occur with scuba diving)
Blood disorders such as sickle cell anemia, antiphospholipid antibody syndrome (APS) and lupus anticoagulant, factor v leiden, and others
HIV infection (the virus that causes AIDS)
Bisphosphonates, which may be linked to osteonecrosis of the jaw
Organ transplants

Osteonecrosis is not life-threatening, but it is debilitating and hurts our quality of life. Although it isn’t well-known and its exact cause is unknown, AVN-ON affects 10,000-to-20,000 Americans annually. Between 30 and 60 percent of patients will experience AVN-ON bi-laterally, which means both sides so if one hip or knee has it most likely so will the other.

Please help those of us that suffer from this condition by creating more research , funding studies and allowing us the recognition, as only through education, research and awareness can we get better treatment options, earlier diagnosis and hopefully prevention.

Thank You

## Understanding Bone Marrow Edema-Linked To Osteonecrosis

Good Morning Pain Warriors Around The World

It is time to educate on the various causes of

Avascular Necrosis-Osteonecrosis

So twice a week we will post some educational info on a cause with links

Today Its Bone Marrow Edema

What is Bone Marrow Edema?

Bone marrow edema is a condition when excess fluids in the bone marrow build up and cause swelling. It is often caused by a response to an injury, such as a broken bone or a bruise, or a more chronic condition such as osteoporosis. Bone marrow edema most commonly occurs in the hips, knees and ankles. In this case, bone marrow edema of the knee is a main cause of localized knee and joint pain, and is only diagnosable via a Magnetic Resonance Imagining test (MRI).

It is usually caused by the following scenarios:

• Avascular necrosis, or “bone death”. This is when a small portion of the bone dies, and can result in a painful bone marrow edema
• Any type of knee bone trauma, including broken bones and bone bruises.
• Joint disorders such as osteoarthritis or osteoporosis. In this case, the knee joint is lacking the cushion that cartilage provides, which can lead to easier fracture and wear on the bone. Subsequently, if a fracture of the bone occurs, the injured area becomes susceptible to edema..
• Knee ligament injuries.
• A condition such as synovitis (an inflammation of the lining the joints, called synovial membranes).
• In rare conditions, bone tumor.

Symptoms of Bone Marrow Edema in the Knee

Bone marrow edemas may not bother you at all, or they may be painful and inconvenient. They can feel more intense than a muscular injury (for example, a muscle bruise) at times due to the nature of the bone. A muscle is capable of swelling, which increases blood flow to heal the area. Unfortunately, bones are not capable of swelling, and thus the fluid (edema) that collects in the marrow can create intense pressure within the bone, resulting in more intense pain. In fact, in many osteoarthritic patients, it isn’t the lack of cartilage that’s causing them pain, but rather the pressure due to the edema.

Some of the most common symptoms of bone marrow endema include:

• Varying degrees of pain, from mild to moderate, depending on the severity and Trauma.
• Swelling of the knee area.
• Inability to put full pressure on the knee to walk.
• Recurrent pain and tenderness.
• Bruising.

Treatment of Bone Marrow Edema in the Knee

Thankfully, most bone marrow edemas will settle down and heal on their own after the injury has subsided. For example, in some cases of osteonecrosis the bone will regenerate itself and heal the edema but note : not all cases of osteonecrosis or spontaneous osteonecrosis of the knee will have the ability to heal itself. Unfortunately, though, in the case of osteoarthritis, the edema may only get worse over time. In this circumstance, treatment options may be explored.

Traditional treatments for bone marrow edema usually involve rehabilitation through physiotherapy and rest. Ice, medications such as ibuprofen or acetaminophen, and even a crutch or a cane can help as well. There is one drug-facilitated treatment that uses a bisphosphonate and vitamin D mixture to help increase bone density. When this treatment is delivered via intravenous, it is found to be quite effective in reducing pain and increasing density. Other drugs that usually treat the vascular system have been found effective for bone marrow edema, in that they encourage blood flow and treat any vascular abnormalities that may exist in the bone and marrow.

In some more challenging cases, core decompression may be used. This is a type of surgery where a surgeon drills a hole into the affected part of the bone allowing that area of the bone to experience increased blood flow, form new blood vessels, and heal.

Another option is subchondroplasty, which can be especially effective for osteoarthritis patients. In this procedure, an x-ray determines where the edema is. The patient is then sedated, and a small needle injects a paste into the area of the edema. The paste then hardens and provides more strength and density to the bone. By improving the strength of the bone, it will enable the bone to deal with the pain of the edema and of the osteoarthritis.

http://louisvillebones.com/understanding-bone-marrow-edema/

Knee

https://www.g2orthopedics.com/bone-marrow-edema-in-the-knee/

https://www.researchgate.net/…/7224238_Bone_marrow_edema_in…

https://www.researchgate.net/…/7224238_Bone_marrow_edema_in…

https://www.hindawi.com/journals/crirh/2018/7657982/

Hip Study

https://www.ajronline.org/doi/10.2214/AJR.05.0086

https://www.ncbi.nlm.nih.gov/pubmed/15049532

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972799/

Shoulder

https://www.sciencedirect.com/…/veterinary-sc…/osteonecrosis

Ankle

https://www.ncbi.nlm.nih.gov/pubmed/21189186

https://www.footanklesurgery-journal.com/…/S1268-7…/abstract

https://wordpress.com/post/avascularnecrosiseducation.wordpress.com/128

Avascular Necrosis / Osteonecrosis Support Int’l.

