My mom had hip surgery and suffice it to say things have not gone quite as expected.

She has pretty bad osteoporosis and osteoarthritis. She had one hip done 10 years ago when she was 69 and the other one on December 23rd. Eight days after the surgery her femur shattered. Yeah, it’s not a medical term, but that’s what the orthopedic surgeon said. Both the greater and lesser trochanter broke as well as the shaft of the femur. Apparently it took an “intricate system of wires and screws” to get back together. So, shattered it is.

In getting informed about my mom’s first surgery and about her new slightly altered prognosis given the 2nd surgery and the bitch of a fracture, I was asked the following question three times by three different orthopedic surgeons:

“And are you taking your calcium and vitamin D?”

Me: “Uh, no.”

Orthopod chorus: “And why not, young lady.”

Me: “Uh, um. Well, I bought some…once and, uh, well, I think they are sitting in the spice drawer, although it is quite possible probable that they are, like, uh, expired.”

Orthopod chorus: “Do you want to end up like your mom?”

Okay, there are SO MANY ways that I don’t want to end up like my mom, but pretty close to the top of my list is having a  fractured femur described as “shattered and needing an intricate system of wires and screws at the age of 79.”

So I looked it up.

According to the Institute of Medicine (IOM) I need 1,000 mg of elemental calcium a day (I’m 45) and when I hit 50 I’ll need 1,200. I shouldn’t take more than 2,000 mg a day. Only 500 mg of elemental calcium can be absorbed at a time, so I can’t take it all at once (damn). I can get it from my diet or as a supplement. Dairy is the best dietary source, but salmon, tofu, and sardines are also good sources. I like salmon and sardines, but don’t eat too much of those. I do, however, eat a fair bit of dairy.

Other calcium pointers:

Some antibiotics affect absorption (like tetracycline), so check with your pharmacist about any medications if you are taking calcium as you might need to space out your pills.  There are three forms of calcium supplements: calcium carbonate and calcium phosphate, which should be taken with food, and calcium citrate which can be taken any time.

The IOM (and the orthopedic chorus) also recommend vitamin D. As I have a sunscreen obsession (and have low vitamin D, sigh, I know, I am non compliant, or was!) I really need my D too. There is a lot of controversy over optimal vitamin D levels. I’m taking 2,000 IU (international units) a day now because I’m deficient then I’ll probably back down to 800 IU a day, although by then there were probably be 10 more contradictory vitamin D studies to confuse me even more. I’m just doing the best with the information that seems most evidence based.

My diet stacks up pretty good: I eat 8 ounces of low-fat yogurt or at least 8 ounces of 1% milk every day, so I’m probably getting a minimum of 400 mg a day of calcium from my diet, but that still leaves me at least another 600 mg short. I pretty much abandoned cheese to lose weight (it was an unhealthy relationship), and I will try to eat more salmon but I’m going to add in a supplement.

Oh, and I’m putting it next to the coffee (and buying a bottle to leave at the boyfriend’s house), you know, so I’ll actually take it every day.

What to know how your food stacks up for calcium? Check out this link. (it’s a .gov site so you know you’re getting good info)

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  1. I’m sorry to hear about your mom’s surgery, and good luck to you! The coffee might be part of the problem, though – it’s not good to take vitamins with caffeine (I’ve been told and read) because it speeds up things moving through the GI tract, reducing the time for absorption. D is fat-soluble, though, so it might not make as big a difference as water-soluble vitamins. I’m pretty regularly frustrated by the conflicting information on supplemental vitamins in general, though I am not ready to admit that there’s no benefit (I think this will vary a lot from person to person – some of my friends are very D-deficient).

  2. My frustration with calcium was the instructions to not take it within 2 hours of taking certain medications, taking on an empty stomach … and honestly, I can’t fit that in. There is no time that I’m 2 hours from taking one of the conflicting medications.
    Though I do tend to get at least 8 oz, but more likely 16 oz of either skim yogurt (homemade from skim milk, no additives, thickeners … just plain milk) and or skim milk. (plus the 4 oz I use to take my night meds that I don’t usually think about as part of my intake, but it is daily).

    The vitamin D .. oy! been working for 3 years to get my number up to a level that doesn’t have my doc frustrated. (she thought a 6 was a bit alarming and a 4 all together unacceptable! .. I’ve got it all the way to 20 now ..working my way up to what she’d like to see of 50)

  3. My internist just told me to up the anti-depressants to deal with my increasing inability to cope with the fatigue, chronic pain, kids, house, full time job, etc. so I finally went to see a acupunturist/nutritionist who told me to request a full panel of blood work. D deficient- 50k mg/week for 8 weeks and within days I had more energy and less pain than I’d had for the last 5 years. I mentioned this to my Gynocologist and turns out she was also taking super-doses and also considers it a magic pill (my words, not hers). Not sure if its true, but couple weeks later my alternative not-doc, just happened to ask about my calcium intake and mentioned that with high doses of Vitamin D you really need your calcium supplements or your body will pull it from your bones to process that vit. D. EEK. I hadn’t heard that only 500mg can be absorbed at a time though, so will have to factor it in. I hate, hate, hate taking pills, but at 40+ I guess its time to grow up and take my medicine- every day.

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