How 'bout them bones?

Two years ago  I had a Bone Scan and didn't think a thing of it until I got an email with the results. 

Shocking! How on earth could the results be so concerning? My doctor called me that night and we set up another appointment. My scores didn't just say Osteopenia. The results were considered pretty severe in regards to the lumbar spine. 

In fact I had nightmares about going to do something that winter and literally having my bones burst out of my body and scatter all over the place. 
Wouldn't that give you a Halloween Nightmare!

I sort of explain things in an April 2022 post where my Osteoblasts are fighting my Osteoclasts.

In short, I was unable to continue with the medication that was prescribed the would keep me from losing more minerals. 

I went back to CrossFit and took up Mobility [and Balance] classes, along with weight training to build up my core muscles to protect my spine along with a moderate change in diet.

I have to be honest. I am horrible when making dietary changes. I do eat my veggies, I do eat mostly properly, but I eat as my husband would say 'like a bird'. I don't like a ton of meat. I like soups and stews, but not steak and tators like he does. I'd rather eat a salad sometimes.

I was asked to drink milk and eat yogurt much more. I don't like milk. I like it if it IS chocolate milk once in a while or if it is a MILKshake. But just milk? Ick. And after a few months of all that extra dairy, my stomach revolted.

So I substituted some Calcium supplements along with some vitamins and continued going to the gym. I enjoy what we have in the gym and it is a social relief to be around other sweaty people. Many times it is comedic relief also.

I let the whole Osteo thing sort of slip from my mind. I figured that I was doing what was right for me and being active and amused is better than being afraid and sorrowful. I let it slip away that is until the next scan which was Monday.

The result was:

Two years and there was almost no change. 

One hip got a tiny bit crappier 'score' and one hip improved on its score. 

The lumbar region had ... and I quote "No significant change".

I feel like I passed a big test and didn't flunk it! To me, this means that I think I am doing something right. Now the endocrinologist may think otherwise when we meet next week. However I will listen to her and discuss medication.  

We've tried Fosamax and Teriparatide aka Forteo with some extremely painful results. I suspect she'd like me to try a newer medication that can only be taken for a year called Romosozumab aka Evenity. It is supposed to build bone density up and can be taken only for 12 months before reverting back to one of the previous meds I've already had or suffer loss of bone due to the new med.

I'd like to hear her take on vitamins and diet and what her thoughts are regarding the No Significant Change. I've had no fractures and no breaks ever in any of my bones so what does she think of that?

Eventually the lower back will have a compression fracture[s] that is inevitable. 

But until then I will be friends with my bones and make sure I take care of them in the best way I can.

What next??

I know I have harped on my Severe Osteoporosis diagnosis since last September. It struck me very hard and I was stunned to find out that my stupid body had failed me. I did all sorts of tests and a full work up. Heart, lungs, BP, eyes, and blood work came back pretty darned good for an old fart.

But my basic construction was falling apart. 
I started to worry about hikes, about the normal things I'd been doing all along. Suddenly they felt like huge issues.

It has messed with my mind to say the least. My osteoporosis score in the low lumbar region was 2/10ths of a percent under a 99 year old frail person. I was nearly off the charts in a bad way.

The consensus was to start taking bone building medications. The first line was a generic form of Fosomax. After three months, the meds and I didn't get along. Fast forward to the second medication, which I didn't do well on.

In the mean time, I went back to the CrossFit gym for some Mobility Classes. I needed the exercise and gentle stretching. The class is geared to any aged person and improves strength and balance. Well, that is, if you stick with it.

Here is a photo from one of the classes. See? CrossFit isn't a bunch of burly dudes running around throwing weights and beating their chests. It can be so much more. I'm on the left and a good friend of mine is on the right. The Mobility Class has teens to elderly adults in it. 

Yesterday, I had a phone visit with the Endocrinologist. We discussed medications and the pros and cons of the medication called Prolia. It is an injection once every 6 months. The downside of the medication is that at the end of 10 years of this medication, you have to take another medication to prevent relapse.

It is complicated. Prolia builds the bone and keeps the cells from breaking down. It is a monoclonal antibody.

We discussed the fact that so far, I've had no fractures anywhere in my body. She attributes that to my activity level. 

