Stress fracture confirmed - pred likely culprit

I saw my sports medicine doctor today at the Bone and Joint Clinic and he took more x-rays of my foot and confirmed I do indeed have a stress fracture that I got from walking an easy 2 miles, probably thanks to prednisone. X-rays don't usually show fractures until they are starting to heal, so my initial x-rays last week showed nothing, but the ones today showed some signs of healing already. He said since I'm on prednisone it may take me a little longer to heal, like 8 weeks instead of the typical 6. I see him for a follow-up in a month and am in a walking boot until then.

He said I could walk as much as I want a day, even 10 miles if I wanted to, in the boot. That seemed wrong to me from what I've read the past few weeks about stress fractures, but he is a good doctor and has never steered me wrong before when I had running injuries. I don't know how it would be comfortable to even walk 1 mile in this boot anyway and I couldn't even walk 2 miles without getting hurt.

Make sure to take your calcium and Vit. D and exercise if you can while on pred!

Thanks. I'm just worried about what happens after this, like if I'll still be able to be active. I was a very active person before recently, so this has me really worried and down. Guess I just have to practice patience and wait for my DEXA scan in two weeks to find out more.

Thank you. I know, I can't wait to be off it. I can barely even look in the mirror right now.

How long have you been on pred and at what dose?

I'm always scared the same thing will happen to me.

Stress fractures are common for people that has never taken prednisone. It's the repetitive motion & force that causes them. Think about runners as an example.

Osteoporosis is more common in the spine, hips & wrists. The member here Keith, had his hip replaced because of long term use of prednisone.

Osteopenia & mild osteoporosis can often be reversed with supplements & exercise. A couple of my friends had it show up in their spines by way of Dexa Scans.Their ob/gyn's recommended calcium, a joint supplement & exercise. The repeat Dexa Scans thankfully have been normal since.

Good luck with your Dexa scan.

straydog said...
Stress fractures are common for people that has never taken prednisone. It's the repetitive motion & force that causes them. Think about runners as an example.

Osteoporosis is more common in the spine, hips & wrists. The member here Keith, had his hip replaced because of long term use of prednisone.

Osteopenia & mild osteoporosis can often be reversed with supplements & exercise. A couple of my friends had it show up in their spines by way of Dexa Scans.Their ob/gyn's recommended calcium, a joint supplement & exercise. The repeat Dexa Scans thankfully have been normal since.

Good luck with your Dexa scan.

Yeah, I know they are common in runners but I never had one before in my life and I ran ultramarathons (lots of mileage). And I was hardly working out at all when this happened, so this wasn't an overuse injury. I was only doing 2-mile walks. I did one slow 1.5-mile run, but that was after the fracture happened (before I knew what was wrong). Both my doctors agreed the fracture is likely from prednisone. Foot fractures can be the first sign of osteoporosis. Anyway, thank you for your advice/info.

I just looked up my results from my DEXA scan in February of 2018 -- "moderate osteopenia with increased risk for fractures in the right femoral neck." I thought it was mild. I'm upset with myself for not taking better care of my bone health the last two years (as much as I could, despite all the pred).

Yes, signature is up-to-date. I drop to 20 mg in 2 days. I'm dropping by 10 mg every 7 days now. My UC feels fine. My BMs are not normal though. They stopped being normal when I dropped to 40 mg and that's partially why I went back up to 50 and stayed there for so long (I was on 50 for a month), but now I wish I hadn't because I don't even think I was having UC symptoms in retrospect. Well, my doctor also said not to taper until after starting Humira. My BMs are all compacted for the past 3ish weeks now, for lack of a better word. I'm still going every day though, usually 2-4 times a day. But this may be from taking Zofran. I took Miralax the past two days, and it didn't do anything. It isn't very uncomfortable lately though. Just makes me a bit worried and I wish i knew for sure what was causing it. I guess when I stop being nauseated and stop the Zofran, I will find out. Lol. I'm assuming the nausea is from the Imuran and hoping it goes away because I won't deal with this forever.

I was off of pred for 9 weeks in September and Oct. I know there were some other chunks of time since May 2018 where I was off of it, too. It looks like I wasn't on it last year November or December or January this year. And yeah, there were at least a few other brief periods (month or two) since May 2018 when I was not on it.

I probably should have started biologics sooner, but I was convinced if I just quit smoking, I would go back into remission. Yeah, that plan didn't end up working out. Lol. I'm still mad at myself for smoking though. I keep wondering if things would be different if I hadn't, but I didn't know this would happen, and I didn't know it would end up taking me a year to successfully quit again.

I'm glad you don't have to take pred anymore!

Thank you. I know, thinking that way doesn't do me any good. I'm glad I quit again too. I cannot believe I was smoking again. Normally when you quit smoking, you get to feel great, have tons more energy, etc., but I've just gotten to feel like crap the entire time so far -- yay.

Yeah, Zofran helps sometimes. My insurance won't give me anymore though because they suck. They said I'm allowed 35 pills in a 90-day period. My GI is trying to get it reconsidered. I have about 5 days' worth left right now. Apparently, they only cover more than that if you have cancer and are undergoing radiation or just had surgery. I still feel really crappy every day for a lot of the day though, even with Zofran. I feel like I'm taking poison with the Imuran. Sorry to sound dramatic, but that's what I feel like. I also don't have high hopes Humira will work because it looks like it only works in 20% of people with UC at the 8-week mark. That's a really low effectiveness rate.

Yeah, I could ask for a calprotectin. Will keep that in mind, thank you.

Only reason I say I probably should have started biologics sooner is so that I wouldn't have been on prednisone so long. I'm really worried about osteoporosis because everything I read says you shouldn't run if you have it.

Congrats. Always love victories/successes, and even a small victory can be the turning point within your battle with UC.

This has nothing to do with my stress fracture, but I had a yearly dermatology check-up today. My gastro. doctor told me to start getting those since I am now on Humira and Imuran. I have a lot of moles anyway so I had seen a dermatologist a few times for check-ups in the past just to be proactive, but it had been several years. Anyway, this doctor told me right off the bat that I should try to get off of either Imuran and Humira and not take both. She then said she "thought" Imuran was worse (maybe she should know for sure since she is a dermatologist??? Even I knew it had a higher risk and I'm not a doctor) and then said Imuran was "notorious" for causing skin cancer. I thought her word choice was poor and not really accurate given what I've read myself and what my GI told me. He told me the risks and did not downplay them, but the risk of skin cancer with Imuran still sounded VERY low to me! I tried asking this dermatologist what the exact rate/risk was and she couldn't tell me any figures. My GI told me, but I forgot. Anyway, I thought she was a little out of line telling me to drop one of the medications I literally just started 3 weeks ago, and I felt like she made the risk sound a lot worse than it actually is. Kind of irritated me.

Yeah, I even told her my GI explained the risks to me and that he said I could probably stop taking it after a year and maybe even after 6 months if I wanted to and she acted like a year was still way too long to be on it. She probably doesn't understand the whole needing to take both to try to avoid developing antibodies to Humira. I never go tanning. I spend time outside running and hiking (well, I used to and hope to again someday, lol), but I'm usually in the shade and very rarely burn.

Thanks for the info./advice! She biopsied a mole today, but it didn't look any different than normal to me, so I'm really not worried about it.

I had to wait too. Solid stools are a good sign that you're healing. Hang in there!