News of a compression fracture in one of my vertebrae and bone density numbers indicating seriously worsening osteoporosis
create enormous emotional upheaval as I work to sort through my options.
The past few days have been the quietest, stillest days I’ve had in many weeks. The oppressive heat seems past. That’s made it possible and deliciously inviting to spend these still days mostly outdoors. I drift from my willow chair in the shade of the patio to the hammock under the trees and then to my wonderful infinitely tilt-able recliners in the dappled shade of the bushes and the fence in the meadow. Reading, dozing, watching birds at the feeders. Losing myself in the beauty of the mountains in the near horizon. Surrounded by birdsong, squirrel chatter and the singing of circling hawks.
Wandering my evening trail last night I heard the first lively coyote interchange in a very long time. It brought tears of delight. The packs here closer to town don’t seem as exuberantly vocal as the ones out in the East End where I used to live. Until this crew began its yipping and howling, I’d been thinking sadly about how long it’d been since I’d heard that wildness. It felt like such a gift from Spirit and Coyote Grandmother!
No longer being surrounded by the orchard and the wildness of the East End has made for lots of changes. The mini-season shifts are not marked by the appearance and disappearance of different kind of fruits. My miniscule veggie garden-in-pots doesn’t seem as compelling to me as my tiny in-ground veggie garden once was. I still savor cherry tomatoes and strawberries warm from the vine. But the chard and kale, though beautiful to watch, don’t much tempt my palate these days. And, the arrugula that I so love seems to have more trouble flourishing in the pots.
On the other hand, meandering on foot in and out of the little village to do my errands is such a joy. Particularly when I’m able to weave such meanders into the middle of my workdays. I so love seeing all the dear little houses and gardens along the many neighborhood routes to the post office, the library and the health food store. The care-full tending so evident. Such a very sweet little town this is.
As I start to write this, I’ve just crossed a threshold that I’ve been facing and skirting for well over two months: I took my first weekly dose of 70mg Fosamax this morning. The tablet sat for days in a new, tiny cobalt blue glass pyramid. With it and the rest of the month’s supply was a slip of paper with my prayers on it. “May my body accept this medicine as healing energy. May my bones be strengthened and supported by it. May I be protected from any ill effects.”
When I awakened, I lit the candles on my altars in each of the four directions, calling in all the parts of my being (mind, body, spirit, emotions) and all of my guardians. I passed the tablet through the smoke of Ojai white sage holding those same prayers in my heart. Then I swallowed the tablet with the 8 ounces of water that the instructions recommend. I stayed upright, as the instructions caution, without eating or drinking anything for the next two hours. Though the instructions call for waiting at least 30 minutes before eating or drinking anything more, the information in the insert reports–in tiny, barely readable print–that optimal absorption of the drug occurs when it can be in one’s empty stomach for a full two hours.
It was an enormous step for me. And, it’s been a long and arduous, incredibly challenging road getting to this step.
The journey began three years ago when I had my first bone density test. I was completely shocked then to discover that I had osteoporosis! Despite years of almost daily weight bearing exercise (hikes and walks and sometimes yoga). Despite years of calcium supplements (with an appropriate balance of magnesium and vitamin D). Despite not having smoked in 10 years and only rarely drinking either alcohol or coffee. And, not the least of it, not ever having broken a bone despite the 2 or 3 falls a year I seem to have on the trails.
I felt scared, confused, despairing, distraught. Suddenly terribly fragile and vulnerable. Though Fosamax or Actonel were recommended (strongly) at the time, I was more than a little reluctant to take either drug. I couldn’t imagine putting into my body something that required that I stay upright for 30 minutes after I’d ingested it lest it burn holes in my esophagus!
Instead, I worked with my acupuncturist to develop a new, more intensive non-Western regime. We shifted me to a supposedly even more absorbable form of calcium (microcrystalline) than I’d been taking. We added a Chinese herbal compound for bone strengthening and began regular acupuncture to stimulate bone health. Since my lactose and soy intolerance removed those options for increasing dietary calcium, I grew and ate more high calcium greens (collards and kales), and ate more canned salmon and sardines with their bones.
Despite the numbers, my uneventful falls convinced me that good muscle tone had some significant value in protecting my bones. I chose to use that to help me as I worked to return to holding an image of myself as a woman with strong, solid bones. It seemed sensible, at the same time, to begin carrying a bamboo walking stick on the trails for the places where the footing might be a little iffy. And, also to begin carrying a friend’s expired cell phone from which I could (provided there were reception on the trail) call 911 were I to get into trouble. With some time and some serious refocusing/reframing, I was able to move past the intense fragility and vulnerability that the diagnosis had triggered. I saw myself again as a strong boned woman, though one with numbers that said I had osteoporosis. It seemed essential to my well being that I not be taken over by the “diagnosis.” That I be able to continue my life on the trails and elsewhere as fully (if more circumspectly) as ever.
