The waiting game

Right now, I’m waiting. On everything. Waiting for the DEXA (next week); waiting to find out if I have a job (supposed to start on the 10th but, seriously, who knows?); waiting to get construction plans from the engineer for a home project we’re hoping to do; waiting to hear from the bank whether they’re going to give us money for the construction project. It’s one big, long, endless, annoying wait. Tune in next Tuesday when (hopefully) I’ll have my newest DEXA scores. Those of you who are old hands, sorry I’m not writing. Those of you who are new, busy yourself looking at the archives. There’s tons of information there.

Hips for walking; ankles for running

ScienceDaily.com has an article about a study where they looked to see which body part generates the bulk of the “power” in different movements. And the results are not what I expected. Turns out that when you run, it’s your ankles that are generating most of the power for that movement (47% to be exact). But when you’re walking, it’s your hips.

Weird, huh? Who would think your itty bitty ankle could do that much?

Oh, but with the hip-power thing? Hips generate 44% of the power in walking until you get to the speed-walking phase – you know, where you’re walking so fast it would actually be more comfortable to just run? When you’re speed walking, I guess ankles takeover then too.

The article is talking about it from the standpoint of how to build devices or robotics that help people with locomotion. But I’m looking at it from the standpoint of what builds denser bones. So maybe walking is better than running?

Here’s something to give you nightmares: Bedbugs + MRSA

And if you don’t know what MRSA is, it’s that terrifying, potentially deadly, antibiotic resistant staph infection stuff. As if bedbugs alone weren’t bad enough, now it turns out they “may” be able to transmit MRSA to humans. May. If they don’t know for sure, why on earth do they report this stuff ?

Did I ever tell you about the time I sublet my apartment to some guy while I was out of town doing a show, and when I came back I found I had a bedbug infestation?

How do you know you have a bedbug infestation?

You don’t. Unless you’re allergic. And swell up in hives. All over your face and arms and neck and chest. And this happens while you’re on your third date with your future hubby. And he looks across the table at you and says (in reference to your hives), “Okay. It just got biblical.” And you reach up and feel your face and it’s like touching a sheet of bubble wrap. Enough with the graphic imagery, you get the idea.

Back to bedbugs and MRSA. Shiver. Why do people tell me things like this? And why am I telling you?!  So that I don’t have to suffer alone! Let’s all be terrified together!

Conflicting studies on gut serotonin and bone growth

Sometime last year (maybe it was the year before) I did a post on how a scientist (Dr. Karsenty) had discovered that mice who had too much gut serotonin had weaker bones. It went something like this:  humans with a genetic mutation that turns off something called LRP5 have very weak bones — so weak many cannot even walk. Dr. Karsenty genetically modified a bunch of mice to turn off / inactivate LRP5 and then observed that the mice had four to five times the normal level of gut serotonin. He then found that when he blocked gut serotonin production, the mice developed denser bones. And so the race to develop a drug that would block gut serotonin and thereby cure osteoporosis was born.

Well, hold on to your prescription pad because a new study has just been published that refutes all of those findings. In this study led by Dr. Matthew Warman, they found that gut serotonin levels had no influence on mice bone density at all.

[Dr. Warman's] group tried, but failed, to find that LRP5 has an effect on blood serotonin levels in mice or that those levels have a strong effect on bone.

When his group made mice with overactive LRP5 genes, the mice did make too much bone, but this had no effect on their serotonin levels. And when his group studied mice with inactivated LRP5 genes, the mice had weak bones but no increase in production of gut serotonin.

Dr. Warman and his colleagues also conducted a reverse experiment, producing mice that made very little serotonin in their intestines. They saw very little effect on the animals’ bones.

So whom to believe? The article concludes by saying the two teams used somewhat different methods to modify the genes they were studying (the LRP5), used different methods for measuring serotonin levels and different methods for measuring bone density. (Oh, why can’t labs all be consistent?)

I am a hardened skeptic, okay? But the fact that there is a drug company behind the research of one of the doctors (Karsenty) makes me lean ever-so-slightly in the direction of Dr. Warman.

BUT some scientists (besides Dr. Karsenty) believe SSRIs (anti-depressant medications like Paxil) work by raising gut serotonin levels, and we know (definitely know, not sorta think) that SSRIs cause bone loss. So I don’t know whom to believe. Doesn’t matter because I’m not taking any of those drugs. [Thanks for the link, Betsy!]

Viagra: It’s giving men something more than they bargained for.

Try hearing loss. There have to be better ways to … boost your … masculinity. Did I manage to say that without offending anyone?

Putting an end to bad myths from doctors

Yesterday, Nina wrote:

“…  I said I wasn’t talking about meds, I wanted to know if what I was doing (exercise, diet, supplements) could build bone when there’s old bone being prevented from exiting my body. She said all that could not build bone only strengthen the bones. I disagree, but still have the question about old bone staying around and no room for new bone.”

