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Do Broken Bones Mean Osteoporosis Medication for a Cancer Survivor?


My arm in a cast

Today was my first day back on the ice after breaking my wrist and being in a cast for almost seven weeks. Most people assumed I broke it skating on the canal, but no, I was figure skating on an indoor rink. Some have suggested, in jest..I think..."Maybe you should consider taking up lawn bowling. It's safer." Safer...perhaps...but where's the thrill? There's no jumping in lawn bowling...well maybe there is if you make a great shot!

Colleen back on the ice

All kidding aside, it does bring up a few questions. I was treated for hormone positive breast cancer. Part of my ongoing maintenance plan is to do hormone therapy to help lower my risk of recurrence...so we hope. The main side effect of taking an aromatase inhibitor is loss of bone density which may lead to osteoporosis or bone fractures. Oh and before I go any further, let me give you the full picture. Not only did I fracture my right wrist seven weeks ago, I also fractured my left wrist almost two years ago doing...yes, you guessed it...figure skating!

So my first question is: As someone who has been treated for breast cancer and is still undergoing hormone therapy, should I be figure skating with the risk of falling and possibly breaking something? The answer to this, at least for me, is unequivocally a "yes". But another not so easily answered question is: Since I am taking a hormone therapy medication which may possibly lead to osteoporosis, should I be taking osteoporosis medication? The answer is not as clear cut. My oncologist would like me to take the osteoporosis medication to obviously offset the side effects of hormone therapy but it comes with its own set of risks and side effects. When does it all end, taking medication to combat the side effects of taking medication.

My bone density has not changed significantly since my baseline bone scan. But I have been re-assessed from low to moderate risk for osteoporosis most likely due to my left wrist fracture two years ago. Wait until they hear I have now fractured my right wrist! But these are not fragility fractures. They are the result of trauma. My family doctor thinks it is premature to go on osteoporosis medication. He provided me with some easily digested research information so I could make an informed decision. He says at the end of the day, it is always my decision to proceed with a treatment or medication. Did I mention that he called my house after getting the x-ray of my wrist from the hospital to make sure I was okay? The next best thing to a house call!

My oncologist, on the other hand, has a different view and highly recommends I go on the medication. So of course, this latest fracture is not going to help my case. Don't get me wrong...I like and respect my oncologist too. But I know my own body best and I feel my bones are strong. I'm opting for the long-term view. If I go on the medication now, it has a window of about ten years of being effective. I’m still young, or at least young at heart, so ten years is not a long time. I’d rather wait and pursue preventative measures like weight bearing exercises and being active, and more natural remedies like taking vitamin D and calcium. If down the road I need the medication, then I’ll make that decision when the time comes. For now, my wrist and the rest of me feels strong and healthy.

My arm after the cast

Back to skating and I’ll be honest. I felt more than a little nervous as I walked up to the rink for the first time since my fracture. My guards still safely on my blades. But, as soon as I took them off and stepped onto the ice, the nervousness melted away. It felt wonderful to be back. I’m sure I had a huge ear-to-ear grin on my face as I stroked around the rink. My feet gliding over the cold smooth surface, the music playing, the wind in my hair...okay, so my hair is short and I had a hat on…but you get the picture!

Skates with guards on

After a good long warmup, I got up the courage to do forward crosscuts. For those of you who skate, you can relate to this thought that crossed my mind:

"That moment of fear when your blades collide while doing a crossover” 

But I pushed past the fear, as we learn to do over a lifetime of experiences in different situations. Yippee, a little pat on the back for me! This then gave me the momentum to try a waltz jump…not a big one…more of a tentative baby one…but I did it!  Another pat on the back. And a good friend also had me doing some spin work and I had a breakthrough. Up until this point, I could never plant one toe in the ice, bend my knee and then pump with the other leg and rotate around the toe in the ice. Somehow I had always gotten stuck. I had no flow around the pivot point. But today for whatever reason, it clicked and I got it. It was like a spinning epiphany and it felt amazing. I was so excited. I even learned to spot the spin so I could count the number of rotations. It’s hard to believe it’s taken me over two years to learn this. All the clichés come to mind. Never give up! Better late than never! If at first you don’t succeed, try, try again! Cheesiness aside, it worked! Thank you, Vick! Now maybe, just maybe, I can be brave enough to lift one foot off the ice and do a one-foot spin. Wouldn’t that be the cat’s meow

Figure Skates

It will take me some time though to work up the courage to do backward crosscuts. That is what I was doing when I fell and broke my wrist in the first place, not once but twice. I have never liked going backward, not even backing up in the car, so why should it be any different with skating. In fact, I was finally getting up the confidence to do forward crosscuts in a power circle with some speed, then a mohawk turn into backward crosscuts. Perhaps I was getting a little too confident and a little too much speed because I caught an edge on my mohawk and down I went. My husband, a black belt in karate, always tells me I need to learn how to fall correctly…uhm, yeah…but who wants to practice that!  He says tuck and roll. All good in theory but when you’re on an 1/8” of steel on a hard, slippery surface…well, easier said than done. 

Alas, I have a matching set of broken wrists. And now I wear a matching set of wrist guards on the ice! When I walked into the arena this morning, I was greeted with heartwarming welcome back hugs from my skating family. So I continue to skate to be active and healthy, to be challenged, to have fun, and to be in good company! For me, skating soothes my soul. It is the only time I forget about everything else that is going on in my life and focus on the moment. I love it. That has to offset at least some of the risk of getting osteoporosis. And besides, playing it safe is no guarantee that you will be safe. So I carry on and...

Keep Calm and Skate On 

Colleen Kanna is a breast cancer champion and creator of coKANna designs, a line of bamboo knit, Canadian-made adaptive clothing for women touched by breast cancer.

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