Infusion

[456again]

Fractured left humorous currently, previous fractured wrist and previous fractured foot, all left side, all due to falls. Am on 3.5mgs down from 15mgs May2022, dexascan levels good, rhuemt appt last week, she said because of being on steroids and a fracture I should have an infusion. Anyone had this, any advice please. Thanx

[SnazzyD]

I would need a better case than that with a good DEXA (providing it’s within a year or two) and traumatic fractures only, plus you are on only 3.5mg.

[PMRpro Ambassador]

It is an indication but I would have thought the orthopaedic bunnies would have been on the case if they though it was that. Like Snazzy, prove it doc ...

However - what really DOES need looking at is WHY you are falling and you should be referred to the Fall Clinic to see if anything else is lurking and if the right physio might help improve your stability.

How did you fall each time?

[456again in reply to PMRpro]

I have to say all falls over 8year span to last month are circumstantial, just curve on paving, a dip in the road, etc, I do have a balance wii board and the Rheumy suggested getting that out again but I won’t do that at the moment. She said my levels were way under the red line but her concern was that my bones are fragil and she thought being on steroids weakens your bones. it seems to me just by the two replies it is not something to rush into?

Thanks for quick replies ladies

[PMRpro Ambassador in reply to 456again]

Some seem to think that being on steroids weakens the bones as if by magic. If your bone density is in normal range - it defeats me how that can happen. I'm the same, 12 years or so of pred hadn't resulted in any greater loss of bone density than I would have expected just with aging.

It sounds as if the previous falls were not anything to do with pred as they were long before it appeared on the scene?

[piglette in reply to 456again]

Surely if you had ‘fragile’ bones your Dexascan would have shown this up??

[456again in reply to piglette]

OK, yes, she did actually say very little ? Showed on last blood test and wanted me to go down as usual, I.e. from 4mgs after 2 months to 3.5.gs, which I have done. I suppose if I hadn't presented with sling on nothing would have been suggested?

[piglette in reply to 456again]

Surely your bone density would not have shown on your blood test or have I misunderstood? ?

[456again in reply to piglette]

I think what I was trying to say, she said there was very little evidence now of pmr and she asked how long I had been on 4mgs, two months, she said to go down to 3.5mgs as the pmr seems ok,

[piglette in reply to 456again]

If the steroids are doing their job you would have very little evidence of PMR at pretty well any dose I would have thought, that is when it is OK to reduce. Don’t ever assume the PMR is OK, it has its beady eye on you.

[PMRpro Ambassador in reply to 456again]

At that dose maybe - but it doesn't mean it has gone away ...

[456again in reply to PMRpro]

Oh no, I realise that but I am OK at moment on 3.5 since last week I only reduce .5mg at monthly intervals.

[Amkoffee]

I had a DEX scan in April of 2018 and was told that I had osteopenia only. Then by August of that same year I had not only fractured my ankle and a rib due to a fall but later I fractured four vertebrae and another rib due to osteoporosis. Apparently the osteoporosis was not picked up by the dexa scan and therefore I don't trust dexascans anymore. I did do the infusion (I'm assuming you're talking about recast). One of the common side effects is flu like symptoms. It made me sick as a dog. I will never do that again. I am quite happy doing Prolia. It doesn't make me feel bad at all. I do have to do it twice a year. And I live in the US so it cost me over $300 each time which is very expensive but worth it in my opinion. I have not had a broken bone anywhere since I started Prolia. Before I started Prolia I had a total of 10 fractured bones, seven of which were caused by osteoporosis. I haven't had a broken bone since I've been on Prolia.

[456again in reply to Amkoffee]

Thanks, I think a friend said she knew of one was preferable to the other, so I will certainly have more questions now for when I go back. They told me that osteoporosis was not detected from the dexascan. I appreciate all the advice on here in readiness for my next visit I am 4 weeks tomorrow from my fall and getting bored now so I must be getting better. I have to go back fracture clinic 2 weeks time.