In March of 2004, I had a really, really hard fall on the trail (my walking stick notwithstanding!). When I didn’t break the hip, wrist or forearm that took the full impact of that fall, I felt convinced that all was going well with my bones.
Then, late this June, as part of an annual wellness physical, I had my first chest x-ray in 20 years. The results that came back in early July were a shock. My lungs were clear. Not so my spine. Apparently I’d, unknowingly somewhere along the years, developed a compression fracture in one of my thoracic vertebrae (T6). Several other thoracic vertebrae showed “a moderate loss of height.” According to the radiologist’s report, all this is ”probably related to diffuse bony osteoporosis.”
I was stunned, frightened. How could something like this have happened without my even feeling/knowing it? I felt betrayed by my body, confused and completely overwhelmed. It was all way more than I felt ready to let in. I was able to give myself permission to put the news completely aside for a few weeks. Remarkably, I pretty much ignored it all and went on with the rest of life-including a 3-½ week time out/vacation. I was totally committed to only going as fast as the slowest part of me felt safe to go! (Even as the doctors were once again pressing urgently for me to begin Fosamax.)
When I finally felt ready to begin confronting it all, I went for a new bone density test. The news was pretty awful. Significant worsening of the disease in my spine (a T score of -4.8 instead of the -3.9 of three years ago). Some further progression in my hips (T scores of -2.9/-3.0 instead of the -2.7 three years ago). And, I’d lost a full half-inch of height in the three years! It was even more terrifying and overwhelming than the news of the fracture had been.
The statistics are horrific. A 50-year-old white woman has a 50% chance of suffering an osteoporosis related fracture in her remaining lifetime. Spinal fractures are highly predictive of more spinal fractures as well as of hip fractures. 50% of women with a hip fracture become disabled. 25% will require long-term care. Up to 24% of women with a hip fracture die from a complication in the year following the fracture. Pretty grim. Even though it’s likely that the statistics are not reflecting what happens among otherwise physically active, fit women who have osteoporosis.
I felt trapped by the numbers, by the scary messages of Western medicine that push us always toward the “right pill.” I felt furious, resentful, in a rage when I wasn’t feeling terrified. I felt betrayed by my body. Betrayed by my alternative approaches that didn’t stay or reverse the progression. And, betrayed by my genes. Save for taking Fosamax or Actonel, I had already, for almost 20 years, been consistently doing almost everything one should do for bone health. But my grandmother had osteoporosis and my dad, aunt and great aunt all have it. Genes obviously trump good practice! It sucks! Early menopause (from surgery when I was 35) probably didn’t help either.
Again, I chose to go as slowly as I seemed to need to go. My local pharmacist gave me the inserts for Fosamax, Actonel, Evista, and Bonviva. I pored over the endless sheets of miniscule print, reading around the double-speak. I read on-line about synthetic parathyroid hormone injections (they cause unspeakably virulent bone cancer in rats so they’re only recommended for use when other approaches are unworkable and then for no more than two years). I read lots about Strontium Ranelate, a treatment available in the UK but not here. A treatment with considerably fewer potential side effects than the drugs peddled here.
When anyone offered advice or help or questions, I bit their head off! Everything swirled and seethed inside me. I was furious at having to consider doing weight training. Resistant to doing anything more when everything I’d been doing seemed useless (although perhaps things would have been even worse without my regimen). Enraged at the likelihood that, when all was said and done, I’d probably wind up having to take Fosamax (the most effective of the lot available in the US in improving bone density/reducing the incidence of further fractures). I just wanted to scream and rave and curse! To kick and break things! (But not my bones!)
Gradually, over the past 6 weeks or so, I’ve calmed a bit and begun to find my way on a new path. I’ve changed my calcium supplement yet again, after discovering that the mix that my acupuncturist had given me didn’t really have sufficient magnesium after all. (Jarrow’s Bone Up seems the most balanced calcium formula around.) I’m taking 1500mg of that a day instead of 1250mg of the other. I’ve added more Vitamin D since discovering that 800 to 1000 mg rather than 400mg is the recommended dose for a woman my age with osteoporosis issues. Though Strontium Ranelate (strontium in combination with synthetic ranelic acid) isn’t available, I’m taking BioStrong from Health Concerns–a natural Strontium supplement.
