14 replies to this topic

[A trophy guy]

I know I have osteoporosis. Granted, I haven't been diagnosed but that is only because I haven't been tested. And even if I don't, I know I have lost (and continue to lose) so much bone density and mass that osteoporosis, and the subsequent risk of fractures, is but an inevitability.

I have worried about this from Day 1. I even got a standing wheelchair; and while it does offer other benefits, improving (or at least preserving) my bone density was the primary reason I got it. Only to find out later (a few years later, after diligently using it despite it boring the hell out of me on a daily basis) that static, or passive, standing does not improve bone density.

In addition to the loss of weight-bearing and use of my legs, I also have this severe atrophy which hastens the bone loss. I just lift my leg (with my hands, duh) and it feels so light; like the bones are made of styro-foam. And I feel defenseless. I want to be proactive, to do the things in my life necessary to prevent such problems from occurring in the first place. That is how I am used to facing problems. And now I feel like I can't.

Sure, there are drugs which work to try to preserve bone density; drugs like Fosamax and Boniva (among others). But, in addition to having the counter-intuitive side-effect of making you more prone to fracture; these are serious drugs. Serious drugs with serious implications on your body. With all the other medications many with SCI must take, adding this to the mix seems ill advised.

Especially when considering the futility of it all. Let's say you have a year's treatment with Boniva and you do show a preservation of bone mass (where there was a steady decline). What happens next year? Or the next? Or the next? These drugs, when used in ABs, have a body that has an active lower body in which to exert effectiveness. In our case, I don't see how taking drugs is a permanent solution to bone density concerns.

So am I just supposed to go around being paranoid, the longer I am in a chair? Scaling back the intensity of my training, my dedication? Every time I even bump my knee or hip relatively hard; or every time I accidentally drop my foot in the shower; I cringe. In part due to the pain and in part due to being scared that I'd just broken something. I guess this thread is just a vent, just a way to say I am scared about this.

[goose]

This is a common problem for all of us in wheelchairs. I am having the same concerns too. I will say in my 25 years in a wheelchair that I've only broken 1 bone. It was the case of my leg vs. a truck door....my leg lost. I was being transferred into the passenger seat when my foot got stuck in the door frame. Being that we were in a rush, my leg was forced but lost the battle. I endured a spiral fracture in my right leg.

I would suggest a complete bone scan so you'll know exactly what shape your bones are in. Your doctor can then recommend your options. You'll need to do your homework to choose the best treatment for you.

My problem is that my bones feel sore but I'm hoping it's just my muscles that are sore. My scan was cancelled for machine maintenance and I haven't rescheduled it yet. I don't like going to the doctor and tend to procrastinate. It's on my to do list!

[A trophy guy]

goose, on 12 January 2012 - 06:11 AM, said:

This is a common problem for all of us in wheelchairs. I am having the same concerns too. I will say in my 25 years in a wheelchair that I've only broken 1 bone. It was the case of my leg vs. a truck door....my leg lost. I was being transferred into the passenger seat when my foot got stuck in the door frame. Being that we were in a rush, my leg was forced but lost the battle. I endured a spiral fracture in my right leg.

I would suggest a complete bone scan so you'll know exactly what shape your bones are in. Your doctor can then recommend your options. You'll need to do your homework to choose the best treatment for you.

My problem is that my bones feel sore but I'm hoping it's just my muscles that are sore. My scan was cancelled for machine maintenance and I haven't rescheduled it yet. I don't like going to the doctor and tend to procrastinate. It's on my to do list!

(bolding mine)

That's just the thing; what options? Unless there is some new, groundbreaking treatment that I am unaware of, not much short of the Fosamax/Boniva, etc. route exists. And that isn't much of an option, in my opinion.

I know I need to see the doc, however, and find out exactly what I am living with. I think that is the only sensible thing to do. It doesn't make me any less scared and depressed though.

[goose]

Well, fear usually comes from the unknown. You bones may be fine. Do you drink alot of milk or take calcium? Millard took daily shots for 2 years and improved his bone density. Can't remember the name of the shots but he'd be good to speak to about this.


When you was growing up did you ever break any bones? Would you say you had small, med. or large bones before SCI? That would be a good indicator to start with.

[ramma7]

Just my opinion but.......I think all of us on here have fear inside them about there injuries/illness. But doesn't then make you feel kinda brave also
for dealing with it. Well that's how I deal with it. Like i said...Just my opinion and how I try to deal with my injury.
Good luck mate

[nomis]

Unless you get medical confirmation that you have a particularly severe form of osteoporosis, then I don't think you need to worry yourself too much.

I think it's healthy to have a little concern because it is a reality for all of us in w/chrs. So take care. But after more than 40 years I've had no problems (I hope I make it to bed ok tonight after saying this). The bones have been surprisingly robust...but I am careful.

I haven't done any standing for some 30yrs. The only thing I can put down any strength maintained in my bones is from being steadily active and generally healthy.

Now for the scare story. I know a para woman who broke her leg lifting it to dry her toes. She got really worried for her future since it happened so easily. That, however, was nearly 20 years ago and she hasn't had any problems since.

[N Chapman]

A trophy guy, on 12 January 2012 - 05:14 AM, said:

I know I have osteoporosis. Granted, I haven't been diagnosed but that is only because I haven't been tested. And even if I don't, I know I have lost (and continue to lose) so much bone density and mass that osteoporosis, and the subsequent risk of fractures, is but an inevitability.

