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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could Severe Pain In Hip And Groin Be Due To Avascular Necrosis?

Hello. I would prefer to simply ask you my question, but I think my history is quite pertinent in arriving at the proper conclusion. I am probably looking for zebras here;too many other medical problems have come my way ever since an awful error made during what was supposed to be a routine microdiscetomy which I never needed as I did NOT have a herniation;I had an annular tear, period. Since the surgery, I have been on opioids incessantly leading to a whole host of complications which have further destroyed me literally resulting to sedation, insomnia, serve constipation leading to surgery removing 2/3 my rectum, urinary retention, awful pruritus, etc. I am a PA( physician assistant) who worked in orthopedic surgery assisting on total hip/kneee replacements, knee/shoulder/elbow arthroscopy, and basically everything but spine,for many years (at Hospital for Special Surgery in NY, NY...if you are familiar?),.until my life was taken from me in 2007. by the way, I only bring up my work place since I wonder if "where I worked" is causing me to "look for zebras" so to say instead of "horses" since we treated the dx I am paranoid I may have (AVN) at my former work place, sadly on a frequent basis. I stopped working summer 2007 when neurosurgeon cut my S1 nerve root, literally destroying my entire life with that one cut. I did not even need surgery which is the worst part;ever since I lie in bed or on the couch all day everyday unless I have doctors' appointments which my husband and or mother take me to. I can walk, but I have 10/10 indescribable and permanent pain (I am repeatedly told I will never recover) every minute of the day. I have been literally screaming in pain for almost 8 years due to extreme S1 pain of my left leg, and all interventions have failed. Many interventions involved steroid, other than my intrathecal pain pump which was implanted in 2009 and FOUR spinal cord stimulators all of which have failed to offer any relief. Starting in August 2007, I received steroid for pain relief including massive doses of Kenalog via ESI, high doses of PO steroid such Prednisone, dexamethasone, medal dose pack, and hydrocortisone, and lastly, several rounds of IV steroid such as solucortef by many different pain specialists trying to help my pain. The steroid affected my adrenals bringing my cortisol to zero for quite some time; I was treated with a small dose of steroid daily for 6 months until I fortunately I responded well to a Cortrosyn (ACTH) Stimulation Test. I told my former pain specialist who implanted my intrathecal pump that my cortisol was zero, and I did to wish to have any more steroid, but I was ignored. As a PA and especially as a patient, I believe patients are not being heard, and the patient often knows their body better than anyone;I learned this by listening to my patients, and now by my own experiences. Back to the steroids, during a hospital admission for one of my frequent pain exacerbations where I thought my treatment would be a ketamine infusion and additional opioids, etc, , I was given 80 of KENOLOG 3 TIMES IN ONE WEEK MARCH 2011 WHEN MY CORTISOL WAS ZERO. BY THE 3RD INJECTION OF 80 OF KENOLOG, I WENT INTO A COMA-LIKE STATE. I COUDL NOT SPEAK, NOR MOVE, BUT I CAN HEAR WHAT WAS GOING ON AROUND ME. My pain physician did not believe me, but my endocrinologist absolutely did, and said he would have expected that. LITERALLY 3 MONTHS LATER, JUNE 2011, I NOTICED MY ONCE FIRM FLAWLESS SKIN WHICH I TOOK FOR GRANTED WAS NOW THIN, FRAGILE, FRIABLE, AND I HAD TERRIBLE LOSSOF SUB-Q FAT, AGIGN ME OVERNIGHT! IT WAS NOT A GRADUAL ONSET. EVERYTHING I HAD ALWAYS USED TO TREAT MY SKIN FOR PREVENTION ONLY, HAD NOT GIVEN ME 2ND DEGREE BURNS! I KNEW IT MUST NE THE STEROID, BUT MY PAIN PHYSICIAN ADMINISTERING THE STEROID(VIE HER FELLOWS) HAD DISAGREED. I was worried about AVC, but I was told it was not possible. OF COURSE IT WAS! I suffered throughout the years with my neuropathic leg pain being my primary concern. All the while my skin would rip or tear just by touching it. I aged overnight, and my sub-q fat missing int he face makes me look withdrawn. I finally saw an excellent dermatologist who took me seriously after seeing photos of burs n my face, massive indentations from a telephone touching my face drug phone calls, and band-aids or surgical tape removing my skin, causing bleeding. Approx. 3 years later, I was sitting during a movie, which RARE, since I stand during the 2-3 movies I have seen in 7-8 yrs due to such pain. The last movie I saw (2 months ago) was upsetting since when I wen tot get up, my hip did not wan tot give up with me I have awful groin pain. Without sitting I am okay, arm rarely sit. NOW, UPON SITTING 1-2 MINUTES, MY HIP IS STIFF, MAKING IT AWKWARD TO GET UP AFTER A SITTING POSITION. I have severe 10/10 neuropathic pain that same leg, so I tried to chalk it up to the pain being from the neuropathic pain. But groin pain s more "hip pain," not S1 nerve pain, correct? I was hoping perhaps a bail tear was causing nasal new hip pain, but I checked for a label tear with internal rotation, and it was neg. I am scared to death. I have been through much too much! I cannot believe someone with my awful my situation could potentially have AVN as well!!?? Life has been cruel to me, as I have lost everything...my career due to pain, the ability to have children, unable to be accepted by my state as an adoptive parent, and I cannot afford surrogacy costing $15,000. (I decided to forgo my dream of becoming a physician thinking I could be great mother and have many responsibilities of that of a doctor. However, a spine surgery that went wrong, I lost everything except family and my I am hospitalized several times a year for exacerbations of my ALREADY intolerable nerve pain which leads to my homebound status. I have not yet told my doctors since I am Paranoid of an X-ray showing my fear is reality! Do you think an X-ray is necessary...or is there anything else that could cause hip/groin pain? I have 1st assisted in thousands of THRs, never thinking at 42 this could be me!!! Can I have your advice please?? I AM TERRIBLY SORRY FOR THIS "NOVEL LENGTH HISTORY," BUT I THOUGHT MY HISTORY IS RELEVANT. Your thought please? (A plain film pf the hip??) One more thing...I have osteopenia due to an estrogen level of ZERO after opioids had literally wiped out estrogen (estradiol), giving me an estrodiol of zero....THS OSTEOPENIA. I also lost my testosterone, DHEA ("TH MOTHER OF ALL HORMONES" AS IT I SCALLED,, OR THE "FOUNTAIN OF YOUTH." Please can I have your option re: my hip? Please tell me if there is something else causing hip/groin pain other than dreadful AVN? I know I need an Xray, onceI tell my doctors. Thank you for your time! I am scared and do not know where to turn. Stacey : )
Sat, 21 Mar 2015
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Could Severe Pain In Hip And Groin Be Due To Avascular Necrosis?