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TO YOUR GOOD HEALTH # 12345_20220121
FOR PUBLICATION WEEK OF JAN. 17, 2022 (COL. 5)
BY LINE: By Keith Roach, MD
TITLE: You can still do weight-bearing exercises at home indoors
DEAR DR. ROACH: I am a healthy 79 year old female who recently had a right knee replacement surgery. In a routine postoperative x-ray, there was an indication of early osteopenia in my long bones. I live in Montana and I walk regularly during the summer months, but in the winter it is more difficult. I have an exercise bike and I can change the resistance level when cycling. Is it the same as the “weight gate” exercise? Should I consider purchasing a treadmill or other type of indoor exercise equipment? I live in a rural area and prefer to exercise at home but have little extra space for a lot of equipment. – KL
ANSWER: Before I even think about it, I would like to know if you have had a bone density test, often called DEXA. Flat x-rays are not a reliable indicator of osteopenia or osteoporosis. This information is essential in determining whether lifestyle changes such as diet, exercise, and vitamin D supplements are likely to be effective, or whether you would benefit greatly from prescription medications. Vitamin D levels in a person living in Montana in the winter are very likely to be low unless they take a vitamin D supplement. The low energy of the winter sun in the North makes supplementation a wise choice. if you don’t already.
The best type of exercise is a matter of debate, but a review of several studies found that for people with osteoporosis they have long bones (like your femur, the thigh bone that can break in a bone fracture). hip), strength training is very effective. You can strength train by increasing the resistance of your exercise bike.
You don’t need specialized equipment to do weight-bearing exercises. Jump rope, calisthenic-type exercises, and dancing are all choices that require little more than floor space.
DEAR DR. ROACH: I’ve had many discussions with people about prescription dosage instructions and I’m wondering if you could clarify. If a drug says “three times a day”, to me that means every eight hours. If it’s “four times a day,” I take it every six hours, and so on. Other people tell me I’m MUCH too specific, whether it means “morning, noon, evening” or even “breakfast, lunch, dinner”. I think it would be best to keep an equal amount in his system for a 24 hour period, so I just put a timer on so I didn’t miss out. Comments ? – LL
ANSWER: You seem like a very precise person, and I’m sure your doctor is delighted with your medication adherence. Indeed, on prescriptions, “three times a day” (still abbreviated “tid” on a prescription, from Latin) means something different from “every eight hours” (“q 8h”). A drug written three times a day has enough leeway in its dosing schedule that it can be taken morning / noon / evening at the patient’s convenience. In these cases, taking the medicine an hour or two earlier or later will not affect how well the medicine works. A medication that requires precise timing would be written every eight hours, sometimes with specific instructions, such as 7 am / 3/11 pm. Every six hours isn’t that easy for someone at home to do, and luckily there aren’t many medications that require precise dosing every six hours.
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Dr Roach regrets not being able to respond to individual letters, but will fit them into the column where possible. Readers can send questions by email to ToYourGoodHealth@med.cornell.edu or by mail to 628 Virginia Dr., Orlando, FL 32803.
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