I was in a bad car accident Jan 9, 2003. I slipped under seat belt just enough for both my knees and left leg were damaged from the impact (no broken bones). I also have 3 herniated disks, 2 in lower back and 1 in neck. To help with the problem in my neck which was causing right shoulder radiculopathy a neruologist prescribed dexamethason starting with 3-4mg tablets/day. After apx 3 weeks on the steroids I got up from my chair at work and almost fell on the floor from extreme knee pain. I went home and by morning could not even move my legs an inch without excruciating pain in my knees. I felt pain all over my body in my bones but mostly in my knees. Since I had to get off the steroids slowly I had to suffer another few weeks taking the pills. Shortly thereafter a blood test showed my calcium below the normal limit. I tried to go back to work for the next month but found I was falling asleep at my desk and my knees started hurting again more every day. After seeking help with another doctor (the neurologist dismissed me immediately after he did the blood test to seek another physiciam) I found I had avascular necrosis in both knees. My knees were swolen, they cracked and even the slightest twist especially inward thwarted excruciating pain. I saw 3 doctors since; one said he couldn't find the necrosis on the MRI's and sent me off; the next one didnt review the MRI's because I couldn't get them to him for the appointment and stated to me you don't have necrosis and gave me a steroid shot in both my knees. This helped but only for apx 1 wk so I didn't go to him again; the next Dr. was a Dr. I had to go to for my employer for disability. He examined me for everything but the necrosis but did mention he saw the necrosis in the MRI's but I need further blood tests and needed to see a dermatologist. What a screw ball. I lost my disability and my job due to this Dr. I finally saw a doctor 2 hours from my home who said he can help me. He couldn't believe what the other Dr.'s put me through and said I definately need surgery. My research shows me that there is no other option because necrosis eventually leads to joint collapse. My question is: Is this my only option? I heard of a procedure where they could try to get the bone to grow again by inserting blood vessels in the necrotic area. I trust this last doctor and he is the only one who will address the situation. I feel all the other doctors did not know what to do and passed the buck. In the meantime since I lost disability benefits through my job I also lost my job and health insurance. I fall quite often and the last time I fell I hurt my ribs bad. I don't know if there is a fracture of if I just bruised them but I am left with no health insurance to go to. I have only been able to access Dr.s who accept a Letter of Protection. I am a single female, age 46 and live alone in a home I was able to buy 3 years ago and I don't want to loose it now. I can't understand why my disability has not been approved. MRI's showed necrosis when the physician hired by my employer reviewed them. Please give me some helpful advice. Thank you.

-- Sharon Ann Wilder (swilder1@tampabay.rr.com), May 17, 2004

Answers

Sharon- The doctor may want you to get a "Core Decompression" where they drill into the bone, then let it heal up. New blood vessels grow as the bone heals up, thereby feeding the necrotic area with blood and helping bone health and relieving pain. I had it done in my right hip back in 1998 due to AV from lomg term prednisone use, which I am taking for a kidney transplant I received in 1994, and it reduced the pain by 50% or so, and was pretty good till a year ago or so. Now it needs to be replaced (the joint was pretty far gone when they did the core decompression, but we figured it was worth a shot.) Some people have much better luck with the procedure, others don't, but I would DEFINATELY recommend it, even if it just holds off full joint replacement for a few years. As far as getting disability goes, I understand that its hard to get and takes alot of hoop-jumping, I'm speaking with a social worker tomorrow about that very thing as I can barely get out of a chair or stand or sit or lay down for any length of time without having mind-bending pain. good luck! -Matt

-- Matthew Thomas Hennek (hennek8291@msn.com), June 29, 2004.