The osteoporosis forum I am on has mentioned vibration to build bone, but the kind of impact you are describing would, I would think, be dangerous for me and others with more advanced disease.
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I went ahead and scheduled the appointment with the rheumatologist – but no surprise, the first opening was almost 4 weeks away. But that gives me plenty of time to think up questions to ask. The rheumatologist might be a good person to ask about exercise questions as well – I have never been diagnosed but I assume that I have mild osteoarthritis— sometimes I have pain in my knees or wrists, but it’s never been bad enough for me to bother with meds. But when I read the posts about the heel drops & jarring the bones I definitely think about my knees.
I’ve been playing around somewhat with the FRAX calculator at https://www.sheffield.ac.uk/FRAX/tool.aspx?country=9 and the more I fiddle with it the angrier I get. Basically, I’ve figured out that age is a big part of the formula – I have no risk factors other than the DEXA results. If I leave off the BMD entirely and just change my birth year, I get the same or higher risk at age 71. Unless I change my race - if I was African American, the “raw” (no BMD) risk numbers wouldn’t be equivalent until age 77 - and the risk actually goes down if I enter the T-Score. Basically, if I was a 90-year-old black woman with the same height, weight, and T-Score I would be below the treatment threshold. Same basic deal happens if I change my ethnicity to Asian or Hispanic.
No one can convince me that my skin color impacts my personal risk of fracture. I realize that there are different genetic factors involved, but those reflect trends, not individual genetic makeup. So my take on that is that these risk numbers may be useful at the macro-level, but not really an appropriate tool for individual medical determinations. (I’m not the first person to notice the racial disparity-- Racial disparities, FRAX, and the care of patients with osteoporosis - Bone Health & Osteoporosis Foundation )
The race question took me down another rabbit hole- where I found a 2020 research journal article saying that that FRAX scores overestimate actual risk of fracture across all racial groups, but particularly for minorities: Performance of FRAX in Predicting Fractures in US Postmenopausal Women with Varied Race and Genetic Profiles - PMC
I’m thinking that I would really need to figure out personal fracture risk is genetic testing as well as more detailed bloodwork – but I don’t think the genetic science is there yet.
I’ll be interested in what questions the rheumatologist asks me & what, if any, sort of things he looks at beyond what the DEXA scan tells him.
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@calmom 4 weeks for an initial appointment for rheumatologist is really good! They are hard to get into!
I figured that. It’s all ok – it gives me time to get back into my Covid-deferred exercise regime. I’m feeling better physically already - just stronger and more energetic after gym visit #3 yesterday.
I feel that whether or not bone density is improved, improved muscle strength must have a protective effect. And while I can’t know whether or not exercise improves the BMD, I can feel the muscle changes right away, and they are also very easy to track for the weight machines in the gym – one reason I like them. I know how much weight I am working with, how many reps I am doing, etc.
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Hi, I’d like to know why you are going to a rheumatologist? Do you think you will get more individualized care for osteoporosis because of their specialty? I’m wondering if it’s something we all should consider. Would you mind letting us know how your appointment goes?
I’d be very interested too, if you wanted to share. Haven’t heard of rheumatologists having particular osteo expertise - would be good to know!
Just because when I asked my PCP what the least significant change values were for my DEXA scan, she didn’t know what I was talking about, so she suggested the referral. So I’m fine with it because I’ll have an opportunity to consult with a specialist and ask my questions.
I’m actually surprised because I thought the LSC question was pretty rudimentary. I was surprised that it wasn’t written in the DEXA report, and I was surprised that the technician at the imaging center couldn’t tell me, and I was surprised that my doctor didn’t know why I was asking. It’s simply the number that reflects the margin of error related to the scans… you can’t make sense of the changes between two scans without that.
I’d note that since I’ve been on Medicare my experience with medical care has changed radically. No deductibles, no co-pays, no network restrictions… and the specialist happens to be in the same medical building as my primary, so there really is no reason for me not to see the specialist.
