The comfort of home is short lived. We leave today for yet another appointment. This time it is for an assessment to see how extensive the Osteroperosis is within my body. As explained to me, there is the complicating factor of having sarcoidosis along with Osteroperosis. Everything I read talks about the need for vitamin D and calcium. I'm my case, many years ago I was told to stay away from both. People with sarcoidosis make too much calcium therefore it is not prudent to take it. It can deposit in areas of the body in assess and cause other problems.
I haven't taken calcium for about fifteen years now. I'm wondering how this will all play out.
Quite honestly I have had a hard time educating myself about it, the way I normally do for an appointment. I'm feeling a little burnt out.
Both Barry and I have read a little, enough to be able to ask intelligent questions but certainly not our normal research before a new appointment.
Because I have both conditions I have to see a specialist who is both an orthopaedic doctor and an endocrinologist. A double specialty.
Today after work, we will drive to Barrie and stay with our dear friends Margie and David for the night. Tuesday we will drive into the city, along with thousands of others. The comfort of having friends to visit changes the stress of going to Toronto for an appointment. What I'm thinking about today is a dinner and visit tonight with friends not an another appointment in Toronto.
I realize Osteroperosis is serious, but I feel as though the good news from last week is carrying me though. Here are some tips on preventing it for those of you who that option. Here is a great website.

Here are the basics; from Arthritis.org

8 Ways to Keep Bones Healthy and Strong

As many as half of all women and one-fourth of all men older than 50 will fracture a bone at some point due to osteoporosis. Whether you are young and still building bone or older and trying to preserve it, these simple steps can help keep your bones healthy and strong.


1. Make Healthy Food Choices
Your bones need a variety of nutrients, including calcium and vitamins, C, D and K.

Low-fat dairy products are well-known sources of calcium, and many are fortified with vitamin D. You can also get calcium in nondairy foods, like salmon, mackerel, tuna, sardines, white beans and tofu. Fruits and vegetables are the best way to get these important vitamins and minerals. You’ll get calcium and vitamin K from kale, collard greens, broccoli, spinach and cabbage. Vitamin C is high in red and green bell peppers, strawberries, Brussels sprouts, oranges and pineapples.

If you're not getting the recommended amount of these important vitamins and minerals from food alone, you may need to take supplements, but talk to your doctor first.

And cut the fat: Consuming too much saturated fat can lead to a high level of homocysteine – a chemical in the body known to decrease bone mass.


2. Supplement Your Diet
For osteoporosis prevention, taking a supplement will be advised by your doctor once you reach a certain age or have osteopenia (a condition in which bone mineral density is lower than normal but not low enough to be classified as osteoporosis). You doctor may suggest taking an over-the-counter (OTC) version of one or more of the vitamins and minerals mentioned above as well as folate, a B vitamin that can aid in reducing elevated levels of homocysteine.

There is also a prescription drug called Ostiva, an oral supplement containing calcium, magnesium, vitamin B6, vitamin B12, vitamin D and metafolin (a form of folate).

If you take corticosteroids, such as prednisone, you may need to increase your OTC vitamin D intake or get a prescription version. Prednisone blocks the body’s ability to absorb the bone-strengthening vitamin. If you’re taking prednisone, have your doctor regularly check your vitamin D levels.

Be aware that high doses of calcium from supplements could be hazardous to your heart. It’s also important to avoid calcium-containing foods and supplements within an hour or so of taking bisphosphonates – bone-building drugs prescribed for osteoporosis.


3. Quit Smoking
Smoking cigarettes is one of the worst things you can do for your health and your bones.

Several studies have shown that smokers have lower bone mass and a higher risk of fractures than nonsmokers, and the risk increases with the number of years and cigarettes one smokes, according to the National Institutes of Health. Compared with nonsmokers, women who smoke often produce less estrogen and tend to experience menopause earlier, which may lead to increased bone loss.


4. Moderate Alcohol and Soda Intake
If you drink alcohol, stick to no more than one drink a day, or up to seven a week for women, and no more than two a day, or up to 10 a week for men. Consuming more than two alcoholic drinks per day raises the risk of falls and bone loss.

Research has also linked heavy cola consumption with lower bone density. While the mechanism has not been confirmed, experts say to substitute milk or calcium-fortified juice for soft drinks when possible.


