00:00 I want to see a doctor.
00:02 Not long ago, the actress Angelica Panganiban posted a vlog about her health.
00:07 Just a little update.
00:09 If you've watched our vlogs or you're familiar with our lives,
00:15 I have a feeling that my hips are aching.
00:18 When I try to walk, I feel a bit wobbly.
00:22 According to the actress, she experienced a skin disease.
00:25 Ouch!
00:29 I have a pain in my left hip.
00:32 I thought it was just a pinched nerve.
00:35 Until it slowly got worse and she couldn't walk.
00:40 There was a time when I couldn't walk again.
00:44 I was in pain and I cried.
00:47 The actress's skin disease is a symptom of...
00:52 I went for an MRI and the results came out.
00:56 I have a vascular necrosis.
00:59 It's itchy.
01:00 I have a bit of pain.
01:02 What is a vascular necrosis?
01:04 How dangerous is it if it affects you?
01:07 And who can have it?
01:09 Wait.
01:12 Ouch!
01:13 Like Angelica,
01:17 Bewang and Balacang experienced a 32-year-old skin disease in 2020.
01:24 It started after I gave birth to my second child, my youngest.
01:31 At first, I thought it was normal because they were 9 years apart.
01:37 I thought it was normal for my hip to hurt.
01:41 I started to walk slowly and my legs stopped creaking.
01:47 Then it started to hurt.
01:51 The pain reliever was sent to Aiko's hospital.
01:54 I was taking the pain reliever and it was gone.
01:58 It was gone and I was taking the pain reliever 2-3 times a day.
02:07 But Bewang and Balacang's pain kept coming back.
02:12 So Aiko immediately went for a checkup.
02:15 I went for a checkup at the ortho.
02:18 They tried to get me to go for rehab.
02:22 They said it might be possible to go through physical therapy.
02:24 But it was gone.
02:28 It was even worse.
02:29 I felt like I couldn't bend over.
02:34 I was lying down and I didn't want to get up.
02:38 I was standing up and I was asking my husband and my son for help.
02:41 Aiko was in a lot of pain and was forced to stop working.
02:46 But what made her sad was that she couldn't take care of her baby because of this.
02:52 I was also filled with anxiety.
02:54 I was expecting to have a baby.
02:59 I was expecting to take care of my baby.
03:01 But I couldn't take care of him for a few months.
03:05 Because of this, he started to hurt.
03:08 Because of this, she went under laboratory procedures like an X-ray
03:12 and MRI or magnetic resonance imaging.
03:16 This is where it was confirmed that she has EVN or avascular necrosis
03:21 or what is called bone death.
03:24 Avascular necrosis is a condition wherein the blood flow is reduced.
03:29 The blood supply to a bone.
03:31 Particularly, most commonly, to the hip joint, the femoral head.
03:35 It can happen to a woman or a man.
03:38 But I saw in studies that this is more common to men.
03:43 Basically, because of the high risk behavior of men.
03:48 Who can have this?
03:51 According to the expert, it is possible that it is in the womb.
03:54 It is also possible that AVN is the cause of injury or trauma to the body.
04:01 A person's lifestyle is also affected, like drinking too much alcohol or smoking.
04:08 But doc, in the case of Aiko, is it true that AVN can be obtained
04:13 when a woman is pregnant?
04:16 When a woman is pregnant, there are many hormonal changes.
04:21 It can also cause high stresses in different joints of the body,
04:27 particularly in the hip joints.
04:30 And theoretically, this can lead to a vascular necrosis.
04:34 However, it's very rare.
04:36 Usually, only 40 cases were reported worldwide.
04:41 The patients who have AVN,
04:45 most of them have underlying causes.
04:49 There are other underlying diseases.
04:51 In Aiko's case, steroids can be used to treat bone death.
04:58 My roommate said that it's too early to destroy my bones
05:04 because my steroid is low, 15, 10.
05:09 I was just playing there and I was under remission.
05:13 So, she was surprised.
05:14 But the main reason is the long-term use of steroids.
05:20 But the question is, doc, is it true that steroids can be used to treat bone death?
05:27 If you take steroids for a long time,
05:31 it can lead to blood flow to the bones, particularly to the femoral head.
05:41 Because Aiko's condition is serious,
05:43 she underwent what is called joint replacement or joint arthroplasty,
05:49 where the bone that was broken in her lumbar was replaced by ceramic.
05:54 I can't do it anymore because my walking is so slow.
05:59 The cartilage of my hips is totally lost.
06:04 So, she really needs a total replacement.
06:08 I think it's better to discuss also the staging of the disease of AVN.
06:13 And the staging will be based on imaging studies.
06:18 You have your x-rays, MRI, which will be done upon consultation with a specialist.
06:25 So, once you're diagnosed to have AVN based on these images,
06:29 that's when I'll know the stage.
06:32 If you fall in an earlier stage, what's recommended is a more conservative treatment.
06:38 However, if you fall under later stages of the disease,
06:43 what's recommended is actually joint replacement or what we call joint arthroplasty.
06:50 So, for the hip, what is done is total hip arthroplasty.
06:54 The joint is replaced.
06:56 After the operation, Aiko's pain in her lumbar and hip is gone.
07:01 And most importantly, she can move properly and she can take care of her children.
07:06 Now, I can say that 90% of the cases are really fine.
07:15 Doc will remind us to avoid AVN.
07:18 You need to avoid taking steroids.
07:23 Maybe your friend advised you or someone else.
07:26 We should avoid it because it's not safe for the body and for the bones.
07:32 That's number one. Number two, of course, we should be careful when we're driving.
07:39 Because these are high impact activities, we should exercise.
07:43 We need to strengthen the muscles surrounding the joints.
07:47 Our muscles should be strong so that the joints are stable and our bones are not stressed.
07:56 Take care of your bones.
07:59 Move around and exercise.
08:01 And if there's a problem, consult an expert immediately so that you won't go home in a worse condition.
08:08 That's number one.
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