Thursday, February 28, 2019

How I Went To A Plant Based Lifestyle

How I Went To A Plant Based Lifestyle 
To Help My Pain From Inflammation

 It wasnt just suddenly but the more plants I ate the better I felt I am a flexitarian as I will eat chicken fish 1x a week and beef 1x a month
Going Plant Based & Helping Lower Inflammation and Having Less Pain
For those who don't know, a plant-based diet is about eating mainly fruits, vegetables, legumes, and whole grains. Animals or animal products are consumed only in small amounts, if at all.
If you're curious about adopting a plant-based diet yourself, here's how you can start:
You don’t need to eat meat to get your protein. Eating this way is now second nature, but it didn’t come easy at first.
Start slow if you eat meat 2x a week go to 1, if you eat meat 4x a week go to 2. It’s easy to get carried away and attempt to make several big changes once you’ve had success with a few small ones. It may take a while to reach your end goal, but moving slowly gives your taste buds a chance to adjust, lessening the shock of any one change

Limit processed foods and meat.

The first thing you need to do is to start limiting your intake of processed foods and meat. This may not be easy since most of these foods are high in artificial sugar, fructose corn syrup, sodium, and other chemical additives. Your body might crave these things at first, so be aware.
When you first start out with a plant-based diet, it’s easy to get caught up in it and trying to do to much to fast . I remember spending ages searching for expensive ingredients, and obsessing over my micro-nutrient intake.
If your diet seems too complicated (or too boring), it’s unlikely you’ll stick to it long term, so it’s important to strike the balance between variety and simplicity.
We ate meat almost everyday. So I started to make half our plate

Know your plants.

There are a lot of vegetables and fruits in the market today, but some are more popular than others. Educate yourself on different vegetables and fruits that you might not know much about to expand your horizons. Knowing how to prepare them properly helps too

Start adding more plant foods.

Start incorporating plant foods into your daily meals. You can also start eating fruit for a snack instead of chips and cookies. By gradually adding plant-based foods into your diet, you're getting your body and mind used to it.'t like a particular vegetable, preparing it in a new way could completely change that.

Eating plant-based, whole foods means fueling your body from the following food groups:
WHOLE GRAINS – This group includes brown rice, millet, oats, barley, corn ( I limit corn because its mostly GMO ) , bulgur, freekeh, and all products made from whole grains including bread, cereals, pastas, and more. Whole grains are filling but have very little fat.
LEGUMES – This group includes beans, peas, and lentils. They are hearty, high protein foods that are rich in calcium, iron, cholesterol-lowering soluble fiber, and even traces of omega 3 fatty acids.
VEGETABLES – These foods are loaded with vitamins and minerals, are very low in fat, and like all plant foods, have no cholesterol at all.
FRUIT – These are vitamin rich and have no cholesterol. They do have natural sugar but are low on the glycemic index, except for watermelon and pineapple.
Before we’re getting right into the vegan meat of the matter, there are a few tips to consider that can make your meal planning journey a lot easier, less frightening, and much more exciting! We really want you to succeed and this means that you’re enjoying the process as well as the results here.
So, here are our top starting tips:
Keep a food journal to track which meals you and your family liked as well as how much effort or time they require, so you know if and when to include them in your next meal plan.
Go for easy meals in the beginning, maybe just 3-4 ingredients each. An example would be rice, beans, broccoli, and avocado. These dishes don’t require a lot of skill or time to prepare and can be batch-cooked easily.
Speaking of which, start batch cooking single ingredients for fast meals. Think beans that can be eaten with rice, in a soup, salad, or pureed and grains which can be used for stir-fries, salads, stews, bowls, or breakfast porridge.
Look out for recipes you could easily double for leftovers to take to lunch like great tasting chili’s ,soups, or bean burgers.
Plan meals you’re already familiar with, replacing the animal-based foods with vegan counterparts like tofu slices for chicken and pureed beans for cream cheese.
Keep collecting recipes that look interesting and try a new one every week when you have more time. You can use the internet for some inspiration!

