About your bones …

Updated at end of story, Thursday, May 28:

May is Osteoporosis Awareness and Prevention Month, a fact I only learned about late last week. And while the month is nearly over, awareness of this insidious, invisible, potentially devastating and even deadly disease is important all year ’round, not just in May.

Your bones are alive. A healthy body replaces dying bone tissue with new, strong, healthy bone tissue. But osteoporosis causes the bones to lose tissue faster than the body can replace it. The resulting brittle, lattice-like bone structure breaks easily. Even something as simple and everyday as bending over or coughing can cause an osteoporotic fracture.


A broken bone is difficult for anyone. But for the elderly or those with compromised health, it can mean catastrophe: loss of independence, permanent disability, or even death. The most common fractures occur in the hips, wrists, and spine.

According to the American College of Rheumatology (ACR), about 4.5 million women and a little over a million men over the age of 50 have osteoporosis. It’s a “silent” disease; there are no symptoms. Most people don’t know they have it until they break a bone. You’re at higher risk of osteoporosis if:

  • you’re of older age (over 30, but more commonly over 50);
  • you’re female;
  • you have a non-Hispanic white or Asian ethnic background;
  • you have lowered sex hormone levels (mainly estrogen loss during menopause and after);
  • you have a small bone structure;
  • you have a family history of osteoporosis;
  • you have inflammatory arthritis (rheumatoid disease, ankylosing spondylitis, etc.);
  • you take certain medications, such as corticosteroids;
  • you smoke cigarettes
  • you drink alcohol to excess. More risk factors can be found here.

There are some pro-active and simple steps you can take to avoid osteoporosis, or to treat it if you already have it:

  • If you smoke, stop. Smoking hastens bone loss.
  • Limit alcohol to three or fewer drinks per day.
  • make sure you’re getting enough Vit. D from your diet, sun exposure (but be wary of sunburn) or from supplements. Vit. D works in tandem with calcium throughout the body in many different ways, including building healthy bone tissue.
  • Do weight-bearing exercise regularly. It can be as simple as brisk walking for a half hour a day, five days a week, or doing gentle weight training or resistance exercises for the same amount of time. Many people mix them: walking one day, exercising the next, or 15 minutes of one, then 15 minutes of the other each day. Exercise is vital to build and strengthen bone tissue and to build and strengthen the muscles that support the joints and bones. Note: Tai Chi and yoga are excellent forms of exercise for osteoporosis. They strengthen muscles and bone, and they improve your balance, making falls much less likely.

Once osteoporosis is diagnosed, treatment is available in the form of medications, too. Some, called bisphosphonates, slow bone loss. They include such well-known drugs as Fosamax and Boniva. Other drugs may include Calcitonin or selective hormone replacement therapy.

Rheumatoid disease can cause changes in the bones that can make osteoporosis more likely to occur. It’s smart to have your bones scanned to determine you bone mineral density, or BMD, According to the ACR, “dual energy x-ray absorptiometry (referred to as DXA or DEXA and pronounced ‘dex-uh’) is the best current test to measure BMD. The test is quick and painless. It is similar to an X-ray, but uses much less radiation.”

Unfortunately, osteoporosis can sometimes lead to the need for knee or hip replacements. The American Recall Center has asked me to let you know that one option for knee replacements, the Zimmer Persona Tibial Plate, has been recalled due to issues that have forced some people back into surgery. To learn more about this, visit http://www.recallcenter.com/zimmer-persona-knee-replacement/ **

For further information, visit the ACR’s osteoporosis web page, or see the National Institutes of Health’s RA/Osteoporosis web page,

**UPDATE:  With the unfortunate weakening of the bones, sometimes osteoporosis can lead to knee or hip replacements. Be sure to always treat any surgery with care and ask appropriate questions. Do your research on the device that’s going to be put in. There has been a few recalls on these, the Zimmer persona knee recall being one for the loosening of the tibial plate. Mishaps like these can happen, which is why it’s important to get educated.

Taking my life back

Kelly Young, who writes the excellent blog “Rheumatoid Arthritis Warrior” posted a piece about cooking with RA and invited her readers to send her their stories, their tips and their recipes.

The idea intrigued me. So I responded. But I also decided to post my response here:HomeCooking1

A little over a year ago I made some massive changes to my diet. Why? My annual check-up with my GP produced this sobering news: My blood sugar was high — I was borderline diabetic; and I was obese and getting obese-er. With a family history of heart disease, I was a living, breathing example of “metabolic syndrome,” the popular term for those of us who are over 50, live sedentary lives and overeat. We’re walking time-bombs. That we will be sick sooner than later is a given.

On top of that, the RA that had been in remission for about 10 years was back, mainly as stiffness and mild pain in my hands. I knew from past experience that it wouldn’t stay mild, that eventually I’d be facing disabling pain and deterioration of my joints.

My doctor suggested changing my diet, both to lose weight and bring my blood sugar under control. She hoped, as I did, that by doing this I’d avoid Type 2 Diabetes and avoid having to take drugs to control it. I’d also be doing my heart and my joints a great favor.

