Using a Prosthesis with Osteoporosis

I am a disabled Marine Corps Veteran, Above Knee Amputee with Gentamicin Toxicity induced hearing loss and vestibular damage. I am currently on 5mg Prednisone/Day for Polymialgia Rheumatica and have recently been diagnosed with Osteoporosis. Dexa scan was -4.9 in left hip, -3.6 in right hip, and -2.1 in spine. I am trying, for the 4th time, to get up and going with a prosthesis. Prior to my AKA I was a Below Knee Amputee and did everything. The balance issues caused by the vestibular damage are the "monkey wrenches" to my success with walking. My physical therapist says the best I can hope for is to walk with the assistance of a walker. With the new issue of Osteoporosis I'm wondering what is "realistic" in the area of goal setting. I've been in a wheel chair for 15 years and continue to push for a more ambulatory lifestyle. Also, I do quite a bit of hopping on my right leg when I don't have my prosthesis on. I'm wondering if this is why my right hip shows less osteoporosis?

Edited July 3, 2011 at 12:26 pm

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Thank you for your service, USMCVet. And congratulations on surviving breast cancer! I can see you are a fighter.

I have no idea what goals are realistic for you, not being a PT or doctor. Maybe the answer is to just keep trying--because after all, walking in a walker is terrific compared to being in a wheelchair. Maybe your PT is wrong, and maybe she/he is right. I do know that the longer you stay off your feet, the more you lose bone in your hips. The shape of the femur will actually change.

Last week I joined this forum because my doctor told me, "It's too late for you." She was wrong, and by now I know that, and I'm certainly not going to act as though she's right. I have EDS, Lyme, and fibromyalgia (and now osteoporosis), and I'm as functional as I am today because I just keep pushing and fighting. I was dealt some crummy cards, but I find that hope and the struggle to meet goals are what make life worthwhile.

So that's all I have for you today, just my own story and my own idea of what makes life worthwhile--hopefully it helps--and advice to keep up the good fight while never yielding hope. Set the goal of walking in a walker firmly in your mind because you KNOW you can get there (you can!), but secretly hold onto your dreams and don't let anyone with a few years of possibly-not-so-good-education and maybe even not a whole lot of life experience talk you out of them. Dreams are important.

And spend some time on this site so you can get good information about things like Vit D3, MK4, the real medical value of optimism and exercise, and so forth.

Good luck!

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Seems like you must have some way of compensating for the balance issues since you are able to hop on one leg. I would think that ability would somehow translate to being able to maneuver with the prosthesis.
As far as the osteoporosis problem, it's really hard to say. The number in the left hip is pretty high, and your cause for this could be longterm usage of steroids. Conventional wisdom says to avoid falls at all costs. But, I don't think you're very conventional and are determined to live a more ambulatory lifestyle. We've all heard the "you'll never walk again" stories that have been overcome. Since I'm not much of a gambler and certainly don't have the bravery of a former marine, I would probably bow to the majority opinion. But then, nothing ventured, nothing gained.
And, it sounds like you've done some research on the process of bone building and shedding. Osteoblasts and Osteoclasts. You seem to know that some impact on the bones speeds up the shedding and building process for healthier bones. It could be the weight bearing hopping on the right leg that resulted in better scores. But, I'm not medically trained.
I'm sure you will do your very best to reach whatever goals you decide are doable. You've proved that by your persistence and drive.