What to Eat

So what do you eat when you’re on a plant-based diet that focuses on whole foods? Lots!
A few categories of foods to include regularly:
  1. Beans and other protein. This means the regular kinds of beans, like lentils, black beans, kidney beans, pinto beans, garbanzo beans, etc. But it can also mean soybeans (edamame), tofu, tempeh, and seitan (protein from wheat, not good for gluten-intolerant people). It can also mean soy milk, soy yogurt, and the like, which are often fortified. Get organic, non-GMO soy.
  2. Nuts and seeds. My favorites include raw almonds and walnuts, along with ground flax seeds and chia seeds, and hemp seed protein powder. Almond and Cashew milk is also good. And quinoa it’s like a grain, but really a seed, and full of nutrition.
  3. Good fats. Fats aren’t bad for you — you should just look to avoid saturated fats. Luckily, not many plant foods have saturated fats. Plants with good fats include avocados, nuts and seeds mentioned above, olive oil and canola oil.
  4. Greens. This is one of the most important and nutritious group of all. Dark, leafy green veggies are awesome, and full of calcium, iron and a ton of vitamins. My favorites: kale, spinach, broccoli, romaine lettuce,leaf lettuce chard, napa and all cabbage,collards. Eat lots of them daily! They also have very few calories, meaning they pack a ton of nutrition in a small caloric package.
  5. Other fruits and veggies. Get a variety — I love berries of all kinds, figs, apples, citrus fruits, peaches, mangoes, bananas, pears, red and green peppers, garlic, beets, celery, cauliflower … I could go on all day! Get lots of different colors.
  6. Good starches. Starches are not bad for you — but ones that have little calories aren’t great. So find starches that give you lots of nutrition. Sweet potatoes, red potatoes, squash, brown rice, sprouted whole wheat, steel-cut oats, among others.
  7. Some other healthy stuff. I love red wine, green tea, cinnamon, turmeric, spirulina and nutritional yeast.
OK, by now you might be overwhelmed by all of this. How do you put it together? It’s not that hard once you get used to it. Start learning some recipes that combine some of these foods into meals, and over time, you’ll have a few go-to meals that you love that are full of nutrition.
Some examples that I like (but don’t limit yourself to these!):
  • Tofu scramble w/ veggies: some organic high-protein tofu crumbled and stir-fried with olive oil, garlic, diced carrots and tomatoes, spinach and mushrooms, and spiced with tamari, turmeric, sea salt and coarse black pepper.
  • Steel-cut oats: cook some steel-cut oats, then add ground flaxseeds, raw nuts, berries, cinnamon.
  • Stir-fry: Here’s my secret … you can make an endless combo of meals by cooking some garlic in olive oil, then cooking some veggies (carrots, bell peppers, mushrooms, etc.) and some protein (tofu, tempeh, seitan, etc.) and some greens (kale, broccoli, spinach, etc.) and some spices (turmeric or coconut milk or tamari & sesame oil, black pepper, salt).
  • Veggie chili over quinoa: Black beans, kidney beans, pinto beans with olive oil, garlic, onions, tomatoes, bell pepper, diced kale, diced carrots, tomato sauce, chili powder, salt, pepper. Maybe some beer for flavor. Serve over quinoa or brown rice.
  • One-pot meal: Quinoa, lentils, greens, olive oil, tempeh (or a bunch of other variations). Read Tynan’s post on cooking this all in one pot.
  • Whole-wheat pasta: Serve with a sauce — some tomato sauce with olive oil, garlic, onions, bell peppers, diced kale and carrots, diced tomatoes, fresh basil, oregano.
  • Big-ass Salad: Start with a bed of kale & spinach, throw on other veggies such as carrots, mushrooms, cauliflower, snow peas, green beans, tomatoes … then some beans, nuts and/or seeds … top with avocado. Mix balsamic vinegar and olive oil, or red wine vinegar garlic and olive oil, sprinkle on the salad. Yum.
  • Smoothies: Blend some almond or cashew milk with frozen berries, greens, ground chia or flax seeds, hemp or spirulina protein powder. Lots of nutrition in one drink!
  • Snacks: I often snack on fruits and berries, walnuts, celery with hummus.
  • Drinks: I tend to drink water all day, some coffee (without sugar) in the morning, tea in the afternoon, and red wine in the evening.

