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Boniva and Porcine Valve

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Kathy McCain

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I have a porcine valve which was implanted Feb 2008. My bone density test last year indicated that I have osteoporosis in the lower back and osteopina in my neck and femur. I also take 5mg prednisone for recurrrent pericarditis. I started the prednisone appox one month after surgery, starting with 60mg. Well I tapered down to the current dose (5mg) which I've been taking for appox one yr. My Dr's including my cardio tell me I need to be taking medicine for my bones, particulary because of the effects of the prednisone. My question is this: does anyone here take this medicine, or something similar, that has a TISSUE OR PORCINE VALVE? I am concerned that this medicine may prematurely calcify the valve. I searched the internet for info, can't seem to find what I'm looking for.

I have not as yet discussed this concern with my cardio.

Any help at all would be greatly appreciated.
 

marie

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I did reclast by IV this year. It's a once a year treatment for osteoporosis. My experience probably won't help you however because my porcine valve was showing some calcification prior to this. My cardio and my family doctor were on board with this but who knows.:D
 
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Kathy, Have your doctors suggested any other type of therapy rather than Boniva? Do you have GI issues? If you do, Boniva may cause problems. Fosomax and Actonel cause GI issues too. Reclast is the newest therapy available, but I think you have to get it through an endocrinologist.


I did reclast by IV this year. It's a once a year treatment for osteoporosis.
Marie, what did you think of reclast? Who administered it? I have been considering it as I cannot tolerate Fosomax, Actonel, or Evista (hormone treatment that causes hot flashes).
 

Kathy McCain

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Louise.

I did not realize that these medicines caused GI problems. That's good to know. My mom died at 57 of colon cancer, so I have to have the "dreaded colonoscopy more often. My GP wanted me to try a very expensive injection treatment that you give yourself. I can't remember the name. My concern with any of this is the possible valve deterioration. I already have some osteoporosis, so I feel I don't have much of a choice.
 
G

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My GP wanted me to try a very expensive injection treatment that you give yourself. I can't remember the name. My concern with any of this is the possible valve deterioration. I already have some osteoporosis, so I feel I don't have much of a choice.
I bet the injection was Miacalcin. This comes in a nasal spray too. You have to keep it refrigerated. I tried the nasal spray, I kept forgetting to use it so I quit. Keeping it in the fridge was not problematic.

Miacalcin
 

catwoman

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Kathy:
Prednisone aside, you should be taking some Rx for osteoporosis.
I've taken Boniva, Fosamax & Actonel, and am taking generic Fosamax now.

Have you consulted medical professionals about how/if Boniva affects tissue valves? If it affects a porcine or bovine valve, it might affect a native valve, too.
My guess is that there may be no research done on the effects of the drugs on tissue valve replacements.

I would also ask if taking OTC calcium w/ vitamin D would also affect your valve.

How long do you plan to be on pred?

Do the benefits of taking Boniva outweigh the risks?

My dad, who will be 81 on Jan. 14, has very severe osteoporosis. He pooh-poohed taking the oral Rxes because of the possible GI side-effects; he has suffered from GI problems for about 40-50 years, even requiring hietal hernia surgery in 1966. He's had several spinal fractures in the last couple of years, and after the last one he realized he needed to do something. So he's giving himself shots daily; an endocrinologist is treating him. I haven't asked him whether the shots might cause calcification of his native valves; the benefits far outweigh the risks for him.

He said that he had to do the shots before considering IV treatments, since he's on Medicare. I'm sure most insurance carriers would probably make you jump through hoops before going to Reclast.

I have osteoporosis, too (genetic???), and my PCP said that before oral meds came on the market, endocrinologists treated osteoporosis, with shots. Now, PCPs write Rxes for oral meds for most cases. If your osteo is bad enough, you go to an endocrinologist.
 

Lynlw

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Kathy:
Prednisone aside, you should be taking some Rx for osteoporosis.
I've taken Boniva, Fosamax & Actonel, and am taking generic Fosamax now.

Have you consulted medical professionals about how/if Boniva affects tissue valves? If it affects a porcine or bovine valve, it might affect a native valve, too.
My guess is that there may be no research done on the effects of the drugs on tissue valve replacements.

