Osteoarthritis At age 22?

​I appreicate the rheumatologist says there is OA. The reason he is probably saying this is becuase he can see osteophytes and can show them to you. However, the radiologist has not entirely ruled out a labral tear. In addition, you have edema - bone lesions, one of which has healed and one which has got worse.   Athe stage of OA you are at, you dont normally get lesions - they are more linked to either injury and tears or to auto-immune arthritis.  So if it was me, i would not accept this just yet especially as the radiology report does not state that your cartilege is bone on bone.  So i would get a copy of all your xrays, get mri on a CDROM - the hospitals normally chage about $15 equivlent for this in UK and go see a top orthopod as you are going to need one. At this point, action, as i said previously required. Surf the internet looking for the best orthopaedic guys in the top 3 teaching hospitals in NY.  Then look at their consultant resume. You need someone in their 40's actively engaged in sports injuries of the leg and stem cell stuff ideally.

​They wil then make much more detailed investigation as to why you have the osteophytes and whether this can be corrected in a number of ways, either by e.g compression, microfractures, stem cells.  Do your finals first and concentrate on them as thats important. Then get on the case and DONT GIVE UP YET. I understand why the rheumy has said OA but that isnt the end of the story yet in this instance. Depending on what is causing this, there are different treatments which will be offered to you compared to aging-type OA.  The rheumy does not seem in this instance to have worked out why the osteophytes may be appearing and this may be dur to labrum or to the scoliosis which in turn is affecting leg.

​You need a top orthopod. Do your exams and then immediately get on the case. Dont despair as you have not got all the story yet.    PIlates wont harm you in the meantime but i;d do your exams first and park all of this for a month and then get on case - and nothing will be more important in your life at that point in getting the right guy to treat you. Action plan called for.  SUggest:

​1.  Do exams and park this.  if you start to worry, just sya, "no, i'm going to sort it in 3 weeks'.

​2. Get your xrays and mri on disc as this will save cash

​3. Research which orthopod to see in NY

4. Write to JH for help ASAP. They wont make you wait months. They may be able to advise on someone in NY

​5. Ask ortho guy a) about edema b) about scoliosis c) about what physical therapy you need to correct either. Dont do much in meantime.

​6. Change your diet to ensure you get rid of the edema - give your body all the nutrients it needs naturally. REsearch it. Quite a fmaoud chef in NY who is widely reported as changing his diet - google, will give you some hope.

​7. Get a veggie cook book so you dont get bored and learn to cook!

​8. Start researching which are the physical therapists in NY who are speciliast inmusculo-skeletal issues and specifically scoliosis of lumbar spine / hip - but who are also into sports injuries - you are probably going to need one.  Ask physios you know who they would go to.

​9. Get decent trainers to make sure you are not pronating your feet.

​i.e. decide action plan, then do your exams and then get on case. DONT GIVE UP YET. You have not got to the bottom of this yet.

​good for you.Thats the attitude.  Here are the people you need to write to:

http://www.hopkinsmedicine.org/orthopaedic-surgery/specialty-areas/hip-knee/experts.html

​Further you may not need a replacement ... depends on what is causing it and state of labrum.  Might be fixed with decompression. As i say dont give up till you know underlying issue...

http://www.hopkinsmedicine.org/news/publications/johns_hopkins_orthopaedic_surgery/johns_hopkins_orthopaedic_surgery_winter_2015/core_decompression_treats_early_stage_osteonecrosis_of_the_hip

If different issue, then they will probably keep you on pain killers till stem cells more common place. Dont go to any stem cell person - teaching hospital is key - as bit too early and a few cowboys out there.  UK just started big 1200 people stem cell 3rd stage clinical trial at Southampton and the UK national orthopaedic centre just started too.  But if necrosis, then need something different.    So the underlying thing a big deal.  The positive is actually that one edema healed itself. After your exams do everything possible to get the other one to heal. Diet key to that.

Hey if insurance is an issue, find a british girl to fall in love with and come here...): or go swot like crazy and get a job here!!... 

​always ways round these things ...the brain is a marvellous thing you know...

​I just went on a swimming course following hte alexander technique last weekend.  Google how to swim the steven shaw way - will help you -  but on that course their was a guy whose wife had been diagnosed with lupus some years ago and had been in terrible pain.  She went on a clinical trial for 3 years and went into remission and got much better.  then the trial stopped. After a further year they re-contacted the hospital to beg them to give her back the drugs she had been on. When they looked up, they were stunned to find she had been on the placebo only.  They believed that because she believed she was on something that was making her better, less crtisol was released less stress and the chemical change was enough to stop the protease enzymes attacking the joint. 

