Tuesday, September 3, 2013

RA and Osteoporosis

Remember to get your questions for Angela into me by this weekend.

As someone with rheumatoid arthritis, we are at greater risk for osteoporosis. Both arthritis and osteoporosis make you more likely to slip or fall. Strategies for preventing and treating osteoporosis in people with rheumatoid arthritis are pretty simple and straight forward. Reduce clutter and trip hazards in your home, use a rubber mat in the shower and using the hand rail on stairways.                                                                                                                          

A well-balanced diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Vitamin D plays an important role in calcium absorption and bone health. Bone is living tissue that responds to exercise by becoming stronger. The best activity for your bones is weight-bearing exercise that forces you to work against gravity like walking, climbing stairs, weight training, and dancing. I have no problem climbing stairs but it is difficult and painful coming down them.

A bone mineral density (BMD) test measures bone density in various parts of the body. The test can detect osteoporosis before a fracture occurs and can predict one’s chances of fracturing in the future. I have been getting a bone density test every 2 years over the past 8 years, they are safe and painless.                                                                                                    

Like rheumatoid arthritis, osteoporosis has no cure. However, medications are available to prevent and treat osteoporosis.   Several medications, including bisphosphonates and a parathyroid preparation, are available for people with rheumatoid arthritis who have or are at risk for glucocorticoid-induced osteoporosis.                                                                               

I have my bike ready to ride this fall, just waiting on some fall temperatures. It has been 95-99 every day last week and this week with heat index from 103-110. Too hot for this boy!

A young man was seriously injured in a motorcycle crash over the weekend. He has serious head injuries and was not wearing a helmet. One of many debates with helmet use is that many experienced riders feel they should not have to wear a helmet. The problem I have with that is it's not about the experience, for me it's about the safety. While a more experienced rider is less likely to show off and watch the road better, 48% of motorcycle accidents occur due to the fault of the other vehicle. Sure riders want the freedom, but are they ready to pay the consequences to receive their few minutes of enjoyment? 

From 1997 through 2008, the number of motorcycle fatalities nationwide more than doubled from 2,116 to 5,290*. Head injury is a leading cause of death in motorcycle crashes. Yes there are more motorcycle riders out there now but the bottom line is that two out of every three riders killed were not wearing a helmet. An NTSB spokesman said "It's a public health issue." No, it's not a public health issue. A public health issue comes from people being exposed to illness, skull fractures are not contagious.   I'm a firm believer in AGATT (All Gear All The Time) no matter how hot or uncomfortable it may be. Unless riding to work, I ALWAYS leave the house with full length boots, riding pants with hip and knee pads, gloves, full face helmet and most days a jacket with shoulder, back and elbow pads. The days that I ride to work with just helmet, gloves, jeans and my steel toe work boots, I almost feel naked.                                                                                                                             

The choice is ultimately yours but remember, you don't just put yourself at risk.  Are your family and friends ready to take care of you long term or say good bye to you forever? 

* http://www.ntsb.gov/news/speeches/hart/hac110214.html


Anonymous said...

I lived in California and rode without a helment for a very short time. Desert wind, sand, and high speed projectiles made the full face the best difference in comfort and safety. Several years later I drove head on into a tall chain link fence and my shield was trashed, but it would have been my face otherwise. I am completely sold on helments and proper clothing.
Phil - Syr

mary said...

Ah, we see this in the biking world as well. To wear or not to wear a bike helmet has started more arguments than I care to remember. There is no law for adults anywhere, as far as I know, but most organized rides and races require helmets. I wear a helmet. Working with folks who have had head injuries convinced me that it was a small thing to do to possibly prevent injury. If I ride up to the hardware store or library, both close, sometimes I forget it and then feel really vulnerable.
The Osteo info is great. Also remember that pred and other steroids suck the calcium right out of the bones. My doctor recommends that anyone who takes steroids should add calcium pills to their diet for the duration of the treatment and about a year afterwards.

Terry said...

Phil, good testimony there. I have had 2 concussions wearing a motorcycle helmet and a third wearing a bicycle helmet. I work with a few guys that refuse to wear a helmet claiming the helmet interferes with their peripheral vision. I'm not buying that one for a minute! I have wore one all of my life ... at least since I've been riding at age 10. Like I tell them, if you want to ride without one thats fine, just don't expect me to believe your lame excuse.

Mary, I use to ride my bicycle for cardio training when I was racing motorcycles. Back then more people did not wear a hemet on bicycles than those of us who did. At the centuries I use to ride, even back then, they all required helmets. My wife works in the OR and regularly has to work on motorcycle victims (most of who were not wearing a helmet) and they have to do the organ harvest on a few of them.

Thank you for reminding me, I forgot about the steroids and calcium.

Wren said...

I was surprised a couple of years ago when my rheumatologist told me I had osteoarthritis in the joints at my fingertips and that I shouldn't be surprised if it started showing up in other joints, as well. Great, thought I. And then the other day I read that osteoarthritis is a co-morbidity of RA (RA sets the stage for it, just like it does bursitis, tendinitis, and osteoporosis). Double-great. Sigh...
This is a great post, Terry. Lots of useful info. And as for helmets... I've never understood why someone would risk their brain--not to mention their lives, whether they died or not--just to feel the wind in their hair and the bugs in their teeth. It just doesn't compute. I'm glad you're so much smarter than that!
Hope you're feeling good. Enjoy your next ride!

Terry said...

Hey Wren, hope you are feeling better by now! I know ... it just keeps getting better doesn't it? Haha I have broken two fingers but, at least to my knowledge, do not have osteo in them yet. I have had osteo in my right knee for several years now. I know when I had my first BMD test, my rheumatologist was surprised that my results came back lower than he thought they would. I am still at a safe level and staying consistent with each test ... just lower than expected due to the drugs.

I've never been accused of being smart, just cautious. I've not heard any update on the guy, I take that as good news. The news station love to report people dying but seldom report on someone improving after a tragedy.

Red said...

Proper supplementation may aid in alleviating osteoporosis. It is very much important to pair the exercise with a balanced diet.

Stephen in Florida said...

Hey Terry,

I just wanted to say thanks for sharing this information. I don't personally have RA, but I have spent some time writing blog posts on medical breakthroughs, treatments, and research pertaining to this autoimmune disease. I was surprised to read that this RA patients are more likely to develop osteoporosis. I have not read about this before, and I'll definitely want to learn more.

Terry said...

Red, you're correct. I try to exercise (hard somedays when you can barely get out of bed) 3-4 days a week.

Stephen, you're welcome. There are several factors, a couple are the meds we take and RA itself can directly affect bone less.

Vladimir Alhov said...

Yeah, there is no cure yet for rheumatoid arthritis and no way to find out the cause, either. Have you been experiencing fractures? The pain must be killing you. How do you deal with it? Unfortunately, there is no permanent solution for it. You can only treat your condition with rest, exercise, joint protection, and a few surgeries.PainHealingDoctor.com

Farrah Greenough said...

Yes. Even if you're a responsible and experienced biker, you can still get into accidents from inexperienced ones. So it's still best to wear them, for safety's sake. Anyway, regarding your RA and osteoporosis, I hope you have found a method that would somehow alleviate those two. Stay healthy and keep safe with your riding ventures!

Farrah Greenough @ U.S. HealthWorks

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