Arthritis or Something Else?
By the age of 19 I had been dealing with Lupus for a bit over 8 years. My medical chart was so thick that they only sent 1/4 of it when I had my appointments at the clinic. I had suffered most of the complications of Lupus within those years already and I pretty much knew what was normal for me and my body (people it's important to know your bodies and recognize changes).
I began to experience a new pain, a pain in my hips. As you already know, if you've been following, my first symptoms were arthritis and inflammation of various joints, so it was reasonable to think that this new pain was arthritis related to the SLE. Nothing I took, however, took away the excruciating pain. One of the doctors had an idea as to what it was and I was sent to and orthopedic clinic (yes another type of doctor) so that we could find the source of this NEW chronic pain.
Of course Ortho Clinic was on a different day so I couldn't see them on the same day that I saw my Rheumatologist even though it was in the same building and even on the same floor. I registered and I waited....I waited....and I waited some more until finally I was called my the triage nurse who took my vital signs and then sent me upstairs to get X-rays before I saw the doctor. I went up stairs did some more waiting to get the x-rays done and then took the stairs (in pain) back to the fifth floor. At this point I was so aggravated with the running around I could've screamed but the doctor called me in quickly (thank God). No it wasn't arthritis this time...
...I had what's called Avascular Necrosis (AVN), specifically Bilateral Avascular Necrosis because I had it in both hips; the left definitely more affected then the right hip. Avascular Necrosis is basically death of bone tissue. This usually happens when blood flow to the bone is interrupted, whether by fracture or disease. But in my case however, as in many cases, it was as a result of prolonged use of Corticosteroids for the treatment of SLE flares. The last reason why someone may develop AVN is the excessive intake of alcohol.
The good news is that it wasn't arthritis, the bad news is that nothing can really be done for it other then maybe some type of osteoporosis treatment and or surgery when it gets REALLY bad. So my doctors opted to put me on an osteoporosis regimen for a while, but after a while I couldn't take the pain in the left hip; something was seriously wrong!!! So I go back to Ortho Clinic (about 6 months later) and got new x-rays done; the left hip had totally collapsed.
So now surgery was in order...I was submitted for a clinical trial for a type of ceramic hip replacement. It was a double-blind trial some people received ceramic hips, and others just the regular types of hip replacement joints. After I was told that I received the ceramic and truthfully to this day I haven't needed any repair.
Hip surgery is a very delicate surgery, because there is a risk of loosening and popping it out of place within the first six month while its healing. My surgery was scheduled for January of 2000. I went in and had the surgery, was knocked out for the rest of the day (from the anesthetics) and by the next day I woke up on my back with a triangle between my legs. Right after surgery I was required to sleep on my back with this triangle between my legs, also for up to six months. I would not be allowed to sleep on my sides or on my stomach, I was not allowed to cross my legs at all. On the second day the physical therapist began getting my out of bed. She taught me how I should get in and out of cars as to not injure the hip as it was healing. I also had to have special bathroom furniture and be super careful not to bend at the hip, etc,etc,.
I was discharged after about a week and I'm proud to say that I left on one crutch; which according to everyone was unheard of but I worked hard during my rehabilitation. A physical therapist came to my house for the next 6-8 weeks, 3 times per week and with his help I was back to my self in no time. The pain that I experienced during therapy and the healing process was no way like that of what I had experienced before the surgery. Overall the surgeons did an excellent job.
Up to date I haven't needed to have the right hip done, however, I do know that it will have to be done in the future since there is some bone death. I also know that I praise a miracle worker who is able to heal any and all infirmities so all I can do is enjoy the now.