Veinous Thromboembolism and Protelos.

This has been swirling around on NOF for a few weeks now, but I thought I should talk about it. Protelos now comes with an advisory warning that it can cause deep vein thromboembolisms. Protelos, as many of you know, is the European prescription form of strontium, called strontium ranelate. Does strontium citrate cause similar issues? It probably could, since the strontium is the active ingredient and the ranelate is just a salt.

Strontium ranelate is also associated with DRESS (Drug Rash with Eosinophilia and Systemic Symptoms; i.e., an allergic reaction.)

Who is at risk? People who already have had veinous thromboembolism incidents and people who are sedentary. For the rash, it usually shows up during the first 10 weeks of taking the drug. If you don’t have any rashes or other allergic symptoms during those first 10 weeks, then allergy-wise, you should be okay. (Although sometimes people do develop allergies to things later on – like me and pineapple.) Other know factors that increase your risk of VTE are hypertension, diabetes mellitus, cigarette smoking, and high cholesterol levels.

Hereditary factors that increase a person’s risk of VTE:

• Factor V Leiden mutation
• Prothrombin gene mutation
• Protein C or S deficiency
• Antithrombin deficiency
• Hyperhomocysteinemia
• Elevated levels of factor VIII
• Dysfibrinogenemia

Other things (outside of heredity) that increase risk:

• Surgery
• Trauma
• Medical illness (heart failure, chronic obstructive pulmonary disease)
• Immobilization
• Pregnancy, oral contraceptives, hormone replacement therapy
• Indwelling central venous catheters or pacemakers
• Cancer or certain cancer treatments
• Antiphospholipid syndrome
• Heparin-induced thrombocytopenia
• Inflammatory bowel disease (I may have this one…)
• Myeloproliferative disorders
• Air travel (keeping your legs moving on a plane reduces the risk.  Step in place at your seat.)
• Body mass index >30 (i.e., being 30 pounds overweight.)
• Previous episode of venous thromboembolism

The guidelines for strontium ranelate:

• Physicians should not prescribe strontium ranelate to patients with current VTE (veinous thromboembolism) or a history of VTE or to patients who are temporarily or permanently immobilized.
• Patients with current VTE or a history of VTE and those who are temporarily or permanently immobilized are advised to discuss their treatment with their physician at their next scheduled appointment.
• When treating patients older than 80 years who are at risk for VTE, clinicians should reevaluate the need to continue treatment with strontium ranelate.
• Prescribers should make patients aware of the time to onset and likely signs and symptoms of severe skin reaction such as DRESS, SJS, or TEN. The highest risk for occurrence of SJS or TEN is within the first weeks of treatment; the risk is highest usually around 3 to 6 weeks for DRESS. Symptoms or signs of SJS or TEN include progressive skin rash, often with blisters or mucosal lesions; symptoms of DRESS include rash, fever, eosinophilia, and systemic involvement (eg, adenopathy, hepatitis, interstitial nephropathy, interstitial lung disease).
• Patients should stop treatment immediately when symptoms of severe allergic reactions, including skin rash, occur. Treatment should not be restarted at any time in these patients.

Am I going to panic about the above and stop taking strontium citrate? No. Because I am very physically active.  But I am glad that I’m taking the half dose instead of the full dose.

You know, calcium supplementation comes with it’s own risks as well: plaque build up. I’m betting that my D3 and K2 are going to help prevent this issues in my case. But I will mention it to my doctor.

You can read more about VTE here.

Chocolate for weight loss? Now there’s a diet for me!

Not that I need a “diet.” I’m too skinny. Maybe it’s because of all the dark chocolate I eat. (I do eat a fair amount of chocolate.) The New York Times has an article today about how people who regularly eat more chocolate weigh less than their contemporaries who don’t eat much chocolate – even though the chocolate eaters consumed more calories and exercised the same amount as the non-frequent chocolate eaters. Cool. Dark chocolate is also known to be good for lowering blood pressure and cardiovascular risk, and helps regulate insulin uptake as well (which is weird – you’re eating something that has sugar, and it helps you regulate sugar.) From the Times:

Dr. Golomb’s study, published in Archives of Internal Medicine and financed by the National Institutes of Health, involved roughly 1,000 adults. The researchers looked at data on how often they exercised, the amount and type of calories they ate — including a breakdown of the types of dietary fat they consumed — and how their health and weight related to their chocolate intake. On average, the subjects were middle-aged, exercised about three times a week and ate chocolate about twice a week. There was no breakdown of the kinds of chocolate they ate, whether dark, milk or white.

