Mastodawn

My world in a snapshot. I got an oil change and an infusion of Reclast today at Kaiser.

So what's going on, Bob? Why...I'm glad you asked!

It seems the 6 weeks of pelvic radiation four years ago did a number on my hips and femoral neck. I beat cancer but flunked my DEXA scan. This was predictable. My bones are now shit... and all the exercise in the world ain't gonna to solve the problem. So I did my research** and came to my own conclusions:

GIVE ME ALL THE PHARMACEUTICALS! STAT!

** Speaking of research, I had a good laugh last week when I came across a doctor on YouTube who said, and I quote, "your femur is the bone you would give your dog to chew on." My femoral neck, being spongy, is probably extra juicy 😁

Anyway, this is going to be fun, once I get through the achy side effects.

@BobHorowitz Ugh so sorry you have to go through that. Very glad though that there are all the pharmaceuticals for you to take.

Bob Horowitz Mar 26

@nomdeb
It'll be fine. The news was discouraging at first but I feel like I'm in problem solving mode now. I work my ass off at the gym so the risk of falling and fracturing teh bones due to muscle weakness is as small as it can be.

The pharmaceuticals for osteoporosis aren't miracle workers... but they inch you in the right direction, mostly with an acceptable level of risk for the vast majority of patients. Some, like Prolia, are dangerous to stop. One of the more effective drugs, Evenity, is only approved for women.

Reclast involves an annual trip to the infusion clinic. And it will peak in effectiveness In about 4 years, then possibly start to fade. There may be something better by then.

@BobHorowitz My MIL (in her continuing care community) is working with UNC on a fall prevention program, and one of the things they have done is apparently related to footware. I don't know if they are doing medications also, but now I'm really curious. I wonder why some are only approved for women, that's annoying if it has potential for men also. :(

Matt Stein Mar 26

@BobHorowitz I don’t know what you’ve been watching Bob, but please keep your bones for yourself no matter how many subscribers the YouTuber has.

Also I’m sorry that this sucks and I hope the drugs are exquisite.

Bob Horowitz Mar 26

@mattrambles if all goes as planned, my dormant mutant powers will be activated In about 2 weeks.

Matt Stein Mar 26

Bob Horowitz Mar 26

@mattrambles Ha! It me.

@BobHorowitz Cheer up, Bob!!

Bob Horowitz Mar 26

@gica19 Roger that 👍

Donncha Ó Caoimh Mar 26

@BobHorowitz Ow, that sounds awful. My hips have been at me the last few weeks. It's painful. You have my sympathies. :(

Bob Horowitz Mar 26

@donncha Ooof. I'm sorry to hear that.
I'm symptomless... And being cocky and fit, I expected I would ace the DEXA scan. But radiation is a gift that keeps on giving.

Salim Medjellekh Mar 27

I’m sorry to hear that; stay strong.

@BobHorowitz Good luck with Reclast! I hope it does the trick. I have osteoporosis, too, and am considering my options. Getting old sucks.

Bob Horowitz Mar 26

@MFennVT
Good luck to you too.

From what I've read, for women, HRT is probably the best thing to do first.

This is the best video I came across on YouTube that discusses the pharmaceuticals once you address HRT. It's an hour-long video but worth it because it talks about the possible paths, success rates, and side effects of the various options.

https://youtu.be/Z4uXAsnhSaA?si=auQptoztKnjR9ZlW

Osteoporosis Medications - Which drug is right for you?

YouTube

@BobHorowitz Thanks for the link! I'll check it out. HRT is my preference, but both endocrinologists I've talked to don't want to prescribe it. I have an appt with a gynecologist in May. We'll see what she thinks. In the mean time, I'm exercising more and eating more good bone foods.

Bob Horowitz Mar 27

@MFennVT
Ooh I just noticed there's an updated version of the video from 10 months ago. I'm going through it now to see what has changed.

Edit: definitely a full discussion of hormone replacement in this updated video. It's a must watch.

https://youtu.be/OVRiiyHXeh8?si=tPd7zS8741Nwh1uK

New to Osteoporosis? Start Here! 2025 World Congress on Osteoporosis Update

YouTube

@BobHorowitz Cool. Thanks for the update.