Priceless – King & Country

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Posted in Avascular Necrosis, Bone Health, Osteonecrosis

## Osteonecrosis of the Knee

Osteonecrosis of the Knee

I have Avascular Necrosis “AVN” or Osteonecrosis “ON” are the terms used to describe parts of your bones that die.

Most commonly this occurs in the knee shoulder and hip, but also can occur in the ankle and other bones and joints including the jaw.

I was diagnosed with Osteonecrosis in my knee in November 2014 and that’s the day my working -active life changed….and has never been the same since…..

I will post more on that later for now

Learn what Osteonecrosis is……

The main causes of osteonecrosis are: injury  or trauma to bone or joint, heavy steroid use, deep sea diving, alcoholism, sickle cell disease or clotting disorders,  damage to arteries.

There are 4 stages of avascular necrosis which explain the severity of the bone death. Depending on the stage, there are many different treatment options available. The problem with treating osteonecrosis is that there are so many different treatment options because none of them are highly successful.

Osteonecrosis of the knee (also known as avascular necrosis) is a very painful condition that occurs when the blood supply to a section of bone in the femur (thighbone) or tibia (shinbone) is disrupted.Because bone cells need a steady supply of blood to stay healthy, osteonecrosis can ultimately lead to destruction of the knee joint and severe arthritis.
When osteonecrosis is diagnosed early, treatment may involve taking medications to relieve pain or limiting use of the affected knee. For patients with more advanced osteonecrosis, however, treatment almost always involves surgery to prevent further damage to the bone and improve function in the joint.

## Anatomy

Your knee is the largest and strongest joint in your body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). The ends of these three bones where they touch are covered with articular cartilage, a smooth, slippery substance that protects the bones and enables them to glide easily against each other as you move your leg.

Osteonecrosis of the knee most often occurs in the knobby portion of the thighbone, on the inside of the knee (medial femoral condyle). However, it may also occur on the outside of the knee (lateral femoral condyle) or on the flat top of the shinbone (tibial plateau).

## Cause

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—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.

Regardless of the cause, if osteonecrosis is not identified and treated early, it can develop into severe osteoarthritis.

## Symptoms

Osteonecrosis develops in stages. The first symptom is typically pain on the inside of the knee. This pain may occur suddenly and be triggered by a specific activity or minor injury. As the disease progresses, it becomes more difficult to stand and put weight on the affected knee, and moving the knee joint is painful.

Other symptoms may include:

• Swelling over the front and inside of the knee
• Sensitivity to touch around the knee
• Limited range of motion in the joint

It may take from several months to over a year for the disease to progress. It is important to diagnose osteonecrosis early, because some studies show that early treatment is associated with better outcomes.

## Doctor Examination

### Physical Examination

Your doctor will talk with you about your general health and medical history, and ask you to describe your symptoms. He or she will then perform a careful examination of your knee, looking for:

• Joint swelling, warmth, or redness
• Tenderness
• Range of passive (assisted) and active (self-directed) motion
• Instability of the joint
• Pain when weight is placed on the knee
• Any signs of injury to the muscles, tendons, and ligaments surrounding the knee

### Imaging Studies

X-rays. X-rays provide images of dense structures, such as bone. Your doctor may order x-rays to look for changes that occur in bone in the later stages of osteonecrosis. In the early stages of the disease, x-rays usually appear normal.

Magnetic resonance imaging (MRI) scans. Early changes in the bone that may not show up on an x-ray can be detected on an MRI. These scans are used to evaluate how much of the bone has been affected by the disease. An MRI scan may also show early osteonecrosis that has yet to cause symptoms (for example–ostenecrosis that may be developing in the opposite knee joint).

## Treatment

Treatment for osteonecrosis depends on a number of factors, including:

• The stage of the disease
• The amount of bone affected
• The underlying cause of the disease

### Nonsurgical Treatment

In the early stages of osteonecrosis, treatment is nonsurgical. If the affected area of the knee is small, nonsurgical treatment may be all that is needed.

Nonsurgical treatment may include:

• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can help reduce pain and swelling in your knee.
• Reduced weight bearing. For some patients, removing weight from the affected knee can slow the damage caused by osteonecrosis and allow healing. Your doctor may recommend using crutches for a period of time to take weight off your knee. In some cases, wearing an “unloader” brace can help relieve pressure on the joint surface by shifting weight away from the affected portion of the knee.
• Exercise. Your doctor or a physical therapist may provide you with an exercise program designed to help strengthen your thigh muscles and maintain range of motion in the affected joint. In some cases, water exercise may be recommended to avoid stress on your knee joint.
• Activity modification. Your doctor may recommend that you avoid certain activities that bring on painful symptoms.

