Woman fears osteoporosis medicine

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DEAR DR. DONOHUE: I am a 72-year-old woman. I had my first bone density test several years ago, and it was fine. The second test was OK, but I was told to take calcium tablets. After the third test, my doctor said she wanted me to take Boniva.

I was acquainted with a nurse who died of cancer of the esophagus. She blamed the cancer on her medicine for osteoporosis. Another friend can’t take the medicine because it bothers her throat. A cousin of mine takes this medicine and constantly clears her throat. My prescription for Boniva is sitting here unfilled. I am afraid to take it. – D.C.

ANSWER:
You shouldn’t be afraid to take it, and you should tell your doctor your fears. Perhaps she’ll put you on a different program, or perhaps I can convince you that Boniva is a safe medicine.

Boniva is a bisphosphonate drug. Others are Fosamax and Actonel. These medicines work by slowing bone absorption. Every day, some of our bones are recycled and new bone takes its place. With age, bone breakdown outpaces bone buildup, and osteoporosis results.

Bisphosphonates can irritate the esophagus and the stomach. For that reason, instructions tell users to take the tablet with a full glass of water and not to lie down for the next hour. That prevents the medicine from lodging in the esophagus and irritating it.

I find no reference to these drugs causing esophageal cancer or causing people to clear their throats.

Boniva can be taken only once a month. The chances of you irritating your esophagus from a once-monthly medicine are just about nonexistent. Boniva can also be taken by injection into a vein every three months. That bypasses the esophagus but necessitates four visits to the doctor’s office every year. There’s another bisphosphonate, Zometa, given by infusion only once every year.

If the bisphosphonate story still leaves you uneasy, Forteo is a self-injected medicine that does a good job of fighting osteoporosis.

Don’t forget vitamin D and exercise along with your calcium.

DEAR DR. DONOHUE: My husband takes garlic pills. He believes garlic is good for health. Recently a friend mentioned that before penicillin was invented, garlic cured bacterial infections. If it kills bad bacteria, doesn’t it also kill good bacteria, which we need? Would you elaborate? – V.C.

ANSWER:
Humans have used garlic for infections for almost as long as human history has been recorded. Humans have also eaten it for as long a time. In those thousands of years, it hasn’t harmed the digestive tract. Your husband hasn’t been affected by it to date. There is no reason to believe he ever will be.

I can’t support garlic’s use as a germ-fighter.

DEAR DR. DONOHUE: Is it possible to have a heart attack and feel the pain in your leg? Years ago I had a charley horse when walking. About a week later, my leg still hurt, so I went to my doctor. He said I had had a heart attack. When I tell other people this, they look at me funny. – F.M.

ANSWER:
Please pardon me, F.M., but I’m looking at you funny too.

I’ve never had a teacher, a fellow doctor or a cardiologist tell me that heart-attack pain is felt in the leg. I’ve never read a medical text or a medical journal that stated people experienced leg pain with a heart attack. I’ve never had a personal experience with a patient who had leg pain as a sign of a heart attack.

Did your doctor do any tests at the time he declared that you had a heart attack? Things like an EKG?

DEAR DR. DONOHUE: How true is this? A cup of warm water with a teaspoon of cider vinegar, taken before each meal, improves your memory. – A.L.

ANSWER: I
would very much like it to be true. I don’t believe it. It won’t hurt you, but I don’t think it will help. I would try it, but I can’t remember to do it.

DEAR DR. DONOHUE: I’m a 62-year-old man with scarred heart valves and an inoperable basilar artery aneurysm in my head. Normal tasks are difficult because of my shortness of breath when I work. I have had chest X-rays and tests of lung function, and all are normal. I can’t do normal chores because I gasp for air. I have had six EKGs that are normal. I would like to enjoy a normal life. Doctors want me to have a valve replacement, but I declined because I think an increased blood flow would distend my aneurysm. Where do I go from here? – M.S.

ANSWER:
Your age – 62 – is young to be as incapacitated as you are. If the problem is damaged heart valves, a doctor has to determine how much damage, and to which valves.

The usual solution to a damaged valve is repairing or replacing the valve or valves. Have you ever had an echocardiogram of your heart? It provides a good picture of the heart and its valves. How about a stress test or a stress echocardiogram? Either shows how well your heart is functioning. Finally, you might need a heart catheterization to determine the degree of valve damage. None of these is a great physical hardship, and none would affect the aneurysm. The same goes for surgery. You’re eliminating the best answer for correcting a valve problem on grounds that aren’t valid.

An aneurysm is a bulge on an artery wall. It’s a weak spot. If the bulge bursts, it causes brisk bleeding. The basilar artery is a brain artery supplying the back parts of the brain. Small bulges are left alone. Large ones have to be fixed to prevent a potentially lethal stroke. If surgery isn’t an option, then you might be able to have it corrected – if it needs to be corrected – without surgery. A trained doctor can snake a soft, pliable tube from a distant artery into the basilar artery. When the doctor reaches the bulge, he or she releases metallic coils into it. Those coils generate a clot that seals off the bulge.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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