There is protein in vegetables and grains, and even more in beans, nuts and seeds.
I do take vitamin B-complex to make sure i get enough
For Iron i use a cast iron skillet : but these are a good source of iron
Legumes: lentils, lima beans
Grains: quinoa, fortified cereals, brown rice, oatmeal
Nuts and seeds: pumpkin,squash, pistachio, sunflower, cashews, un-hulled sesame
Vegetables: tomato sauce, swiss chard, collard greens,
Other: blackstrap molasses, prunes and juice


Minestrone Soup

  • 1 onion, diced
  • 4 stalks celery, thinly sliced
  • 4 carrots, thinly sliced
  • 8-10 cups chicken or veggie stock
  • 1 can diced tomatoes low salt
  • 1½ cups fresh or frozen green beans
  • 1½ cups cooked white beans ( or 1 15 oz. can)
  • 1½ cups cooked red beans (or 1 15 oz. can)
  • 1 tsp dried oregano
  • 1 tsp garlic powder
  • 2 cups spinach
  • 4 cups gluten-free noodles
  1. In a big pot, add onions, celery and carrots. Saute them until they start to brown and the onions get translucent.
  2. Add stock diced tomatoes, beans, and green beans.
  3. Add dried oregano and garlic powder.
  4. Simmer until all veggies are soft.
  5. About 15 minutes before serving add noodles. (I'll sometimes cook noodles separately since some GF noodles are fragile.)
  6. Cook until noodles are soft, about 10 minutes
  7. 5 min before serving add spinach

Taco Salad

  • Lettuce ( prefer a mix of greens and romaine)
  • Cooked Beans (I use pinto, black beans )
  • Cooked Grains like left over mexican brown rice recipe below
  • Cooked Corn (I just buy organic frozen corn)
  • Pico de Gallo or salsa
  • Avocado, sliced
  • Lime Juice
  • Crispy Corn Tortillas* or Tortilla chips (Optional)
  1. Layer all ingredients into a large bowl (I use a serving bowl for me) except the tortillas/chips.
  2. Toss the salad so everything is well mixed and add a few chips for crunch.

Mexican Rice


  • 2 1/2 cups of water
  • 1 cup of brown or black rice I sometimes I use quinoa also
  • 8 oz tomato sauce
  • 1/8 tsp salt (optional)
  • 1 tsp onion powder
  • 1/2 tsp garlic powder
  • 1 tsp cumin
  • 1 serrano pepper de seeded and chopped
  • 1-2 Tblspn cilantro
  1. Dump all of the ingredients except cilantro into a skillet and turn on medium heat.
  2. Cover skillet with a lid and set timer for 25 minutes. After 5 min turn heat to low.
  3. When timer beeps give the rice a good stir. If liquid remains remove lid and let the rice cook a few more minutes to allow liquid to evaporate.


Pesto Penne

  • 8 ounces dried penne pasta I use Gluten Free
  • 2 -3 cups 1-inch broccoli florets
  • 1½ cups packed with fresh basil leaves
  • 1 cup water
  • 2 to 3 cloves garlic, coarsely chopped
  • 4 Tabspn olive oil
  • 1 15-ounce can garbanzo beans (chickpeas), rinsed and drained
  • 1 cup unsweetened almond milk
  • 1 cup halved cherry tomatoes
  • Crushed red pepper, to taste (optional)
  • Sea salt, to taste
  • Freshly ground black pepper, to taste
  • Lemon zest optional
1. Cook pasta according to package directions; drain. Meanwhile, in a small saucepan cook broccoli in a small amount of boiling water 5 minutes or until tender; drain.
2. In a blender combine basil, ½ cup of the water, olive oil,and the garlic. Cover and blend until finely chopped.
3. In a large saucepan mash garbanzo beans with a potato masher, leaving some beans intact. Add milk and the remaining ½ cup water. Bring to boiling. Stir in basil mixture, tomatoes, and, if desired, crushed red pepper. Reduce heat. Simmer 10 minutes or until tomatoes are slightly softened.
4. Stir in cooked pasta and broccoli. Cook over medium-low 2 to 3 minutes or until heated through. Season with salt and black pepper. To brighten dish add some lemon zest.

Here are a couple links to get other recipes vs mine

If you have any meatless recipes please feel free to post them so others can try and enjoy !!