### Surgical Treatment

If a large portion of the bone surface is affected, or if your pain does not improve with nonsurgical treatment, your doctor may recommend surgery. There are several different procedures used to treat osteonecrosis of the knee.
Arthroscopic debridement and microfracture. In debridement (cleansing), your doctor uses a small camera and miniature surgical instruments to remove loose bits of bone or damaged cartilage from inside the joint space. For small lesions, he or she may also drill multiple holes, or microfractures, in the underlying bone to help promote blood flow and induce a healing reaction
Core decompression. This procedure involves drilling one larger hole or several smaller holes into the bone to relieve pressure on the bone surface and create channels for new blood vessels to nourish the affected areas of the knee.

When osteonecrosis of the knee is diagnosed early, core decompression is often successful in preventing collapse of the bone and the development of arthritis.

Osteochondral (bone and cartilage) grafting. Core decompression is often combined with bone and cartilage grafting to help regenerate healthy bone and support cartilage at the knee joint. A bone graft is healthy bone tissue that is transplanted to an area of the body where it is needed. The tissue may be taken from a donor (allograft) or from another bone in your body (autograft).There are also several synthetic bone grafts available today.
Autologous chondrocyte implantation (ACI). This is a two-stage procedure. In the first stage, your doctor performs an arthroscopic procedure to remove a small number of cartilage-producing cells (chondrocytes) from your knee. These chondrocytes are sent to a lab where they are cultured (multiplied) for up to 6 weeks to obtain more cells.In the second stage, your doctor performs another procedure to implant the chondrocytes into the area of your knee with cartilage loss. The cells then grow in the joint, replacing the damaged cartilage with healthy cartilage.
Osteotomy. In an osteotomy, your doctor removes a portion of bone from either your tibia (shinbone) or femur (thighbone) to help shift your weight off the damaged area of the knee. Shifting your weight off the damaged side of the joint will help relieve pain and improve function.
Total or unicompartmental (partial) knee replacement. If the disease has advanced to the point where the bone has already collapsed, you may need surgery to replace the damaged parts of your knee. In knee replacement, your doctor removes the damaged bone and cartilage, and then positions new metal or plastic joint surfaces to restore the function of your knee.

## Outcome

For most patients, treatment for osteonecrosis is successful in relieving pain and improving function. Outcomes vary, however, depending on the stage of the disease at diagnosis and the type of treatment.  Your doctor will talk with you about the expected outcome of treatment in your specific situation.

Stages Of Osteonecrosis Knee

Support Group For All Forms Of Avascular Necrosis/Osteonecrosis

Avascular Necrosis/Osteonecrosis Support Int’l

AvascularNecrosisAndBoneDiseaseAwareness

http://www.ChronicallyGratefulDebla.com

## High Heels When You Have Bone Problems

Not the best idea I had, but let’s be real I’m 5’3 and I needed to wear heels 👠 or my pants would be dragging all over the floor.

Also I can fudge my way through hemming pants but I’d do much better if I owned a sewing machine.

But I since I wore these darn shoes I jacked up my knees the good one and the not so good one.

I am ready to throw them out that’s how bad my knees hurt.

So I am a mess this week.

I mean I cannot believe the pain and discomfort I feel.

So I did some research and did you know high heels are terrible on on body , not just the feet !

The entire body.

High heel lovers it’s time to confirm what you may have long suspected: heels aren’t great for your health.

This revelation may not really be that surprising considering high heels essentially force you to teeter around on your tip-toes all day, but what may come as a shock is exactly how much damage they are capable of doing.

Put it this way, it’s not just your feet that suffer.

Feet

Let’s start at the bottom and work our way up. What do high heels do to your feet? Short answer: nothing good.

“There’s some good evidence that when ladies walk in a high heel shoe, there is increased pressure on the front part of the foot,” Associate Professor Lloyd Reed from the QUT School of Clinical Sciences in podiatry told The Huffington Post Australia. “Particularly under the big toe joint, the first metatarsal.

“A lot of weight gets shifted over to the front there, and there is less pressure out near the little toe.

“The types of problems that we see [as a result of this] is something like a bunion on the big toe joint, or hallux valgus.

“Other problems can include corns and calluses on the feet, especially under the ball of the foot and then on the tops of the toes.

The pain under the ball of the foot is called metatarsalgia.

There is also something called Plantar fasciitis which some people would refer to as ‘heel spur syndrome’ which is pain directly under the heel.”

So reconsider your high heel addiction, take into account what Reed refers to as Haglund’s Deformity (mmmm. Sexy).

“That’s a bump on the back of the heel which can be quite painful when ladies are wearing their dress heels or court shoes,” Reed said. “It may be associated with using high heels for prolonged period.”

Not that pain is going to stop women from wearing heels any time soon. As Reed points out, one American study found 42 percent of women wore high heels in spite of pain for aesthetic reasons.

