Flisty Medical types - advice?

[amberdreams]

A friend of mine in her fifties is worried about developing osteoperosis - her problem is that the T-score in her spine is very close to osteoporosis (-2.1) and she's concerned about that deteriorating more. Her medical advice is to treat the existing osteopenia by increasing vitamin D to 2000IU and adding calcium to 500IU. What is bothering her is that she's also been prescribed Fosomax 35mg, and she is concerned about the side effects.

Just wondering if any of you medical types know anything about either osteopenia or Fosomax? She is information gathering and would appreciate anything you can add to the mix.

She's already doing a fair bit of exercise (not sure if it's weight bearing all the time but she walks a lot, goes to the gym, cycles...), eats pretty healthily...

Comments

[murfenskow.livejournal.com]

My late MIL was involved in a lawsuit against the company that makes Fosamax. I would be very wary of that particular medication. Best wishes to your friend. I hope she finds a safe,effective treatment plan.

[amberdreams.livejournal.com]

Thanks, I'll pass this on! Her hubby's a dentist and is advising her against taking it too.

[fireheart13.livejournal.com]

I gotta say, my stpemother took fosamax for years and still developed a stress fracture in her hip :-( I'm not sure what the hell it did for her.

I'd think walking is great. Does she do any weight work at the gym? Even light weight work might be helpful. She'd want to work with a trainer there to figure out what is good for her with weight and reps. Increasing her D and calcium is very sensible.

There's always karate :-D I'm 56 and 200 lbs, and we have lots of 50-60 year olds, one or two 70s', and one 80 year old. A good instructor will scale down to accomodate any restrictions, just as a good sy trainer will do.

[amberdreams.livejournal.com]

Thanks! I have a feeling she doesn't do that much weight work as she mostly talks about cycling and walking - I'm inclined to agree with you and push her towards getting a trainer. Though the spine is a difficult area to strengthen in terms of weight work...IDK.

[quickreaver.livejournal.com]

I think it's more about strengthening the muscles around the spine, to take the pressure off the bones, in addition to preventing calcium loss? But I'm just guessing here. We have osteoporosis in my family too, especially in the shoulder/neck region, so I should really start doing research...

[amberdreams.livejournal.com]

You should - though if you are fit, eat healthy and do the weight training you will probably be ok... Oh and the idea of the weight training is actually to put weight/stress directly onto the bone because that causes the bone density to increase.

[quickreaver.livejournal.com]

Shows what I know ... or don't! I actually just started a boxing workout 2-3 times a week and I feel better already. Though it makes me ache like a baby. Squats and push-ups? NO THANK YOU. But I still do them because I'm stubborn. Don't do them well, mind you, but hey.

[amberdreams.livejournal.com]

Since I stopped playing hockey my gym visits are down to once a week, and I just can't seem to get motivated to get back my old 3-4 times a week. I've put weight on and creak around like an old lady. Ack!

[ephermeralk.livejournal.com]

heh, my mother being a small woman who eats healthily and likes to walk and garden but not do other stuffs has osteoporosis as well.

we decided together that since the drug itself has such a ridiculously high half-life, and she's very prone to having medication side effects, that she wouldn't take it.

instead, she went to see a natropath, whose helped her balance out her vitamin/mineral absorption and excretion, as well as taking a better bones and balance class, where they have research that shows that people who do rowing and weight exercises to strengthen the muscles around the spine have decreased t-scores over the years--so either retreating to osteopenia/osteoporosis.

Definitely something that your friend should seek medical help for in deciphering nutrition/exercises and follow evidence-based practice rather than doing nothing if she decides not to take alendronate.

[amberdreams.livejournal.com]

Thanks, I know I'd be looking at alternatives... I'll pass your suggestions on!

[ephermeralk.livejournal.com]

hahah, right?

between fracture/ breaking my back hip...and facturing my hip/cancer...I'll take neither :D

[hybridshade.livejournal.com]

Well, I'm no expert, but I work for a Rheumatologist and I myself (despite being in my 20s) am already osteopaenic. Vitamin D deficiency will be the next generation's epidemic, LOL!

So vitamin D supplementation is obviously extremely important. Her level needs to be at least above 50-60, but ideally around 80-90 for her body to be keeping adequate bone strength etc. It usually takes about 12 weeks for supplementation to show on blood tests, for the record. Also weight-bearing exercise is very necessary, especially if she's already osteopaenic!! (My mother, who's a GP, is on my back about this constantly!!)

The part where my knowledge runs thin is in relation to her age. I'm assuming she's post-menopausal, otherwise it's unlikely she'd be given calcium supplements and prescribed Fosamax. (From experience it's only something that 'older' people are prescribed... and from what I can tell, results are sometimes questionable. It depends on her level of bone loss and whether she is able to prevent her bone density from getting worse. If her bone density is/gets to be a longterm issue then Fosamax may become the only next step...) But really the problem with being a female is that after menopause our bodies are basically fucked, lol. Perhaps she should seek further opinions first, but there's also the matter of whether her doctor is someone she's seen for a long time and trusts their opinion? Shitty GPs are a problem that I come across constantly...

Um, yeah. End essay. ;)

[amberdreams.livejournal.com]

It sucks you are already osteopaenic!

Thanks for this - her hubby is a dentist and one of his patients is a spine surgeon so she's getting further advice from him but I guess what she really needs in these circumstances is someone who is a spine AND osteopaenic expert...

[hybridshade.livejournal.com]

Yup, found out randomly about 4 years ago that my vitamin D level was 18! Very very bad *smacks self* Had no idea how long it had been that low, therefore my bones have suffered accordingly... At least I'm aware of it, though, and am treating it. Most people who have low levels have no idea.

Agreed. This is very much a doctor question. Diet, exercise, etc. all helps of course, but if she's post-menopausal and osteopaenic she has to take it seriously and talk to the right professionals so she doesn't end up an old, stooped-over lady! And a spinal surgeon should definitely know a thing or two! Or anyone with orthopaedic knowledge, really. Hope it works out for her :)