I would also ask if taking OTC calcium w/ vitamin D would also affect your valve.

How long do you plan to be on pred?

Do the benefits of taking Boniva outweigh the risks?

My dad, who will be 81 on Jan. 14, has very severe osteoporosis. He pooh-poohed taking the oral Rxes because of the possible GI side-effects; he has suffered from GI problems for about 40-50 years, even requiring hietal hernia surgery in 1966. He's had several spinal fractures in the last couple of years, and after the last one he realized he needed to do something. So he's giving himself shots daily; an endocrinologist is treating him. I haven't asked him whether the shots might cause calcification of his native valves; the benefits far outweigh the risks for him.

He said that he had to do the shots before considering IV treatments, since he's on Medicare. I'm sure most insurance carriers would probably make you jump through hoops before going to Reclast.

I have osteoporosis, too (generic???), and my PCP said that before oral meds came on the market, endocrinologists treated osteoporosis, with shots. Now, PCPs write Rxes for oral meds for most cases. If your osteo is bad enough, you go to an endocrinologist.

I don't know about the shots and valves, BUT Justin has problems with calcifying his conduit (that was made mainly of his own heart/pericardial tissue) and I asked if there was anything diet-wise we could do to help, not as much dairy ect type of things and we were told that (diet) has no effect on the tissue calcifying, it had more to do with age, like younger peoples bones are growing, broken bones heal quicker ect and that is why they calcify tissue quicker than older people,who bones don't heal as quickly tend to be less dense ect.
Now I asked about 10 years ago maybe they discoverred things that changed their thinking since then, but I haven't heard different.

Kathy is there ANY other meds you can take for the pericarditis? Prendisone does a number on bones ( and many other organs) even in people with no history or ostea or are much younger and starting with really good bone density.
 

catwoman

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Lynn's got some good points.

The reason I suggested that Kathy talk to med professionals (not just a cardiologist) was to determine whether the calcium generated by osteo drugs is the same type that is found on calcified valves.

I thought that valve calcification was due to cholesterol, rather than the calcium found in milk, cheese, generated by osteo drugs, etc.
But I'm not a med professional, so I could be wrong.
 

Kathy McCain

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Thank all of you SOOO MUCH for the responses!

They tried all of the other known drugs for percarditis, and they did nothing!! The prednisone was and is the only thing that is effective. My cardio says that is really the only thing that works. He also said he doesn't have a problem with me on the prednisone, at this point , because it is such a low dose. I would much rather be off it completely. It does cause a number of problems. I would think that over time, even a low dose could have harmful effects. Other than brusing, I haven't noticed anything.

I told my GP that I did not think my insurance would pay for the injections. Even my OBGYN did not think they would approve it. He said it wasn't severe enough. I am going to schedule an appt for another bone density test, and go from there. You know I agree. I bet the medical community has never even done a study of the effects of these types of meds on VR patients with tissue valves. I also have read that it's cholesterol, that effects the valve. I am high in that area, both good and bad.


Hopefully soon, I will be able to get off this stuff. It's so ironic. I'm the type of person that just HATES having to take any type of med. Hates dealing with Drs. It's seems, that's all I do now, especially since my heart surgery. Having said that, I AM GRATEFUL to my surgeon, and my cardio, for giving me a new lease on life.
 

Lynlw

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Lynn's got some good points.

The reason I suggested that Kathy talk to med professionals (not just a cardiologist) was to determine whether the calcium generated by osteo drugs is the same type that is found on calcified valves.

I thought that valve calcification was due to cholesterol, rather than the calcium found in milk, cheese, generated by osteo drugs, etc.
But I'm not a med professional, so I could be wrong.
I agree this is definately something to ask all the docs on your team and not just the cardiologist.
I think it depends on what kind of stenosis, like plaque or calcification this was the quickiest easiest answer I could find, http://en.allexperts.com/q/Heart-Cardiology-964/Cholesterol-vs-Calcification.htm
Question
Speaking of Aeortic Stenosis, and spinal stenosis. What is the differenct between Cholestrol and Calcification.
If your arteries fill with Cholestrol; what fills the Aeortic valve and spine. Cholestrol or calcium?
Thanks, Carole

Answer
Carole,

Cholesterol, Calcification, Aortic Stenosis and Spinal Stenosis are all more different than the same.