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A rheumatologist treats joints and joint disease including osteoarthritis, which sometimes co-exists with osteoporosis. They actually have extensive training in osteoporosis and are considered the expert specialist for osteo - sometimes along with someone like a GYN doc. They actually see a high volume of patients with osteo and some joint diseases like RA make patients high risk for osteo.
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In my experience, gyns know diddlysquat about osteoporosis. But endocrinologists know a ton. That’s who my gyn referred me to after I asked him questions he couldn’t answer.
Usually endocrinologists are the first specialists to see, but rheumatologists can be good too. In my experience, doctors don’t go by much besides DEXA and don’t offer much besides meds. That is why I also consulted with Keith McCormick, a chiropractor who specializes in osteoporosis and wrote “The Whole Body Approach to Osteoporosis.” I would think functional medicine doctors could also be helpful.
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What did Dr. Keith tell you? I’m reading his book and it looks like you’d have to go through this very comprehensive set of tests to diagnose your individual reason for the disease. It would be great to have something like that for the masses instead of “take this med”.
Would you mind asking him about the foot/heal stomping thing? I think @abasket has raised a valid point. I do remember now mentioning it to my doc, but she never said anything about it. I just told her what I was going to incorporate.
I just did a few blood tests. But for earlier disease, I am sure he would do more testing. As I wrote before, I like him because of his personal experience. He was a triathalon athlete who developed early osteoporosis, pretty severe. While his approach afterward was “whole body” he did take meds. So I think he is open-minded about all approaches but offers ways for people with early osteo to maybe avoid meds, and also ways for people like me, post Forteo or Tymlos, to maybe avoid life long meds to maintain gains. And he is very nice. He does telehealth as well as in-person (preCOVID).
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Regarding stomping: google vibration osteoporosis (vibration therapy, vibration plate , whole body vibration machine etc.). This may be the low impact alternative to stomping with the same effect on BMD. Here are just a few of many sites:
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My age and personal history could be a factor in choice of specialty. When I was first diagnosed 2 years ago, I did see my chiropractor first, even ahead of MD. He gave me some articles about vitamin K and told me to go to the gym 4 times a week and do strength training on the machines. So that’s what I did. At least until Covid shut everything down.
I bought a low end vibration plate for use at home after seeing the Margaret Martin video, but I doubt it does much for bone density. I checked the research and there’s really not all that much, and anything showing improvement in humans has been with vibration of 30hz or higher. But my plate only goes up to 12hz max, at the highest. But it feels really good, like a massage, and when I stand on the plate that is 15 minutes I’m not sitting, so there’s that. I use the vibration plate late in the evening when I wouldn’t ordinarily be doing any other type of exercise, so I do like having it.
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I don’t personally suggest or use this, but am sharing ideas that come up on the National Osteoporosis Foundation Inspire forum. Many on there are not taking meds and some are still using strontium. The forum is useful but like all forums, requires some skepticism 
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Here’s a link to the vibration plate I have – I specifically wanted something small enough to be easy to move around & store, due to space limitations in my house combined with the fact that I won’t use anything unless it is in my livingroom where I can see it. (Unfortunately I’m an out-of-sight, out-of-mind type of person – that’s just me. )
https://www.amazon.com/LifePro-Waver-Mini-Vibration-Plate/dp/B084VTNH1S/
I honestly bought it more out of Covid-boredom than anything else. But it does feel good to stand on it and move about – but again, I doubt that it does much for bone density.
If I thought the evidence was strong I might invest in a more expensive machine – (around $400 or so for one that goes up to 40hz) – but now that I’m vaccinated & the gym is open, I think I’m better off focusing my attention on the weight training.
By the way, I did appreciate the suggestion of the Inspire forum and signed on.
Unfortunately, with osteoporosis, it seems like the more I learn the less I know.
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Look for dexaguru!
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