“There’s even some evidence to suggest women more likely to have inappropriately fitting shoes than blokes, even into older age,” Reed said. “And of course, people who have the worst fit in shoes are more likely to have problems with calluses and bunions and so on.

“Some of that also has to do with the style of high heel. For instance I know the fit of the shoe often has a tapered toe and narrow upper section, and that in itself can be a problem for the feet.”

Knees

“What happens when you wear high heels is that your heel is raised off the ground, which in turn makes your body start to push forward,” Associate Professor Kevin Netto and Director of Research at the School of Physiotherapy and Exercise Science at Curtin University told The Huffington Post Australia.

“So you set up what is known as sheer force in your knee. Basically, the front part of your body is trying to fall forward and you are trying to pull it backwards by keeping yourself upright. It’s a constant battle.

“That’s why most people who wear really high heels will find their knees hurt rather than their ankles. Basically because of the sheer force you set up in your knee.”

Knee osteoarthritis is much more common in females than males in all ages. In fact the prevalence is about 30 percent higher in females.

In terms of the actual damage caused to a regular high heel wearer, Netto has this to say:

“If you cut their knees open, it would be a pretty disgusting mess. Cartilage in your knee helps cushion forces, and if you are wearing heels every day you keep tearing on it and pulling on it and pulling on it. As such, it tends to become quite worn, and that’s not something you can regenerate. It’s not regenerative material.”

Adds Reed: “There is evidence that when person walks [in high heels] they do a couple of things, and one of these is to increase the bending of the knee in order to improve their walking and adjust to the fact their ankle is not going to move as much.

“The consequences of this is it produces much more pressure, or more load, in the inside edge of the knee, in the medial compartment of the knee joint.

“Now, the medial compartment of the knee joint is the most common place for knee arthritis, and it has been shown knee osteoarthritis is much more common in females than males in all ages. In fact the prevalence is about 30 percent higher in females.”

Lower back

“There is a common thinking that when it comes to the back, what’s called the lumbar lordosis or the curve at the lower back will increase with higher heeled shoes,” Reed told HuffPost Australia.

“Scientific research is not conclusive with that. It’s very common on the internet but the scientific research is mixed on that front.

“What there is lots of evidence for is the increase in muscle activity in the lower back. Also there’s some increase in the abdominal muscles and, for some people, there’s an increase in muscle activity in the thoracic region of the spine and the neck.

“So effectively the increase in muscle demand can go right up through the body, from foot to leg to the lower back, to the middle back, up to the neck.”

“I challenge anybody to say they walk normally in really high heels. You don’t need a PhD in bio-mechanics to explain that one. Just look at someone’s gait.

Injuries

Put simply, those who wear high heels are at risk of doing themselves an injury. (Yes, even if you’re super talented at walking in the highest of stilettos, this means you.)

“Wearing high heels effects your centre of mass, which is basically the balance point in the body,” Netto said.

“Everyone has a balance point in their body, and to maintain your balance, you have to keep this little balance point over your base of support, which is your feet, basically. If you lose your balance then your balance point moves outside where it’s supposed to be.

“When you wear heels, you bring the balance point in your body higher, so you become less stable and much more prone to falling etc.

“The higher the heel, the more you are going to raise your centre of mass, and the more unstable you are going to become, which means you have a higher potential of falling.”

For those who are reading this thinking, ‘yeah… but I’m great at walking in heels, so this doesn’t apply to me’, Netto has this to say:

“I challenge anybody to say they walk normally in really high heels. You don’t need a PhD in bio-mechanics to explain that one. Just look at someone’s gait.”

According to Reed, a study over a ten-year period (from 2002-2012) in the United States revealed the rate of injuries suffered by ladies wearing high heels doubled within the decade (though they’re not sure why).

The highest rate of those injured were within the age bracket of 20 – 29, followed closely by 30-39

“The most common injury was a sprain or a strain in the foot or the ankle,” Reed said.

“There was also a similar study done in Victoria, conducted from 2006 – 2010, which looked at the number of injuries presenting to emergency departments which were directly attributed to a high heel shoe.

“All of the people injured were less than 55 years of age, and the most common injury was an ankle injury, which doesn’t really come as a surprise, as when ankle is flexed, it’s more prone to ankle sprains.”

Interestingly, most ladies presented with their injuries on Sunday mornings between 8am and 12pm.

“So perhaps due to a Saturday night injury,” Reed said. “We don’t know this for sure, but that’s what we may infer.”

More injuries were also reported in the summer months.

Recommendations

“Obviously we would recommend people don’t spend a lot of time in high heels,” Reed told HuffPost Australia. “And even if they have to wear a high heel, try and get the shape of the shoe to be slightly rounder or broader toe box to fit the foot. if possible.

“Sometimes we suggest that even if there’s a bit of heel height, a larger width of heel might be advantageous, particularly with the slip risk.”

Netto was more to the point.