The people who ate chocolate the most frequently, despite eating more calories and exercising no differently from those who ate the least chocolate, tended to have lower B.M.I.’s. There was a difference of roughly five to seven pounds between subjects who ate five servings of chocolate a week and those who ate none, Dr. Golomb said.

Chalk it up to those wonderful isoflavinoids. I wonder if hot chocolate counts, too?

86-year old gymnast puts us all to shame.

Now there’s something to which we can all aspire! (Or by which we can all be inspired!) Holy cow! I love this! I wonder if she was always a gymnast? (More than likely, yes.) But … just… wow.

Metal on Metal hip replacements: bad news on a cracked plate. But the company kept selling them anyway.

By now I’m sure most of you have read about the problems with metal on metal hip replacements: how they breakdown prematurely; how the little shards of metal can get in your bloodstream. Yet DePuy, the company that manufactured the artificial hips, continued selling them to doctors in an effort to deplete its entire inventory for as much as a year after all the health problems came to light. Big lawsuits brewing over that one. Serves them right. Corporations: they’re not people, nor do they have our best interests at heart.

I’m almost done with this show.

The last draft is dragging on for-ever. Possibly because they take a secret delight in prolonging my agony.

Speaking of agony - I just read an article yesterday that said that the American Academy of Dermatology is reporting that acne is becoming more common in women of all ages. 55% of women in their 20s have it; 25% of women between the ages of 40-49 (lucky me to be in that 1/4 of the female population). No word on what I can look forward to in my next decade. Ugh. I think it’s all stress related, but that doesn’t make it any less agonizing trying to find ways to cover the pimples with make-up, yet somehow not have make-up caked in all my wrinkles. Yeah. You try and figure that one out. I’m probably being more sensitive about it than I should be, but then again my nicknames in junior high school were “Dr. Pimple” and “Pizza Face.” Some childhood agonies never end.

Oh!  Oh!  Remember when we were discussing BonOlive? Well, it turns out that LifeExtension now has this Omega supplement that also has the olive extract in it. As with all things Life Extension Brand related, it ain’t cheap. But I got some anyway, because Omega-3s in general aren’t cheap. At least not if you get the ones with the salmon and what is it? Mackerel? that you’re supposed to get. I should really just join LifeExtension already so that I can get the member discount. Between the Super K, Super Curcumin, Two Per Day Multi, and now the Omega-3, I think it’d be worth it.

Lastly, I wore my weight vest to my body combat class the other night. It kicked my behind! Great way to add a little challenge to the same-ole, same-ole. I’m surprised gyms don’t stock weight vests specifically for that purpose. They should think about it.

When this job finally DOES end, I will definitely go to a Silver Sneakers* class and let you know what I think. And I should be back to blogging with more regularity.

Want to save a life?

Graham and Britton Douglas

I love everything about this story. Twin brothers. One had leukemia. They’d always assumed they were fraternal twins, so the brother who didn’t have leukemia was going to give a bone marrow transplant to save the brother who did have leukemia. Only it turned out they were identical, not fraternal. Their blood was too close for the twin’s donated marrow to be able to effectively fight off the leukemia. A stranger made a bone marrow donation at the last minute that saved the dying twin’s life.

The non-sick twin vowed he would invent a way to make finding bone marrow donor matches easier to find. And he did. And it’s brilliant! Brilliant!

He’s selling boxes of bandaids where a DNA swab kit comes in the package of bandaids. So if you cut yourself, before you slap a bandaid on it, you do a DNA swab, put it in the little self-addressed, stamped envelop that comes with the DNA swab in the bandaid package. and send it off to a lab.

Et voila! Faster and easier location of donor matches. Thousands of lives saved. The box of bandaids costs around $4.00. You don’t have to become a bone marrow donor if you don’t want to; but if you do, simply let the lab know you want your name added to the registry. All donors names are kept anonymous. FYI, donating bone marrow is fairly simple.

There are two ways to donate: having blood collected from the arm during an outpatient setting or directly extracted from the hip in a surgical procedure that requires anesthesia. The first takes about five hours and the second requires an overnight stay in the hospital.

Once collected, doctors separate out the stem cells needed for transplant. Patients recover quickly and regenerate their bone marrow.

The name of the product?  “Help I’ve cut myself and I want to save a life!” Genius! Sheer genius!

More info on becoming a bone marrow donor can be found here. And here’s their funny little commercial.

Yoga, exercise, mood elevation & other goodies.

