When I was diagnosed with RA I knew that it was possible to have destruction and damage to my joints. And I could tell by looking at my hands and my feet, and by the way that they felt, exactly where the damage was likely to be.
But the problems are always in what you don't know and so don't ask.
This is what I did not know: While my joints were being damaged I was also losing bone mass. "This loss of bone mineral density in rheumatoid arthritis occurs early in the disease and this is the time to start treating for osteoporosis risk by preventing bone loss".
So the RA treatment I was getting was aimed at putting out the house fire (inflammation) while there were termites in the beams (loss of bone mass).
That's my rheumatologist there in the front seat of the fire truck concentrating on putting out the house fire(inflammation). None of my 3 rheumatologists ever mentioned osteoporosis as something to worry about. I had 20 years of treatment with never a word (that sunk in) about the dangers of osteoporosis,thinning bones and fragility fractures.
Once I found out that my inactivity and inflammation had actually made my bones hit the red line for osteoporosis my first reaction was anger. Then I kicked myself for not using common sense and figuring this out. Next I got a referral to the Osteoporosis Clinic at Women's College Hospital in Toronto. They have an excellent multidisciplinary program where patients meet with a doctor, physiotherapist, dietician, pharmacist and an occupational therapist. Armed with all of that information I was ready to be a late starter and work on my bones.
I started with simple muscle tightening which I describe in my blog post here.
Now I do a modified form of Pilates. It is customized to accommodate damage to my hands and feet and a fragile spine. With osteoporosis you should avoid flexion (bending forward) as much as possible and do a lot of extension exercises.
I do it at home because I am afraid that I will be the Tin Man in the gym. Exercising in a group may be more fun and if any readers in Toronto want to get together for Pilates they could join me, but the big plus to exercising at home is that all of the time you have available is used for exercise, not in getting from one place to another, including parking and changing.
Here is a link to my favorite osteoporosis site by Dr Susan Ott. You can calculate your own fracture risk using the calculator on the site. http://courses.washington.edu/bonephys/ She does a great job in keeping it updated and ad-free.
The next post will deal with what to do to improve your risks and why exercise is helpful.