Morgan Fletcher Mar 26

I broke my left femur at the ischial protuberosity, the big part twice, once in my twenties and once in my forties. The first time they put metal in, and then took it out a year later. The second time I asked, 'Will you take this metal out?' The doctor looked at my chart, said, 'No, at your age we leave it in, like rebar.'

Jon Bosak Mar 26

@BobHorowitz You have my sympathies. Drugs are good.

Bob Horowitz Mar 26

@bosak Adozen years ago I used to brag "I don't need any drugs, I'm healthy as hell." And then my prostate cleared its throat and said "ummm Bob..."

Lol.

Now I brag that I never forget to take my pills and I can swallow a bunch of them at the same time. Big ones!

Jon Bosak Mar 26

@BobHorowitz Oh, not the drugs that are *good* for you. Where's the fun in that?

Bob Horowitz Mar 26

@bosak oh I have stories!!!
You have no idea how beautiful Market Street is at 2:00 a.m. when your eyes are dilated. It's like aperture f/1.2 at ISO 12800.

Jon Bosak Mar 27

@BobHorowitz Oh, I know exactly what that looks like (different streets, same look). One of the things that pleases me most when I look back on my life is how much of it I was able to live as a hippie.

Bob Horowitz Mar 27

@bosak I was a young teenager during the summer of love so, while in high school and eventually college, I missed peak hippie days. But I came out of the closet during peak disco... and until the AIDS years crushed us, the partying was awesome.

Jon Bosak Mar 27

@BobHorowitz HIV killed it for everyone. It was the first STD that couldn't be completely cured with a shot.

Bob Horowitz Mar 26

@Morgan
You can choose to be good or evil now, like the Terminator or Robocop.

Ewen Bell 📸Mar 26

@BobHorowitz

You greet the daunting challenges of life with grace and kindness Bob. You are a beacon of light and I hope we and your chewable dog bones stay with us for a good while to come. Praise be to science!

Bob Horowitz Mar 26

@ewen Never fear, Ewen. Even in the afterlife, I plan to stick around and haunt everybody 😁

Harald H. Foto Mar 27

@BobHorowitz @ewen
That's a great plan. 👻
I was thinking about what I could write to you. Unfortunately I didn't find the right words (this happens quite often, I have to admit). But Ewen did. I absolutely agree with him. 🫂

Bob Horowitz Mar 27

@Harald @ewen
Daawww... thank you, guys.

And no worries. I'm gonna be posting for a long time. And eventually they'll be posts.mortem 😉

Harald H. Foto Mar 27

@BobHorowitz @ewen 😀👍

FreddyB Aviation Photography Mar 26

@BobHorowitz So I can give you an override code for those V Braun pumps so you can torture your nurse Bob

Also as we always tell new nurses when they are being quizzed. Drugs the correct answer is drugs.

Bob Horowitz Mar 26

@cvvhrn They always lock up the best drugs. But yes... Correct answer.

jon ellis Mar 26

@BobHorowitz happy drugs are best... but this'll do!

keep at 'em bob!

James Donohoe Mar 27

@BobHorowitz Just read all the side effucks and risks - really puts the FU in fun eh?

Likely more radiation for me in the next month as as Timmy the tumor in my right lung has almost tripled in size since December. Yay. Left lung tumor responded well to radiation which suggests it should work again. Pelvic tumors seem mostly stable, like they are taking a nap. Hopefully it is a long nap.

Bob Horowitz Mar 27

@JamesMDonohoe Oosteonecrosis (jaw bone death) sounds really fun. All the best zombie and post-nuclear holocaust shows feature bone disintegration 👍

Jesus, James. Stop feeding Timmy.

I will keep my fingers crossed that the radiation does the trick. It tends to do that. And you know the drill so it's familiar territory.

James Donohoe Mar 27

@BobHorowitz Yeah, that jaw thing was the first "holy crap" thing I read. Geez.

Radiation almost the same. Last time Timmy was very close to the airway so they went low and slow like smoking a brisket. Eight days. This time they want to turn it up to 11 and only do 3-5 days BUT they will skip days to let me recover. Batter-ish I guess?