I tend to do my yoga before bed. But I know some people feel it’s best if you do your practice first thing in the morning. I have, on occasion, done the roll-out-of-bed-and-start-sun-salutating. It leaves me feeling so… human… as in not yogi like… as in a mere mortal. Because my muscles are so tight first thing in the morning. I suppose one could argue that the yoga then loosens them up so that you feel great for the rest of your day. However, something about yoga makes me extremely relaxed; I’m more likely to want to go back to bed than I am to want to seize the day. Mid-afternoon practices have been fantastic for me. I’m often surprised by how much more energy I have (and focus) in a mid-day practice than those last-thing-before-bed-practices. But old habits are hard to break. I’m in the habit of the before bed practice. So it was with some relief when Dr. Fishman recently weighed in on a “what time do you practice?” question on the yoga-vs-osteoporosis discussion board.

Yoga is a wonderful way to prepare for sleep. It can enliven you too, if used properly. — Dr. Loren Fishman.

So there you have it. Whatever works for you. Yay.

I posted awhile back that I had been feeling a bit blue. ScienceDaily has an article that says recent studies point towards there being some evolutionary advantage to being depressed. That it somehow helps fight infection? There was a time in my life when I must have been the most infection-free person on the planet. Get this: people who are genetically prone to depression are also prone to have higher levels of inflammation because they tend to have over-active immune systems. (Are you seeing a pattern here? Me… inflammation… depression… bones?)

For several years, researchers have seen links between depression and inflammation, or over-activation of the immune system. People with depression tend to have higher levels of inflammation, even if they’re not fighting an infection.

“Most of the genetic variations that have been linked to depression turn out to affect the function of the immune system,” Miller says. “This led us to rethink why depression seems to stay embedded in the genome.”

“The basic idea is that depression and the genes that promote it were very adaptive for helping people — especially young children — not die of infection in the ancestral environment, even if those same behaviors are not helpful in our relationships with other people,” Raison says.

Then it gets really interesting. They throw eating disorders in the mix.

The authors propose that evolution and genetics have bound together depressive symptoms and physiological responses that were selected on the basis of reducing mortality from infection. Fever, fatigue/inactivity, social avoidance and anorexia can all be seen as adaptive behaviors in light of the need to contain infection, they write.

The theory provides a new explanation for why stress is a risk factor for depression. The link between stress and depression can be seen as the byproduct of a process that preactivates the immune system in anticipation of a wound, they write.

On the opposite end of the spectrum, physical activity makes people feel more enthusiastic and excited. If you’re feeling blue, go for a run. Or … you could go where fashion sits, putting on the Ritz.

And the good news about Vitamin D just keeps coming. The latest? It helps shrink fibroid tumors. Caveat: they’ve only tested this in Rats. No news about whether it works in women.

For the current study, the researchers tested the vitamin D treatment on a strain of rats genetically predisposed to developing fibroid tumors. After examining the animals and confirming the presence of fibroids in 12 of them, the researchers divided the rats into two groups of six each: those that would receive vitamin D and those that would not.

In the first group, small pumps implanted under the skin delivered a continuous dose of vitamin D for three weeks. The researchers then examined the animals in both groups. Fibroids increased in size in the untreated rats, but, in the rats receiving vitamin D, the tumors had shrunk dramatically. On average, uterine fibroids in the group receiving vitamin D were 75 percent smaller than those in the untreated group.

The amount of vitamin D the rats received each day was equivalent to a human dose of roughly 1,400 international units.

I have a lot of fibroids. Or maybe I should say “had.” Only the next ultrasound will tell…

An abstract in Medicine & Science in the Sports & Exercise section discusses the link between inactivity and blood sugar levels.  In the study, scientists had volunteers reduce the numbers of steps they took each day by half. First they outfitted volunteers with pedometers to know what their normal number of daily footsteps were; and then told them to do half that amount for three days,

“Spikes and swings in blood sugar after meals have been linked to the development of heart disease and Type 2 diabetes.”

Besides pedometers to measure footsteps, the volunteers also got these glucose monitoring do-hickeys that checked blood sugar levels continually throughout the day. And they kept food diaries. Now, it should be noted that the volunteers were all fairly active before this experiment. The average number of steps each volunteer took per day pre-experiment was just under 13,000 steps. FWIW, 13,000 steps is around 6.5 miles (depending on the length of your stride); 10,000 steps daily is about 5 miles. So during the study, at first the volunteers wore the glucose monitor gadgets and did all the stuff they normally did in terms of walking, exercise, kinds of meals they ate – and their blood sugar didn’t spike after they ate.