How does your doctor think the exercise is “making bones stronger” if it is not, in fact, making new bone? How would that work exactly? Do doctors even hear themselves talking?

The bones are stronger because there’s more of it! The exercise caused your body to up the ante on osteoblastic production and to make some more bone in order to keep up with the demands you were making on it.

Forgive me for repeating myself, but when I was in school for personal training, in my anatomy classes I learned that the human body is constantly making new cells. And every seven years, the cells of your skeleton have replicated / regenerated – whatever you want to call it. So the skeleton you have in 2011 is not the same skeleton you had in 2004. Before I even learned about the B.E.S.T. program or the Yoga vs. Osteoporosis program, my thinking was that if my body is making a new skeleton, I could through diet and lifestyle changes (exercise) encourage my body to make a better skeleton. Wolff’s Law proves that the skeleton responds to the stresses being made on it – that’s why the greater trochanter even exists. You would not have that huge knobby thing on the outside of your femur (thigh bone) if learning how to walk (and the muscles pulling on the thigh bone as you learn how to walk) didn’t cause it to develop there. Look! They’ve even got pictures of how it works in a medical textbook for cryinoutloud! (I hope you guys can read that fine print.)

The above picture depicts weight lifting, but the same is true for yoga. Only instead of one limb pulling against a weight, you have one limb pulling against another limb, pitting the strength of the two against each other. But both are effective.

Because our doctors keep telling us exercise cannot improve bone density; that our bones are our bones and we can’t grow new ones; and because I hadn’t stumbled on the picture above, I started wondering if I was the victim to some urban myth (or really bad anatomy teacher.) You know, “there are copperhead snakes in the button bins at Walmart” or “the moonwalk never happened” or whatever.

So I wrote to Dr. Fishman:

Only three more weeks ’til my next DEXA. Thanks for writing a prescription for me! I have a question which you may or may not be able to answer. It’s my understanding that we essentially have a new skeleton every seven years or so. It’s also my understanding that our bones are constantly being remodeled, the osteoclasts breaking down old, weak bone; the osteoblasts building new, healthier bone. And I know that bone responds to stresses placed on it (which is why the yoga study works).

So why then does my doctor (and everyone else’s doctor that I know of) tell me that it is impossible to grow new bone? That it cannot be done. Aren’t we in fact growing new bone all the time? No, I’m not getting taller or anything like that, but aren’t my bones constantly recreating themselves? If I see improvement on my DEXA, what is that if not more bone, i.e., new bone? And why do they think the drugs are so great when they know the drugs don’t build bone either, they just keep you from losing bone?

Just curious. If I have one more doctor tell me that it is impossible to reverse osteoporosis without the drugs I may run screaming in the streets like somebody out of a Greek tragedy.

Thanks,
Raye

And he wrote back:

You’re quite right. Just as your hair and nails grow, and your skin sheds all day and all night long, your bones metabolize. Yoga tilts the balance in favor of bone deposition, You know it even if your MDs don’t.

Loren

So this brings up a larger issue.

If doctors don’t remember/understand that your skeletal cells are constantly being replaced on a daily basis until, seven years hence, you have a new skeleton; if their belief is that the new skeleton can only be worse than your old skeleton; if they know that exercise makes bone stronger, but don’t understand that it’s stronger because exercise makes more bone — then no wonder they’re pushing drugs willy-nilly. But how tragic that they are so misinformed, they can’t offer patients exercise and diet as an alternative treatment.

Is it that they don’t believe people will keep up with the exercise? Or is it that they truly don’t believe in exercise? I don’t know.

It is a sad truth that exercise will not work for everyone, as Pam wrote yesterday. Sometimes there are so many things going on in the body and its systems are so out of whack, exercise isn’t going to be a big enough weapon. But if you don’t have anything else going on but osteoporosis, and no secondary causes (make sure they test you for everything), then why not give exercise, supplements and diet a try? Give yourself a time limit and go for it.

And Nina, sadly I don’t have an answer for you about whether or not you are depositing new bone in weak areas if the Fosamax is preventing the old bone from getting broken down in the first place. I’m sorry, I just don’t know about that one. But do know that your exercise is definitely having an effect. Congratulations on your new, improved scores!

The latest fitness craze? Ballet barre workouts.

Although I don’t think it’s that “new.” I can remember maybe 10 years ago, maybe more, Sarah Jessica Parker and New York City Ballet came out with these ballet workout DVDs. You know, if you didn’t do any the bending with the upper body, a ballet barre workout would probably be great for hip density and for posture. But I worry about all those sweeping movements at the bar where you hold your arm out to the side, then raise up on your toes taking the arm overhead and doing a little backbend (still a safe movement), then lower your heels to the floor and return to an erect postures (still safe), then take the arm out to the side and bend forward, sweeping the fingertips across the floor (very, very unsafe) as you move the arm in front of your body and return to standing. Or like when you put one foot up on the bar and then try to bend forward and rest your chest on your shin — very unsafe. You couldn’t do that.

