Bone Health

 

On the 13th of January in 2020 we had a blast at Galaxy's Edge, a brand new Star Wars installation at Disneyland California. I was laughing out loud and screaming with excitement in the cockpit of the Millennial Falcon five days before *It* Happened. 

This day at Disneyland instantly became one of those moments in life that you look back on happily with zero regret. I'm so glad I got to do this before...

On the 18th, a permanent life-altering event occurred and changed the trajectory of the rest of my life. I would never be able to joyfully ride a roller coaster or any kind of extreme thrill ride ever again. There are worse fates. I know this. I reminded myself daily. 

But nobody wants to use a walker when they are not even close to retirement age! Nobody wants to be seen using a walker. Nobody wants to hold up traffic because they have to take such baby steps to avoid sharp stabbing pain. 

I was simply watering the plants on my balcony . A few drops spilled on the smooth tile floor. Add to that hazard that the balcony turf was damp with dew. I was barefoot. I stepped inside, wiped my feet on a bamboo mat, took a few steps, did not see the water droplets, and slipped much the way a clown does when they do the banana peel stunt for laughs. Except I wasn't doing it for laughs. I was not prepared for that hard landing. My right heel slipped in the drops of water. My right leg went straight up, and there was nothing to break my fall. I came straight down on my butt. 

Whatever happened inside my spine at that moment, it splayed me out on the floor hollering in pain and frozen in the one position that was least painful. For the next many weeks, that would be my favorite position: flat on my back with knees up. 

My husband was home, which was very fortunate, because I could not have crawled or reached for a phone. This is no exaggeration. I told the EMT crew that I could not sit up on the chair they wanted to use to carry me down two flights of stairs -- a reasonable hope and request, they thought -- they rather insisted that I try, just try and get into the chair, we'll help you -- stabbing pain aside -- I did try, and it was so excruciating I blacked out. Total blackout. Unconscious. My brain flipped the NOPE switch. I didn't know pain could do that. I remember them holding my arms, pulling me up, turning me to sit in the chair and that's the last thing I was conscious of. I guess I fell forward and they caught me. They decided to carry me down in a sheet or blanket. I was unconscious during this decision and came to as they maneuvered me onto the sheet -- also very painful, but I was laying down, so it didn't matter if I blacked out again. It's a weird feeling to go unconscious. It's not like falling asleep, which happens gradually most of the time. It's a millisecond. You're aware. You're not. Blink of an eye. How does the brain do that? And why? 

Anyway. It was a bumpy ride. They kept apologizing and asking me health history and checking my vitals. At the ER they had to transfer me onto a hospital gurney. Every move was a 10 on the pain scale. This terrified me. What happened to my back? Did I break my hip? What's going on in my spine? 

Eventually an X-ray showed that I had a compression fracture on the L3 vertebra (lumbar region, middle-to-lower back). They called it "mild". My 10-level pain said otherwise. And every time I sat up, I fainted. So they admitted me to the hospital, because I was in no condition to walk up two stairs, let alone two flights. In the event of a fire, I would have been stranded -- maybe I could have slithered down the stairs like a lizard. 

The experience of "breaking your back" is daunting. Overwhelming with questions and anxieties. Will my back heal completely? Will I have to live in pain for the rest of my life? Will I have a back problem for the rest of my life? How bad will it be? And most importantly: What can I do to make a full recovery?

Meanwhile, the specialists were trying to get at the root cause of my blacking out every time I sat up. They never did solve that. It went away on its own about a week later. They weren't sure what caused it. It was none of the things they tested and examined -- it was not a vein issue, not a heart issue, not a respiratory issue. They even sent in a psychiatrist. I suppose to see if there was some underlying motivation causing a psychosomatic event. Nope. They chalked it up to a vasovagal nerve event (https://www.mayoclinic.org/diseases-conditions/vasovagal-syncope/symptoms-causes/syc-20350527)

This was before the pandemic started in the USA. There was little knowledge of the new deadly virus. I don't watch news. I had not heard anything about people dying in hospitals in China, and even if I had, it was so remote, I wouldn't have worried about it. But then my wild-conspiracy-theorist brother called and told me about it and predicted, well, I have to admit, he predicted worldwide impact. It was going to spread everywhere fast and it was going to kill millions. 

I was stuck in a hospital from January 18th to February 6th. Two weeks of physical therapy helped me to manage going up and down stairs safely. 

From this point on, I was on a mission to regain my strength. I didn't care that I had to use a walker. I cared about one thing: walk every day, as much as you can, until you can walk all the way to the beach (1 mile from home) and back without having to stop and rest. 

I had physical therapy appointments twice weekly, however, by early March there were 8 cases of coronavirus in my home town. These were the known cases. There was not a lot of testing happening yet, and it was likely many people were walking around with sniffles and mild coughs, thinking nothing of it, not masking, because none of us knew how to stop an epidemic at that point. (Later, we would learn the hard way why it wasn't a good idea to fire the pandemic response team. I wonder how much money that saved, compared to the cost in lives and hospital bills and supply chain obliteration.) 