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Thursday, November 22, 2018

Giving Thanks Everyday

Give Thanks To Our Creator
Often in pictures of the pilgrims someone is usually praying and giving thanks.
Think about how you have been blessed this year and all the years in the past. Because you have been blessed.
Psalm 100 :1-5
Shout joyfully to the lord all the earth serve the lord.
Give thanks to him bless his name
The lord is good
Faithful to all generations
God is faithful to us all,even when we are not as faithful to him. 
In spite of all I have been through in my life I am grateful and thankful for everything I have gone through, good and not so good because through it all I have learned one thing.
God will never leave me. I am never alone.
I take time to give my thanks to God throughout the day.
It seems like it gets less and less recognition every year.
Where is it in your heart?
It’s on the calendar but it seems like we go from Halloween to Christmas.
We are forgetting to give thanks to God our creator ,for our life , our job, grateful for knowing god, grateful for seeing you thrand never leaving you. The source of all our blessings.
We seem overlook all that is precious to us, and the source of all our blessings .
The world is changing and not always for the better. Sure we have better technology, drug treatments for some illnesses but people? Mmmm so many seem to have lost the light in their soul or don’t know it’s even there. Some instead of being grateful focus on things that are negative and it's interfering with gods blessings.
We moan and groan about everything.
Don’t pray
We can’t have a nativity scene,we can’t pray in school, and it seems we can’t even remember to give him thanks on thanksgiving.
Here are a few reason why we need to give him thanks everyday and especially on thanksgiving.
Think about the impact of thanksgiving on our life.
Thanksgiving keeps us continually aware that we are walking in his presence which contrived to living a godly life.
Reasons For Giving Thanks 
1. Give Thanks as we are walking with God. He has never left us. We may have left him but he is and always will be there for us. We must show him gratitude.
2. Everything that happens in our life is for a purpose. It should motivate us to look for his purpose in everything that he allows in our life.
3. Helps us seek out God in suffering , pain and loss. Loneliness is a horrible feeling... but Jesus is always there. He will never leave us !
4. Reminds us we need god in our life. We are dependent on God. We need him every day ,all day. We often overlook what is most precious.
5. Of all the things we need to be grateful for is that we have Jesus in our hearts so we need to live a life of goodness.
Do you ever just thank god you got home safe today?
Or thanks that we are able to buy food to eat and nourish our body?
We often over look what is most precious, and focus and dwell on negativity.
Stop asking god why did you allow this to happen to me.
No one lives an easy life.
So just stop and thank god everyday.
Whatever your struggling with he is there with you.
I can’t always understand why things are happening in my life. It’s not his obligation to explain it but he is there to see you through.
So I find joy in the lord in the midst of suffering. And he always sees me through.
God gives me peace when I become anxious or worried. If you get bad news in a friend or family member remember, Jesus said my peace I give to you.
Learn to thank him for everything and anything going on in your life. You have been blessed.
And he will always see you through the good and not so good even when we don’t understand what’s happening in our life, give God thanks for seeing you through.
The apostle Paul knew all about suffering but he writes about the glory of God.
If your wondering where god is ..... he is right there inside you. Ask and he will always see you through.
And give thanks in everything going on in your life.
Have faith it will be ok.
And live as if your prayers have been already answered. I know sometimes life can become weary, It can cause us to lose hope , lose faith
No matter who we are ,where we are never forget god loves us. He is always our perfect hope.
So this thanksgiving give thanks to God for everything happening in your life. Yes.....everything
Today, as we gather with friends and family or if we’re eating alone for Thanksgiving, may we always remember that it is only by the grace of God that we live in a land of plenty. Together, may we give thanks to the Lord, the Source of all good gifts.
May you have a blessed day and I pray everyone reading this has a fantastic blessed day and that they know God you are right there where you always have been , right there with us.
Show us how to live a life of thanksgiving, work in our hearts today and everyday.
Happy Thanksgiving 


Thursday, October 4, 2018

Bone Marrow Edema & 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 aka Osteonecrosis , 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.


Hip Study



If you have #Osteonecrosis feel free to join our #group
Avascular Necrosis / Osteonecrosis Support Int'l.