5. Exercise and Maintain a Healthy Body Weight
Being too heavy or too thin are risk factors for osteoporosis. Along with healthy eating, exercise is a key part of osteoporosis prevention and treatment. Like muscles, bones become stronger when they are active. Weight-bearing exercise strengthens bones by making them produce more cells. The best exercises for building stronger bones include brisk walking, dancing or aerobics, and muscle strengthening exercises. But always check with your doctor before starting any new exercise program.


6. Spend Some Time in the Sun
Your skin makes vitamin D in response to sun exposure, and your body needs vitamin D to absorb calcium and build healthy bones. Depending on where you live and your skin pigmentation, you may get enough by spending as little as five to 30 minutes in the sunlight a couple of times a week. If you live in a northern state, don’t spend much time outdoors, always use sunscreen or have darker skin, you may need to increase your vitamin D-containing foods or add a vitamin D supplement to get your recommended daily intake of 600 to 800 international units.

Food sources of vitamin D include fatty fish such as salmon, mackerel and tuna; egg yolks; cheese and fortified milk; as well as fortified juice and cereal products.


7. Review Your Medications
The medications you take can negatively affect your bones.
Chief among these are corticosteroids, such as prednisone, prescribed for inflammatory forms of arthritis. They weaken bones by decreasing the amount of calcium absorbed in the intestines and increasing the amount excreted by the kidneys. One way to minimize the risk of bone damage is to take the lowest dose for the shortest time possible to decrease inflammation. If only one or a few joints are affected, injecting corticosteroids directly into the joint(s) may relieve inflammation without the bone damage of oral corticosteroids. If you need corticosteroids in high doses or long term, ask your doctor about medications to prevent or treat osteoporosis.

Another class of drug to watch out for is proton pump inhibitors, like esomeprazole (Nexium) and omeprazole (Prilosec).They often are prescribed with anti-inflammatory drugs to control gastrointestinal irritation.


8. Consider Treatment Options
If you are taking corticosteroids or have already been diagnosed with osteoporosis or osteopenia speak to your doctor about treatment.

A number of medications are approved for treating or preventing osteoporosis. They are the bisphonates alendronate (Fosamax), ibandronate (Boniva), risedronate sodium (Actonel) and zoledronic acid (Reclast); hormones including estrogen products and calcitonin (Mialcin); the bone-forming agent teriparatide (Forteo); the selective estrogen receptor modulator raloxifene hydrochloride (Evista); and the biologic agent denosumab (Prolia).

Although there are many differences in these drugs, they work basically in one of two ways to increase bone mass: by slowing the breakdown of old bone or promoting the growth of bone.

 It's been a few days since my appointment with my neurosurgeon and I can honestly say I wake up each morning and it is the first think I think of. I smile as I start my day. While I am crippled and stiff each morning once I'm up and moving it works itself out.

Yesterday was a beautiful Saturday and for once in a long time I had plans with a friend. Lynn and I went to the first of many Christmas craft shows. It was packed and admittedly a bit of a struggle with a walker but so worth it. It felt like a normal, frivolous way to spend time. And it was the first time I was out with a friend and not a family member. Thanks to Lynn for encouraging me and for insisting on taking the walker - I certainly needed it and made it enjoyable. I'm not even embarrassed by the attention it draws to me anymore. It is what it is, a means to an end. We even stopped at The Artisan Cafe for a wonderful lunch before heading home.

I feel as though a new beginning has happened. I can put in place some of the plans I have wanted for myself and family but been afraid to put in place.

I slept for most of the remainder of the afternoon because we had a supper date with friends. What I have learned over the years is to recover after an activity before you pile a second one on. I had no choice really yesterday because I was very tired. Those times when I don't feel like sleeping, lying down and resting, reading or meditating has been incredibly helpful.

Dinner at Darlene and Kevin's turned out to be a feast for a king! A healthy king that is. What a wonder array of herbs, spices and beautiful ingredients. So very delicious.

We had a wonderful evening and it was once again so great to have a normal evening with friends.
At one point, Kevin asked "What do you need Maureen?" What a perfect question to ask. What I needed was a softer surface to sit on at that point, but I hadn't wanted to interrupt the flow of conversation, so I hadn't said anything. He asked, we moved. Simple right? I must remember to ask that very question while with someone who has been sick or had surgery. Simple but perfect.
Barry was able to have a drink and wine with dinner, knowing I could drive home which hasn't happened in a while. A relaxing, enjoyable evening with friends.
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This day was a long awaited day back to normal. I like normal. I like normal way better than I used to.