“Don’t wear them. It’s pretty bloody simple,” he said. “It’s a bit like smoking, if you don’t want to get lung cancer, don’t smoke. If you don’t want a bad back and bad knees, don’t wear heels.

“Even if you feel you have to wear them, you don’t have to wear stilettos. They just aren’t called for. If you are going to have to wear something, wear something light and stay on your feet as little as possible.

“Look, in terms of recommendations, I’m not going to say very much. I don’t want to be an advocate for them.”

Reference

https://m.huffingtonpost.com.au/2016/08/17/this-is-what-wearing-heels-all-day-does-to-your-body_a_21453115/

## 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

## What Is Bone Marrow & What Does It Actually Do?

Ever since I was diagnosed with several bone problems I have become fascinated by the human body and the bones are just a small portion of just how marvelous our body is.

Science is  constantly making new discoveries about the human body.

Fact: Did you know The Smallest Bone in the Human Body is in your ear- The Stirrup Bone located in your middle ear; it measures 2-3 millimeters.

Biggest (and Strongest) Bone in the Human Body: Femur – The femur is the strongest bone in the human body. It extends from the hip to the knee.  It can resist a force of up to 1,800 to 2,500 pounds. Only events of a large amount of force can cause it to break, such as by a car accident or a fall from an extreme height, taking months to heal.

Body Part with the Most Bones: The Hands – The hands have the most bones — 27 in each hand.The hands and feet together make up more than half the bones in the human body. There are 206 bones in the human body; 106 of these are in the hands and feet (27 in each hand and 26 in each foot).

Most Fragile Bone in the Body: The Toe Bones – The small toe bones break the easier and most often.

Most Commonly Broken Bone: The Ankle -Even more common than breaking a toes is spraining or breaking your ankle.

The Most Complex  parts of the body – The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia).

Now whats cool is learning about the marrow in the bones………

Bone marrow is a nutrient-rich spongy tissue located mainly in the hollow portions of long flat bones like the sternum and the bones of the hips. There are two types of bone marrow: red marrow and yellow marrow. Yellow marrow has a much higher amount of fat cells than red marrow. Both types of marrow contain blood vessels.
Stem Cells
The bone marrow works like a ‘factory’ that
produces all of the cells that are found
in the bone marrow and in the peripheral blood stream.

This factory is dependent on the function
of the pluripotent stem cells.

Pluripotent refers
to the ability of a cell to become many different
types of cells

Pluripotential is derived from the Latin

pluri meaning more and potential meaning power.

Fact :  Did You Know?
At birth, all bone marrow is red. As we age,
more and more of the marrow converts to
the bone marrow is red and half is yellow.

The bone marrow has two types of stem cells, mesenchymal and hematopoietic. This
process of development of different blood cells from these pluripotent stem cells is
known as hematopoiesis.

Pluripotent hematopoietic cells say that 3 times real fast Pluripotent,Pluripotent,Pluripotent the Pluripotent hematopoietic cells can become any type of cell
in the blood system. Under the influence of tissue and hormonal factors these cells
develop into specific blood cell lines. When these cells differentiate or mature they
become the cells that we can recognize in the blood stream.

The majority of  our Red Blood Cell’s (RBCs),platelets, and most of the White Blood Cell’s (WBCs) are formed in the red marrow while only very  few of them are formed in the yellow marrow.

Everyone needs a continuous production cycle of blood cells from our bone marrow throughout our lives since each blood cell has a set life expectancy.

Healthy bone marrow produces as many cells as your body needs. Red
cell production is increased when the body needs additional oxygen, platelets increase when bleeding occurs, and white cells increase when infection threatens.

Fact: Did You Know?
Red blood cells live an average of
120 days and platelets live 8 – 10
days. Some white blood cells are
very short lived and live only hours,
while others can live for many years

As RBCs age, they become less active and become more fragile. The aging red cells are
removed or eaten up by white blood cells (macrophages) in a process known as phagocytosis and the contents of these cells are released into the blood. The iron from the hemoglobin of the destroyed cells is carried by the blood stream to either the bone marrow for production of new RBCs or to the liver or other tissues for storage.
Normally, a little less than 1% of the body’s total RBCs are replaced every day. The number of red blood cells produced each day, in the healthy person, is about 200 billion cells.

Importance of the Circulatory System
The circulatory system touches every organ and system
in your body. Red cells flow in the blood circulation
circulatory system in order to function since oxygen is
essential for proper cell function.

Hemoglobin
Hemoglobin (Hgb) is a protein that is found within
red blood cells. This protein is what makes ‘red cells’ red. Hemoglobin’s job is to pick up
oxygen in the lungs, carry it in the RBCs, and then release oxygen to the tissues that need
it like the heart, muscles, and brain. Hemoglobin also removes CO2
or carbon dioxide and
carries this waste product back to the lungs where it is exhaled.

Fact: Macrophage is derived from the Ancient Greek:
‘macro’ meaning big and ‘phage’ meaning eat.