​The team i work with at Southampton are also interested in for example placing a little box in the neck which has a magnet as gys in Amsterdam worked out the vagus nerve turns on and off inflammation. So when the pain flares, the patient turns on the magnet and turns off the immune system.   Neither of these things will help you but i write to show you things being done and this is at forefront of medical advancement... the drug companies are vying to be the first to find a cure for arthritis as its worth billions and there are 3 avenues of research:

​1. stopping the chemical reaction in the joint where the protease / free radicals are destroying it. This is where tons of antioxidants helps in meantime

​2. Stem cells to repair it

​3. Controling inflammation via vagus nerve or other route.

​So you see, you have an issue. But it is not insurmountable. Granted you cant take a pill and it will go away, but with a bit of action and commitment you will be OK. You have a life to live trust me on this. A wonderful life.  Its a challenge but its not life threatening.

​Go swot to keep all options open!!

​you need to get to an orthopod to ascertain what is the underlying cause. IF this is e.g. necrosis (which is lack of blood supply to the joint) then the standard treatment would be compression (they stick a screw in to stabiise the joint) which delays hip replacement for many years. In other cases in early OA, with different underlying causes, they may try microfracture where they drill tiny little holes in the bone which helps the cartilege to stabiise. Different treatments for different underlying issues. The edema gives them an idea of what is causing the underlying issue and sounds as if it could be a scoliosis of the lower back which has meant you put more pressure on one side than the other and then when you start favouring one side, the other goes.   This is why you need a good orthopod.   It is a bit different at your age compared to older adults (who are wearing out per se). 

​However, OA is not a continual disease in a straight line. It is more accurately described as wear & repair & wear etc.... there are periods when it flares a bit and then the body repairs itself and then something triggers the next flare.  So dont despair on the right leg as might just be on a flare.  Take heart in that one of your edemas healed. Eating right will give the other a chance of healing.  What happens is that generally in "inflammation",  which sounds innocous but is not, is that free radicals get out of control. These are uncharged molecules which have an unpaired electron. They are highly reactive and normally short lived. When we eat anti-oxidants, they attach themselves to the free radicals and destroy them. Good.  Too few anti-oxidants and the free radicals cause damage.  So you cant really go wrong eating a lot of natural anti-oxidants (rather than supplements as supplements dont have the specific thing included in them to destroy free radicals as well).  Also high doses of supplements will interefere with how your body absorbs other vitamins. Personally, i feel much better when i come off supplements with perhaps the exception of vit D. However, if your have an underlying bone issue ,they may prescribe you high doses of Calcium.  THis is where you need a good orthopod.   But generally you cant go wrong if you eat them rather than take them.  High Anti-oxidants are pretty much any fruit, especially berries - anything red or black or dark is generally mch better e.g. red/black  grapes, red/black cherries, blackberries, raspberries, blueberries;   Nuts - 3 Brazil Nuts a day give you your daily allowance of selenium which most people are weak on;  Selenium is an anti-oxidant you need. Any nuts will do but brazil nuts very good for selenium but you only need 3 a day as they have 33 calories in each! You then - wait for it - need dark gren veggies - i find it better sauteed; replace potatoes with sweet potatoes - again anything orange or red etc always has a lot, then eat FISH, So basically eat a lot of roasted veggies with fish done in the oven - really easy as fish only takes 10 mins to cook; just chop up a ton of veggies and chuck them in the baking tray with olive oil. Yummie. Or sautee them off and have with omlette. Learn to cook.....its quite fun... never used to as i ran a business but got into it now and have way fewer flares now.

​Dont worry about your right leg - probably on its first flare and will die down. However, mainly dont worry about it until you have seen a good orthopod  as they will work out the underlying cause, the treatment you need and the physical therapy you need to rebalance it especially if you have a scoliosis - you might just need a wedge in one shoe to balance or something. This is where a top guy really helps.

​The name of the game is that if your pain is 'flaring' and hurts, then normally take ibuprofen & codeine to get rid of the inflammatin fast - maybe for a few days. Then come off it. Always eat right as you have a propensity for damage so need to be more careful thanthe general population. Get rid of inflammation causing foods - red meat, alcohol, wheat, sugar, especially when its hurting as you are fedding the free radicals. You will get used to it.... inflammation is your enemy. You will enjoy it the more you learn to cook.... you need to love fruit & veg & fish & Nuts & Seeds & chicken...

​Swimming... earn to swim the Steven Shaw way - videos on google - will help you.

​The joint also needs movement in order to release the good chemicals. So worst thing is to become sedentary. BUt if it is hurting better to do pilates or yoga for movement and muscle building. When it is less painful (in a healing phase) then walk - i personally feel much better doing 5 miles per day than 3. I track on i-phone.

​It takes about a year of doing the above to feel much better. However, you have an underlying issue re the edema and scoliosis which the orthipod needs to provide specific advice on so in the meantime i;d just cut the supplements, get cooking anti-oxidants, do pilates as none of that will harm you, until you get top whack advice on exactly what is going to really help your specific issues.