In the second part of the experiment, the volunteers kept eating the stuff they usually ate, but cut their daily steps back to below 5,000 steps per day for three days. By doing “average American” activities like taking the elevator instead of the stairs, or having food delivered instead of walking out to get it, the volunteers managed to get their steps down to around 4300 per day, which — and this is terrible — The article says 4300 steps per day this means volunteers exercised just three minutes daily. YIKES.

So what happened with their blood sugar levels in these three days of decreased activity?

… volunteers’ blood sugar levels spiked significantly after meals, with the peaks increasing by about 26 percent compared with when the volunteers were exercising and moving more. What’s more, the peaks grew slightly with each successive day.

Wow! That kind of change in just three days? And it got a little bit worse with the passing of each of those three days! Silver lining? Blood sugar regulation returns to normal very quickly as soon as you start moving again.

I know I haven’t written — I know, I know!

Just bear with me while I finish up this last order of scripts. I think the entire world has lost its mind right now – including my boss. Have you guys been noticing all the hostility to women in the news lately? I feel like someone is trying to shove me back into 1952. Newsflash: I ain’t going. Just get me through these next three weeks, that’s all I ask. Let me get through these next three weeks with a few active cells of sanity left.

P.S. what do you do about a neighbor who constantly comes to your house uninvited? As in daily. And calls you and texts you two to five times per day? (For the record, more frequently than my hubby calls.) I don’t mean they show up at the door. I mean they show up and then open the door and walk into your house. One time when she showed up, I was actually naked, getting ready to hop in the shower and was sitting on the toilet. I heard her open the door and call my name. But being naked and in the middle of a bowel movement, I thought if I didn’t answer she’d go away. Wrong. She walked into my kitchen and I heard her open the refrigerator door. Then she started walking up the stairs. The bathroom door was open and I couldn’t close it because I was (foolishly) worried about how I’d explain not having answered when she called my name. So I tip-toed into the bathroom closet (which has a lock on its door) and locked myself in the closet (trying not to make any noise.) I hid there for… I dunno. Half an hour maybe? Until I was certain she was gone. And even then I wasn’t certain. I was half convinced I’d open the door and find her sleeping in my bed or sitting on my sofa eating my roasted almonds or something.

This “showing up” is now happening daily. If I remember, I lock all my doors and close all the drapes so that she can’t get in or see inside. I hear her try the doorknob, and when she can’t get in she walks around the outside of the house looking in the windows. So I, being so mature, hide behind the back of the sofa until I hear her go away.

This is insane, right?

Have I told you guys this before? I forget.

And you know, we sometimes rent out our house to help pay the mortgage. I’m terrified she’s going to pull this stunt while there are renters there. In fact, she did. But the renters were at breakfast and didn’t see her. She calls me on my cell (the weekend the renters are there), and says, “I just stopped by your house, but you weren’t there.”

I went ballistic. (Because I have told her repeatedly she cannot just “show up” at my house. Her response? “What kind of car do you drive?” (I’m assuming her thought is, “If I see a car that isn’t your car, then I won’t go up to the door.”) I don’t remember what I said, but I there was yelling involved. Something along the lines of “It doesn’t matter what kind of car I drive! You shouldn’t just be showing up uninvited!” I said something about how people pay a lot of money to stay at my place, she cannot just stop by. Blah blah blah. Her response? “Well, if you’d answer your phone when I call, I wouldn’t have to stop by.”

Does this count as being stalked? Should I file a police complaint? Help!

The past two weeks, this behavior has been escalating. And since she paid absolutely no attention to my screaming fit on the telephone two Mondays ago — when she’d called and said she’d stopped by when the renters weren’t there — which is when I started locking doors, closing drapes, and diving behind sofas.

So today, I heard her try my doorknob (which was locked) and then knock on the door. And I thought, I have to settle this once and for all. Because the five phone calls, two text messages, and one uninvited drop-by per day are driving me insane.

So I go to the door in my underwear (didn’t even bother to dress, that’s how mad I was!), shaking my head, threw open the door and said, “You CANNOT keep doing this!  What part of “Don’t drop by” do you not understand?”

And then more excuses from her:

Rude Neighbor (RN): “There’s no renters here. I thought you said not to drop by when renters are here.”

Me: “It doesn’t matter. I’m working. I’m trying to WORK! I work from home and I can’t do it with you interrupting me all the time.”