Platelets
Platelets are produced in bone marrow by a process known as thrombopoiesis.
Platelets are critical to blood coagulation and the formation of clots to stop
bleeding.
Sudden blood loss triggers platelet activity at the site of an injury or wound.
Here the platelets clump together and combine with other substances to form fibrin.

Fibrin has a thread-like structure and forms an external scab or clot.

Platelet deficiency causes you to bruise and bleed more easily. Blood may not clot well at an open
wound, and there may be a greater risk for internal bleeding if the platelet count is very low.

Fact: Did You Know?
Healthy bone marrow normally manufactures
between 150,000 and 450,000 platelets per
microliter of blood, an amount of blood that fits
on the head of a pin

The majority of RBCs, platelets, and most of the WBCs are formed in the red marrow while only a few of them are formed in the yellow marrow. Everyone needs a continuous production cycle of blood cells from our bone marrow throughout our lives since each blood cell has a set life expectancy. Healthy bone marrow produces as many cells as your body needs.

Repeating Because This Is Important To Know : Red cell production is increased when the body needs additional oxygen, platelets increase when bleeding occurs, and white cells increase when infection threatens.

Iron
Iron is an important vital nutrient for  the body. It combines with protein to make the hemoglobin in red blood cells and is essential in the production of red blood cells (erythropoiesis). The body stores iron in the liver, spleen, and bone marrow. The storage form of iron is known as ferritin.
Ferritin can be measured through a blood test. Most of the iron needed each day for
making hemoglobin comes from the recycling of old red blood cells.

Red Blood Cells
The production of red blood cells is called
erythropoiesis. It takes about 7 days for a
committed stem cell to mature into a fully
functional red blood cell. Red blood cells
have a limited life span of approximately
120 days and must be continuously
replaced by the body.
Erythropoiesis is stimulated by a lack of oxygen (hypoxia) in the body. This lack of oxygen tells the kidneys to produce a hormone, erythropoietin (EPO). EPO then stimulates the bone marrow to produce RBCs.

Erythropoietin does this by entering the blood stream and traveling
throughout the body. All the body’s cells are exposed to erythropoietin, but only red bone
marrow cells respond to this hormone. As these new red cells are produced they move into the blood stream and increase the oxygen-carrying ability of the blood. When the tissues of the body sense that oxygen levels are enough, they tell the kidneys to slow the secretion of erythropoietin. This ‘feedback’ within your body ensures that the number of RBCs remains
fairly constant and that enough oxygen is always available to meet the needs of your body.
As RBCs age, they become less active and become more fragile. The aging red cells are
removed or eaten up by white blood cells (macrophages) in a process known as phagocytosis
and the contents of these cells are released into the blood. The iron from the hemoglobin of
the destroyed cells is carried by the blood stream to either the bone marrow for production of
new RBCs or to the liver or other tissues for storage.
Normally, a little less than 1% of the body’s total RBCs are replaced every day. The number of
red blood cells produced each day, in the healthy person, is about 200 billion cells.

White Blood Cells
The bone marrow produces many types of white blood cells, which are necessary for a healthy
immune system. These cells both prevent and fight infections. There are five main types of
white blood cells, or leukocytes:
Lymphocytes
Lymphocytes are produced in bone marrow. They make natural antibodies to fight
infection caused by viruses that enter your body through your nose, mouth, or cuts.
They do this by recognizing foreign substances that enter the body and then sending a
signal to other cells to attack those substances. The number of lymphocytes increases
in response to these invasions. There are two major types; B- and T-lymphocytes.
Monocytes
Monocytes are also produced in the bone marrow. Mature monocytes
have a life expectancy in the blood of only 3-8 hours, but when they
move into the tissues, they mature into larger cells called macrophages.
Macrophages can survive in the tissues for long periods of time where
they engulf and destroy bacteria, some fungi, dead cells, and other
material foreign to the body.
Granulocytes
Granulocyte is the family or collective name given to three types of white blood cells: neutrophils,
eosinophils and basophils. The development of a granulocyte may take two weeks, but this time
is shortened when there is an increased threat like a bacterial infection. The marrow also stores
a large reserve of mature granulocytes. For every granulocyte circulating within the blood, there
may be 50 to 100 cells waiting in the marrow to be released into the blood stream. As a result,
half the granulocytes in the blood stream can be available to actively fight an infection in your body within 7 hours of recognizing that an infection exists!

Once a granulocyte has left the blood it does not return. It may survive in the tissues for as long as 4 or 5 days depending
on the conditions it finds, but it only survives for a few hours in the circulation.
Neutrophils
Neutrophils are the most common granulocyte. They can attack and
destroy bacteria and viruses.
Eosinophils
Eosinophils are involved in the fight against many types of parasitic
infections and against the larvae of parasitic worms and other
organisms. They are also involved in some allergic reactions.
Basophils
Basophils are the least common of the white blood cells and respond to various allergens
that cause the release of histamines and other substances. These substances cause
irritation and inflammation in the affected tissues. Your body recognizes the irritation/
inflammation and widens (dilates) the blood vessels allowing fluid to leave the circulatory system and enter the tissue in an effort to dilute the irritant. This reaction is seen in hay fever, some forms of asthma, hives, and in its most serious form, anaphylactic shock.