Dont give up on stem cells if cartilege issue - get yourslef on a trial - they are run for free.... lots of clinical trials being run now at 3rd stage - i.e. pre going live on national population.  Write to JH - they will be interested in you due to your age. Dont give up - expect to find as many duff doctors as good ones and if you find a duff one to start with, dont give up, just keep going till you find one who knows their stuff.   You are NOT going to be disabled by this - the next bit of the action plan is to change diet, get to middle or lower of your bmi on weight; take up pilates; get a very good orthopod.   All of this will help you and get rid of inflammation.  Inflammation is your enemy. Do everything possible to get rid of it by natural means and when too much,through anti-inflammatories but go low on the latter unless on a 'flare' when more important to get rid of inflammation than to live with it.   If you are tempted to eat a massive burger for dinner with a beer, then just rememeber its going to eat your joint. I find the image unappeaing and it puts me off.

​There is a good book on Amazon on this called Arthritis RX. Also a chef in New York 'cured' his RA (which you dont have) by changing diet and this is worth looking up as the diet is good. Google Seamus Mullen New York.  Finally, if you need a bit more of the upsied... Novak Djokovic the no 1 tennis player was brought up by parents who owned a pizza restaurant. He ONLY won his 1st slam event after changing his diet... look it up as thats the diet you need to be on.... he is quite religious about it so easy to find on google.

The diet - especially cutting out wheat, sugar etc will control the inflammation to some degree as it gets rid of free radicals causing damage - but you still need a good orthopod - but you can wait 2 weeks till after your finals...

Keep your spirits up which is hard i know but you will be OK. Try not to be frightened as the cortisol doesnt help. If in huge pain take some nurofen plus - dont know what it si in USA - nurofen + codeine to lower the inflammation.  I'd probably take that thourhg my finals and then go find an orthopod.   Take care - if you feel down, just write... you will be OK. 

​you remind me of that scene in the movie Titanic when Jack is saying to the girl "you wil be ok Rose, you will live a long and happy life and have grandkids..." and she does. So might seem like you are sinking but you really are not... lots to be done yet and the rate of progress is quite fast so hang on in there... centre your brain on an action plan and top of that list is to do well in your finals.

In 23 myself, and also have osteoarthritis and carpal tunnel in my wrist.

When I was in the army 4 years ago I broke my scaphoid during training, and my doctor mentioned that taking half the scaphoid out would be more beneficial than putting in a screw.

So, I agreed and he did the surgery. I did occupational therapy for almost a year, with literally no results what's so ever. My wrist is actually worse now.

I ended up getting medical separated from the army after 5 years of service.

Now, I have severe arthritis and carpal tunnel. My wrist is always swollen, aching pain (sometimes very sharp stings), and lately I haven't been able to sleep because it hurts so bad and it's very bothersome.

No doctors will help me, basically gave me anti inflammatory medication.

Long story short, yes you can have it.

​They have not really made clear to you if you have a back issue which has affected your hips or a hip issue etcetc. They have presumably from the MRI and X-ray come up with a clinical diganosis of OA based on that fact your bloods are pretty normal and presumably your x-rays show joint space narrowing.  What have they explained to you in terms of what you should do / what meds to take / how badly the joint is affected?  What is the follow up they have suggested at the current time?

​The vit D  level is VERY low. Supplements are OK but they are not as good as sun - you need at least an hour a day outside to boost this and there is a correlation between arthritis and low Vit D. HOwever, the population at large normally has low Vit D levels in winter - but this is VERY low - mine is low at 44 for example and i make every effort to be outside without suncare for at least an hour a day...

But virtually everyone in NY wil have Vit d levels of e.g. about 40, all low especially after winter...

​So the issue you have is a) soemthing is triggering this but it may be up to you to work out what as this is the forefront of medical science - everyne trying to work out triggers... hence all the exclusion diets to try and work out...  b) IF it is OA, which woudl be incredibly rare, then given your age, what did the ortho guy suggest? Did he suggest microfracture, gel, stem cells or what?  I think if it was me, then i would a) check my knees out b) ask the guy to show you ​on the xray and mri WHY he thinks there is joint space narrowing c) has it got as far as bone being on bone or is it early stage and d) if early stage, i'd personally book an appointment to discuss with a top stem cell guy.  The thing about stem cells is that within 2-3 years this will probably be the norm - the first massive trial now being done in UK - so wheras a year ago,maybe 100 done in UK, by end of year, maybe 5000. So if early stage then the stem cell guys may say wait a year... or they may say try this instead... etc.

​However, i think my gut feel is that you need to try and ascertain why the hip is going - did you ask about necrosis - as if the latter thay would almost certainly pin it and you'd be fine for some years.  What did the guy say?  What is the follow up?

I'd think the sex thing is simply because if you have an issue with your hips, then going to hurt using them...    the thing is you need to see the xrays - did they show you which side the joint was going? e.g. if on inside, did they recommend pilates to put pressure on outside etc.  If you knew which side (inside, outside) the issue was you can probably adjust your position so you don't hurt so much...

​what did they say - i dont think its good enough the guy just said nothing to be done at your age... what did they recommend...