Bob Horowitz Mar 27

@JamesMDonohoe I'm not a doctor (I only slept with them)... But what learned from my external beam radiation was that the gels and steroids they give you for your skin are really, really important. Stay on top of it and be super regular, even after the radiation stops. In my case, the burns peaked 1.5 to 2 weeks after the final treatment.

Also, you're not like steak. You don't have to cover yourself in foil and rest for 30 minutes before serving.

Molle Sjölander Mar 27

Good to hear you beat the enemy. Those side effects can be h*** but hey, life is still on ...! (My man's take on it, he has kidney cancer.) All the same, sorry about your hardship.

Bob Horowitz Mar 27

@mamzikorven I'm sorry to hear about your man's cancer, and I hope he's responding well to treatment. Best wishes to you both.

And yes, in my case the cancer itself only had mild symptoms, but the treatments were hard, with many side-effects. I've gotten through most of them. Life's good 👍

Molle Sjölander Mar 27

Thank you, fighter!

saarmuller Mar 27

@BobHorowitz I had my first infusion just a month ago. Side effects were a lot worse than suggested but I survived Hopefully it did it's work as well. I hope you feel better soon!

Bob Horowitz Mar 27

@saarmuller
You too, eh? I'm in good company 👍

The infusion itself was a breeze. Much easier than the chemo 4 years ago. No PICC lines, no burning, no nausea... just a pleasant procedure with a very friendly RN. I was in and out in under an hour.

Tonight I'm achy but still gay 😁

A year from now we will do another bone density scan... And at some point within the year they will check kidney values and a few other things to make sure everything is going smoothly. Four or five years out they'll probably want me to take a drug holiday and give the body a year or two off to avoid side issues. We'll see. I'm also rotating in some new exercises at the gym that may also help a little. But damn, I really hate the stairmaster.

saarmuller Mar 27

@BobHorowitz It is given at home here now (Amsterdam) also an hour, but a few days earlier you have to stay at home to receive the infusion package..I started my treatment a year ago and as it is primarily my spine that is desintegrating I first got a year of Romosozumab injections. A 12% improvement (in the spine). Zolendrinic acid (Reclast) is required to consolidate and hopefully further improve.
And yes, I do gym, but rather careful since I know how brittle my spine is.

Bob Horowitz Mar 27

@saarmuller
Ah, that's a great improvement! You can gain a full point on the T measurement with that kind of result, which is often enough to move you out of the danger zone.

I wish Romosozumab / Evenity was an option here, but for men it is only approved for extreme cases.

Spines respond better to treatments, from what I've read. Hips are stubborn bastards but easier to replace 😁

saarmuller Mar 27

@BobHorowitz The main thing I learned is that T scores are overrated, in particular when as in my case some vertebrae are collapsing. I got Dexa scans since 2012 and with just vitamin D the T's seemed not too bad. But as the depressions in my spine seemed to progress and I rather quickly got shorter, I asked for a referral. Where the misleading T scores where explained and the most agressieve treatment started...

@BobHorowitz glad you could get Reclast! May the side effects be mild and pass quickly 🤞

Bob Horowitz Mar 27

@LittleRedhead Thanks, Charlie.

I will probably be okay tomorrow but I said to my husband that if I am still achy we need to get some ice cream. Now I don't know which outcome I am rooting for. Either way I win.

@BobHorowitz 😁 sounds like a win-win situation for me!

fred_edler Mar 27

@BobHorowitz
I can share with you (if you are ok...)
I wish you a speedy recovery !

Bob Horowitz Mar 27

@frederic_edler
Now that's what I'm talking about!
ALL THE PHARMACEUTICALS!!!

My god, Fred. You okay?

"juicy...femoral neck" is a new phrase indeed 😭
wishing you spring healing and relief from pain 🙏🏻💚

Bob Horowitz Mar 27

@MephitisTouch
Juicy femoral neck would be a nice addition to the menu at House of Prime Ribs 👍

And thank you, Soleil. Just sore shoulders this morning. Everything else has settled down. I have my coffee and the world is good.