I’ve started walking with 1-½ pound wrist weights and am very, very gradually trying to start adding a few simple upper body free weight exercises (from Miriam E. Nelson, Ph.D.’s Strong Women, Strong Bones book). I’ve gotten a Body-Slant foam slant board that I stretch out on several times a day for 10 minute breaks-from-gravity. I’m also very consciously aware of walking tall, “forward and up” as my friend’s Alexander teacher would instruct, lengthening through my spine.
I’m back to doing yoga more often after some time of not being much into it. And, I’m choosing to practice asanas that work my bones more. Studies seem to indicate that Tai Chi is helpful both to balance and to bones, so I’m about to start Tai Chi instruction (from one of my masseuses who’s also a Tai Chi teacher). We’re arranging for me to have an hour’s lesson just before my 2-hour massage so it won’t involve having to add more scheduled-time into my life.
I’m about to get some serum blood work done that will help assess whether I have absorption problems with the calcium and vitamin D I’ve been taking. And, I’m set for a mid-November consult with “the” bone health specialist in our area (she’s the endocrinologist who runs the bone health clinic at which I had the tests). It all feels like a lot. But, I’ve really been taking it incredibly slowly and not pushing myself. And, I have permission to stop and start and take breaks whenever it feels “too much.”
I did decide to go ahead and try taking the Fosamax, much as I hated to succumb to it. In the weeks between deciding that I would take it and actually beginning with it today, I’ve had a lot of inner work to do. The pyramid and the prayers were part of that work. The harder part was the work of changing my attitude about the drug. It made no sense to take it while I had so many negative considerations about it. It took weeks to ease myself into viewing the drug as a chemical ally that I could use to change the way my body was restructuring bone. Taking it into my body has come only when I was finally able and willing to whole-heartedly accept this chemical as my ally. (It was quite a stretch!)
It’s been a much more challenging process to reclaim my image of me as a strong boned woman this time around. (A strong boned woman with numbers that indicate osteoporosis and with a vertebral fracture!) For several weeks since the diagnosis I’ve had clusters of spasm and pains in my back. My poor terrified body seemed to be trying to use muscle-contractions to “splint” my weakened bones! I’ve talked to her calmingly and invited her to join me in experimenting to find the best visualization for us to use to energetically strengthen and support our bones. After many false starts, I’m now able to visualize and feel earth energy swirling and weaving up into and through my bones as I lie in my bed in the tent doing my morning Reiki. I feel the radiant golden threads vibrating in the core of me. (And, then–no surprise–my mind wanders off somewhere else and I have to call it back to the visualizing!) I also do the visualizing/feeling when I’m on the slant board. (Since Ms. Pretty likes the slant board a lot, we’re often on it together!)
Now, two and a half months after the x-ray results, I feel a lot less crazy, less agitated and enormously less frightened. I feel, once again, solid in my bones and body. Pretty much back to “normal,” not worrying about what might happen “if….” Not feeling particularly fragile, just more mindful of my body moving through space. And, I notice that, without much conscious effort, I seem to have become more in-my-body and more balanced in my walking. I haven’t had any falls since the big one a year ago March! I still trip with some frequency. Yet, I regain my balance more automatically. Each time this happens, I give thanks to the Grandmothers for their help.
What’s so strange is that for years I’ve understood that all I (or any of us) do to support and sustain our physical and emotional health is just what we do. It doesn’t necessarily guarantee that we’ll be healthy or live a long time. That it’s all a crapshoot anyway. That many of the healthiest-living people still get cancer and other life threatening diseases and die early. Genes, environmental exposures we know nothing about and who knows what all else are the wild cards that can always trump diet and lifestyle and good intentions. Nonetheless, here I was furious and shocked when just that scenario was playing through my own life. Knowing what’s possible doesn’t seem to stop the reaction process at all!
I’m still open and available to exploring other natural/alternative treatments for osteoporosis. And, I seem at last in a place where I’m interested in hearing about what other people may have to share. So, please let me know if you know anything I don’t seem to.
Even as I’ve been in the midst of all this self-preoccupation, Hurricane Katrina’s ravages have captured my attention. The horror, devastation and dislocation of all those dear souls torn from their homes and communities and lives wrenches my heart. The unconscionable delays and inadequacies of the government’s response are beyond one’s worst imaginings. The rhetoric has been equally unpardonable, stupid and wounding. I cannot imagine being stripped of everything and subjected to such inhumane treatment. How on earth will all those families recover any normalcy? I send prayers for all the displaced and, too, for all of us. It clearly could happen to any of us, anywhere, at any time and our government is not prepared for disaster of any magnitude. Even after all these years since 9/11.
Originally published September 2005
