How can I protect my bone health?

[Music] how can I protect my bone health bone health is very complicated and very important in myeloma as well you definitely should talk to your doctor about being on a bone strengthening agent along with that we also generally encourage calcium and vitamin D supplementation and you should talk to your doctor about how much of that you should take it's sometimes not safe to do when people are first diagnosed and when their calcium levels are too high and then if at all possible recommend things like exercise trying to keep your muscle mass up trying to keep active because we know all of that improves bone health as well the number-one thing a myeloma patient can do to protect their bone health is to keep their myeloma in control that is 95 percent of what you can do it is true that if your disease is out of control using Zometa oryx Chifa to decrease your risk of fracture is excellent primarily for xgv and not as much for Zometa but to ward off against hypocalcemia or low calcium in your blood you can provide patients high-dose vitamin D so called ergo kalsa for all 50,000 units weekly or twice weekly along with calcium and vitamin D supplementation sometimes you can get symptomatic low calcium levels in your blood with ex Jeeva you rarely see that with some ADA but trying to ward against that before patients are exposed to xgv can sometimes make them feel a whole lot better lastly there are some data to suggest that weight-bearing exercise and just exercise in general does improve some bone health but let's face it the number one thing is control the myeloma we know that all bisphosphonates and we know that you know somewhat xgv decreases the calcium we recommend that all patients should take vitamin D and calcium when they aren't bisphosphonates but it's absolutely necessary that you take heart semen vitamin D especially calcium when you're on XG ver this is so important because that the hypocalcemia that means calcium is very low in your blood can have life threatening ranges if few onyx Jiva so we really talk to our patients saying you have to make sure that you take your calcium and daily or kind of or weekly according what your doctor prescribed you because that can have life-threatening light effects especially when uxg ver [Music]