I asked if I could take a reprieve from medications and try a different route for a while:
hiking - low impact - free weights - balance and mobility exercises. Good diet with milk for calcium and foods with vitamins in them.

I explained that the medications worked backwards on me. I had a hard time staying physically active.

She thought this was a good idea and she said she was very open to it. 

Note: This doctor listened to me and explained the benefits of the medications along with saying that new meds are being found all of the time that may help. She didn't speak down to me. She didn't get that air of being far superior.
She even said that it was my body and this felt like a good short term plan to see if I could improve things a bit on my own.

So here are a few things to consider. I signed up to go back to the gym for Mobility Classes and some personal training to tailor exercises for my specific needs.

I was asked why would I spend that money like that? 

Easy.
The cost of the exercises at the gym are far less than medications cost and far less than physical therapy costs.

The benefits for me are multi faceted. I live with a shut-in who doesn't socialize. I get exercise and social interaction at the same time. Plus I suck at doing exercises at home on my own.

Bonus points: It helps my mental and physical well being.

My Osteoblasts are fighting my Osteoclasts!

 

I thought this was interesting in a way. I had a visit with an Endocrinologist yesterday. The first line of meds for those folks with bone loss is a med called Alendrontae. I did not get along with that medication at all. I didn't suffer GI issues, but the other issues were pretty severe. 

An Endocrinologist treats conditions related to the body's hormone issues. Apparently some hormonal part of my body forgot to tell the Osteoclasts to quit with the TNT sabotage or perhaps my Osteoblasts went on vacation?

Emily, the PA, was excellent at going over everything and asking the questions she needed to. She spoke directly to me and looked me in the eye. She did not stare at the keyboard and just type. 
She then told me what she was writing as she typed it into my visit notes.

We discussed the severity of my Osteoporosis. A score of -2.6 is severe. That is in my right hip joint. You know the part that swivels the hips? But wait! 
GO Big or Go Home!

My low back has a score of -4.4 

And what does that mean? Kinda like my bone loss is equivalent to a really really old lady? 

I prefer to think of myself as having bird bones, except I can't fly.

So some medication choices were discussed. The first med I tried made me extremely sick but is generally the first line of medication choices and works well. They are in a class of bisphosphates which my system doesn't like much.

So we discussed alternatives. Two meds that actually help rebuild bone use daily injections for 18 months. After 18 months, a med that is supposed to maintain the Osteoblast Guys and prevent the Osteoclasts from blowing me up is taken for the rest of my life.

So hmm. The rebuilders are called: Foteo and Tymlos. Average cost with no coverage per month for these meds are about $2000. I don't see it in the formulary for my medications. However the doctor has someone doing some research. 

The alternate maintenance med is in the formulary.

Osteoporosis is not painful. It is arthritis that hurts along with fractures. The diagnosis really threw me for a loop. I'm supposed to be Superwoman, right?  

Exercise in the proper way, good diet, and positive outlook are all helpful ingredients that cannot be found in a pill.

Because of the severity, I have a few recommendations. No skydiving, no jumping rope, no box jumps, no running~like distance running, and no twisting with weights or heavy weights over my head.

Good recommendations. Continue daily hiking, do weight bearing exercises, fresh air. Walk the dog, enjoy everyday.

Doctor Doctor

Now that I am OF age, a curious thing happened. I had a complete Wellness Exam. 

I GREW shorter! I'm a half inch shorter than I was at 20 yrs old. Well, no real surprise there. I'm a little people.

Taking care of me is as important as taking care of hubby. 
A couple of things came up. The eyeball thing of course which will be re-evaluated tomorrow, stress from caregiving and dealing with the mental status of the other half.

My doctor Ann, is awesome. I've been with her for 23 years. She said with the stress and anxiety issues I go through she'd like me to go see a counselor. I agreed. [Seeing means by zoom in these times and I am not sure about that. I need human contact. Even if it means conversing outside.] Phone calls are OK. But seeing another face other than my walls is what I need.

Interesting that she said I qualified for meds for this. She rattled off the med list and I shook my head with each one. She smiled and said she did not see me taking those meds either. 

I told her what I currently do to try to keep sane. I will go back to CF with modified exercises until the bay doors are closed for cold weather. Then I will go back to Virtual CF. She prescribed hiking and Yoga. 

