What diet, exercise and pain management be followed in case of RHD?
Patient: PLEASE HELP!!! Freedom, and Freedom From the PAIN!!! Please Help!!! I have been diagnosed, (at U.C.D.M.C. Sutter Coast Hospital, Mad River Hospital) with AVN/ON, full skeletal system, with “special complications, vascular and arterial reroute, RHD{Reflex Sympathetic Dystrophy, etc., etc., just to name a few complications” from steroid, Solu Medrol and Prednisone Poisoning. I have had both hips replaced. Left hip twice, due to rare infection! Found via Radio Active Isotopes, Bone Scan. Hip removed, bedridden without a hip, for over a year, then replaced. Three Teeth Surgically Removed . Due to complications of Avascular Necrosis of the Teeth and Jaw Bone! Have had recurrent, asepsis and sepsis every 2-3 years. Being taken via ambulance, just day’s, sometimes month’s, after having pain meds cut in half, or more, each time, and again! Exactly what he was told not to do, repeatedly, by my Dr. s at U.C.D.M.C., S.C.H. and M.R.H.! I have tried everything my current Dr. has asked, or pushed me into, that I am capable of doing. I ve had endure endless, painful test, retest, pills and more pills. That I have had to bring in information on, from U.C.D.M.C.. To prove to him, that I should not even of tried it, or had it done. That it was hurting me and crippling me even more! I just want not to be in pain, hurt anymore and have something resembling a life back! I have been trying to get a referral for a Medtronic Pain Pump. U.C.D.M.C., Follow Up Care calls me every year, that I m hospitalized, with a pain pump, or a new pain pump comes out. Asking, if I had all up to date information, parts, pieces and if I wanted to try out, or have my current pain pump replaced. Is there anyway I can expedite getting a referral, or skype to see a physician. So I don t have to endure another lonely and painful year, of unnecessary, painful test and pills that hurt me! Specialist that have no experience, patients with or have even heard of AVN/ON. I do not wish to burden, risk my life or those around me. To be taken via ambulance, only to awaken in the hospital for the 9th time. Being asked by Dr.s , the same questions, why, how, and who, has let my pain gotten, so far out of control, yet again?! Why is your current Dr. not listening to you, or followed our instructions and orders?! All Dr. s I ve spoken with agree, with the proper nutrition, exercise and pain management, I should be able, to do anything, (non weight bearing) within reason. Right now, I am not, because of all of the above, all due to pain management. I would like to be healthy enough, that I am able to have surgery, safely, when and if needed, including Stem Cell Therapy. To date, they have had no success, to cure it that way, as of yet. Please, Please Help! I can t take the pain or abuse much longer. Any direction, guidance or help would be more than greatly appreciated. Please Help!!! Thank You, Mr. Robert E. Hunter (707) 464-2019 (707) 9546-220(707) (707) 954-6220 {text only} YYYY@YYYY Doctor: Hello,  As what I see the history I am sorry to hear this.   Coming straight to the point. You need a competitive physical therapist who can understand the RSD. This is a quite complicated one to be handled by a regular therapist. This condition mainly gives sharp shooting pain which is unbearable and uncontrollable by any individual who is undergoing it.  In my clinical practice of 12 years seen bunch of cases with RSD and what has done wonders to them is the self-confidence of regaining the movement and also ability to bear the pain beyond the control. There is a saying which I always mention to RSD patients of mine - No pain No gain. So for having gain, let's take up the challenge now without having any kind of delay. This RSD will lead to lot of muscle wasting and also leads to overall weakness.  First thing first. Take TENS therapy for a minimum of 30-45 minutes. Start the mobilizing of the limb in passive mode by a physical therapist so the joint get free and also get muscle stretch which might be painful. Again take the TENS therapy for 20-30 minutes if the pain is unbearable. Continue the same till you get adequate movement of the muscle and joint. Please understand that this condition needs a lot more effort from your own side to cooperate with the competitive physical therapist. Use hot water fermentation whenever you find time and post which please do active stretching if you can so that you maintain the mobility achieved while in session. If 8 weeks of proper competitive therapy is followed I am hopeful to get results to the optimum.  Coming to the Hip, you need a good muscle strengthening now. having recurrent THR is not a good thing to hear for the surgeon or even the patient. Just that, you need a competitive physical therapist as I mentioned earlier to work on you case. The therapist should show 1000℅  of interest in you and you should show 1000℅ of interest in the therapy to get the cent percent results.  I know, this sounds to most as a philosophical talk but the truth is I have achieved results in my RSD and THR patients to the maximum ability of their to have a independent ADL, which is more of the help  Therapy takes times but its assurance that it will give wonderful effects if assessed, examined and planner properly.  Hope I have answered your query. Let me know if I can assist you further.  Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist