May 28, 2014
I'm in much better shape since the [hip and shoulder] replacements. I walk with a little limp, but I have 100% mobility in my arms.
-- Stephanie Brooks-Wiggins, 68
Activist and author, Baltimore
Diagnosed with HIV in 1986
Both HIV and aging put you at risk for accelerated bone weakness. Here's how to keep your bones healthy well into your golden years.
"We're the first generation to age with HIV, so it's a complete adventure!" says Stephanie Brooks-Wiggins, 68, a retired hospital administrator in Baltimore diagnosed with HIV in 1986. She's chosen to turn her personal adventure into activism, speaking publicly, and serving as a member of Older Women Embracing Life (OWEL), a support and advocacy group for women her age with HIV. When she's not busy with that, she's back in school learning to be a tax preparer for H&R Block, visiting her kids and grandkids in various states, or making magic in the kitchen for her husband, Vernon, a retired cop. "I'm a gourmet cook," she says proudly. "I make a roast lamb with a rosemary thyme crust that people die for. And I make ribs that disappear!"
But despite a full life, Brooks-Wiggins has had her HIV-related challenges along the way, including osteonecrosis, or bone death. She's had to have her left hip and both shoulders replaced. "I'm in much better shape since then," she says. "I walk with a little limp, but I have 100% mobility in my arms."
Her case may be especially severe, but osteoporosis, or bone weakening, is indeed something that people with HIV experience more, and sooner, than their aging HIV-negative peers. (Its milder precursor is called osteopenia.) That's believed to be from a mix of the toll that HIV itself takes on bones (once again, inflammation) and of HIV meds, some of which have been found to sometimes harm bones. What's more, bone weakening has no overt symptoms until the point of fracture.
So it's all the more important to prevent and screen for bone loss as we advance beyond age 50. Here's how:
Get scanned. A DEXA scan, that is. A camera will scan you to check your bone mineral density (BMD), a marker of bone health. All men with HIV over 50 and post-menopausal women with HIV should have this test every few years. If your health plan doesn't cover it, keep in mind that it costs about $150. Not cheap, but important enough that you might want to pay for it yourself. The test will score you against the bones of a healthy 30-year-old of your sex. If your "T-score" is below -1.0, you have osteopenia; below -2.5, osteoporosis.
Talk to your doctor about bone-builders. There are several prescription medications that have been found safe for HIV-positive people to take to build stronger bones. In addition, make sure you're getting enough vitamin D and calcium, essential bone nutrients, via your diet (think low-fat milk and cheese, yogurt, broccoli, kale, canned salmon or tuna, and fish oils); supplements (top guidelines for HIV-positive folks recommend 1,000-1,500 mg of calcium and 800-1,000 IU of vitamin D daily); and sunlight.
Talk to your doctor about all your meds. Are any of them linked to bone problems? Some HIV drugs have been known to decrease bone mineral density, so if you already know you have osteopenia or osteoporosis, your doctor might want to monitor your BMD if you're taking certain medications.
Do resistance exercise. Anything demanding that puts some rhythmic impact on your bones is great to build bone density. That includes everything from walking, running, hiking, tennis and basketball to yoga, dancing, weightlifting, weight machines and basic push-ups and squats. Swimming and cycling are great for overall health but not so great for bones, as they don't put impact on them.
|Tips From the Pros|
Stephanie Brooks-Wiggins, 68
Since her shoulder and hip replacements, Brooks-Wiggins has done a lot to improve her bone health. Most importantly, she quit smoking. "I got pneumonia, and I said, 'Okay, this is it.' I wore the nicotine patch for a week, plus I see a therapist every other week."
She's also put a new emphasis on diet and exercise; "I eat lots of fresh fruits and vegetables. I walk my dog, Nairobi, for exercise. And I go to my orthopedic surgeon at least once a year for an MRI to see how my bones are looking."
But despite the time and effort she's had to put into her health, Brooks-Wiggins remembers to pull back and look at the big picture. "Don't let HIV define you!" she insists. "You're only as old as you let yourself feel."