Dr. Nilesh Kapadia is a family physician working day in and day out for his patients and has a good will among both rich and poor alike.

JAN 2005

(ESWT 1 -19-2-05)

Makarsankranti , kite flying festival is very famous in Gujarat. it demands a person to stand and move to control the kites in the sky whole day long and lasts for at least two days.

After few days of this strenuous activity he started pain in the right hip which became severe gradually to the tune of VAS 9-10. He could not walkand was almost bed ridden and required support to go to bathroom. He took medicines for pain for next 5-7 days and got partially relieved and was able to walk for few steps which allowed him to go for X-rays which turned out to be normal. pain persisted grossly affecting ADL . he underwent MRI on 17-2-05 which showed avascular necrosis of right femoral head with huge cystic lesions with synovitis and effusion. He was admitted to hospital on 19-2-05 for ESWT and was advised rest for few days and started his clinic again with walker after 3 days working 11-12 hours a day. rest pain had disappeared and he could walk with walker NWB without pain but could not sit on ground or crosslegged.Gradually cycling exercises were started on 6th day. he already knew yoga and pranayam and he increased it to about 1.5 hours a day. he even did self hypnosis and diet was reviewed for calories after 1 month to suit his recovery. Two wheeler was abandoned for transit and he switched to car for transportation after 7-10 days of first sitting. he used walker through out first 6 months for ambulation with non weight bearing to partial weight bearing.

Follow up studies were done at regular intervalsof 6 weeks-3 months- 6 months.This revealed persistant cystic lesions with sclerosis and signs of regeneration. Pain was abasent except on sitting crosslegged.

2nd sitting was done in Aug 2005 . After 2 days of rest ADL was resumed with stick support. he continued his family practicefor 12 hours a day in his clinic and avoided home visits. He continued his fitness programme of Yoga, Pranayam for 1.5 hours and cycling 45 mins 7 days/ week and swimming 15-20 mins 3-4 days/ week. He achieved success in sitting cross legged after 7 months with minimal pain (VAS- 1)

His son being in Australia working as a soft ware engineer wanted him to visit Australia, so he went there and travelled extensively for 3 months with occassional stick support. He enjoyed all fun rides, water rides and underwater swimming. He was on his own with stick support. He continued his cycling 3-4 days in a week , Yoga and Pranayam all days. He purchased tickets for transit to travel across the continent and enjoyed train, bus, ferry and air travel. He did suffer transient surge of pain 3 times in 3 months after vigorous travel and walking for long in malls;3-4 hours without sitting anywhere. Pain did subside with simple rest and icing for 20 minutes and no drugs were needed, rather avoided.

He could walk gradually from partial weight bearing with stick support to full weight bearing as his confidence level rose which took about 10 months from 2nd sitting.

Regular clinical assessment with X rays is mandatory and was done at 3-6 months even when he was feeling fine and fit.

He frequently travelled to around 5-7 days small trips in India along with his friends and family at regular intervals of 3-6 months. The places he visited were Palitana, Goa, Dakor, etc. he climbed the hills of palitana with stick support .there are about steps and it takes about 2-4 hours to climb. He took 3.5 hours to reach the top.

In Goa , he enjoyed all beach rides including banana boat , water scooter and speed boat.

He being an avid traveler and loves to see countries worldwide preferably on his own legs.

His next plan was Egypt.

Before going to Egypt routine X rays were taken as he had mild pain (VAS 1-2) in right hip on spreading the legs. The X rays revealed few cystic areas with thin shell of bone. He was advised another sitting before going abroad. He underwent another sitting on 8-2-2008 (3rd). Subsequently he traveled to Egypt for 13 days and walked in Sahara desert and enjoyed camel rides and posed before pyramids and Sphinx. He could only do yoga and pranayam due to non availability of cycle and swimming pool.

His son migrated from Australia to USA in 2007. He was again invited to USA. He managed his visa and travels on his own. He was in USA for 3 months in 2012. He travelled extensively to Indianapolis, Vraj, NY, NJ, Niagara falls , etc. He stayed in Chicago and visited local sightseeing often. He cycled on the roads of Chicago everyday for 50-60 minutes in all weather. Yoga and pranayam continued through out 1 hour per day.

He used to do stationary cycling for initial 4-5 months. Then he started cycling outdoors everyday for 5 kms to start with. He gradually increased the journey to present 25 km / day. He took part in first cyclathon of 52 kms in Jan 2013, 2nd cyclathon of 56 kms in Jan 2014 and successfully completed it nonstop and he was awarded for the same.

He also participated in Triathlon at Sports club Ahmedabad in April 2014 which included 200 meter swimming and 10 km cycling in succession.

He travelled to Pune and Lonavala in 2013 for 8 days. He enjoyed all 13 rides in AD Lab imagica on Pune Mumbai highway for whole day.

He visited Goa and Karvar holiday resort for 8 days in 2013

2014. He went to Bhutan for 6 days. He could climb Tiger Nest, which is a hill with Buddha temple of 7th century on the top at 10000 feet height. He climbed it all alone with the guide taking 3 hours 20 minutes with stick support as it is very slippery and muddy trek.

He also visited Calcutta with Samet Shikhar, a jain pilgrimageenroute. It has various hills with country side treks of about 10 kms. He could climb the hills with stick support and took nearly 4.5 hours to climb up and returned in 2.5 hours.

He visited his son in USA in 2016 and 2017 each time 6- 8 weeks and did all sorts of activities from trekking to cycling and outdoor activities.

He visited Bali in 2018 and did many water sports including kayaking.

He also went to kerala, munnar and thekkady in 2018

Recently in 2019 he had been to Meghalay, Assam and Arunachal pradesh.

He is as active as anybody would desire and enjoys every moment and is like a role model for anyone having AVN of hip.


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Bilateral AVN of Hip treated with ESWT - 4 years follow up