RN: “But you said you were coming up for air.”

NOTE:  I’d texted her in response to the four days worth of phone calls and texts that I’d ignored that I was still swamped with work, but had a second to talk. I meant on the phone. I didn’t mean for her to just show up on the door.

Me: “I meant I could talk on the phone. I said to call me back, I was available until — (LOUD GROAN) — What do I have to say to get you to understand that you CAN’T do this?!! (Now I’m almost in tears.) You are driving me crazy! This doesn’t work for me. I’m not that social a person. You have called me more in the past five days than my own husband. The balance of things is off when I’m having to explain my whereabouts more to you than I do to him. I’m am not a “drop by” kind of person. And this has nothing to do with you. It’s not that I don’t like you. I don’t like this dropping by. I sit down to try to write, and in the back of my head I think, “when is [RN] going to show up today?” I know I’m going to be interrupted. So it’s like I can’t do anything, I can’t focus at all, until that interruption is over.”

RN: (hugs me) “I’m sorry. I won’t do it anymore.”

And then —  she shoves past me into my house and sits on my sofa and blabs at me for 30 minutes. And because I feel so badly about yelling and I worry so much about hurting anyone’s feelings, I can’t say what I really want to say, “Get the F**K out of my house and offa my yard!”

So when RN gets ready to leave, she say, “Don’t worry. I won’t drop by anymore. But you’re always welcome to come in my door anytime you want.”

Me: “Okay. Thanks.”

And part of me gets the feeling that she still doesn’t get it. So I add:

Me:  ”[RN], I’m not kidding you. You walk into my house when my hubby is here, and he is going to chew you a new a**hole.”

RN: (indignant) “I’ll chew him one back!”

And I’m thinking: on what grounds? You still don’t get it! He has every right to scream at you for trespassing. But I don’t say that. Instead I say:

Me: “I’m serious. You come in this house or drop by uninvited while he’s here, and he is calling the police.”

RN: (waves her hand dismissively) “He will not.”

Me:  ”He will!  I’m serious, he will!”

Off she goes with a dismissive wave of her hand.

So I go upstairs and try to call the hubby to tell him what happened. NOTE: I am not wearing my hearing aids while all this is going on and I don’t put them in after she’s gone because I can turn up the volume on the cellphone and hear okay. The rude neighbor talks so loudly, I don’t need my hearing aids when conversing with her.

Anyway, I go upstairs, get my cell and call hubby, but hubby isn’t home so I leave a brief message on the voicemail. And then I try his cell. but don’t get him there either, so I leave another brief message on his cell. And then I call my friend, Vicki, who is very concerned about this situation and keeps urging me to go to the police. I call Vicki, and I’m retelling the entire conversation (much as I’ve done on this blog), and I’m just YELLING in frustration. And I veer from recounting what I said to Rude Neighbor to just a general venting about the neighbor.

Then I hear this sound (I don’t have my hearing aids in) that sounds like the dog is scratching at the door to get in. So I walk downstairs to let the dog inside. Only she’s already inside. She’s hiding under the table (because she doesn’t like it when I yell.)  I look out the little windows in the front door and see Rude Neighbor making her way to the drivers’ side door of her car. And I think, that’s weird. She left ages ago. Why is she still here? Momentary worry that she heard me yelling, but then I think, “She’s outside. She just heard generalized yelling, probably not specifics of what I was saying.”

In retrospect, I realize the sound I thought was my dog’s nails on the glass door was actually the door latch opening. My neighbor must’ve let herself in my house again without knocking. I’d neglected to lock the door behind her when she left because… well… after all that had been said, I thought she’d gotten the message. More than likely, she thought of one more stupid thing she wanted to tell me and figured there was no harm in letter herself in again, since she’d just left.

I feel badly that she probably overheard me talking so vehemently about her. But another part of me thinks she deserves it for (yet again) not honoring my wishes.

So what do I do? (And I don’t mean, do I apologize. I don’t think I owe an eavesdropping trespasser an apology.)

I mean, I still don’t think she’s gotten the message that she can’t barge into my house or into my life. Do I go to the police? (Which seems extreme. I don’t thinks she’s going to stab me or shoot me. I think she’s just going to bore me to tears.)

I guess what’s so disturbing about the situation is that you get a house in a remote location so that you can escape the noise and people of the city, only to have some person show up and you can’t escape them. I’m tempted to never come up here again.

Boy. I didn’t mean to talk about that. I guess it’s kind of on my mind (understatement). Anyone ever had a similar situation?