So I have a diagnosis code Z63.6 which is Dependent Relative. The hardest part is having to admit it to your provider. I'm pretty sure I wouldn't have been this comfortable discussing these issues in a Zoom or Virtual Appointment. 

Here is a not so great fact. Most CareGivers do not outlive their dependent if they do not take steps to Care For Themselves.

This is not new information to me. It is just how it is. I hate to admit it, but I do have more times per week that I get irritated with the other half for no real reason. I always am nicer after a nice long hike or workout.

And now I will take time to do a bit of bragging. I passed my exam with flying colors as far as all the vital readings go. I even got a BMI rating! Too funny, I had to look it up. 
Since I am small, I've got to do a bone density test. Hmmm, how do you study for that? One fasting lab and poke and I'm done with my tests. 

I also got the flu shot and am scheduling shots for Shingles. Interestingly enough on a side note. A friend who WILL not get the Covid vaccine did get the Shingles vaccine. 

Ruminate on that for a moment.

My last thoughts for today.
Doctor Ann told me that last week they had to divert patients because our little hospital had NO room in the ER or beds. She did not say why, she just said it happened.
The ambulance had to take patients to another state. There were no available ER's within 100 miles of our tiny town.

It did not make our local news. 

She told me to stay safe and do her prescribed hiking and yoga plan. To follow up with a phone call to get in touch with a counselor if the VA couldn't provide any help.

~~~~~

I'm going to make up a sheet to put on the fridge. 

It will go something like this:

Val must go hiking every week as a prescribed medication. Dr. Ann Said So.

I do like my doctor.

The Possibilities are Endless

The other morning I wrote that while looking at a photo of little Charlie looking up the road from the mailboxes. The whole world lay at his feet and that is because Charlie knows no end to possibilities.

That got me thinking feeling a bit philosophical.
Some days the burden of being a CareGiver seems difficult.
It can be hectic and overwhelming.

Then I go to CrossFit and grimace at the workout of the day, or WOD. I see other folks who I've been working out with since last October and we greet each other and laugh.
Our coach encourages us each step of the way.

Yesterday I did the Back Squat. Ok. I was afraid of this particular lift because it involves weights and a bar. And it involves a movement that I've struggled to do forever.
Learning the proper way to lift is like learning a dance move.
[I've never been a good dancer]

I went through the motions with the rest of the group, pretty sure that I was going to have a hard time with the lift again. But I saw little Charlie in my mind and how he views his world. Never a negative thought. Always with possibilities.

So I tried lifting with just the bar.

Next I added weight, a bit at a time.

Wait.
Wait.
It felt right. I suddenly didn't feel awkward and strange like I had two left feet.

Suddenly my day looked brighter.
Then the next day I was able to do pullups on the bar with the black band. I did 3 in a row with a green and red band. Big deal? Yes.
Until then, I hadn't been able to do it that way.
Small victories in my strength.

And it isn't just about working out. It is socialization too. And for me that means a lot.

It seems that I am slowly finding my way after all that we've been through.
See?
The possibilities are endless.

Playtime

I have a younger neighbor with 3 children ages 5 and up. On Fridays she started meeting up with other moms and their kids to play an hour of soccer at a playground in town before the kids had to go to soccer practice.

I went last Friday and had a blast running with the kids and I even went to watch the kids do soccer drills after the 'free' play time.

I asked and was invited to come again this week. I'd pulled a muscle during the week but still wanted to go. I'd play to my ability.
There is something very inviting to be able to just go out and play. To me it was more like the games of kickball I'd played as a kid.

Last week we were the only people there. 4 adults and 6 kids. We laughed hard, played hard, and had a wonderful time.

This week something pretty neat happened. The original players were there. Another mom showed up.
Then a girl wandered in slowly and joined the game. Soon another boy stood off to the side and gazed at us on the field. He was asked to join in. From another direction another kid showed up, he joined in.

Two other kids took up places on the playground equipment and watched the adults against the kids and the chaos and laughter that ensued.
Someone in a vehicle stopped for a few minutes to watch also.

Playtime.
Just good ol' playtime. No electronic devices [I had to run to my car and grab my pocket camera so I could take this shot]. Just play.