I have worried about this from Day 1. I even got a standing wheelchair; and while it does offer other benefits, improving (or at least preserving) my bone density was the primary reason I got it. Only to find out later (a few years later, after diligently using it despite it boring the hell out of me on a daily basis) that static, or passive, standing does not improve bone density.

In addition to the loss of weight-bearing and use of my legs, I also have this severe atrophy which hastens the bone loss. I just lift my leg (with my hands, duh) and it feels so light; like the bones are made of styro-foam. And I feel defenseless. I want to be proactive, to do the things in my life necessary to prevent such problems from occurring in the first place. That is how I am used to facing problems. And now I feel like I can't.

Sure, there are drugs which work to try to preserve bone density; drugs like Fosamax and Boniva (among others). But, in addition to having the counter-intuitive side-effect of making you more prone to fracture; these are serious drugs. Serious drugs with serious implications on your body. With all the other medications many with SCI must take, adding this to the mix seems ill advised.

Especially when considering the futility of it all. Let's say you have a year's treatment with Boniva and you do show a preservation of bone mass (where there was a steady decline). What happens next year? Or the next? Or the next? These drugs, when used in ABs, have a body that has an active lower body in which to exert effectiveness. In our case, I don't see how taking drugs is a permanent solution to bone density concerns.

So am I just supposed to go around being paranoid, the longer I am in a chair? Scaling back the intensity of my training, my dedication? Every time I even bump my knee or hip relatively hard; or every time I accidentally drop my foot in the shower; I cringe. In part due to the pain and in part due to being scared that I'd just broken something. I guess this thread is just a vent, just a way to say I am scared about this.

You, mentioned that you have a standing wheelchair. Maybe, you should have an oswestry standing frame and with this equipment you should stand for an hour a day plus drink plenty of milk!!!!

[Edinburgh Colin]

You can take suppliments to help.
I take 1 gram of Calcichew D3 per day and 70mgs of Alendronic Acid once a week. Supposed to help fending off osteoporosis.
Having said that I did manage a compound fracture of my right femur in the summer!
EC

[Tetracyclone]

meditate, Grasshopper. To become human is to transcent the fears of the body...

[Grinch83]

Do have access to a therapy center that has an FES bike? I haven't tried it yet, but apparently using electrical stimulation on your legs to pedal a stationary bike will help with bone density, muscle atrophy and skin integrity. The rehab center near me has a few of these machines and I'm just waiting on a few personal things to get sorted out before I start with a regular program. It ain't cheap and it's not covered by my insurance so I have to shell out around $100 a month for two/three one hour sessions a week, but from what I've heard it can really help with all of the degeneration.

Also, for what it's worth, I've been involved in a bone density study since three months post-injury (so about a year ago) in which I undergo a complete bone scan at baseline (one year ago), one month, three months, six months and one year (just a few weeks ago I did the one year scan) and in that time frame I've found I lost about 25% of my bone density and am now "below average" for bone density for AB in my age group (27). This loss is considered "normal" for SCI and from what the research doctors have told me, it tends to plateau after the first year. So from what I understand, for the first year or so after injury one loses about 25-30% of their bone density, and then the loss slows dramatically after that. Don't get me wrong, we still lose bone density over time, but at a much slower pace after that first year.

As part of this study I am required to take 600mg of calcium and 400 I.U. of Vitamin D daily. Even if I were not part of the study, it has been recommended to me that I take this amount of calcium and Vit. D on a daily basis to maintain bone health and slow bone loss. Also, us SCI are almost always deficient in Vit. D.

My question? If a stationary standing is not beneficial to bone health, what is it good for? I have a standing frame and try to use it for an hour a day, three days a week as recommended by my physical therapist while still in rehab. And while I seem to have a better bowel program the following morning, I wonder what other benefits one gets from regular standing?

[Muskie]

I don't know if you have access to weight bearing treadmill at a rehab center, but it does use you muscles to help with atrophy and I would think bone density. There are 2 type one that is completely robotic and one that uses PT's to move your legs and hips. I know most neuro recovery networks have them as well as programs like project walk

[Tetracyclone]

Regardless of the effect on bone mass, standing frames are very good for heart strength and BP.

[Edinburgh Colin]

Tetracyclone, on 12 January 2012 - 11:11 PM, said:

Regardless of the effect on bone mass, standing frames are very good for heart strength and BP.

For those of us who were injured as adults it's also nice to stand tall again, it brings back good memories, especially when my wife and kids come and stand beside me and I can look down on the tops of their heads!
My 3 year old loves it as she cannot remember when "her daddy walked" and she giggles like mad!
Sorry for hijacking the thread.
EC

[edlee]

I gave mine away,, after using ,, for four years or so,, as a clothes pole. I thought I'd gain some space by getting rid of it,,, but,, as it turns out,,, stuff seems to accumulate to fill whatever space is available. Is that anything like " nature abhors a vacuum"?
ed

[rage]

edlee, on 12 January 2012 - 11:28 PM, said:

Is that anything like " nature abhors a vacuum"?

I would think Aristotle is jumping with joy in knowing his philosophies give meaning to where you place clothing, ed.