Guidance request, not medical advice 43F Hip AVN diagnosed
Mods, please delete and accept my apologies if not approved (and let me know what I need to change).
TLDR; I walk a lot for exercise, to the tune of 6-12 miles a day on flat streets. It helps my joint pain from the medications I was on.
How much can or should I actually be walking with AVN of my right hip (2/3 of the femoral head is affected per my MRI report) with absolutely 0 pain? Is 4 months of my meds going to bite me? Is Fosamax good or bad for my situation?
It's a long story, but I'm a breast cancer survivor (DMX skin sparing direct to implant in January, HR+, stage 1B) who was lucky enough to have not one, but 2 types of cancer (IDC and DCIS). My Oncotype was 13, so no chemo or radiation. I was on tamoxifen beginning in December, but the side effects, everything it could possibly have, I had. But the neuropathy was the deal breaker. So I was switched to Aromatase Inhibitors as I'm pre menopause; specifically monthly Lupron injections and Letrozole. Then my bone density scan came back in March, score of T -1.4, so Fosamax was added weekly. That tripled my existing side effects- mainly the joint pain in my knees, elbows, wrists, and ankles. Plus my lumbar, but that has been an issue since 2007. At the end of April I decided to upload my last spinal MRI report to my oncologist so he could see what I was dealing with. That's when I saw it.
Avascular Necrosis of the hip noted. Correlate with dedicated MRI of the hips to confirm.
My primary missed it. The pdf was 3 separate files. I missed it. I had a follow up with my primary back then in January, she said nothing. We discussed my back. The MRI results were available to us both on Dec 23, 2025. So roughly 16 months ago! I only noticed in April! I immediately messaged my primary and she said she missed it, too. Que an orthopedic referral and bilateral hip MRI, the results of which I received Thursday. I immediately stopped the Letrozole. My orthopedic appointment is June 9th. That's the soonest they can do. My oncologist is a tool and is currently getting his ass handed to him by the office manager for not replying to my messages notifying him of this and requesting guidance. I see said tool on Wednesday. And his MA quit, likely because he's a tool.
I'm freaking out. The meds I was (and kinda still am on as the Lupron injection is monthly) are terrible for bone health. Yes, I'm lucky I caught it. But what about the fosamax? It literally, albeit at a low percentage, can cause bone death (mostly in the jaw, but still). I've read so much on my own, but everyone knows Google isn't a specialized doctor. Fosamax is good and bad, depending on what you read.
Can anyone give my some guidance on my dilemma, please? I'm happy to read any linked information and appreciate any and all help. I'm falling apart over here, literally.
Sorry for the novella and thanks for reading. 💙
How much can or should I actually be walking with AVN of my right hip (2/3 of the femoral head is affected per my MRI report) with absolutely 0 pain? (The no pain scares me because I could easily cause a collapse because it doesn't hurt at all.)
Is 4 months of my anticancer meds going to bite me?
Is Fosamax good or bad for my situation?
I am not asking for medical advice. Guidance is what I need. Opinions. I understand anyone who comments is a Doctor or layperson, but is not MY doctor or medical advisor.