But if you did the plies and releves and jetes and whatever that move is where you change the foot from front to back, striking the floor rapidly and hard with the ball of the foot as you scissor the legs back and forth — that would probably be great for hips. I wonder if you could find a ballet barre class and tell the teacher you have osteoporosis and can’t bend forward — I wonder if she could modify things for you?

I have one of the NYC Ballet DVDs. It is killer. And it makes me feel so mortal. The dancers on the DVD move so beautifully, and there I am clodding around my living room floor. Clunk Thunk Shuffle. You can read the article here.

I’m a slow bone maker.

I’ve talked on here about NTx testing before. And I’ve mentioned there’s an upper limit where, if your results are above that, it’s indicative that you are losing bone too quickly. I think the number is around 65. What I somehow managed to miss is that there’s a number that if you drop below it, it means you’re not making bone quickly enough – they call it low turnover osteoporosis.  Ideally, they say your number should be in the high 30s to mid 40s.

My number was 30 last year.

Urgh. At the time, I didn’t know about that “low turnover” thing. So I was all, “hee hee hee, no osteoporosis for me!” But looking back at all my bloodwork, the low NTX score combined with a low alkaline phosphatase score means I’m not making bone fast enough. So even though I’m not losing bone rapidly, I’m still in trouble.

Well. At least that explains why last year’s DEXA scores didn’t improve by as much as I thought they should’ve…

It says that low alkaline phosphatase can be a result of a bunch of scary things or of too much Vitamin D. Since I was taking between 4000 and 6000 IU of D a day last year, I’m assuming (hoping) that was it. Can I tell you how much I dread this years’ DEXA? I think I’ve been doing a lot of things wrong:  too much D (still); too much magnesium which has given me diarrhea (makes me worry I’m losing my nutrients too quickly); caffeine again; beer again; worrying again. (Oh, you don’t want to know how much I’ve been worrying. Mostly about things I have no control over like my neighbor and the economy.)

Dr. Fishman did write me a prescription for the DEXA. Hopefully my OB/Gyn will honor it. I really want to have the test done at the same machine by the same technician. I’m dreading the 7th, ya’ll. I worry I’m going to let you all down. That if I have bad scores, you’re going to lose faith in the exercise stuff, even though my bad scores will probably have more to do with my horrid diet and out of control anxiety (and annoyingly slow bone making) than the yoga program.

I remember reading somewhere that people who have anorexia and exercise bulimia have low alkaline phosphatase. I wonder if that sticks with you, like if your body’s system gets reset/stuck in that mode even after your eating habits have returned to normal?

So I finally ordered the lactoferrin today (since that’s supposed to help with the bone building markers.) Argh!! Three more weeks!

Pasta primavera as you’ve never had it.

… with selectively chosen combinations of fresh vegetables, not overcooked, and without the cream. Whole Wheat Penne with Chard and New Potatoes, Bucatini with Butter Braised Turnips and Sage, Orecchiette with Favas, Watercress and Brown Butter — and more. Click here and prepare to have your mouth water.

Why do I pay a hairdresser?

As I mentioned before, after having spent a considerable amount of time (1 year) growing out my hair, the last time I went to the hairdresser I wound up with a cut that made me look like the love child of Ziggy Stardust and Mrs. Partridge. For two months I have suffered with this awful cut. No matter what kind of styling product I used, no matter if I blew it dry or allowed it to dry on it’s own, no matter what I did it just looked bleh.

When I’d gone to the hairdresser, I told him I wanted to go with a stacked bob and then continue to let it grow out. He said he thought a bob was a little “safe” for me, and then gave me … a modified mullet. Ick.

Today, fed up with looking like I was wearing a perennial coonskin cap a la Davy Crockett, I took the scissors to my head. Did I mention my husband is out of town and I’m bored? Never leave me alone with scissors. Anyway, with enough styling product, it looks okay. It’s going to wing up and do goofy things around my left ear, but even when I pay ton-o-money for a haircut, it will wing up and do goofy things around my left ear. I think I’ve got a cowlick over there or something. I have cowlicks everywhere. Two in front, one over the left ear, one at the crown of my head, another at the nape of my neck.

Anyway, here’s the result. (I’m cheating and only showing the non-winging-up-un-goofy right side of my head.)

UPDATE:  After further consideration, this haircut does make me look a little like the love child of Louise Brooks and Justin Bieber. I’m not certain that’s a bad thing. I’m not certain that’s a good thing either. It just is. Like gravity.