Wife has pre-osteoporosis, tandem?

Advice
#1

Hi all, my wife has pre-osteoporosis, and apparently this means no twisting. I’ve read up on this, and it looks like a real thing.

Last summer, we paddled a tandem before the diagnosis, and I was pretty much steering and powering the tandem. I’m wondering, for light paddling, if I could do a tandem kayak with her? We go to outdoor concerts on our bay, and short paddles. Would that be an option under normal, mellow conditions?

I own a sectional Point 65 Mercury Kayak, and could simply buy the tandem piece to add to it for trips when she’s interested in going.

Does this sound reasonable? Is there something I’m not thinking about?

Thanks in advance.

#2

Have you considered a peddle boat? I’ve seen some tandems that move right along. That is if your wife is able to use her legs.

#3

You didn’t say where it affects her. My lower back is an arthritic mess, but paddling isn’t a problem. Getting out of the boat is another story.
Mild exercise has been recommended by both my doctor and physical therapist.
I think you have a good approach.

#4

@string said:
You didn’t say where it affects her. My lower back is an arthritic mess, but paddling isn’t a problem. Getting out of the boat is another story.
Mild exercise has been recommended by both my doctor and physical therapist.
I think you have a good approach.

Exercise also helps osteoporosis.

#5

It sure "sounds reasonable " to me !
if you guys are not only husband and wife, but best friends like my wife and I are, ,by all means put her in a tandem and tell her to sit back and enjoy the ride. she can be the photographer and navigator while you are the engine.
That is what I would do.

jack L

#6

You should ask your wife’s doctor what is safe or not because her entire story is not visible here or even possibly known to you or her so the lack of information will compromise the quality of advice.

However, all else being equal, there was a British study a few years ago showing those who spend at least 4 hours a week doing weight bearing exercise per week have 70% less osteoporotic fractures. Unfortunately paddling does not count as weight bearing as you are sitting down and your skeleton is not resisting the mass of your body versus the resistance of gravity. Machines, swimming, cycling or excercise bike or any weight done while sitting is in the same boat so to speak.

Fortunately, the easiest and most practical exercise of them all is walking. So if she only does one thing, she should walk 4 hours a week. More than that is gravy but beyond that should be asked to someone who is intimately familiar with all her results, conditions and circumstances.

To get the gold carpet treatment don’t just ask this on her next visit but then ask to be referred to a reputable physical therapist that can recommend an appropriate regimen and make sure they fax her records to that PT.

#7

May be worth a better discussion with your wife’s doc. I was officially pre-osteoporosis for years. I took Fosomax and did weights for a while and no one ever said not to twist. I subsequently hit official osteoporosis when my bone scan came back minus 2.7. Which happened happily at a typical time, and considering the rest of my medical history. is pretty good. Still no restriction on twisting (or weights if I wanted to rejoin that gym).

Solving the boat options may be easier than figuring out the right response to this medical statement.

#8

I agree with Celia. I think the prohibition against twisting is only for advanced cases of osteoporosis. I would ask a knowledgeable doctor, preferably an endocrinologist or rheumatologist specializing in metabolic bone disease. Better not to cut off avenues of pleasurable physical activity unless truly necessary, as any exercise that strengthens muscles is beneficial to the bones.

The main thing to do is to try not to fall. Balancing exercises help. Any maybe skip rollerblading. :wink:

#9

Hey all, thank you so much for all the feedback and advice! I will tell her about this. Her doctor said no twisting, but she also felt that he didn’t have a lot of information or recommendations for her. Excellent suggestion about consulting with an endocrinologist or rheumatologist.

She does do swimming, and I have a feeling that she may reverse the impact, or delay them as you suggest.

Part of my thoughts about the tandem are for when we are traveling and renting a kayak. But with my existing kayak, the Point 65 Mercury, I can easily add the tandem piece to the boat. So it actually wouldn’t be hard to move around, because I’ll disassemble the sections and carry individual pieces. I have paddled the both of us in a tandem, and had no problem doing that if we’re just going to a concert or on a bay or lazy river.

Really appreciate the help and guidance. I do think she may have received far too minimal advice.

#10

Yes, many PCPs know little about osteoporosis, a specialist will be able to give much better advice. Also bear in mind that something like 40-50-% of women over 50 have osteopenia (beginning osteoporosis), and more than 20% have osteoporosis. Since it’s progressive there is a LOT of difference between people with the general diagnosis. Best of luck!

#11

@Beagle045 said:

She does do swimming, and I have a feeling that she may reverse the impact, or delay them as you suggest.

Alas, swimming is not a weight bearing exercise. CA139’s [a physician] advice about walking was excellent. Easy to do any time and anywhere (barring blizzards).

Here’s a link to a NIH report about exercise: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796736/

#12

Yeah, on exercise stuff like swimming has quite limited impact on osteoporosis. Not weight bearing enough.

Sorry but a lot of docs are idiots about this. Weight bearing should be taken literally. Weights are a highly underrated option for impacts of osteoporosis. Like lifting at least light weights. Walking also good.

And ALL women will risk heading into osteoporosis, officially a raw score of -2.5 or more, once they finish menopause. It is a normal result of losing hormones. I don’t get why this is a mystery. For whatever reason, being overweight tends to also limit the loss of bone mass. It is partly that it automatically increases the weight bearing part, and partly because having a metabolism that runs on the fatty side seems to be protective in this area.

Before modifying the heck out of activity, your wife should see someone who has a better understanding of this issue than a PCP.

#13

Celia, another major reason being overweight is protective is that when you fall, you’re less likely to break a bone because of the padding. They even did a study where they had thin women wear padding (fat suits) and found that they reduced their fracture rates to a level similar to the heavier women.