As soon as I saw that 8 known cases were in my neighborhood, I canceled my PT appointments. I would DIY my rehab from then on. Walking became my mainstay. I only needed the walker for a  month. Then I managed to keep steady with a cane. By May 2020, I was able to enjoy myself, as long as I always had lumbar support. I bought this great lumbar pillow and took it on long drives and airplane trips. I've lost it twice and immediately bought another, that's how perfect it is. This is the one I bought: 
https://www.amazon.com/dp/B09HS43Z72

Pandemic sidenote (skip this paragraph if you can't stand to think about it). We (me, my husband, our children and grandchildren) were grateful and supportive for the shutdown mandated in California. We weren't upset. And were not whiny about masks, handwashing or social distancing. We were well informed and committed to doing whatever it takes to stop the spread, to save lives, to ease the burden on hospital staff. Some people favored the idea of herd immunity -- just let the virus sweep across the globe and kill whomever -- anyone who can't survive it, tough luck. We didn't subscribe to that attitude. Doctors were dying trying to help other families live. Nurses and EMTs were dying. Firefighters were dying. School teachers were dying. Our workforce was dying. The global supply chain was coming undone. Moms and Dads who worked in tight spaces, food processing plants -- the front line workers who kept us all well fed -- they were getting hospitalized for weeks, sometimes months, and still dying.  Babies and children were getting multi-system inflammatory disease. I had no tolerance for whining. Wearing a mask was such an easy little thing to do. Grow up! Sorry, I had and have no sympathy for whiners. Just do it already. The pandemic cost me personally a lot in terms of faith, hope and love. I'm still not over it. It was ugly, selfish, and short-sighted. It was lazy. It wasn't hard to be informed. It wasn't hard to check facts. It wasn't hard to wear a mask. It wasn't hard to stand six feet apart. It wasn't hard to dine at an outdoor patio instead of sharing air in a small, enclosed space. It wasn't hard to wash hands and use sanitizer. That was all so easy and life-saving. I will never forget the violence and ugliness of people who refused to mask and attacked others for masking. I lost all faith in humanity in 2020. 

Okay, I'm done talking about that. The bigger *It* that happened in 2020 for me was the broken back. Five years and eleven months later as I write this, I have a lumbar support pillow behind me. I go water jogging most days and walk 2-3 miles other days. I go hiking on steep mountain trails without any trouble. Why did the fall cause a compression fracture to begin with? Easy. I was on a low calcium diet due to chronic kidney disease, since 2014. I had osteoporosis. 

Hiking in Idaho
August 2020

Hiking in Oregon
October 2020

Hiking in California
October 2020

RULE #1 - If you want to strengthen your bones, you must use your muscles! When we use muscles, it pulls on our bones, and that triggers the body's natural bone-strengthening process. When you stop using your muscles, you lose bone density and bone strength. A simple fall can be life-changing. My lifestyle became all about recovering my bone strength and keeping my bones and muscles strong. 

I faithfully did all of the exercises taught to me by physical therapists at home on my own during the pandemic. I was laser-focused on getting back to my normal -- to recover my ability to go hiking. I love the outdoors -- that's my happy place! 

I knew in 2016 that I was getting osteoporosis. A bone density test said so. But in 2016, my kidney function was still at Stage 4 CKD, with only 20-30 eGFR and creatinine >2.5. I had to prioritize my kidneys. 

Once my kidneys were close to normal range, in 2022, I began to prioritize bone health. I let them give me two injections to promote bone growth, increased my calcium intake, and started an exercise routine. The single most important thing I did 2020-to-present is invest time and money into a fitness tracking device (Fitbit) and a nutrition tracking app. I made it a daily habit, to enter everything I ate and drank, and to increase my activity. At first, it was hard to hit 1,000 steps daily. But I kept pushing myself to do a little more. I also pushed myself to lose weight, because I was around 160 pounds in 2020. Carrying 40 extra pounds is not helpful to the joints and spine. So losing weight became important to me for health reasons. I didn't want to need knee or hip replacement surgery. The less burden I put on my joints, the longer they'll last, pain-free. That was my motivation...strengthen my bones, and make it easier on the joints. Today I weigh 118. I use Fitbit device for activity and Cronometer app for nutrient tracking. 

In 2022 I spoke with a registered dietitian about my health priorities and limits, and she gave me priceless guidance that I have followed since. 

I take two Seed synbiotic capsules every morning (seed.com). I eat very healthy, with my focus on maximum nutritional value per calorie. I do splurge occasionally - I treat myself to tiramisu about once a month. I occasionally indulge in chocolate or cheesecake. But for the most part, I stay true to my healthy habits. It's too easy to backslide. 

I research nutrition facts at what I consider to be reliable science-based sites, like WebMD, Mayo Clinic, and others. Here's a fantastic comparison chart on the nutritional values of various cooking oils. 

Follow me @herzenity on Instagram for more tips, or feel free to use the contact form below to ask questions. 

Today, I won't ride a roller coaster or do anything that jerks my spine, and I am habitually careful about the ways I use my back. A compression fracture does not heal exactly back to the way it was -- it never pops back up. Think of a soda can getting crushed somewhat. The L3 vertebra still shows up as compressed in my CT scans. My spine will always have a weak spot. But I am pain free! I am able to go hiking! I can do long plane trips thanks to the lumbar pillow! So, I am deeply grateful to the specialists who have contributed to my recovery. 

Hiking in Idyllwild, August 2025
❤