Imagine that.
Kids and adults from 5 to 62 just playing.

Jumping Rocks and other fine things

Good morning!

That is how the other members of the 6am CrossFit class greet me. The 5am class is finishing up and they all say Good Morning and actually mean it!

My husband doesn't quite get the allure of CrossFit. He calls it "Workout".

I started doing this in mid October. So what changes have I noticed?

I have something to look forward to each day and can have good social interaction and the workout relieves stress.

One of the measurable changes I've noticed is my blood pressure has changed dramatically.
I take it in the morning and the afternoon...not because I am ordered to, but because Rich is supposed to monitor his.
Earlier this summer my blood pressure readings were a bit on the high side. 
130ish/80ish.

On days I don't work out it hovers at 115ish to 120 over the 70's.
After working out? 106/68.

Hmmm. It makes one think about blood pressure and exercise. It is easy to take a pill and hope for the best...but...
I'm thinking this workout deal is much much better.
[Ok, off my soap box now!]

What else?
I used to struggle with peeling hay off a round bale and tossing it over the electric fence. I opted to shove it under the fence instead.
Over the weekend, I discovered I can easily toss fork-loads of hay with no effort.

Balance.
I used to be so surefooted. But the past year I found myself ...well, maybe not as surefooted as I used to be?
CrossFit works well with balance exercises. Most of the warm ups and many workouts promote balance.
While walking in the creek yesterday I came to a spot that I had to climb down a steep rocky bank to get to a place that I wanted to photograph.

Once I got down, I had a choice, get my feet soaked 1/2 mile from home, or jump to where I wanted to be. I used a skill learned from Box Jumping to launch to a rock clump in the middle of the creek.

And I stood there with the water flowing around me, grinning like an idiot. My balance was better!

See? Better!
Yes!
My creek jump...the banks are about 4 feet high...

And this is all worth it. Even after hiking to the end of the valley and back, I still felt energetic.

Anyway, the reason I jumped was for this shot:

And further towards home, I straddled some logs and got some very cool Ice Fingers...

I am happy that Gun Season for Deer is over. I can wander about again.

Tonight I am going to the LaCrosse Camera Club meeting and we are going to review 'night' shooting and tour the Rotary Lights by the river.

Color me happy.

Up and at 'em

The alarm rings and I grab for it. Some mornings of course I am awake before that 4:30 ding a ling.

I consider not getting up but then I remember the CrossFit thing I've committed myself to.
And I get up and smile through my first cup of coffee.

Some folks around me don't voice it but I'm sure they may be thinking...
"Has she gone daffy?"

During the WOD or workout portion of rowing, burpees, rope jumping, lifting, or pull ups [each workout is modified to my ability as a beginner...] ... I feel my parts saying NO NO! And my mind is saying please yes!

My workout mates gather around and cheer me on if I am doing something hard, or I find myself cheering another on, or helping him/her put things away or set them up.
I've found a clan of nutty people.

And suddenly that alarm is no longer intrusive in the morning, but awakens me with a smile.

And then when I do drive home...
I get these views...

And yes, I even do that early workout before driving to Madison for appointments.
Well, as long as the appointments for Rich aren't too early themselves. It is a 2 hr drive and I have to get him up and awake which is a job in itself.

This week is no piece of cake in the appointment department. But the all day endorphines seem to help.

Oh yes. I do give myself breaks. The other morning I slept in until 6:30. However my day felt off somehow.

Rich is doing okay. Speech Therapy is proving to be extremely frustrating for him and he can't let go of the fact that language and writing used to be so easy. And now some days it is impossible or he feels it is impossible.

Those mornings though are something else.

I have a purpose with each waking day.

I can handle the difficult issues that keep coming up each day with a bit of a better tempermant. This is why I get up and do CrossFit.

And ...
why not?
Tomorrow we get to RUN! OHHH my favorite!

Take A Hike!

There is an App that can be used with cell phones called MapMyHike. I had been using my Etrex Garmin GPS for years, but it seems to have issues now, so I thought I'd try this out.

I thought this graph was pretty interesting. It shows that I kept a fairly good pace even with the elevation changes. I know that since May I have increased my power and strength for hill hiking. I surprised myself last weekend when hiking the KVR. It was rather flat and I covered ground in 12 minute miles or less depending on when I stopped for taking photos or re-routing along the river.

