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When you were first diagnosed, what w... - Osteoarthritis Ac...
When you were first diagnosed, what was your doctor's initial advice?
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alnapier
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My Doctors’s first advice was self referral physio if it didn’t clear up. I was diagnosed 14 months later 😊
Physical therapy is a great option to reduce the amount of pain that you have but it may not make the pain go away completely. Do you continue to do the stretches/exercises recommend?
In my case despite doing exactly as I was told for 2 months it did not help at all unfortunately.
Hi. New poster on this forum. I also contribute to the Lung Forum as I have had (relatively mild) bronchiectasis - a widening of the small branches in the lungs that makes you accumulate mucus which can cause regular infection and needs exercise, lung clearance techniques and prophylactic antibiotics - since 2013.
I'm a Brit expat - 67yo- now living a second married life, this time with (our Thai-glish) children in an agricultural region of Thailand near Laos and Cambodia after a lifetime career based from the City of London. I was diagnosed 18 months ago with osteoarthritis of the hips - one or probably both hips having cam and pincer problems. The private consultant in one of Bangkok's finest hospitals wanted to do microsurgery having examined CT scans but I was sceptical of the projected cost and conscious of the old adage "cutters want to cut" (I had been referred on within the private hospital to one of probably no more than a handful of surgeons in Thailand who perform microsurgery on joints). So, by now egged on by my UK private insurer who said that the quote was near double their guideline maximum for such a procedure and by a UK orthopaedic consultant who I consulted by e-mail and who quickly advised extreme caution, I took further consultations within Thailand and then planned my visit to the UK to see said UK specialist. I had selected the UK guy over the internet; he seemed very experienced and had proved to be remarkably responsive (through a good personal assistant) in the early consideration of microsurgery. He was professor of orthopaedics at a leading UK University and with significant joint trauma experience in one of those nasty terrorist wars the Brits have got involved with in my latter lifetime. I saw him at a Nuffield Hospital in the city where I base myself - sister's house - when visiting the ole country for family and lung heath monitoring)
Like the other Thai consultants I had sought second opinions of, he confirmed his disagreement with microsurgery - said it was a waste of money and would not work in my case. He advised that if I could make the necessary lifestyle changes - no more running and some relatively low impact meds I could expect to prolong the need for a hip replacement or replacements into my 70's, which would be a useful thing to do as I would want my first replacement to last most of my useful life if possible and the replacements currently last only 15 years ish.
My initial consultation had taken place in Bangkok after one hip had essential broken down after a weekend of more extensive jogging and walking than normal - I run our local Hash House Harriers 'drinkers with a running problem' social group in my region of Thailand. I could not walk for a couple of days but managed with a stick to get around and then was able to drive 550km to Bangkok to get it seen to. Over the coming weeks I progressed back to my normal pain-free state but I noted the occasional twinge that would bring me up sharply and leave me a bit careful for a few days and consuming the odd days worth of celecoxib (an NSAID I'm sure many of the followers on this site are familiar with).
It was three months later that I saw the Cambridge guy and was reasonably already under control and had already taken the decision not to run/jog anymore. I was advised by him when in the UK to take cod liver oil and glucosamine/chondoitrin. I have since read that there is a lot of scepticism about the usefulness of, particularly glucosamine and some question chondoitrin also. NICE doesn't allow the NHS to prescribe it as it's on the list of 15 'not sufficiently proven effective drugs'.
Anyway so that's a rather detailed summary of the advice I received. The consultants also talked about perhaps doing a physio programme to strengthen muscles to supplement and the UK guy said to refer back if I was getting too much pain and we could talk about injections into the joint.
However, touch wood I have been pretty much pain free in the last year, so I didn't pursue the physio. Indeed my early enquiries in my region of Thailand produced a response that suggested that there was little expertise on osteoarthritic joint strengthening at the physio facilities in local hospitals. That's not a poor reflection on Thai health - osteoarthritis is just not a high priority as Asians don't suffer from it (cutural factors and small physical frames I was told).
I have probably been lucky but my reasonably low impact experience to date is no doubt also down to:
Regular exercise - I do still run the local hash house harriers and will lay a 6km trail every month (but walking it these days). I do no jogging or running but I either swim for half an hour or walk for an hour most days. My general health is quite good apart from my lungs and even those don't stop me doing most other things I did before. I've always been relatively fit and with a good BMI and diet, which I've now changed onto an anti-inflamatory/low gluten basis. I have no idea whether this works, but whilst things are going well I'm not going to change back. I've swapped milk for coconut milk, my cereals are now mostly rice not grain-based and I now include my baked beans on half a baked potato as the last round of my super-healthy (is it? who knows?) breakfast, instead of multigrain bread. A local Norwegian friend who loves to bake is keen to have a go at gluten-free baking when I can sort out appropriate flour supplies. Luckily fruit is endemic in Thailand and cheaper than chips. Fresh pineapple is supposedly a good inflammation fighter so I always start my day with a quarter of a large one and bananas, rambutan, mangos and durian all feature large in my world depending on the season! My wife farms several of these fruits.
Drugs - again, who knows whether the cod liver oil and glucosamine/chondoitrin works but I'll carry on with it until it's more robustly proven to be a waste of time. I also take curcumin - a supplement containing the active ingredient of turmeric, which is also having an (unexpected to me, so it can't be autosuggestive - effect equivalent to at least 25mg of sildenafil as far as I can tell!! Guys will maybe know what I'm talking about). If I overstretch myself with the walking or in advance of some expected additional efforts like doing the 6km I'll take one-a-day for a few days of 'Celebrex'; I reckon once every 3 or 4 days is my overall average on this celocoxib and it is definitely a worthwhile crutch in my book.
Fingers crossed I make it into the 70s then I'll follow my Mum down the path of replacement joints. Not worrying about that as, although now dearly departed from other causes, she was a spring chicken after years of pain from a far-broader exposure to arthritis and osteoarthrotis than I have (yet?) faced.
OnOn!
(A hash house harriers refrain yelled out to the following pack when its is believed one is on the right path, even if that can be sometimes expected to be a short-lived correct route)
Welcome to the Osteoarthritis Community, santisuk! Thank you for sharing your story and experiences - all very interesting. It sounds like you've had quite the journey but have come around to a good place. Agree with so much of what you shared re: avoiding surgery when possible (so many risks, not necessarily the best path, can't uncut what's been cut); drug therapies (you're right that scientific evidence is not great for glucosamine/chondroitin, mostly anecdotal support and few adverse side effects); diet considerations (choosing healthy foods that do not promote inflammation); and staying active! Despite no longer being able to run, which you clearly love, you've found many other ways to be physically active to keep your joints mobile in a gentler way. And most importantly, you've found new solutions to maintain an active life and stay involved with the Hash House Harriers. Nothing better than keeping up with good friends and good life.
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