Oh dear

So I’ve got down to mid 12mg from 15mg but the 20% drop makes a big difference. I’m waking with stiff hips and my brain has gone to complete mush with the deep exhaustion coming and going unpredictably. I’ve noticed I have to sit down next to my learners much more than I did as I’m getting so worn out.  And I don’t feel capable of having proper conversations with people – I find I’m wittering on, talking rubbish unless it’s about maths, or talking to my close family (who are used to me!) It’s so sad as I felt normal at 15mg – it’s like in Awakenings when the L-dopa wears off. However, I do realise that I can’t live on 15mg forever.

I was on the  way to 11mg but a chat with my GP made me think I’d better stabilise at 12mg for a couple of weeks – better not to go too fast and have to start again.

I went to see my GP but I realised I didn’t bother to say how very exhausted I was the whole time. I think I couldn’t be bothered because I was too tired! I also put a very bad case for strontium ranelate v bisphosphonates – my first problem with them is the stomach side effects – it creates a vicious circle with the stomach meds I don’t want to take but suspect I would need to if I took the bisphosphonates. The second difficulty is that bisphosphonates work by inhibiting the resorption of old bony bits. They do this by encouraging apoposis of the osteoclasts. Osteoclasts are the cells that get rid of the old bone to make way for new bone created by osteoblasts. Apoposis is the posh way of saying planned cell death – which means it’s intentional, but in this case has been arranged by the bisphosphonates not your bone making system. There is also a hint that osteoblasts (the cells that make the new bone) may be adversely affected by bisphosphonates. So you end up with old bone (better than no bone obv) rather than new bone.   How bisphosphonates work

If you are muddled by the roles of the different osteo-cells here is a very interesting article about bones from Frontiers. I found it clarified the whole thing.

I have also read an interesting article that outlines how strontium works very much better on people who haven’t already taken bisphosphontes. Remember strontium encourages build-up of new bone rather than hanging on to the old stuff. Effects of prior bisphosphonates on BMD. This seems particularly cogent when considering whether to start on the bisphosphonates or not.

Anyway, the upshot was that my GP will write to the rheumatologist to see what she says. I do feel I know what she will say. Remember she patted my knees as she talked to me – I was going to try to demonstrate this to my GP but it seemed too rude! However, it seems to me that there isn’t such a rush as all that to decide as, if and when I eventually get to take strontium ranelate, it will actually create new bone, rather than hang on to the old stuff for grim death like the bisphosphonates. So there is only an urgency if I am to take the [fed up with typing bisphosphonates a million times – will call it Bis from now on] Bis – which will mess up the strontium anyway.

On a difference note – for fun I have taught myself the periodic table up to 101 so far, trying out the mind palace technique. It was so quick it was amazing, especially as I have a rubbish memory. I am reminded of this as strontium sits on the end of my sofa in my mind palace. If you want to know more, let me know!

 

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