My hands may ache and feel horrid, but my legs are strong and can carry me along. Some of this route was similar to what I can ride Sunshine, Mica, or Siera on. However the majority of this hike was on deer trails and not groomed trails.
It involved 'creek leaping' as well as ducking and hopping over dead falls.

I love to chose to go along the creek first anyway. I've even tossed out some flat rocks to assist with the creek crossings.
I went past the Ice Wall to see if there was any ice forming. This area is wet with a lot of water seepage so the ice is forming.

Last year....
in January...

The temperatures will be dropping drastically through the weekend and since I have some avid hikers coming to visit, I thought I'd check out the route we like to take together.

These are the trails I take. There is an old logging road that is a bit wider but nothing is groomed so it is always rough going. I am not complaining as this has been my backyard hiking for the past 20 some years.

I wanted to see if the 'Ice Cave' had any ice on it yet. The ice formation on these rocks are dependent on moisture from the ridge. There hasn't been enough rain or snow melt to create any formations here.
The raccoon have taken over the 'cave' area. I could smell the scat from above it.

As I entered the cropland area I saw this mud-grass bird nest full of cracked corn and berries. I wondered if some field mice didn't use this as a storage bin.

Then it was back out onto the cropland. I hiked through the corn stubble and cut across to our property line.

I hustled down the steep hillside to the creek. I checked my time and I wasn't far off schedule. I'd told Rich that I'd take about an hour and a half. I had 20 minutes to spare.

I marched an slid down the hillside and back to the creek. I grabbed the knotted rope we call "the elevator" and used it for balance while climbing up the steep bank.

The arrow points to the rope I use to go up the bank.

View from the top of the bank into the creek.

I made it home with two minutes to spare.

I grabbed some dry clothes [I'd sweat through my shirt and sweatshirt] and helped Rich finish the stock tanks.

How did I feel afterward? I thought I'd ache all over.
I did not.
I thought I'd feel it today.
I do not.

However, I did sleep like a baby last night. 8 full hours of sound sleep. After 9 years of odd shift work and no sleep pattern, I am finally feeling a bit more normal. I feel like leaving that job gave me back years of life.

I'm already plotting my next hike.

Dang it All to ...

Well dang it all to heck and back.

I'm not going to really whine about this too much. Hmmm. Maybe I will. It seems that osteoarthritis has crept into my life. Well at least into my hands.
I of course figured that it wouldn't happen to me.

Stupid me. I sort of knew it would. My Grandmother Pearl had twisted gnarly hands and she barely whispered a word about it. I'd see her gardening, crocheting, sewing, and doing all those normal things with her beat up hands. At the time I admired those well worn hands and said something to her about it.
In all her infinite wisdom that I never learned...she replied, "Oh I don't think you want these hands. Some days they don't do so well."
She said this as she was artfully cleaning a fish with quick skilled movements.

My mom began to suffer the same fate as did her sisters. Arthritis crept up on their hands deforming them and sometimes twisting the joints.

Over the past year or so, my hands began to ache a lot. Certain movements hurt. Grasping things was painful. My left thumb continued to hurt making grasping door knobs a real chore. In fact when we remodeled, I had handles put on the door that I could just push down on.

Opening a jar can be tricky. Using an old fashioned can opener can be a trying feat. Over the winter my hands became worse. I developed Herberden's Nodes on the ends of my fingers. As those nodes develop, the pain is quite intense. I recall my father showing me the tips of his fingers and telling me that once the bump was formed, it stopped hurting, so it wasn't so terribly bad.
Oh, he was not kidding!

So this summer those wonderful little nodes pretty much quit hurting and I was able to get along except for the thumb issue. Sometimes at night, I'd fall asleep with a cold pack wrapped around the left hand. It numbed things enough so I could sleep.
Peeling apples for apple crisp last month made the pain nearly unbearable. So I decided to see how I could process apples without causing myself a lot of pain. Easier to make jelly, juice, and apple sauce than to peel apples.
Plus I got a food mill which helped tremendously.

Brushing the mules out for riding was even a bit difficult, but I decided worth the pain.

I sort of knew what may be going on with the hands. Goodness knows I've seen it in my grandmother, my mom, and my dad. However my fingers are not being deformed much.