So you see the body is such a marvelous complicated system we run it like its  a machine but its not a machine.

There is nothing  built today that runs as well as the human body and there is nothing more fascinating than the human body.

More Fun Facts:

If you use an average of 80 beats per minute, your heart beats about 4,800 times per hour. That’s a whopping 115,200 times per day. Over the course of a year, your heart would beat about 42,048,000 times! If you live to be at least 80 years old, your heart would have beaten approximately 3,363,840,000 times!

Your nose can remember 50,000 different scents.

• A human baby has over 60 more bones than an adult.

• There are 100,000 miles of blood vessels in an adult human body.

Pretty Cool 😎

## Steinberg Stages

Many who suffer with Avascular Necrosis-Osteonecrosis are unaware of the many stages the disease progresses to

This will be helpful so the patient and doctor can have a better idea if what form of treatment or surgical procedure would be best for the patient.

As a patient myself with Osteonecrosis in my knee I make it a point to educate myself and help others learn about the various

Stages

And

Treatments

So they can make the best decision for their own well being.

Steinberg Staging Of Avascular Necrosis/ Osteonecrosis

Steinberg staging of avascular necrosis of hip is a commonly used system similar to the

Ficat and Arlet staging

History and etymology

It is based on the radiographic appearance and location of lesion. It primarily differs from the other systems by quantifying the involvement of femoral head which allows direct comparison between series1. Seven stages of involvement are identified. Following staging, extent of involvement of femoral head is recorded as mild, moderate or severe.

Classification

stage 0: normal or non-diagnostic radiographs, MRI and bone scan of at risk hip (often contralateral hip involved, or patient has risk factors and hip pain)

stage I: normal radiograph, abnormal bone scan and/or MRI

stage II: cystic and sclerotic radiographic changes

stage III: subchondral lucency or crescent sign

mild: <2 mm

moderate: 2-4 mm

severe: >4 mm

stage V: joint space narrowing with or without acetabular involvement

Quantification of extent of involvement is necessary for stages I to V:

stage I and II

B, moderate: 15% to 30%

C, severe: >30%

stage III

A, mild: subchondral collapse (crescent) beneath <15% of articular surface

B, moderate: crescent beneath 15% to 30%

C, severe: crescent beneath >30%

stage IV

A, mild: <15% of surface has collapsed and depression is <2mm

B, moderate: 15% to 30% collapsed or 2 to 4mm depression

C, severe: >30% collapsed or >4mm depression

stage V

A, B or C: average of femoral head involvement, as determined in stage IV, and estimated acetabular involvement.

Steinberg Staging Osteonecrosis

Avascular Necrosis Of The Hip

Fixated and Arlet Staging

Legg-Calvé Perthes Disease

AVN CharityUK

Education On Steinberg Stages

https://avascularnecrosiseducation.wordpress.com/2018/06/26/steinberg-stages-of-osteonecrosis-avascular-necrosis/

References

1. Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br. 1995;77 (1): 34-41. Pubmed citation

## WEGOHealth Awards and How to Nominate Others

I’m honored to say I’ve been nominated for the #WEGOHealthAwards! These awards seek to recognize Patient Leaders who are making an impact with their advocacy. Learn more – nominate today.

Here’s how you can also nominate others who educate, advocate and make a difference!

WEGOHealth Awards and Nomination Info

Patient Leaders have started non-profits, published podcast episodes, and authored books – there is no shortage of Patient Leaders’ contributions to the world, so let’s recognize as many of them as we can for their talents, contributions, and commitment.

Feel free to add their names and web info also in my comment section! And they can get some recognition here to !

Have a Great Day Everyone

## Body Confidence

Can you be body confident when suffering from chronic pain? Do these two things even mix? Can I live in harmony again in a body that seems to work against me? I’ve been living with chronic pain for 4 years now. Some days I am in more pain than others .

I had to retire for now from my optometric tech -optician duties because of all the pain I have had and the limited mobility drives me crazy because I don’t like to be limited.  I mean my knee just wont move the way it should. My goal is to get back to work someday.

Overall I am  happy with myself, I am pretty, I am smart, I am good hearted , kind, compassionate giving person. I’m happy with my life, in spite of the challenges I deal with daily but I feel as if I’m struggling to be happy with my actual body. I mean I have a few things that are keeping me from dropping some weight which in turn will help my bones.

Dealing with adrenal fatigue and hashimoto’s on top of hypothyroidism , osteonecrosis , osteoarthritis and spondylolethesis just some days is well challenging.

My body is changing constantly, with new aches and pains.. It hurts a persons confidence sometimes. Don’t get me wrong, I am, confident  but I’m not 100%. like I used to be.

How can I be? My body stops me from being able to do things,like hiking which I miss and love, I cant roller skate anymore , I cant work like I used to . I also can’t  wear things because of the pain like my spike heels.