Although our hotel room was great, when the 6am alarm went off we both admitted to a restless night. It was well after midnight when I settled in to sleep and I lay there for a long time waiting for it to come. Once asleep every sound woke me. I felt as though I was just waiting for a trickle of morning light so I could get myself out of the farce of a night's sleep. Barry described a similar night.

Usually dreading such an early alarm we both moved into action at it's first sound. We arrived at Xray even before it opened. Once it did open, I had an X-ray and headed upstairs to the neurosurgery floor. We didn't stop for coffee and hardly said a word. Going through the motions we found our seats to wait. Within minutes I was called into the office. We met with the fellow as always and he pulled the x-rays up from days after my surgery and today. We held our breath and waited, silently.
He said "It looks good." I cried. Barry let out a sigh of relief he'd been holding for months. We could hardly contain ourselves, as the doctor continued to talk seemingly oblivious to our joy.

He explained there was a possibility of some bone growth. The beginning. A beginning. A humble, but hopeful start to what I now believe in my heart will be the beginning of the end of this year long medical tunnel we've been in.

I'm happy. More than happy, I guess it's relief, satisfaction and determination rolled into one. I want a new beginning to be strong and healthy again. I'm at the 10 week mark now and with every day I can see minor changes.

With our excitement to we didn't want to jump right in the car and head home so we did a little shopping, nothing exciting, just Costco. I was reminded of how easily I run our of steam when I had to hand the cartloads of stuff over to Barry to ring through the check out as I made my way to the car.

Once he joined me I could see he was feeling a little worn out too. I decided after much debate and consideration to get a cheap hotel and make it an early night. We will get on the road tomorrow at the crack of dawn to make it back in time for Barry to work.
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It's been a long day, and one that was a long time coming. I know I have a lot of work ahead of me but for this night, I will bask in the good news and snuggle happily under the covers.

I'm feeling nervous and excited at the same time this week. My post op appointment is on Thursday in Toronto....at 7.30am. It wasn't originally set for that time but the Tuesday clinic got cancelled and I'm being fit in. It's the worst time of the day for me. I'm so stiff after sleeping that it takes a while for me to warm up. It means having to stay in Toronto the night before so we booked a hotel and we drive down on Wednesday. At least it was rescheduled the same week. Normally I'm very nonchalant about these things; but if you have been with me awhile you will remember this is the point at which I found out that the last surgery failed.
I have symptoms that could be seen as concerning, but they could be normal healing so until I have that appointment and the appropriate testing I will assume it is normal healing.
My leg often bothers me and is jumpy at night. I have some nerve pain, and there has been a peculiar sound in my back at times. My foot as with the last surgery is not perfect. I have nerve pain in it and sweeping and discomfort. All those signs refer back to the L4-5 vertebrae. Time will tell and that time is coming up soon.
The following week I am back to Toronto again to have an assessment at the osteoporosis clinic. That assessment will tell me how wide spread it is and where to go from here.
I haven't been able to get out for a walk since I had the injection last Tuesday. Taking a week to let it work is always a good idea and to let the inflammation die down. It was great to get back out there last night. I didn't walk as far as I normally do because it felt difficult so I went three quarters of the distance I usually walk. My knee certainly felt better than the last time I walked so that's a positive sign.
I'm still using a walker for distance. When I use canes, walking sticks or any other form of aids that require me to use my arms more, I get neck and shoulder pain. It makes me nervous because I had injured my shoulder years ago from using the cane. Right now I am trying to find a good balance. I have to transition from the walker to unaided but those darn canes are in between. I think I have a plan. My treadmill has safety features, a clip that is attached to me and turns the machine off if it is pulled, and guard rails down the sides. My plan is to use the thread mill to build strength. I am doing this at Physio on the underwater treadmill, so I can do it at home with the help of my physiotherapists guidance.
These next two weeks will tell the story of my future and what to expect for my physical health. Honestly I'm feeling hopeful. The eternal optimist in me hasn't died despite being challenged time and time again. Those of you who are inclined to please pray for me and I will take all the positive vibes you want to send my way.