Question on Riba and Bone Problems

[TnHepGuy_]

I'm on week 17 of the combo fun. About 70% of the time since starting I've had pain in my upper thigh/hip region. I've read where the riba can cause fun little things like bone density loss and in rare cases avascular necrosis (i.e. - bone death). The SARS patients in China who were given mega doses of riba are now having hip and joint replacements done - among other related problems. Have you seen anything published on these bone-related concerns in Hep C patients? I've only been able to find precious little so far.

Also, I'm thinking of beginning to take a calcium supplement (though one article I read said that they believe the reason riba causes bone density loss is by interfering with calcium absorbtion - so adding more to my diet might just be a waste). Have you heard/read of any possible contradictions between calcium supplements and interferon or riba?

Thanks.


TnHepGuy

[TnHepGuy_]

Thanks for the input. I have a great primary doc who upon hearing of my pains has ordered an MRI - to get a good look at whatever may or maynot be going on in my hips/thighs. so, Monday morning I get to so lie in the noisy tube.

P.S. - I've started on the calcium citrate - w/ vitamin d and magnesium.


TnHepGuy

[cheriums]

I just posted this somewhere else, but can't remember where, of course.  (Now, I had a memory here somewhere once upon a time, where did that darned thing go to? ... Today I found some rubber stamps I lost, here in the house, about 18 weeks ago!) Take calcium and half as much magnesium, because they WORK TOGETHER to build bone AND the Mg calms the nerves which transmit pain impulses.  Try a dose in the Am and a dose at bedtime, because during the night is when bones rebuild.  My own hip pain has reduced with 500 mg magnesium (with an equal amount of Ca), twice/day.  Depending on things like age and activities, you might also be developing osteoarthritis (nobody promised our bodies wouldn't do anything else during treatment!), which can be quite painful.  A hip is a usual place for it.  I got cysts in the cartilage with mine. Ouch!! Glucosamine and chondroitin can help, if you are losing cartilage.  A reliable brand is a must, tho. cheri

[gonagetbetr]

I am so sorry to hear about the bone and joint pain. Sometimes I read posts and just don't know what to say I feel so bad for everyone when they are so desperatly trying to get better and the meds make them sick but the alternative is just not acceptable either.

I did read somewhere that doing strength training exercises will not only strengthen the muscle but also the bone. just try to take it easy at first.

I believe that I was looking at a site about ostioperosis horrible spelling
my mom has bone cancer and I look up things for her as well

btw mom was just following dr orders and not questioning anything either until your pep talk now she too has made a list for the doctor

thanks again for being there and I hope that you are feeling relief asap

[TnHepGuy_]

Thank you very much for you thoughts and kind words.

I'm doing a bit better today - the bone aching has toned down a bit - and my energy level has increased. Just another adjustment to make along the way... ahahahhaha.

Glad to hear that you and mom are both becoming 'self-advocates' for your respective conditions. You'll read of folks here who get stepped on, brushed off, passed over and left in the dark by some docs and their offices. Patients can be left completely out of the loop on major decision making - or just end up doing it passively. Adding to your knowledge base and asking questions can only lead to better treatment decisions.


May God's blessings and mercy be upon you and your Mom.


TnHepGuy

[TnHepGuy_]

Thank you for your thoughts. I'm doing somewhat better today than the prior few.

7.9 - Whew!!! - you must have felt absolutely lousy being that anemic.

I've been able to have gotten by with one shot of Neupogen so far - back on week #5.

I've also decided to move getting my blood drawn to Wednesday - rather than Thursday. This way in case I do need to be put on Procrit, I'll have an extra day to make sure I can locate some before the weekend.

Take good care.


TnHepGuy

[doll face]

My Hg dropped to 7.9 at one time. The procrit has increased it to 12.0 now, still low  but not bad. Before I started on the procrit I was experincing a lot of bone pain. Hopefully you will get some relief soon. I still get some pain in my bones, ecspecially forearms and hips, but nothing like I used too.
Good luck and let us know how the dr visit goes. Are you still on Neuprogen?

[layla]

It's good to hear say Life is wonderful after tx!!! It helped my spirits today. Have a good day. LL

[TnHepGuy_]

Bone Disease is SARS Aftermath
Epoch Times
10/25/2003

On October 17, Asian Times reporter Zeng Huiyan wrote that although the Severe Acute Respiratory Syndrome (SARS) epidemic has not yet recurred, a new outbreak of political cover-ups and medical difficulties is coming to light.
Recently, there has been some news circulating inside China indicating that 33% to 50% of Beijing medical personnel who were infected by SARS are suffering from avascular necrosis. Other regions of China are also reporting patients with similar symptoms.

On Friday the Southern Metropolis Newspaper reported that Li Hsiang, head of the Beijing LianHe University Institute of Chinese Medicine, suggested that the four members of the hospital staff who had contracted SARS undergo Magnetic Resonance Imaging (MRI) scans. The scans revealed that three out of the four individuals had varying degrees of avascular necrosis.