I walked out of her office truly scared. My weight gain had taken place over a period of about 15 years; I’d pretty much given up trying to keep it in check. Coming home tired from a full day of work each evening had made me a rather lazy cook, depending more often than not on processed foods out of boxes and cans, or fast foods picked up on the way home because these were quick and easy. And while I tried to avoid snacking, it was a losing proposition. I loved my crackers and chips too much to give them up in the evenings and loved the donuts and other goodies my co-workers (and I) brought to work most mornings to share.

Yet I knew, now, this was serious. I had to face it. I could become very ill. Diabetes could blind me or cause me to lose a limb. My weight, along with making me feel ugly and blob-like, could trigger a heart attack. It could cause, with the RA, terrible damage to my joints. I might end up in an extra-wide wheelchair or worse, bedbound and dependent upon others for everything in my life.

And scariest of all: I could die. It wouldn’t be a dignified, painless or gentle death, either.

So I started researching diets. Oh, I knew how to diet — I was a chronic and chronically defeated dieter. But this time I looked into nutrition. I looked into the ingredients in processed foods. I learned how the sugar I ate (in many forms in many products) destroyed my body’s ability to use it efficiently, and how that excess sugar in my blood was damaging my body. I learned that “giving up sugar”  would take more than just saying “no” to a couple of donuts with my coffee each morning.

I didn’t want to have to weigh everything I put into my mouth, or count calories obsessively. I didn’t want to feel like I was missing out on tasty foods, restricted to bland salads dressed with rice vinegar. Ugh. But after reading and learning, thinking hard about it all and readying myself for the change, I knew what to do.

Basically, I simplified the whole shebang.

Today, I eat only fresh chicken breasts, pork loin or fresh fish. If I eat red meat, it’s lean lamb stew meat, cooked into soup. I’ve given up “white” foods — white flour, white rice, white pasta, potatoes — in favor of whole grain flour in bread and pasta, and brown basmati rice. The reason? These “white” foods all turn into sugar once you eat them, making the body’s blood glucose level spike way up. Whole grains take a lot longer to digest, so they don’t cause that dangerous spike in blood glucose. They also provide excellent fiber. I eat beans of all kinds. And I eat a lot of fresh fruit and vegetables. The fruit I make into smoothies with yogurt and soy milk; the veggies are steamed, stir-fried or made into salads. Snacks consist of a piece of fruit or a handful of almonds or other nuts.

Yes, it seems restrictive, all written down like this. But what was amazing, to me, was how easy and quick cooking this way was. I use an indoor, electric grill for cooking the meats and fish. While they cook, I steam or wok the veggies, or perhaps make a salad. The other amazing thing was that I liked what I was eating. Grilled foods, subtly seasoned, are scrumptuous.

By making my portions smaller (except for veggies, which I eat as much as I want) and eating everything fresh, I started losing weight. It was slow. There were a lot of plateaus during which I lost nothing. But I kept with it, learning new ways of cooking and trying new recipes. I discovered Indian food, which I love. And a little over a year later, I weigh 50 pounds less.

My doctor is pleased with me. I am no longer a “metabolic syndrome” patient. My blood glucose levels are normal. I’ve lowered my risk of heart disease. And while I still have RA (and as I expected, it has slowly ramped up in terms of pain levels) I feel confident that at least, I’m keeping my weight from doing even more damage to the joints in my hips, knees, ankles and feet. I take Arava and sulfasalazine for the RA, see a rheumatologist every three months, and have my blood tested every six weeks. I’m a healthy work in progress.

And, to my surprise, I don’t miss donuts, candy bars, potato chips or crackers. If I want something sweet, I put Splenda in my coffee or I treat myself to an occasional “no sugar added” fudgesicle, which lets me enjoy the sublime taste of sweet milk chocolate while not causing my blood sugar to go through the roof.

I don’t eat out very often any more, it’s true. But guess what? I spend less money that way. And when I do go out for a meal (once a week or less) it’s a treat. I eat what I want for that one meal, and then I go back to my healthy food.  I take healthy leftovers from home for lunch rather than buying fast food. I spend less overall on groceries since I no longer buy snacks and processed foods in boxes, cans, and out of the freezer section. Goodbye, Hot Pockets and Red Baron!

As a result I feel much, much better. My clothes are smaller, they feel less restrictive, they’re prettier and I’m enjoying looking nice again. I can bend down and pick something up off the floor without cutting off my own breath. I have more energy. My self-esteem has improved greatly. And even showers take less time — I have less of me to wash!

Most of all, I feel as in control of my life as I can be. I know I can sustain this diet, this lifestyle, indefinitely, keeping my weight down while eating mindfully and with my own overall health at the top of my agenda. I don’t know what new problems RA will face me with in the future — only that it will. But at least I will be able to face them with a stronger, healthier body and a positive attitude. I’ve taken my dignity back.