When I was working in Peru, as a field biologist, one of the guidelines we followed was to never camp near sandy river banks. Sandy areas attract sandflies, and sandflies in most of the tropical regions of the world carry leishmaniasis. One of my colleagues did contract the disease, and at that time the only available treatments involved antimony based chemicals. A tough position: live with ulcerous sores all over your body or ingest relatively large quantities of heavy-metal compounds. He and I used to joke about the cure being as bad as the disease, though he did go through with the treatment.
As part of the followup to my crash and injuries of last June the orthopedic surgeon ordered a DXA bone scan to check for bone density. I’ve had the results for 3 months, but her and I just had a chance to talk about them a couple of weeks ago. Bone density of my arms is normal (for a 30 year old male, the standard, so above normal for someone my age), the lumbar vertebrae are a bit below normal, but still OK, and the measurment of my left femur is in the realm of osteopenia. That last number is the one the orthopedic surgeon wants to concentrate her attention, and she has prescribed a three part regimen to deal with the ‘problem’:
- Take calcium, lots of calcium (at least 1500-1800 mg/day) . Interestingly, she did not prescribe Vitamin D to go with it.
- Walking, at least 30-40 min/day beyond normal ‘maintenance of life’ movement. Basically this is weight bearing, and the only weight bearing activity she wants me to undertake involving the legs/hip at this time.
- A bisphosphonate drug for ‘osteoporosis’.
I can accept #1 and #2, but #3 is where I have a divergent opinion. I am not a big fan of pharmaceuticals in general, but the bisphosphonates are particularly troubling. There are high rates of ‘troubling’ side-effects, including but not limited to severe muscle and joint pain, gastric issues including esophogeal erosion, and upsetting the bodies electolyte balance. More troubling is the increasing association with necrosis of the jaw. The more one reads about these compounds the more it seems that they are likely worse than what they are meant to cure. I think I will pass on them.