Certain Guangzhou experts had already stated explicitly that large dosages of the anti-viral drug Ribavirin, used in treating SARS, could cause avascular necrosis, a serious orthopedics disease where bone ends weaken and sometimes collapse.

According to the report, Beijing has already reported that many patients who recovered from SARS are suffering from avascular necrosis. Avascular necrosis commonly affects the ends of long bones such as the femur. Other common sites include the ankles, knees, and shoulders. Clinical tests have already proved that using the anti-viral drug Ribavirin to treat primary illness may causes avascular necrosis, affecting the femur 98% of the time, in the other cases affecting the hips, upper arms and ankles.

However, reports from the State-controlled Xinhua Net directly contradicted the Southern Metropolis Newspaper story. Xinhua Net

[TnHepGuy_]

donAlfonso - sorry to hear about your osteoperosis condition. Are you able to find relief in any measurable way?

Galen - I'm coming to believe that it's most likely a result of my body's response to the anemia caused by the riba. I am scheduled to get blood work done this Thursday - so that will tell me if my red counts have dropped (4 weeks ago they were still at 12.7). Did the Procrit raise your Hg levels sufficently? Did it help ease the chronic pain?

honey15637 & revenire - thank you very much for searching out all the info and links. I went out today and picked up some calcium citrate, w/ vitamin D and magneseum. Another pill for the arsenal.

cuteus - I meet with my GIPA next Monday. I'm going to discuss further the when's and if's of me and Procrit. I prefer not to take any pain medication if at all possible for this condition. If this is something I get to live with the rest of the way, I'd just like to know - so that I can better deal with it.


P.S. - Scott - all this talk of your undying love of interferon has led me to do a little backwards math. Based upon my prior 10 months of mono tx at 3 shots/week - I believe as of yesterday I have just given myself my 143rd shot of the joy juice!!!


TnHepGuy

[cuteus]

This is just another reason why the drs should prescribe the blood boosters during tx. weight bearing exercises are extremely important to decrease bone loss.  we get so weak and anemic during tx, we stop exercising which leads to more bone loss.  
For those on the long haul tx, procrit should be considered in order to keep this loss at a minimum.

[Galen]

Being as I am a post-menopausal woman, I had a bone density test done at age 45.  I finished up tx at age 50 and a repeat test showed no change from the last one.  I took, and still take, 1,000 mg of calcium citrate daily and have for about 10 years now.  One reason for the bone achiness could be the anemia.  As I understand it, red blood cells are produced in the bones, primararily the large ones like the femur and hip bones.  I had lots of pain/ache in my hips throughout tx but am fine now.  Also had severe anemia and was on Procrit for most of tx.
Calcium is hard for our bodies to assimilate and calcium citrate is more easily absorbed than the carbonate variety.  Make sure to take with food to increase the production of stomach acid to break it down.  Avoid caffeine for one hour before and after as it can inhibit absorbtion.  Take a supplement that also contains magnesium and vitamin D.
Fosamax is not such a good thing on tx as we already have stomach problems from the drugs and it can cause esophageal bleeding.  I don't know about you guys, but I had to go on Nexium while on tx and will probably be on the stuff for life.
Hang in there.  Life after tx is WONDERFUL!!!

[honey1616]

http://www.aegis.com/pubs/catie/2000/CATE1
http://www.medhelp.org/forums/hepatitis/archive/612.html1008.html

Sorry, I couldn't find anything more updated as you are right there is just not alot on this subject.  Of course I did read on several sites that one of the sides of interferon is bone pain. Are you anemic because I do agree with Galen on that maybe causing bone pain also. I am also taking calcium daily but don't know how much this is actually helping me while on tx.

[honey1616]

http://www.medhelp.org/forums/hepatitis/archive/612.html

I just noticed my links weren't working and try this one...Should go through!

[donAlfonso]

Sorry, haven't got any studies to cite, but I do know that Hep C itself is related to loss of bone density/osteoporosis.  Pretty sure I saw a study a while ago that found about 1/3 long term hep c patients had suffered measurable bone density loss.  I have severe osteoporosis in my left hip, moderate in right hip, osteopenia in lower spine.  I also had prostate cancer, which also causes bone loss, so who knows what affected me more.  I do have pain, sometimes quite severe, especially in left hip, so I empathize with you there.

Re calcium supplements, I think the consensus is that very little is absorbed, and it is more important to take vitamin d, which increases absorption.  And absorption is best from foods rich in calcium.  Eat your spinach.  Got milk? (yuck, not me).

Finally, treatments like Fosamax have been shown to work when taken regularly for at least a year.  However, according to my doc, it is contraindicated for those with a hx of esophageal varisces and/or upper GI bleeding.

I'll look for studies about riba, but I think that if YOU can't find it, it ain't out there!

dA