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Happy Fourth of July! Thank you so much for your service to our country. I certainly admire you and all the men and women who have served. We all owe you a debt of gratitude. Since one exercise to build bone is jumping rope, I bet hopping has been helping. I refused to take prednisone for a foot problem, as I had osteoporosis and did not want it to get worse. I am eating more fruits and vegetables, taking Ultra Bone Up by Jarrow to help build bones. New Chapter Bone Strength is very good too. An 80% alkaline diet to 20% acid diet helps. Better Bones web site with Dr Susan Brown is a good site. She has a FRAX(fracture assessment you can do)to see where you are, and gives tips on things you can do to help prevent fracture. Some come up with DEXA scores that are bad, but never fracture. Others have mediocre scores and fracture. I hope that you will keep reading the posts, and do more research. I got serious about a year ago, and do feel it has paid off. With your spirit I know you will find what is right for you! :)

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Thanks for your encouragement, Chaya7! I plan on continuing with my prosthesis. My intention isn't to discredit my Drs. or therapists, however, I believe people living with chronic medical conditions are able to offer lifestyle advice that might be passed over between the Drs., therapists, and patient.

Two years ago my immunology Dr. started me on 1,000 IU D3/day and 500calcium/200vit.D twice a day because my calcium levels were low. I'm not familiar with MK4... but will check into that, also.

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Keep reading/learning & keep trying. That's the best any of us could do. So many people have been told by doctors that there is "nothing else", but what they meant was that there was nothing else that that particular doctor knows about. I have found that Integrative Medicine doctors & CAM (Complimentary & Alternative Medicine) practitioners can come up with more ideas & more "natural" ways to deal with health issues (than some of the doctors know about).

For example, Yoga for Osteoporosis, is one thing I learned about through this website. The study is ongoing, but the yoga has had some good results.
You might be able to adapt some of the poses, if you are interested (contact them). I don't mean to sound like a commercial, but it sounds promising.

http://www.huffingtonpost.com/loren-fishman-md/pilot-study-and-new-book_b_3 84430.html

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Loren Fishman, MD.Medical Director of Manhattan Physical Medicine and Rehabilitation in New York City, Author, "Yoga for Osteoporosis"
Posted: December 8, 2009 02:43 PM BIO Become a Fan Get Email Alerts Bloggers' Index .Pilot Study And New Book Prove Yoga's Benefits In Treating Osteoporosis
As a physician and advocate of integrative medicine, I have shown that Yoga can improve upon or substitute for traditional Western medical treatments for osteoporosis, which affects 200 million people worldwide. And I have co-authored "Yoga for Osteoporosis" (scheduled for publication by WW Norton on March 29, 2010) to provide individuals some achievable control over their own bone health.

Both men and women are subject to osteoporosis; 50% of hip fractures in people over 55 contribute either to death or to nursing home admissions. It's well-known that physical activity, weight-bearing and strenuous exercise, will help keep osteoporosis and its precursor, osteopenia, at bay. But much strenuous weight-bearing exercise has serious disadvantages, which must not be underestimated when thinking about your health, while Yoga has unique and wonderful advantages.

High impact aerobic activity, and even jumping rope, (which has recently and mistakenly been recommended for osteoporosis) leads directly to osteoarthritis. That foot-pounding, hips flexing, knee impacting, spine-jarring activity takes men and women trying to prevent or reduce bone loss out of the frying pan and puts them in the fire of developing painful, crippling hard-to-control osteoarthritis. Older people are confronted by a dilemma: Too much impact exercise and you will help your bones while hurting your joints. Don't exercise and your osteoporosis will advance. It's both ends of the bone against the middle.

While Yoga is no panacea, it does provide weight-bearing exercise with none of the dangers that lead to osteoarthritis. Yoga pits one muscle group against another to generate forces far greater than gravity. Yoga is isometric exercise. It is also weight bearing. Both of these types of activity have been proven to improve bone strength. Unlike most forms of "weight-bearing" activity, Yoga does not damage cartilage or lead to osteoarthritis, another peril of aging. Yoga stretches the muscles, increasing the range of motion that osteoarthritis otherwise inexorably narrows. By improving range of motion, Yoga counters the chief and sometimes terrible impairment that comes with osteoarthritis.

Some Yoga postures seem to have been designed many hundreds of years ago specifically for those who want to keep their bones strong. That's one reason my co-author Ellen Saltonstall and I wrote "Yoga for Osteoporosis". In the book we describe which Yoga poses are good for preventing or reversing bone loss safely and give detailed instructions about how to do them. Every pose is presented with three different levels of difficulty: one to be done by beginners, one for intermediate, and then the classical pose, generally for experienced practitioners. Every pose has a list of contraindications, and modifications for people with different levels of physical well-being.

"Yoga for Osteoporosis" includes the results of the pilot clinical study I did to examine just how much Yoga can help this dangerous condition. During the two-year study, participants added more than 3/4 of a point on the T scale in their DEXA bone density tests for the spine and 4/5 of a point for the all-important hip, with only 10 short minutes of yoga daily. That means that participants hovering about half-way between osteoporosis and osteopenia -- those with a diagnosis of osteopenia - improved enough to re-enter the normal range. Several of the patients who had full-blown osteoporosis improved enough to be re-classified as having osteopenia.

The average age of people in my study was 68 years, but Yoga would have helped if they were as young as seven years old or as old as 107, either to prevent, halt or reverse the process of bone loss. Eminently portable, quiet and just about free, yoga has few undesirable side-effects. Participants in my study did over 20,000 hours of yoga. There was not one injury!

Since I did that pilot clinical trial, more than two hundred people have asked for the video I made to help them do the Yoga correctly and have joined the larger study that is now progress. I have been following the results, which are, taken as a whole, retaining their significance.

Yoga's other positive effects that have been demonstrated fairly persuasively (by Western standards) include reducing lower back pain and blood pressure, better coordination, better posture and increasing the thickness of the cortical layers of the cerebrum.. In addition, Yoga improves strength, refines balance and fosters calm. All in all, there are few if any ways as simple and effective for treating osteoporosis.

To enter the study, do daily Yoga and receive a free 10 minute DVD, please go to Sciatica.org.

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Patsugarloaf,

Since I'm new to Osteoporosis, I'm not knowledgeable concerning the process of bone building and shedding or Osteoblasts and Osteoclasts. Information like this is what I'm looking for as I go about determining what lifestyle modifications I should consider.

While I'm not steady enough to master crutches, I do a fair amount of hopping along the kitchen counter which I think does help keep my right leg conditioned to some degree. Last year I fell, and two weeks later found out I had 3 fractures of my sacrum and 2 fractures of my coccyx. I've always been one to take risks, but am beginning to realize there is a fine line between taking a risk and being foolish. lol

I believe it takes the bravery of a Marine to live with chronic medical conditions. Every day is a battle to be fought and won. Thanks for the information and encouraging words. I wish you well as you fight Osteoporosis in your life.

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Sally48,

Thanks for the suggestions and the web site with Dr. Susan Brown. I briefly checked out the web site and found several things I can do minimize some of the risk factors associated with Osteoporosis.

I'm a bit overwhelmed with educating myself and implementing the necessary changes, so am very thankful for all the advice I'm gleaning from this site. "One stop shopping" helps make it a more manageable process... thanks!

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First having worked as a therapist for the V. A. and learning what our soldiers go through you have my utmost admiration. Second look at www.osteopenia3.com its a very useful site loaded with info on bone building and has reasonable info. Kate

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Thanks for the yoga "commercial," petplant! lol This sounds great and I'm intrigued with the correlation between yoga improving balance and coordination which might help compensate for my vestibular damage. This is definitely something I'm going to educate myself on.

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Hey Kate, thanks for helping vets! Wow, the osteopenia3.com site has some great stuff. My PT has me doing the strength and balance exercises... I have Oscillopsia from Gentamicin Toxicity, too, so my balance really sucks, but I'm seeing some improvement. This site also mentions yoga, which I'm excited to try.

I'm slow responding because reading kind of challenges me, but I'm very appreciative of all the great advice so far. Semper Fi!

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I hope you find what works for you!
Best wishes!

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