Wednesday, March 21, 2007

continuing education

Over the past week or so I've learned the following interesting medical facts:

Bones grow faster than muscles. I knew that bone growth occurred at the bone plates, but I never gave a thought to the fact that the musculature often doesn't keep up. This is a big part of DS1's gait/coordination problem: about the time of my original cancer diagnosis, he was going through a major growth spurt, and because of all my medical dramas, he wasn't enrolled in any kind of organized physical activity. He lost ground there, and has been playing catch-up ever since. (Here's an article by Dr. Sears which talks about this problem.)

Vitamin D deficiency is the latest buzz in early detection and treatment. I was surprised when my endo ordered a whole Vitamin D panel on my last bloodwork. I'm coming in on the low side of normal, but still within range -- the value we're shooting for is 50, and I was at 39, which isn't too far off. (The dr was not concerned). What's the big deal? From Science News Online:
over the past decade and especially the past 5 years, research has linked a broad range of additional benefits to having ample vitamin D. It's shown that the nutrient fights cancers and diabetes, is the pivotal feedstock for a hormone that protects muscle, and inhibits autoimmune disorders from multiple sclerosis and lupus to inflammatory bowel disease.
Who knew? Not me, and I thought I was relatively on top of this stuff.

Yoga is probably not the best exercise for preventing osteoporosis. I talked this one over with my endocrinologist also. I'm at high risk for osteoporosis because I'm tall, on the thin side (not so much these day!), and I'm on that suppressive dose of thyroid hormones to keep my cancer at bay. The new dr stressed that the joints really need to be pounded -- she suggested jumping jacks -- to get the bones to respond the way they should. It's the repeated stress on the bones that makes them grow stronger. But strength training exercises are important also.

Acute sinus infections left untreated can become chronic conditions requiring more invasive measures to resolve. The entirely personal information I learned today on this topic is that I've been to my primary care physician 5 times since August of 2006 for sinus infections. He (PCP) suggested I take this to my ENT, it may be time for a CT scan of my sinuses. But what I'm really going to do is take the vile anti-biotic he prescribed (14 days! ick!), use my Nasonex faithfully every day, and just try to get over this one and prevent another one. CT scans are expensive and I'd rather not unless I absolutely have to. Fortunately I have a good game plan and rather comprehensive information.

Sometimes, the intended use of the drug is "off-label" even though it's exactly on point. Case in point: bile acid sequestrants are often prescribed to post-cholecystecomy (gallbladder removal) patients, because without a gallbladder, too much bile flows into the intestines causing various "digestive transit" problems. My g/e doc prescribed some Cholestyramine for me. Reading the drug information sheet, I noticed there was not a word on it -- not anywhere -- about this use. The closest it came was noting that it can relieve itching associated with liver disease. Fortunately, the web comes through and backs up the g/e dr's treatment plan with the first hit from my "cholestryamine gallbladder" search. (You really have to know how to construct those queries!)

It's a good thing I read that sheet, too: the cholestyramine can interfere with thyroid hormones when taken too close together. Fortunately, I take my thryoid meds first thing in the morning, and the Questran will be an afternoon thing. It's not sticky or goopy like fiber drinks -- it's more fuzzy. This, I'm sure, is because it's a resin, and resins simply do not dissolve in water (what they will dissolve in, you would definitely not want to drink.)

So now I'm on a boatload of new drugs:
1)Mucinex, for the sinus infection
2) Nasonex, for the sinus infection
3) Biaxin, for the sinus infection
(damn sinus infection!)
4) Questran, for the rapid transit issue

In addition to all that, I'm still taking all my other usual meds, plus ibuprofen every four hours to take the edge of this never-ending flare.

Meds, meds, meds. What I really need to do is 1) consistently exercise and 2) consistently get at least 8 hours of sleep each night. On point 1, I'm not doing badly at all -- even swam today. Point 2 is my undoing, and I'm sure is contributing to my upwardly-creeping weight as well.

There's always tomorrow (notes time). (Ahem) Well, the rest of today...

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