So what's your problem anyway?

Good question. As I said in The Back Story, I have Avascular Necrosis (AVN), otherwise known as Osteonecrosis (ON). I think ON is the more modern term, although you hear AVN a lot too. Avascular=without blood, necrosis=death. So, in other words, the bone is dying because it's not getting enough blood. Osteo=bone, so osteonecrosis means bone death. Two names, one disease.

There are lots of risk factors for ON. An injury can interfere with the blood supply to a bone, which can develop into ON. Sickle cell disease and other blood coagulation disorders can make it hard for the blood adequately supply the bone. Many times ON patients have other serious problems like cancer, HIV, or lupus and the ON may be due to steriods, radiation or other treatments. In my case, I'm not sure why I have it. I took some steroids for allergies, but not the massive doses that most ON patients take. Heavy alcohol use can also cause ON, but I am (or was) a social drinker and not an abuser. Scuba diving is also related to ON. In my case, based on the timing, I think it was primarily the steroids and perhaps some sort of predisposition to it for some reason.

ON is most common in the hips. Most people who have it get it in both hips, unless it was due to an injury. The femoral head--the top of the femur bone in the leg which sits inside the hip-- doesn't have a great blood supply on a good day, so it's at particular risk. So if you hear me complaining "my hip hurts" and then "my leg hurts", it's not something new, it's the same thing. Sometimes the pain radiates down to just above my knee.

Speaking of pain--it sucks. I have heard that ON pain is as bad as bone cancer pain. Thankfully I haven't had bone cancer, so I wouldn't know. However, I have had a kidney stone, and the kidney stone was worse. Having said that, ON is no... well I want to say it's no walk in the park, but that's just sad because I really can't go for a walk in the park! I guess the best way to explain the pain is a general dull ache that makes it uncomfortable to sit, lie down, or exist in any position, which is made worse by standing up or walking. Oh yes--and then there are the occasional sharp, shooting pains when I almost trip over the cat or turn the wrong way. Before I knew what was wrong I was walking a lot more and some days could hardly get out of bed. I think the pain is still just as bad, but I'm walking less and taking pain meds, so there is probably less inflammation, and I don't feel as stiff as back when I was walking lots.