OsteoporosisConnections Question of the Week

Hi PJ, thanks for commenting.  I totally understand your delima with exercise of the upper body, and in my case the lower body is a challenge also.  I'm wondering several things, have you decreased the amount of weight you are lifting?  Lessening the amount of weight until you can gain some strength in your shoulder may help, then build up slowly to heavier weights if possible.   Another thought is do you perform the exercise standing or lying down?  Also, I've found that doing upper body weight lifting hurts less if I'm lying down.  Now I'm not sure you're getting the maximum benefit from gravity, but you are still lifting weights.  Also, have you ever tried Nordic poles?  When you walk you could include these since they do give some upper body weight resistance and of course cardio, which I don't think would hurt your shoulder, they actually give you a better walking workout.

As far as your calcium issue goes I have the same problem, but I believe it's best to get the majority of my calcium from my diet.  I don't seem to have any trouble doing that, but for those who do, I'm sure others can give us some easy tips on how to add things you might not think of to increase your calcium.  Many Dr.'s believe dietary calcium is best, but not as convenient.  So I would say mixed it up, and on the days you get plenty of calcium don't worry about taking a supplement, and on those busy days pop a viactiv.

Sorry to hear that Actonel is causing problems, I wasn't aware of it's ability to cause joint deterioration.  Good Luck, and speaking with a Physical Therapist about your issues could help tremendously since they could give specific exercises that you should be able to do without causing pain or further injury.

Thanks again, Pam

I like the idea of the poles to get more of my body involved, Phyllis - thanks.

Oh, and Pam - just to clarify, it's the cancer drug hurting my joints, not the Actonel. The Actonel offers other unpleasant side effects!

Thanks, both of you, for the good suggestions. PJH

Hi PJ, thanks for clearly up my misinterpretation on which med was causing the joint detioration.  Glad to hear it wasn't Actonel, but sorry that the cancer meds are doing this.

If you do try the Nordic poles I think you'll find them handy for giving the arms and upper body work out, plus the additional cardio, that hopefully won't aggrevate your shoulder.  The great thing is it keeps us standing up straight and unloads the weighted stress on the hip and various other joints, that others have problems with.  You'll still get a good hip and all over workout, but this helps for those with spine, si joint, hip, shoulder and knee problems.

Pam, I wish I'd thought of the Nordic poles yesterday - did a 20K walk for breast cancer. I could have definitely given my upper body (along with my sore feet) a workout! PJ

Hi PJ, sorry you didn't think of the poles but congrats on going above and beyond to help raise awarness and money for breast cancer.  I'm sure your local hospital/Univ, appreciates your constant support of their research, and I agree it's these smaller yet comprehensive studies for a cure, is where we'll eventually find it for those with cancer.

Keep up your unfailing support of something so dear to your heart!!  We all appreciate your dedication SO much!

HI PJ,  I'm so glad that Pam mentioned Nordic walking.  I've been using walking poles for many years and wouldn't think of going for a long walk or hiking without them.  I made mine out of a pair of old bamboo cross coutry ski poles with the baskets cut off.  They are light weight and the only complaint i have about them is that i have replace the rubber tips several times a year.  Walking poles are so helpful when walking....they help keep your posture nice and straight, get the arms involved, no fat fingers from your arms hanging down, take the stress off of your lower body joints, especially your knees and hips, and  help going up and down hills.  It took me a year, but my walking buddy now uses them too and has for a couple of years.  We've even seen others using them around town.  You can buy them or make them...like i said mine are old ski poles or you can make them out of whatever you have on hand around the house,  as long s the pole is long enought.. to find the right length bend your elbows at a 90 degree angle and measure to the ground.

Another idea for adding to your walking is a  weighted walking vest.  I have one, but don't use it as much as i should..when i'm ready for a walk i head out the door and forget the extras except for the poles which i keep im car.  For walking with the dogs in the fields i leave the poles at home..to many weeds to navigate.

Have you talked to a physical therapist who can give you suggestions for upper body work without straining your shoulders?  Like so many other things in life its a martter of finding what works for you.

take care...phyllis

Hi Nathji:  Your point about bisphosphonates is one that so many worry about and some refuse to take.  We do have to keep in mind that not all taking them have these problems, as I didn't and others I know, but I totally understand your reluctance in taking them.

The only other options, as you know are Forteo, Evista (not approved for men) Fosteum, Miacalcin and the over-the-counter supplement Strontium Citrate.  Have you looked into Fosteum, Miacalcin or Strontium Citrate?  UC Davis is doing a study on Strontium Citrate but the results of it probably won't be availabe for some time since the end date for clinical trial patient recruitment is Aug 10, 2009.  They will be studying the efficacy and results of the supplements with baseline and final dxa, among other tests, to determine how it works.  If this goes well, I suppose the FDA will be looking into it, but we'll have to wait and see.  However, it is available over-the-counter now in the US.  There's also the possibility of Denosumab by Amgen which we should hear about in the next 2 months.  I can't say the FDA will approve it, but it's looking very possible, and it's not a bisphosphonate, and comes in a injection.  The only thing is the marketing is for women and will include distribution, if approved, in other countries besides the US.  The proposed trade name on Denosumab is Prolia with a 3 times a year administration via infusion or injection.

Hope some of this info helps, and thanks for commenting.

Nathji, one thing I forgot is you could rely on supplements alone plus plenty of good weight bearing exercise.  I can't say this will work, it didn't for me, but I've heard of others who have had success with this.  Also, remember there are other things coming in the pipeline, the only problem is it takes time to get it tested and then to market.

Pam

Dear Pam,

It was so nice to hear from you again and to receive your very wise and studied reply, well researched in all respects. The onyl weight bearing exercise I had been doing was walking, and I dont know if it helped because there are no dexa scans where I live. I wont find out til I go to New Delhi, where a swine flu is prevalent and so I hesitate right now. But I am feeling normal otherwise apart from leg fatigue when walking. I was diagnosed with osteopenia in May 2007 and took Actonel for 13 months and then gave it up since Dec 2008.

Maybe Phyllis's report with strontium will be the best bet and the next generation drug, but it will be a long time before someone makes it here.

Thanks a lot for your continued help to me and to everyone else! 

Yours,

Priya

Hi again Priya, thanks for the kind words and thank you for contributing to our discussion.  Be careful with the exposure to the flu, you don't need that.  It must be very difficult to not have access to tests like dxa's and others, but don't give up hope, I'm sure you'll find something to treat your bone loss.

Remember you can order Strontium Citrate from the US, so hopefully Phyllis can tell you more about it.  Since I don't think we can name specific manufacturer's of Strontium Citrate, it is very easy to find online, but look for a reputable company.

One more thing I wanted to add, was the reason why execise and supplements didn't help me was due to the many other secondary causes I have for osteoporosis, so my bone were pretty bad by the time I was first diagnosed many years ago.  But thanks to Forteo I made great strides in re-building bone after having fractures.

Dear Pam,

Many thanks for the consoling words. I think Pyllis gave the address or name of some French Manufacturer of Strontium. I will look up her reply and find out! Thank you always for your continued help and support, it is so nice to have you out there on the web. I will take your advice and not go to New Delhi till the swine flu scare is prevalent. Since I am living in a very pure atmosphere at Mussoorie in the hills that would make my immune system more vulnerable to infections in the pollution of the plains. I will keep in touch.

Yours,

Priya