Tag: Bone Loss

^{(Title image: Photo by Nick Fewings on Unsplash)}

This past weekend marked eight years since my breast cancer diagnosis and I recently had another oncologist appointment.

Over the years my appointments have become lighthearted. This one was not so much.

While I was concerned about the migraine auras that I’d been experiencing in the fall of last year, my oncologist had called me in November 2024 with the results of my bone density scan: I’d lost more bone and was deeper in osteopenia.

To be fair, I don’t even know how much more. It had been strange to find myself labeled with osteopenia when I had my first bone density scan over five years ago. Neither my oncologist nor I could understand it. I live a very active life with frequent workouts, including a lot of strength training. By all accounts I should have strong bones. At the time, we figured it was something to do with algorithms applied to the bone density data and my bones were actually in better shape.

This time around, it was worse. Since the first measurement, I’d had two years of tamoxifen and one of aromatase inhibitors. That didn’t help. But all the exercise? Did it not matter? Apparently not enough.

That was frustrating on its own. But to add to that frustration, I’ve been hit with injuries. My left shoulder, my left hip and most recently my lower back.

Each one of these has taken a toll on my exercise schedule and I will likely have to seek out physical therapy for at least the shoulder. At least. The hip I have been able to manage to a certain extent. Then I tweaked my lower back rowing about two weeks ago…I kept working out, more gingerly for sure…until I managed to re-tweak my back because apparently I am incapable of leaving things well enough alone.

On the bright side, the pain in my back made me completely forget the pain in my hip. Which is not to say that there is no pain, just that it pales in comparison to back spasms.

My oncologist offered to order a spinal scan for me. I graciously declined—I’m pretty darn sure it’s just my back muscles—but his concern is valid. If I’m lifting weights with increasingly porous bones, he’s worried about spinal compression fractures.

I guess he won’t have to worry about it now. I’ve been smacked in the face with a healthy dose of humility. No, I had no intention of pulling back on my workouts, but doing so is unavoidable. The amount of weight I can lift without injury has steadily decreased (injury by injury) and with this last helping of pain, I have to face reality. I need to completely rehaul my workouts along with my expectations.

Perhaps most importantly, I need to not view this as a failure on my part. Because while I knew that eventually that day would come, I was not prepared to actually accept that it was here. I was still trying to “work my way back up” to where I was before, even when I knew that it was unrealistic.

After all, I remind myself, the fact that I need to adopt a slightly gentler approach to my workouts is a sign of success: the reason I need to be more careful now is because I have survived this long past my diagnosis. That’s not a punishment or a capitulation. It is, in fact, a blessing and a luxury that many cancer patients don’t have.

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What now? I am resistant to bone-building bisphosphonates at this time, for a variety of reasons (hello, side effects). I want to see if I can stop/slow the bone loss on my own. I have the exercise part down, no problem. But to be completely honest, my dietary intake of calcium was very low. I had every intention of supplementing with calcium after my first bone density scan, but got spooked by the potential for heart issues.

Since then, I’ve learned about the importance of Vitamin K2 and the Japanese fermented bean natto, which has loads of it and makes sure calcium gets to the bones instead of the heart. I’ve re-started the calcium supplements with a daily serving of the fermented stuff. You could say, I’ve become an aficio-natto.

And now that I am forced to back off the intense exercise, I have the opportunity to focus on mobility work, stretching and rehabilitation as I discover what body parts are going to need the attention of a physical therapist. We’ll see how this new approach to fitness works.