Friday, March 11, 2016
Possible Sesamoid AVN: Email Advice
Good morning Dr. Blake
I found your blog by searching help for my condition, I was just diagnosed with an avascular necrosis of the sesamoid bone.
I have an increasing pain since last august, at the beginning that was nothing, just like small cramp when I was walking but it gets worse since November. I did X-Ray and MRI and my doc in France concluded a " contusion " of the sesamoid bone and I had some insoles to wear in my shoes, but it doesn't do any real difference and the pain continue to increase.
Finally, I saw a doc here in the US and he told me that was a AVN after taking new X-ray and MRI where we can see more cyst in my bone. As I understood, that the worst case we can have for this bone, and I don't even remember any event in my life around last summer as a bad jump or a fall ! I don't smoke, I don't drink any alcohol except a glass of wine every two or three weeks....
My doc wants me to wear a walking boot for 6 weeks to try to ease the pain, and he will give me my options then... But he never talks about healing the bone, only release the pain !
Is there anything we can do to heal the bone ? Dis it happens to someone ? I'm only 24 years old, I never had any bad health problems before, I don't run, I'm normally active but doing low impact workouts for years... I'm getting very pessimistic, I will enter in one of my most important year for my career as I will graduate soon, and I'm afraid that this condition would ruin all my hopes ...
Dr Blake's comment: 6-9 months of Exogen bone stimulator, along with some weight bearing with orthotics and dancer's pads can turn this around. I believe avascular necrosis can only be diagnosed on CT scan, so consider getting one. If the bone has fragmented, definitely consider surgical removal.
Does the surgery help ? My doc told me that if we remove the bone the other bone can get the same... Will I walk normally again someday ? :(
Dr Blake's comment: Since you did not deserve this, is there any problem with bone density or Vit D deficiency?If you are a vegetarian or vegan, you may want to temporiarily change or at least get a dietician to consult.I have never seen the other bone have a problem, but sure it could. This is one of the reasons you try to save the injured one now, even if it seems alot of time. And it is never at a good time to injure this bone.
And my other foot begins to be painful too, but the X-ray shows nothing abnormal ...
I'm trying to walk less as possible, I'm wearing a " step " bracelet and I set the vibration at 5000 steps, and try let it vibe as late as possible in the day ! But i'm working in a lab and you always have to go get stuff in other buildings or just walk in you own building because your experiment requires to go to different rooms.
I also stopped to workout, I was doing occasional weight lifting (no squat or lunges) and some " horizontal " bike, a thing I can do without using the ball of the foot, but I don't have the feeling it helps my bone. Should I stop everything ? I stopped for 2 weeks now.
Dr Blake's comment: We need circulation, leg strength, cardio, and weight bearing. This is a good time to test things out to see what does and does not bother you. Simply putting the pedal of a bike on the arch can off weight the area enough to help.
Sorry for the tone of my email, I'm completely down by the news...
Dr Blake's comment: Send me a photo of the 3 xray views when you can to see what they are calling AVN. And ask about a CT scan.
If you have any advice to give me, I would be so grateful !