My fashion choices have changed as I have gained weight and when my pain gets worse,

If you were looking to me for some magical answers with this post, I don’t really  have any.

I’m exploring it all myself.

Yes I try many things some help a little , some help a lot but all seem to be temporary.

I do things like take curcumin for my pain, I make sure I eat healthy.

I am a Flexitarian who eats mostly plant based. I take my vitamins, I do exercise as best as I can.

Chronic pain affects people in different ways, but I really don’t think people understand how it can effect our body confidence.

I just cannot sit for 1-2 hours everyday to curl my hair & put on makeup, nor do I really want to.  I am now a eyeliner – lipstick kinda woman now and of course I still curl my hair just not with all the products in my hair

Can I wear a bra around the house? Mmmm I could but why LOL.

I try to ride my recumbent bike a few miles daily

Some days I walk some but its really a pain because depending on where I walk my knee will either love it or hate it.

My new thing is using dumbell’s every other day they are 8 lbs each ,

I have to keep the muscles somehow. And I am hoping I can build more muscle lose more fat.

I only use them for a few moves because I cant squat due to the knee problem and if I tried my knee pain would have me on the floor.

I don’t care if i lose 50 lbs but a good 25 would be nice. I dont even mind being a plus size curvy girl, I just know for my height and health of my bones dropping 25-30 lbs would be a real plus .I know I would feel so much better if I could drop some of this weight, I love me ,I love my body, I just want to love it more again.

Now Some Facts :

Here’s a look at what fat does to arthritis, as well as some tips to put you on the road to losing weight.

## Fat and Osteoarthritis

Osteoarthritis, OA, is the most common type of arthritis, affecting approximately 27 million Americans. It is characterized by the breakdown of cartilage – the flexible but tough connective tissue that covers the ends of bones at joints. Age, injury, heredity and lifestyle factors all affect the risk of OA.

Why Obesity Matters

OA has a logical link to obesity: The more weight that’s on a joint, the more stressed the joint becomes, and the more likely it will wear down and be damaged.

“Weight plays an important role in joint stress, so when people are very overweight, it puts stress on their joints, especially their weight-bearing joints, like the knees and the hips,” says Eric Matteson, MD, chair of the rheumatology division at the Mayo Clinic in Rochester, Minn.

Every pound of excess weight exerts about 4 pounds of extra pressure on the knees. So a person who is 10 pounds overweight has 40 pounds of extra pressure on his knees; if a person is 50 pounds overweight, that is 200 pounds of extra pressure on his knees. “So if you think about all the steps you take in a day, you can see why it would lead to premature damage in weight-bearing joints,” says Dr. Matteson.

That’s why people who are overweight are at greater risk of developing arthritis in the first place. And once a person has arthritis, “the additional weight causes even more problems on already damaged joints,” says Dr. Matteson.

But it’s not just the extra weight on joints that’s causing damage. The fat itself is active tissue that creates and releases chemicals, many of which promote inflammation.

“These chemicals can influence the development of OA,” explains Jeffrey N. Katz, MD, a professor of medicine and orthopaedic surgery at Harvard Medical School and Brigham and Women’s Hospital in Boston.

This effect can be seen in the numerous studies that have linked extra weight to hand OA. “Obviously, you don’t walk on your hands, so there may be something that is produced by fat cells in the body that causes the joint to break down more rapidly than it might otherwise,” says David Felson, MD, a professor of medicine and epidemiology at Boston University School of Medicine.

For both reasons – excess joint stress and inflammatory chemicals – fat should be kept in check among all people, especially those who already have OA.

For more info on how Excess fat can Affect The Bones with various conditions click >>>  How Fat Affects Bones

## 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.

Before you take one more bite or swing into that fast food place stop and consider how it affects your health. I have osteoarthritis (OA) and Osteonecrosis and what I eat definitely effects my levels of pain and inflammation.

So I started to help myself by eating mostly plant based but I am a flexitarian.

Did you know 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.

In a 2017 study 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.

For me I went to a mostly plant based lifestyle to help ease my pain from Osteonecrosis and Osteoarthritis in late 2016. And I know that I have less pain.

I’m not cured and there are still days when I feel like crap. But it’s not everyday all day like it was before.

We have to fight back

The solution is to change the way we eat. Switching to an anti-inflammatory or Mediterranean-style diet can help you significantly improve your joint pain , and help your heart and  brain health and the food tastes great.

An anti-inflammatory diet is heavy on fruits and vegetables, whole grains, fish and healthy fats like olive oil, avocados and nuts.

Poultry’s and fish are 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.

For me it’s also gluten because I have a sensitivity to it.

It takes a little work in meal planning but the benefits are worth it.

Stay tuned an example of what to eat will be in my next post.

Remember

The food you eat can be either the powerful and healing or a form of poison.

You are what you eat.

Have a fantastic day

Deb Andio

xoxo

References

https://www.sciencedaily.com/releases/2017/05/170523190029.htm

https://www.health.harvard.edu/nutrition/can-diet-improve-arthritis-symptoms