And, of course--
 

--everything possible should be done to optimize the conditions that would help build bone: major calcium/magnesium supplementation, probably in conjunction with that vitamin D3 supplement--oil-based, preferably (having seen the decidely Caucasian Liza Jane, I'm highly suspicious that she may not be manufacturing enough D through the skin--we do live at relatively high latitiude and she does work indoors, as most of us do nowadays, and there's a lot of evidence coming around that many of us are chronically deficient in vitamin D, and that leads to a lot of problems, including osteopenia/osteoporosis).

Wings' point, I think, is valid. By comparison, we've all seen what Billye is going through, with her multiple fractures. The fact that Liza Jane has not also been experiencing that does lead to the supposition that she has healthy bone cells and sufficient density in at least some body areas--though it'll be a good idea for that bone metabolism specialist to run bone density testing on various bodily areas to see how they compare with established norms. I, too, am suspicous of how her inhaled steroid "overdosage" may have affected her fusion process--and annoyed that the doc is not interested in reporting her case; I suspect she's not the only person this has happened to (though she may be one of the more extreme cases).

From one interesting patient to another--hope you fell better.

Liza Jane,
I'm not too well versed in this area at all- but do have a son who 7 mos ago had a burst fracture at C-5 and had to have an anterior and posterior osteo surgery by a surgeon skilled in spinal cord injuries.
Sadly, he's now a quadriplegic, but in therapy with the doc who treated Chris Reeves and is progressing, somewhat slowly.
True, his case is SCI replated, but my thought is that of the surgeon and the type of 360 surgery that was performed.
You are having problems with regrowth of bone and stabilization of the area.
The screws & plates aren't helping.
Possibly you may find that searching in the area of a surgeon who deals with spinal cored injury (SCI), may give you further insight into the methodology as to what would be best in your situation. I don't know if there is an SCI trauma center near you, but that probably would be a starting point.
I don't know if this would be helpful, but it was just a thought.

Nide--I've now seen 3 spine surgeons, and all are in favor of a 360 if I proceed. The two in NY do loads of them, so I'd trust either with the mechanics. It's the bone metaboliism that worries me.

I've been taking a Calcium supplement with magnesium made by life extension foundations, called Bone Restore. This is what it contains:

Serving Size 5 capsules Servings Per Container 30

Amount Per Serving

Vitamin D3 (as cholecalciferol) 1000 IU
Calcium (as dicalcium malate, calcium bis-glycinate, 1200 mg
calcium fructoborate)
Magnesium (as magnesium oxide) 340 mg
Zinc (as zinc amino acid chelate) 2 mg
Manganese (as manganese amino acid chelate) 1 mg
Silicon (from horsetail herb, Equisetum arvense) 5 mg
Boron (calcium fructoborate as patented Fruitex B® 3 mg
OsteoBoron™)

Granted, I do forget it sometimes. Also, I'm taking Acetyl L Carnitine, Alpha Lipoic Acid, Fish Oil, Flax seed oil, SAMe, 5 HTP (This is my wonder drug), and an AREDS formula of antioxidants including A,C,E, Zn, an Lutein. Folate,
and a multi.

I'm supposed to add no-flush niacin, because my cholesterol is very high, and my doctor is reluctant to put me on a statin. Although I'm beginning to think that a low dose of a mild statin might be just the thing. I've tried diet before, and haven't gotten much change in the numbers.

My carnitine blood levels are always low if I begin to miss it, and it makes a huge difference in energy.

Am I covered? Any other thoughts on improving healing as well as lowering the cholesterol?

I would definitely prefer--
 

--given your situation, an attempt to use niacin and perhaps more fish oil (and lots of insoluble fiber) to control the cholesterol--nobody with a history of nerve damage, central or peripheral, needs to be on statins, given their propensity for tissue breakdown.

As far as the rest, I suspect you might need a higher dosage of vitamin D3, and I think you would a better magnesium supplement in a higher amount. The general "optimal" ratio of calcium/magnesium is in the 2:1 range, given their electrochemical properties and their tendency to act antagonistically in the body. I don't think you're getting that, given you are using magnesium oxide, which is not well absorbed; a chelated magnesium or magnesium acetate would be more bioavailable.

Have you seen the very long Vitamin D threads at Braintalk on the Vitamin forum and in the Gluten section (which I think would be good to import to the corresponding forums here)?

http://brain.hastypastry.net/forums/...0761#post40761

http://brain.hastypastry.net/forums/...ad.php?t=15249

Reviewing the literature, I am becoming more convinced that many of us--especially us northern latitude types who don't go outside a lot--are walking around with a de facto Vitamin D deficiency, and since D is needed to drive calcium (and to a lesser extent phosphorous) into the bones, this deficiency contributes in a significant way to osteopenia/osteoporosis. I imagine as the demands for bone construction go up, as in those who need to fuse, this can only become more urgent.

I am sorry, but the magnesium in this product is useless... totally. You are getting less than 8mg of magnesium/serving from it. OXIDE is not bioavailable.

I am sorry I don't have much time today.... but you can look at the magnesium thread on Vitamin forum for further data.
You can use a magnesium glycinate, lactate or chloride delayed release with more success.

Hi L.J.

On the neuro with no personality....what can I say, the majority don't have the best bedside manner, however, if he does have Aspergers, he is likely the BEST read on your procedure...and those people get absolutely OCD on their topics...he may be the best technical doc...he probably doesn't do his own exams or own interviews, because the guy might know he has no social skills. If so, I give him credit for that. He knows his strengths and weaknesses. You can't educate an Aspergers person very easily if at all in reading social clues. I equate it to teaching a blind person what 'blue' is if they never saw it. I have an almost adult adopted Aspergers child who no longer lives with me. You could ask that kid any part of the anatomy of any bug, and she knew it...unfortunately she got into artificial computerized creatures...I will go no further on this issue. Lots of computer geeks have it...and they are good at what they do. We do expect our docs to have social skills, some have a lack of them due to problems, some are just arrogant.

I guess we have to choose. I have always been more prone to go to physicians who have personalities....and for most things, I agree that is key, except for highly technical surgeries...I have learned to change the rule there. If the BEST guy or gal for the job has zero social skills, but is excellent in the surgical suite (pitty the poor scrub and ciruclating nurses), that would be my choice...then I do not need to see him/her again...just do the job, man/mam!!

I think seeing some one regarding why your bone is not healing is key. Having gone thru that 'bone not healing thing' myself, only with a far less important situation, just a tibial plateau, I can not imagine the frustration and worry you must have with your spine. I know my spinal problem of desication at T8 and T9 is very hard to live with...I know I have talked to you regarding my chances of operability. I know what you are facing.

It is essential to find out why that original one did not heal, and I am really reluctant to advise anyone to proceed with a back surgery after one 'failed back' until they find out why it failed...which you are wisely doing.

Perhaps the loose screws allowed for movement..hmm, but that won't come up in conversation. Gosh, even that, tho would probably result in some spurring??

I feel badly that the doc that is supposed to operate has this affliction with social skills. It is so comforting to get docs that can sit down and really talk to us. I just can't imagine going thru surgery without it, but like I said, you need a successful surgery so maximize your chances.

I commend you on your cautious approach, no rushing into things. More people should follow that rule.

If you do choose this guy, maybe you can luck out or even ask for the anesthesiologist with the best bedside manner. That might help in the OR...even a good nurse to hold your hand.

You generally give most readers on the forum advice, so likely I am not telling you anything new....

It sounds like you guys in NY have quite a support system. Out here in the nether world we don't have that....we are just lost in the woods or prairie grass.;)

Vitamins
 

Okay, I need to go back onto the CaMg product that I used to take. I thought I had upgraded with that one, but clearly not. In terms of Vit D, my doc did blood levels. And, as you know, I NEVER leave a doctor's office without copies of my labs, so here they are:


Vit D, 25-OH 37 (9-54)
Vit D, 1,25 82 (19-67)

This is without a major Vit D supplement. Just what's in the multivitamin or Calcium product. It seems okay, do you agree?

So, maybe increase the fish oil from 2 Gm to 3, add the niacin, anything else?

Here's my lipid profile. Everyone in my family is on a statin, so it was worrying me. I've been running in this range for a good 15 years now.


Cholesterol <200 253
HDL >40 95
Chol:HDL 2.7
LDL <130 134
LDL-C <130 155
HDL-C >40 93
VLDL-C <30 24
Sum Tot Chol <200 272
triglyc-direct < 150 124
Tot Non-HDL-C <160 179

For Setting LDL-C Goal

LP(a) Chol <10 17
LDL-C <20 12
Real LDL-C <100 126
Sum Tot LDL-C <130 155
Remnant LIPO < 30 25
Real LDL Size Pattern A A
HDL-2 >15 33
HDL-3 >25 60
VLDL-3 <10 13

Trigly <150 120

(I'm siorry, I tried to make nice columns and highlight the abnormals, but they don't seem to stick.

Is your HDL 95? Wow that is high! That is fine..but even with exercise I can not get mine out of the 40's, even when I did sprint triathlons...my husband takes a statin and his is high, but his was high even when he didn't take statins or exercise.

Niacin to lower LDL and raise HDL cholesterol
 

I've been taking 1,000 mg. of pure crystalline niacin twice daily after meals for about two years now. I'm tolerating the niacin with few bad effects except for minor flushing. My lipid panels improve with every test.

hmmmmmmm =\