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osteoporosis and Advair
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Loisdaughter posted:
My mother has COPD and the doctor has prescribed Advair. She won't take it because she read that it can make osteoporosis worse. Me, I think that if I had to weigh breathing against my bones, would take breathing. She's afraid of going back to the dr. because she won't take the advair. I recommended the advair because I had to take it once when I got a chemical burn to my broncial area.
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bonebabe responded:
The inhaled steroids are not as toxic on the bones as the injections are. It also depends on the dosage and the length of time she's on it.

I don't see any reason why she couldn't do both. We have a lot of patients who have to be on heavy prednisone and are also on an osteo med. One doesn't exclude the other. Just make sure she takes her 1200mg of calcium and 1000 IU of Vit D each day along with any osteo med she may be prescribed.
 
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NATIONAL OSTEOPOROSIS FOUNDATION
Susan Randall, RN, FNP-BC, MSN responded:
It's very important that your mother works closely with her doctor to determine the most appropriate treatment to control her COPD while also reducing her risk of fractures. COPD is a serious condition and people affected need to work closely with their doctor to make sure their symptoms are well controlled. While the steroids taken by mouth appear to cause the most bone loss problems, taking Advair may also increase her risk of bone loss. Depending on her bone density and her other risk factors for having a fracture, she may need to take an osteoporosis medication. Adequate calcium, vitamin D, exercise and fall prevention are also important for reducing her risk of fracture. Visit www.nof.org for more information on these topics.
 
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Loisdaughter replied to bonebabe's response:
Thank you for your reply. I'm not sure what was decided about the advair. I hope she's taking something. She did gain 3 pounds in six weeks, so something is helping.

THanks again.
 
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Loisdaughter replied to Susan Randall, RN, FNP-BC, MSN's response:
Her bone loss is fairly bad. I guess they called it "serious." Her weight loss has been dramatic. They say that's because she can't breathe. She's been taking actonel. They switched her to boniva. She's been taking Calcium (when she remembers) and, I'm not sure about D. Like I said, I weigh breathing against bone loss and I take breathing.

Thanks for your response. I'm so glad that she's gained three pounds in six weeks. Don't know what helped but I'm glad something did.

Marcey
 
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bonebabe replied to Loisdaughter's response:
You're right, breathing is important and anything to help that needs to be done. Along that line, something to know/think about, when a person's bone density is serious, compression fractures often happen. On the surface, that doesn't seem like much, bones heal. But...with compression fractures the spine curves forward compacting organs - including lungs. It in itself can make breathing difficult. You want to do everything you can to avoid those fractures.

What about her posture? Good posture can help with balance and breathing. If she's having difficulties there, maybe some postural exercises would help. She might also want to try using a backpack instead of a purse. It frees up the hands in the event of a fall and aligns the spine naturally.

It's very important that she take in 1200 mg of calcium daily. If she doesn't, any osteo meds she takes won't do the job they're supposed to. Also, if she hasn't had her Vit D levels checked, it might be a good thing to ask the doctor about doing.

She's got two serious things going on. One doesn't need to be sacrificed for the other.
 
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Loisdaughter replied to bonebabe's response:
Bonebabe,

Thanks again for your response. She has severe osteoperosis and severe osteoarthritis. She is also 12 years cancer free from breast cancer. Yeah... she's got a lot!

Funny you should mention about the posture. Her's is much better than mine. She's never mentioned about her purse getting her "down" with the breathing, but I will tell you now, she won't do that! I can't even get her to use the little "go carts" at the grocery store, even though I offered to get in one and figure out for her how to use it. Pride!

Please, if you would, pass on the posture exercises. I breathe fine, but I look awful and, with what you said, I'm afraid that will change. Maybe I can get her to do them too.

Marcey
 
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bonebabe replied to Loisdaughter's response:
I'm going to suggest that you go online to the National Osteo Foundation website (www.nof.org ) and order their booklet "Boning up on Osteoporosis." It costs $6.50 and is one we use in our rehab and education classes. It has illustrations of exercises along with correct and incorrect moves. It would be a lot more understandable than my telling you in this forum how to do some exercises. Besides that it gives you tons of information.

As for the go carts in the grocery store - keep her out of them as long as possible. We had a community education program today with a physical therapist talking about falls and balance. She stressed in particular the use of those carts lead to more use and that leads to muscle weakness which leads to falls. Use it or lose it.

Try the backpack. Get one with the zipper on the side touching the back to avoid theft. They are surprisingly handy and will help steady her too.
 
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NATIONAL OSTEOPOROSIS FOUNDATION
Susan Randall, RN, FNP-BC, MSN replied to Loisdaughter's response:
Dear Marcey - You can also learn some exercises to improve your posture on NOF's Web site. Here are the links:
http://www.nof.org/aboutosteoporosis/movingsafely/spinestrengthening

http://www.nof.org/aboutosteoporosis/prevention/excersiceexamples

I hope this information is helpful!
 
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Loisdaughter replied to Susan Randall, RN, FNP-BC, MSN's response:
THanks, Susan. I will. It's pretty sad when my posture is worse than a 72-year-old with osteoporosis! I'll look it up.

Marcey
 
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phototaker replied to Susan Randall, RN, FNP-BC, MSN's response:
Thanks, Susan! Even though I do swim aerobics, zumba, and UJam, these exercises should help me even more with my shoulders. I am being VERY careful not to bend in my zumba class during this one dance, especially, where we bend over many times. I just remain straight, which is awkward looking as everyone else is bending over quickly, but I know it's the right decision for me.

There "is" one dance routine where we squat lower and we're supposed to pat the floor (bending)our knees and upper back, touching our hips with our hands, then shake our bottom, back and forth to the music. I squat, but I don't bend down to the ground. I hope this is not injuring anything in this squat type position with my back bent a little. You're making me think about some of the dances, which is good. I'm not sure if this one is good either now.

Susan, I'm also starting a senior weight lifting class with our swim teacher, after swim class. What size weights would be good to start with? Are there any movements I should stay away from? This teacher had been injured greatly and went through a lot of weight training to get back to normal again. She knows about seniors and movement.


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