Typhoons passed but left the marks!! The same happened with COVID-19. COVID 19 seems passed away. But no one can say it is gone completely because you never know which RNA strand is the new variant of this deadly condition!! The marks of this Tsunami are here and everybody is addressing these as- POST COVID COMPLICATIONS. It seemed earlier that this virus will leave its marks on the respiratory system alone. Then we included kidneys and later on the digestive system and mental health. Nobody knew treatment of the coronavirus mat cause some complications!! But it is here in terms of Post-covid Avascular Necrosis.
I am Vaidya Pardeep Sharma, an Ayurveda physician. Right from the start of my clinical practices, I am seeing patients with Avascular Necrosis. And in starting years I thought it is a rare disease and there are not many patients. This changed with time. And now if you ask me about Avascular necrosis- it is as common as diabetes. I never thought this will happen. But as a clinician, I take it as a failure of medical science. Because from which stream I come (Ayurveda) I was taught-
प्रयोगः शमयेद्व्याधिं योऽन्यमन्यमुदीरयेत् |
नासौ विशुद्धः, शुद्धस्तु शमयेद्यो न कोपयेत् ||२३||
It translates “A therapy that cures one disease but causes another is not shuddha (or pure or incorrect). The ideal treatment is one that alleviates a disease without causing any further problems.”
But nowadays, the treatment itself is causing problems.
Now “Vulturine,” thought process of the medical business is aiming at “growth in joint replacement”. Because patients are just “targets for marketing”. See the image below and read (Avascular Necrosis Market??)
Perhaps this is what we all know as Kaliyuga!!!
Is AVN Post-COVID complication, Really?
Smart is the new business.
I have read many articles and have seen much news on this, claiming Avascular necrosis aka bone death is the new post-covid problem.
Midday, newspaper comments that this is something- AVN is a new post-covid complication. And similar stories like this can be seen in Google News.
See how smartly, media is managed and a common man will certainly believe this is just what Covid did to all of us. But truth is, this is all about the heavy use of steroids.
Let me admit honestly. Steroids proved life-saving and I don’t have an issue in using these for saving a patient’s life. But this complication of the steroids is not new. And my questions are simple-
Cannot we guide a patient for “Post-Steroidal Treatment Diet and Lifestyle?”
Nobody did and nobody want.
Otherwise from where these new marketing trends and discussions about CAGR regarding post-covid Avascular necrosis will come?
AVN, osteonecrosis is not just because of the COVID infection. The main culprits are the same which saved lives, the steroids. It might be dexamethasone or prednisolone- everything did the same to the human body. In one word exactly, this is the complication of the steroids.
What is Avascular Necrosis?
Two words, Avascular and Necrosis tells the whole pathology of the disease.
Avascular: Vasculature refers to the blood supply of tissue and “avascular” means no blood supply.
Necrosis: is rotten-the dead tissue.
So, Avascular Necrosis literally means- tissue death because of the lack of blood supply. This lack of blood supply occurs because of the blockage in the blood arteries. When blood doesn’t cross the channels, it causes problems.
This condition appears because of different causes inside the bones. But here when we are discussing the same in context to the “post-COVID” condition this is all about the steroids.
Blood is equally responsible for providing nutrition and excreting the wastes from the tissues. When there is no blood supply, on one side the cells start dying without nutrition. On other hand- the tissue becomes a morgue for dead cells. This leads to inflammation, swelling in the tissues. This is the reason, why fancy words like “bone-death” are in use.
How does Steroids cause Avascular Necrosis
Anabolic steroids, more properly known as anabolic-androgenic steroids (AASs), are drugs that mimic the effects of testosterone and dihydrotestosterone in the body. They increase protein within cells, especially in skeletal muscles. The word anabolic, referring to anabolism (growing larger rather than breaking down).
Steroids have been associated with a number of negative side effects. They include increased risk of heart attack and cardiovascular problems, liver damage, acne vulgaris, breast development in men (gynecomastia), aggressive behavior, and paranoid jealousy. Some steroids are used to treat some of these conditions but this is controversial due to the number of reports of severe side effects.
Because these are responsible for “building” up, therefore, these impact three things-
So we have a blockage on the inside with pressure from outside the arteries. This causes the “avasculature” in the affected tissue- Avascular condition.
No blood situation starts destroying the tissue and you call it necrosis or bone death. This is how post-covid avascular necrosis happens to be the impact of the excessive use of steroids.
Why were steroids Important for COVID
The deaths in the last pandemic were considered due to the Coronavirus.
In reality, these deaths were because of the “confused state of the immune system”. The two words were commonly used for this condition and these are- Cytokine Shower or Cytokine Storm.
In these conditions, the immune system losses its control and lead to destruction. It destructed the lungs (leading to low SpO2), Kidneys (leading to kidney failure), and other issues too.
Where these emergencies emerged, it was important to address the problem with some life-saving drugs. And steroids did wonder by shutting the immune system up.
So, it was not a mistake. It was something that was important to save lives and turned to be dangerous for the bones and has caused Post-Covid Avascular Necrosis.
What are the Treatment for Post-covid Avascular Necrosis
The first hurdle in the treatment of the post-covid AVN is the wrong diagnosis.
Most of the time, when the problem starts, the main focus goes on the spinal nerves. Because sciatica and AVN mimic a lot.
Read the article: how do differentiate between AVN and Sciatica
Once diagnosed, every second medical practitioner makes the second mistake. They think that Avascular Necrosis is all about- bone decay. Which it is not, really.
It is a disease that causes bone decay, but how can it be a problem of bone.
This is something like- you don’t have electricity and one of your home appliances is not working. Do you replace these?
No, way. You try to restore the electricity.
But doctors are not smart like engineers.
Doctors believe in replacing the appliances.
The only advice orthopedics offers you is a new joint- now it is your turn to choose the metal/porcelain or some other ornamental replacement for your bony bones.
Address the problem not the impact
Many humanitarian organizations have been criticized for their approach to relief efforts. In a time of tragedy, it is human nature to want to help in any way they can, but oftentimes this has led to further suffering and exacerbated the problem with which people are trying to fix.
In the medical world, relief is everything. The patient wants to make sure that pain should go away and the doctor aims shallowly.
The problem is blood supply, not the bone.
Replacing one joint doesn’t solve the problem. Clinically now it is well established that AVN can occur in any of the joints and I have personally seen many patients. Patients who opted for Hip Replacement, later on, found that their- knee joint/shoulder joint got Avascular Necrosis.
Every pathological process impacts the whole body, it is subjective. Not just objective. Thus treatment should also be comprehensive and subjective, rather than objective.
Joint replacement is not a solution
Replacning a joint in Avascular necrosis is not a solution, it is a “temporary” fix.
Some people agitate to use of “temporary” and argue it can last for 10 years or so…. for them 10 years is not temporary. But for me what doesn’t last life long is- temporary.
You never know about the “revision surgeries” and “infections” and blah blah….. after joint replacement. For sure, the main problem- succesptability of the other joints for the AVN doesn’t end just by replacing one affected joint.
Solution is restoring the blood supply to the dying tissue and only Ayurveda is promising in helping this.
Ayurveda treatment for Post-covid Avascular Necrosis
The treatment of Avascular Necrosis is same, it can be post-covid or without covid.
The mail line of treatment is very much simple and that is to make sure that blood supply should resume to normal. This is not about a bone or some tissue, it is about the whole body. Every part of the body should get proper nutrition.
At Sukhayu Ayurved, we have worked on plant based medicines to achieve the goal. And we work on the two phases-
The first thing is to make sure the blood supply should resume:
This is the phase where we work on resumption of the blood supply and the aim is to stop the further progression of the disease.
Most of the times, patients give a very cold reaction to this.
“Only to stop the progression!!”
Yes, the most important thing in Avascular Necrosis is to make sure that the disease won’t progress further. Because under lack of nturition tissue keeps on dying. This is a regular process, doesn’t happen in “episodes”.
Stopping the further decay of the bone means that – living tissue is getting proper nutrition.
To help the bone to regrow
Science is more like a belief and beliefs has their own “dogmas”. Therefore science becomes a dogma.
Because every person is like- “I believe what I have read, what I know”.
Modern medicine is of an opinion that “body doesn’t have a power to regrow”- only in orthopaedic clinics where they work for “joint replacement” industry.
But when you read the book.
Bones are- mesenchymal in origin. Mesodermal tissue has a skill and efficacy for “repair” and “regrow”- just like muscles.
The bone marrow has “stem cells” and have capacity to regrow. These just need proper nutrition. You provide the nutrition to these and things starts changing.
We have evidences!!
These evidences are not from Ayurveda.
These MRIs were done in the modern medicine set-up and believe me “they don’t believe themselves for these”, becasue these evidences are challengeing their dogmas.
Ayurvedic Treatment for Avascular Necrosis is all about making yur life easy.
You can contact with us on +91-9050-80-2060 or email us.