O O

as in osteoporosis, that is.

A bone density test confirmed that I am the recipient of a big O - as in ow! ooo! ouch! The scan showed evidence of osteopenia in my upper thigh/pelvic region and osteoporosis in my spine. Without going into a whole lot of boring detail, the upshot is that I'm very likely to break more bones in the near future due to pronounced thinning of bone tissue which has resulted in a marked decrease in bone density. My spine (most notably L1-L4) will be much more suceptible than my hip/pelvis, but the news re either area is not good. At least I now know the source of the discomfort in my lumbar area.

Have been instructed to take 1000 mg/day of calcium (= 1 TUMS Ultra or 2 TUMS regular) together with 1000 IU of vitamin D. I cannot  take magnesium to promote calcium absorption as it would interact with my chemo drugs. Some interesting info re vitamin D  (source: http://ods.od.nih.gov/factsheets/vitamind):

Most people meet at least some of their vitamin D needs through exposure to sunlight. UV-B radiation with a wavelength of 290–320 nanometers penetrates uncovered skin and converts cutaneous 7-dehydrocholesterol to previtamin D₃, which in turn becomes vitamin D₃. Season, time of day, length of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation exposure and vitamin D synthesis. Perhaps surprisingly, geographic latitude does not consistently predict average serum 25(OH)D levels in a population. Ample opportunities exist to form vitamin D (and store it in the liver and fat) from exposure to sunlight during the spring, summer, and fall months even in the far north latitudes.

In supplements and fortified foods, vitamin D is available in two forms, D₂ (ergocalciferol) and D₃ (cholecalciferol) that differ chemically only in their side-chain structure. Vitamin D₂ is manufactured by the UV irradiation of ergosterol in yeast, and vitamin D₃ is manufactured by the irradiation of 7-dehydrocholesterol from lanolin and the chemical conversion of cholesterol. The two forms have traditionally been regarded as equivalent based on their ability to cure rickets and, indeed, most steps involved in the metabolism and actions of vitamin D₂ and vitamin D₃ are identical. Both forms (as well as vitamin D in foods and from cutaneous synthesis) effectively raise serum 25(OH)D levels. Firm conclusions about any different effects of these two forms of vitamin D cannot be drawn. However, it appears that at nutritional doses vitamins D₂ and D₃ are equivalent, but at high doses vitamin D₂ is less potent.

Curious gentle readers may be interested to know that - quite by accident - I picked a bottle of vitamin D3. I say "by accident" as there were at least a dozen different "vitamin D" offerings available and I had no idea which was the best choice for my situation. No, I didn't ask the pharmacist as I was in a rush so shopping at Shoppers' Drug Mart in Sechelt, a store notable for less-than-reliable pharmacy staff. In any case, I was thrilled - tickled to my toes, in fact - to learn that D3 is derived from lanolin. If only it was absorbed effectively through the skin, then all those years of spinning raw fleece might have had medically beneficial side effect!

Of course, TUMS and vitamin D alone won't do much to slow the progress of the osteoporosis. I will have to take special meds, too. At present, the form that medicine will take is unknown as I won't be able to meet with the amazing Dr. Wadge (the internist who was overseeing my chemo treatment in Sechelt) until Sept 29. While my GP (Dr J) could easily have prescribed something, concerns re potential interaction with the Foretinib and Lapatinib have made everyone extra cautious. Stay tuned for further developments. Just hope I don't break any more bones or get any shorter in the meantime!