So when my doctor and I looked over the hand X-ray results, I was sort of surprised. There it was osteoarthritis in both hands. No fingers were left unscathed.
The left thumb showed degenerative joint 'disease'. Oh. Ick.
Mostly it means that the hands will slowly get a bit worse as I get older.

Now dammit, how did I get older? In my mind I am about 30! I look in the mirror and see that older person looking back at me. She disappears when I take my glasses off. She looks much younger after I take a shower and peer at her in a fogged up mirror.

My doctor recommended that I see Occupational Therapy for exercises to strengthen my left hand and to see how they could suggest non drug like therapies to lessen the aches and pains. I am all for that. Our local clinic has an excellent PT/OT department and they have helped me quite a bit in the past.

How am I going to 'deal' with this? Well, now that I have a name and a cause for the pain, I will not quit doing things or baby my hands. The pain is not indicative of something that will harm me.
It is simply wear and tear. I need to work out how to do some things smarter and need to be aware of the "Use it or Lose it" theory. If I stop doing things with my hands, or I stop being active ... I will be in more pain and more health problems will arise.
If the body stops moving, it will destroy itself.

My doctor said that if the thumb issue got too bad she would send me to a hand specialist to explore injections [eeks!] and perhaps surgery [eek gads! NO!]. She said she had a patient who went through the surgical procedure and the recovery and PT time took about 6 months. No thank you!

This is not earth shattering but it will include some minor changes for me.

Yes, I think my father was correct. Aging is not for sissies.

Day Hike

It has been way too long since Morris and I took a long hike through our woods and through the neighbor's woods.

Yesterday afternoon I grabbed some water, my pistol [hubby had watched a coyote run through our pasture yesterday morning, ... thus the pistol], Morris, his leash, and my camera back pack.

I took along my micro/macro lens, and the 35mm lens. Now one would say those two lenses are too close to do me any good but, I ended up making good use of each lens.

My trusted camera assistant was able to find our trails even though they were hidden by fallen leaves and a bit overgrown.
Of course he has travelled these trails with me since he was a pup.  Good Morris, you are a fabulous navigator.

One of the first very cool things we found was several trees that were surrounded by fungi!  I kept expecting a woodland faerie to appear.

Silly me, I didn't check to see if the dead trees were all the same kind of trees.

Anyway, we finally made onto the ridge on PeeWee's Land.  This area has been not been pastured now for 10 years and it is becoming quite the chore to get through certain areas.

But the view of the East hillside was pretty beautiful.  I used a polarized lens in this shot to bring out the color and to keep the sky from washing out.

The meadow was so overgrown that Morris and I had to fight our way through the weeds on what used to be an old cow trail.  
The area is now choked with Wild Parsnip and the Golden Rod is taller than I am.

We used the snow mobile trail to get around because cutting through the woods is no longer possible.

The creek crossing was hidden in lush weeds.

I heard Morris plop into the water and take a long cool drink.

Eventually we made it out of the woods and onto the crop land.  The walking was easier.  I can see by this corn, it looks ready to harvest.

Morris and I made it back home after hiking about 2 1/2 miles of hills.  I was tired and so was Morris.
He went into his crate and literally looked as though he were dripping out of it.

Today is our rest day, tomorrow Morris visits the vet to get a shot and check up.  I think he needs his teeth cleaned also...his breath is pretty foul.

After our appointment Morris and I are going to head over to Duck Egg Park and see if we can't get some shots of the dam and the Bad Axe River.

So today, we rest.

A bit of Fractal Fun

Mandelbulb Maniacs posted a fun little exercise for us to do with the program.  We were to begin with one formula and then create 'something'.
Next step was add another formula and create the next step.

And so on until we had gone through 6 formulas.

The top shot is the 6th and last step.

This was 5 formulas:

 

This was 4 formulas:

 

This next is the second step.

Things really change up when you add formulas and sometimes your choices end up quite ugly and you have to work hard at finding a proper edit worth posting.
These two 'creations' have mainly the same color themes.  Just a tweak here and there to keep them interesting.

So know you know what I do when it is bitterly cold outside. I play with graphic 3d programs and fractals.
It does help the time go by.

And it doesn't involve dropping anything on my feet!

Have a great Thanksgiving!