Wishing you a pain free and fantastic day

Saturday, September 29, 2018

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 shoulder and hip, but also can occur in the knees and really anywhere else in your body that you have a bone.
I was diagnosed in late November 2014 and that's the day my working -active life changed....
Back in July 2014 I was doing an intense dvd workout when i felt a sudden stabbing pain that sent me to the ground. 
I felt like i was hit with a lightning bolt in the knee cap.
I stopped what i was doing and got some ice and hobbled to the sofa and rested my knee.
The next day I made an appointm, I mean ent with my pcp 
My PCP did the  McMurray test tocheck for a medial meniscus tear and oedered an mri and pt.
PT was killing me. I felt like i did more and more damage every time i went to pt. So I stopped and told my pcp i would like to wait until after mri. He agreed
Now into late August I had MRI 
PCP appointment mid September 2014 and it confirmed medial meniscus tear of the femoral condyle.
Back to pt 
Well after 2 weeks of trying my best  I could not walk any better in fact I felt worse and I was getting pissed off.  PT should maybe feel discomfort but not intense sharp pain
So again I advised PCP 
He suggested to stop it once again
Here we are into October
He then referred me to and orthopedic because it was just " a medial meniscus tear and nothing broken I had to wait a few weeks to get in. All this time the pain in my never eased up never...It was becoming exhausting and going to work was brutal.
Finally I get in to the ortho's office he had no personality at all . He entered the room and said well your knee looks like butter.
I asked to explain
He said I had osteonecrosis and i will need a joint replacement when my knee collapses as I have what they refer to as death of the bone. 
All my brain heard was death, my heart started to race, he then told me he was giving me a shot for the pain and he wanted me to wear a knee brace for a few weeks rest is as much as possible and no work . He said limit all weight bearing....
Hello............standing and walking is weight bearing
He said the brace will help and come back in a week when the brace is in ,and out the door i went.....
Scared and pissed off I never heard of this , so I went home researched it  and was in panic mode for a few days .
My job was standing so now i cannot work either .
I loved my optician job.
So i tried to do only pretesting patients i could sit more , that was  not helpful at all.

Finally the brace was in , 240.00 later a donjoy special knee brace.

It was great when it stayed up on my leg, it liked to slide down...LOL
The pain is nearly unbearable  this has to ease up....
Sometimes its hard to move....

I kept researching because I feel like one torn meniscus caused me to get this . The doctors aren't sure.
the pain is all day everyday.....

Doctors don't listen

It took a couple years to research and find things that dont cure but help the pain..

I will post on that  next week....

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.


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).


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.


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

maging studies will help your doctor confirm the diagnosis.

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 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.


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


It's Flu Season

It's flu season .... Have you got your flu shot ?

Cold and flu season is here
Look into the aisles of any local pharmacy or grocery store and you will find more than 20 over-the-counter medications available to treat the symptoms of fever, headache, sore throat, and achy muscles. Many of these “multi-symptom” products contain acetaminophen, the active ingredient in Tylenol. This means cold and flu sufferers who are using multiple combination cough and cold remedies may inadvertently be taking more acetaminophen than they intend and putting themselves at risk for a serious complication: acetaminophen-induced liver toxicity.
Read The Labels
The problem with too much acetaminophen
Nevertheless, you may not realize that acetaminophen is an active ingredient in a combination medication unless you read the label carefully. For example, NyQuil, Theraflu, and Percocet (oxycodone with acetaminophen) all contain acetaminophen. Unfortunately, using multiple products that contain acetaminophen can result in accidental misuse and overuse, as well as potential liver damage.
Acetaminophen is primarily processed in the liver. The liver breaks down most of the acetaminophen in a normal dose and eliminates it in the urine. But a small portion of the drug is converted to a byproduct that is toxic to the liver cells. If you take too much acetaminophen — all at once or over a period of several days — this toxic breakdown product can build up and cause damage to the liver.
What this means for your cold and flu season
Acetaminophen is a safe and very effective drug. The vast majority of all patients who take this medication to treat common symptoms of pain and fever will find relief with appropriate use. However, even when in the fog of cold or flu symptoms, be careful to read the label of any cough, cold, or pain medication for the amount of acetaminophen in the drug so that you don’t inadvertently take too much. If unsure, ask a pharmacist for assistance in how to safely use combination medications that include acetaminophen.

Finally, keep in mind that in most cases, viral illnesses such as the common cold and flu generally get better on their own with rest, fluids, and time.

Also if you can get your flu shot and if you happen to get the flu
Give these a try today.
Don’t go to work sick
Stay home and get plenty of rest.
Mind your flu manners.
Drink plenty of fluids.
Treat aches and fever.
Take care of your cough.
Breathe in steam.
Run the humidifier.

Treat it and the aches that come with it with over-the-counter medications like acetaminophen, ibuprofen, or naproxen. Ask your doctor which is right for you.
Never give aspirin to anyone younger than 19. It’s linked to a condition known as Reye's syndrome, a serious illness that can damage the brain and liver.

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