Cholesterol is a substance that is produced by the liver and found in foods from animals (plants do not have cholesterol). About 85-95% of the cholesterol in our bodies comes from our liver and 5-15% comes from the foods we eat. Cholesterol is vital for the manufacture of cells and other important uses. Low density lipoproteins, "LDL cholesterol", can "oxidize" and get embedded in the lining of artery walls. This is the beginning of atherosclerosis, or artery disease. As this disease progresses, calcium can move into the blockages, called "plaques", and the plaque can become "calcified", or harden.

Aortic valve calcification is a somewhat different type of process where calcium deposits form on the aortic valve and can cause the valve to not function properly.

By the way, calcification can happen weather you eat a lot of calcium or not - do not restrict or avoid eating or drinking foods that have calcium. Low-fat, or skim, dairy products have just as much calcium as high-fat dairy products. Skim dairy products are a great option.
( ME-lyn THIS makes no sense, it doesn't make a difference, but it is a good option?)

Spinal stenosis is a collective term that covers several different conditions that have many causes. Cholesterol has nothing to do with spinal stenosis, and calcium is not responsible for most forms of spinal stenosis. Since I'm not a spine expert, go here to learn more about spinal stenosis:
http://www.nlm.nih.gov/medlineplus/spinalstenosis.html

the mayo has an interesting article explaining how the 3 different things can cause aortic stnosis, which finally helped me understand why rhuematic fever caused problems. http://www.mayoclinic.com/health/aortic-valve-stenosis/DS00418/DSECTION=causes

Aortic valve stenosis is narrowing of the aortic valve. Many things can narrow this passageway between your heart and aorta. Causes of aortic valve stenosis include:

Congenital heart defect. Rarely, some babies are born with an already narrowed aortic valve. Others are born with an aortic valve that has only two flaps (leaflets) — not three. Known as a bicuspid aortic valve, this deformity may not cause any problems until adulthood, at which time the valve may begin too narrow or leak and may need to be repaired or replaced. Having a bicuspid aortic valve requires regular evaluation by a doctor to watch for signs of valve malfunction. In most cases, doctors don't know why a heart valve fails to develop properly, so it isn't something you could have prevented.

Calcium buildup on the valve. With age, heart valves may accumulate deposits of calcium (aortic valve calcification). Calcium is a mineral found in your blood. As blood repeatedly flows over the aortic valve, deposits of calcium can accumulate on the valve's leaflets. These deposits may never cause any problems. However, in some people — particularly those with a bicuspid aortic valve — calcium deposits result in stiffening of the leaflets of the valve. This stiffening narrows the aortic valve. This cause of aortic valve stenosis is most common in people older than 65, and symptoms often don't appear until age 70.
Rheumatic fever. A complication of strep throat infection, rheumatic fever may result in scar tissue forming on the aortic valve. Scar tissue alone can narrow the aortic valve and lead to aortic valve stenosis. Scar tissue can also create a rough surface on which calcium deposits can collect, contributing to aortic valve stenosis later in life. Rheumatic fever may damage more than one heart valve, and in more than one way. A damaged heart valve may not open fully or close fully — or both. While rheumatic fever is rare in the United States, some older adults had rheumatic fever as children.



Thinking about this MY GUESS is IF the meds would affect any valves, it would probably affect native valves, more than it would the newer tissue valves that have the anticalcification treatment in it
 

marie

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Kathy, Have your doctors suggested any other type of therapy rather than Boniva? Do you have GI issues? If you do, Boniva may cause problems. Fosomax and Actonel cause GI issues too. Reclast is the newest therapy available, but I think you have to get it through an endocrinologist.




Marie, what did you think of reclast? Who administered it? I have been considering it as I cannot tolerate Fosomax, Actonel, or Evista (hormone treatment that causes hot flashes).
My family doctor administered it and medicare paid for it. She is an internist. I understand that it is very expensive and medicare has to pre approve it. It can have some side effects however I don't think I had any. I had some leg pain which she (my doctor) thinks may have made the pain worse but I'm not really sure that's what caused my leg pain. My cardio did not want me taking Evista. He was on board with the reclast though.
 
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