#14

But being thin is an independent risk factor for osteoporosis.

#15

Yup Doggy, it is. Question that I can’t remember the answer to is precisely how they get to thin as a factor. Some of it is due to metabolic diff’s in calcium absorption related to a higher fat percentage - people with more fat tend to hang onto more calcium. And how much of it is dietary background of people who tend to be thinner.

#16

Being overweight is a risk factor for heart trouble and Type 2 diabetes. And getting older is a risk factor for everything.

#17

From WebMD: “Bone structure and body weight. Petite and thin women have a greater chance of developing osteoporosis. One reason is that they have less bone to lose than women with more body weight and larger frames. Similarly, small-boned, thin men are at greater risk than men with larger frames and more body weight.”

Have been reading about osteoporosis since I’m a good candidate given my sex and weight. Seems like the most popular drugs prescribed weaken the bones.
https://universityhealthnews.com/daily/bones-joints/warning-issued-on-bisphosphonates-side-effects-include-weaker-bones/

#18

Most of the available drugs result in bone structures that are not the same as what your 33 year old body was building. BTW, there are really only two despite variations in delivery. Biphosphate based meds and endocrine based ones. That is not necessarily the same as saying the overall result is weaker bones.

The charge with biphosphates is that the bone structure it creates is more brittle than what a young body would build. The fractures from this tend to only become a problem statistically over protracted use. The biggest gains from treatments like Fosomax will happen in the first two years of use. My own numbers showed that to be true. I got a distinct and useful boost when I was first using it.

My recall is that the endocrine based ones do less well for wrists than for other parts, but I haven’t researched it as much as I did the Fosomax. I jumped on the endocrine based systems when they became available because the Fosomax had already done what it was going to do. The endocrine based stuff can be more of a battle to get insurers to cover.

But there are two periods of bone density loss, the slower decline from 33 and, just for women, a much more rapid loss thru menopause. You have to hit menopause with some head room or you come out of it looking at high chances of a catastrophic hip fracture. Women used to rely on HRT to help with menopausal bone loss before we knew that the heart health claims were hogwash and it could up cancer risks.

At a younger age you have an easy option. Eat calcium foods and get serious with weights twice a week if you aren’t already. Or fast walk or jog if you and your joints can take it. Not everyone’s can.

But if you get to a point where such efforts can no longer stave off the bone loss like you want - and that is far more likely than not - balance an intelligent use of meds with the risk of a catastrophic fall at a point in hour life where recovery could be challenged.

The good news is that, compared to someone with a bad heart or sugar issues, this particular part part of aging is pretty easy to manage. But it still means choosing which risk rather than avoiding risk entirely.

#19

Thanks all again for more good advice. I think she’s heard a lot of this and has been on that path (lifting weights, diet change).

#20

It’s not just the PCP’s that don’t know a lot, the specialists only act like they do but they’re no great shakes either. It’s not their fault, it’s that the options aren’t great.

The truth is that, as Celia mentioned, there really is no ideal therapy because all the meds have their issues and there’s no going around it.

I believe I mentioned the British study of weight bearing 4 or more hours a week. Past exercising while you stand up it’s very nebulous and needs to be individualized to the patient, so no one will be super at managing it, PCP, specialist, no matter what they do it will never be a perfect fit because the options for treatment realistically are highly imperfect.

The calcium thing is also very, very controversial because there have been some new studies not only showing that it doesn’t really help long term fracture risk much or at all, but that it could calcify your arteries causing circulatory disease. And again, there are no certainties there, just shades of “could, would, might (sometimes combined with the word NOT)”. Maybe the 100lb skinny minnies might benefit more from calcium. Maybe it could lead to the premature death of the 200lb plumpers with sleep apnea and diabetes from heart attacks. And being overweight in general could protect you from osteoporosis, but it also hardens your arteries and gives you diabetes (which hardens your arteries) and high cholesterol (which hardens your arteries) and high blood pressure and sleep apnea (which harden your ateries) so the flip side is being fat will ruin your circulation, and bad circulation will starve the bones giving you the osteoporosis anyway on the back end. No can say for sure. Plus calcium has side effects too.

Just make sure that other potential secondary causes are being ruled out of which there are many but they are not hard to find if you order the right testing and that’s a question for your wife’s doctor(s), anything from thyroid to celiac, other hormonal issues, urinary/kidney issues. What was that old adage on hyper-parathyroidism, bones, stones, moans and groans? It’s complicated, ask someone who is qualified to look into it should the problem get worse faster than you expected. The younger you are when osteoporosis is diagnosed, the more you need to rule out the other causes.

Also make sure to eschew any toxic habits like tobacco or excessive alcohol consumption and keep all chronic illnesses as best controlled as possible. If you already are hypo or hyperthyroid, make sure you and your doc are super on top of that as the only thing that wrecks your skeleton faster than excess thyroid hormone will be (cortico-)steroids (as opposed to sex or anabolic ones like Testosterone or Estrogen). Then again most illnesses that require (cortico-)steroids are so debilitating or will just kill you so if you’re on prednisone, you’re probably stuck anyway. Again with this controversial crap!

Agreed it’s not that bad, could be worse. Most women will have a lot of bone weakening as they age. All the ladies in my family did but no one ever had a problem from it except my almost 90 year old grandmother with all her broken back bones and her recent injections of polymer in her back, she is like Lazarus that keeps coming back from the dead but again, that varies.

The older you get the more problems you will have from it but that’s just age, find me an organ system that doesn’t do that. Ageing is awful but it sure beats the alternative! My brother in law’s sister just buried her husband last year who died of a ragingly aggressive Multiple Myeloma at age 51, talk about bad luck. I gave her a canoe cart for Christmas because she couldn’t take her canoe out to the lake any more as it was too heavy.