Posts Tagged ‘anabolic’
Several patients have concerns about oral surgery while taking Prolia. This is not a problem – if you follow guidelines.
Prolia is different from other Antiresorptives. Prolia does not accumulate in bone. 5 to 6 months after your last dose, Prolia has lost its effect of slowing bone turnover. Therefore, it is safe to proceed with surgery on bone (including dental surgery) 6 months after your last dose.
Patients worry about OsteoNecrosis of the Jaw (ONJ), but this is very rare. In fact ONJ virtually never occurs without a tooth extraction or serious periodontal disease. Even then, it is rare unless you also have cancer, have poorly controlled diabetes, or are seriously Deficient in Vitamin D3, or Calcium, or Protein intake.
Elective Orthopedic Surgery timing is the same. If you need a Total Hip Replacement (THR) or Total Knee Replacement (TKR), schedule the surgery for 6 months after your last dose of Prolia.
Any time you plan to have surgery on bone, you should Optimize Your Bone Health First. Get a Complete Bone Health Evaluation. Optimize your Vitamin D level (at 40 to 80 ng/ml). Optimize your Calcium intake in foods and supplements combined (at 400 to 500 mg at all 3 meals daily). Optimize your daily Protein intake (1 g Protein for every kg body weight).
Sometimes you will also need the Anabolic, Forteo, to increase bone matrix and improve healing. More about that another time.
Get the best possible result from orthopedic or dental surgery. Wait 6 months after Prolia, and do your part to optimize your bone health.
Jay Ginther, MD
Aunt Henrietta enjoys her independent life at 90. Especially when compared to how she was 4 years ago!
I visited her while out east for NOF. She easily walked the 3 blocks to and from church. She led the procession up and down every aisle in the huge Shoprite and the Rite-Aid, while stocking up on provisions for the month. She even strolled more than 1/4 mile across the Delaware River pedestrian bridge.
She lives alone in a 2 story house. I am not happy about the stairs, but she does not fall too often, and has not broken anything in 4 years.
Before Aunt Henrietta started treating her osteoporosis aggressively, she was rightfully terrified to do anything. She was talking about dying in her house. She had broken one wrist, then the other wrist, then her shoulder, in 3 separate falls. Her plight and response has been an inspiration in my efforts for bone health.
She started Adora Chocolates (she loves dark) for Calcium, then added high dose Vitamin D. I harrassed her into eating more protein. But when she fell, she broke. Her Quality of life was in the Dumpster. Time for drastic action!
I talked her into the Anabolic, Forteo. She failthfully gave herself a shot every day for 2 years. Because of her aging kidneys, I followed with Prolia. She has worked hard on proper nutrition. She was determined to regain her Independence. She succeeded.
Aunt Henrietta resurrected her Quality of Life. She is stronger, more active, stubbornly Independent, and Fracture Free! At age 90, that is everything.
Aunt Henrietta beat her osteoporosis! You can too.
Find out what you need to correct with a Complete Bone Health Evaluation.
Take Control to Avoid Fractures and remain Independent.
Jay Ginther, MD
Ann spends a week in Florida each winter with several friends and was stronger, more agile and more confident this year than last. She stepped in and out of the hot-tub easily instead of slowly and awkwardly. She zoomed up and down stairs. She had to slow down when walking with her friends. What has happened?
A year ago she followed a fragility fracture with below average and decreasing BMD on DXA, and a newly crumbling vertebral fracture on VFA. She has Clinical Osteoporosis. That got her attention. She was determined to play on the floor with her active preschool grandchildren. You cannot do that if you are crumbling. She was ready to do whatever it took to get back in the game.
She added Adora Chocolates (500mg calcium in each) to her usual diet. She added Protein shakes (chocolate) and increased intake of chicken, fish, and beef to meet the new protein guidelines. She remembered to take extra Vitamin D3 and her Multiple Vitamins & Minerals almost every day.
She got serious about her “10,000 steps” every day and went up and down stairs frequently instead of saving up things for a single trip. She did not actually join an exercise class as promised.
She started the anabolic, Forteo, to build her bone density and strength. A daily little shot is a nuisance, especially keeping it cold while travelling, but she wanted results.
This year repeat DXA showed increased BMD. VFA confirmed no further crumbling. She zoomed through airports and left her friends in the dust in Florida. These results have made her even more determined.
She has Taken Control of her Future Life. You can too.
Jay Ginther, MD
Recently a patient asked me to review all osteoporosis medications for her to consider and choose from. We had already optimized her Calcium intake, 25-hydroxy Vitamin D level, Protein intake, Multiple Vitamins & Minerals, and Exercise program. These had all helped substantially, but not enough for her peace of mind. She feels that she needs osteoporosis medication too. Here they are: