On the left are the rail-less granite slabs that serve as steps leading away from my back door (the steps continue unseen to the left). This angle demonstrates the steep drop from the top step to the bottom of the window well outside a basement window, about six feet.
So there I am on the that step, standing on one leg while I put on a shoe, when I lose balance and fall into the well. It's a slow fall and I think as I fall, "shit, I'm probably going to break the window; a real pain to fix."
I should have been more worried about breaking me, given the state of my bones. A few months later, the hinge on my folding bike breaks and down I go. But again I remain unbroken. Many people with osteoporosis break a bone just standing up or sitting down. Why didn't that happen to me with two hard falls?
The answer may be a concept called microarchitecture. I may not have density, but there is something protective about what little structure I do have. Sounds like a theory made up to explain something that can't really be explained. Whatever it is, I'm grateful for it.
Now about half-way through the recommended 5 yr course of alendronate, which increases bone density. Some studies have suggested that for the first five years, bone density increases, with minimal benefit thereafter but continuing (though very low) risk of side effects such as jaw osteonecrosis ("death" of jaw bone cells)--some dentists refuse to do oral surgery on patients taking alendronate.
Question: when should I repeat a bone density test to see if the alendronate is working? At least 2-3 years--got to give it time to work. I'll probably wait for the 3yr option, and if no improvement consider alternatives.
The six month repeat x-ray shows no changes in the size or position of the stones. Good news, I guess, but I am a little disappointed, hoping that some the changes that I've made would have made a difference.
Mainly, I'm trying to drink more water, easier said than done. I've been taking low dose hydrochlorothiazide (HCTZ), a mild diuretic that in higher doses is used as an anti-hypertensive. HCTZ also decreases calcium concentration in urine, which I hope also means increased calcium availability for my bones.
I added a magnesium supplement that has been associated with decreased kidney stone formation, and greatly decreased drinking sodas with phosphoric acid (root beers, colas, dr pepper).
For the new year, I will try to add 4oz of lemon juice to my drinking water every day because its high levels of citrate may even dissolve stones already present (though I should think of it as more of a preventative strategy.
I don't think I'll try to decrease dietary levels of oxalic acid (my stones are probably calcium oxalate); high oxalic acid foods include chocolate, nuts, berries, grapes, and leafy greens, all of which have advantages that I think outweigh the oxalate factor.
