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Wednesday, November 17, 2010

Sunny Side Up Bina 2010

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Editors note:

Title: Sunny Side Up
Byline: Debbie Shapiro
Lead in:

I always heard that vitamins are crucial to our health — after all, I’ve studied biology and health — but I assumed it was just talk, something for hypochondriacs and little old ladies who worry about everything under the sun. So while my friends were popping massive dosages of vitamin C at every sniffle, I just grinned and purchased extra boxes of tissues. I was wrong.

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At first, the changes were so minor that they were almost imperceptible. I didn't realize that anything was amiss until, at age 55, I felt ready to enter an old-age home. I started paying closer attention to what was happening to my body and realized that although there were no earth-shattering changes, I was slowly losing the ability to do the things that I had always taken for granted. I couldn't pull myself out of a low chair without help. Getting down on my hands and knees or sitting on the floor was completely out of the question. I became so weak that my muscles screamed in agony at even the simplest tasks. At weddings, while passing a bottle of soda or a salad bowl to the woman next to me, I'd find myself grimacing in pain.

My doctor ordered dozens of blood tests. Although the tests showed a loss of muscle function, it was not considered significantly abnormal. I wasn't in the midst of a major medical crisis, and was, according to the doctor, basically healthy. So I continued to grin and bear it, and wondered, If this is how I feel in my fifties, what will I be like in my sixties? Despite my clean bill of health, I suspected that at the rate that I was losing my ability to function, I'd end up in a wheel chair by the end of the year.

I reached my breaking point while visiting my daughter in England. My muscles were screaming in pain from the plane trip, and I lay in bed stifling my moans. My daughter suggested that I soak in a hot bath. But when it was time time to get out, as much as I tried, I was unable to lift myself up from the tub. After this humiliating and unpleasant experience, I had no doubt that, despite my doctor's reassurance that I was basically healthy, there was something seriously wrong with me.

I began making the rounds visiting specialists. After exhaustive tests, the rheumatologist confirmed the original diagnosis. I was in perfect health, so my pain and weakness was psychological. The doctor, one of the tops in his field, explained that I was under too much stress, which manifested itself through physical symptoms; he prescribed anti-depressants. But although his explanation made sense, I really didn't feel depressed. I felt sick and I was in terrible physical pain, and I was certainly upset about that, but otherwise, life was wonderful, so why should my symptoms be psychosomatic? I was not about to accept such a diagnosis until I was positive that there was no underlying physical problem.

A friend of ours suggested that I see a different general doctor. After a thorough examination, he, too, suggested anti-depressants. As an afterthought, he also referred me to both a neurologist and an orthopedist.

The neurologist informed me that my muscles were not working properly and that that, together with the blood tests showing loss of muscle function, pointed to a serious degenerative disease. “There's definitely a problem here,” he assured me. “We'll get to the bottom of it. It's not in your head.” Although I was thrilled that someone had finally found a physical reason for my pain — after all, the first step to finding a solution is defining the problem — I was also frightened. Perhaps I was suffering from something really serious, or even incurable, G-d forbid? The neurologist referred me to the hospital for tests. Thank G-d the first available appointment was in two months time.

In the meantime, I visited the orthopedist, who agreed with the other doctors that my pains were probably stress related. But just to be on the safe side, he ordered a bone scan. The results were abnormal. “Your bones are degenerating,” he said. “There’s nothing we can do about it; it happens as we get older.” When I pointed out that I was only 55, the doctor shrugged and said, “You're really very young to be having such problems. We usually see scans like this in people who are in their late seventies or eighties. But it's not unheard of.”

Meanwhile, I made an appointment at B’shvilaych, a well-women's clinic in Jerusalem. After a grueling two-hour examination, the doctor suggested several blood tests, including one to check my vitamin D level.

Although some foods, such as certain types of fish and fortified milk, contain vitamin D, the primary source of vitamin D is sunlight. Vitamin D is necessary for our bodies to absorb calcium and deposit it into the bone. With severe vitamin D deficiency, the bones do not mineralize properly, resulting in rickets in children and osteomalacia in adults. Since we need calcium for muscle function, a vitamin D deficiency often results in decreased muscle strength and muscle pain. Vitamin D is necessary for balance, so a lack of vitamin D increases the probability of falling, which, when combined with fragile bones, can be disastrous. In addition, we need calcium for our cells to function properly, which is why vitamin D deficiency increases the risk of cancer and autoimmune disease.

Until recently, the blood test to check vitamin D levels in the blood was very expensive and only performed in major hospitals. Today, however, it is routine. When I took the test two years ago, the Israeli insurance had just started offering it in their laboratory, and it was available only in the main branch on specific days of the week.

It took less than forty eight hours to receive the results. Normal vitamin D levels are above thirty ng/ml, while anything below twenty is considered a serious deficiency. Mine was less than five. When I showed the results to my family doctor, his response was, “You must be in agony.” I burst into tears; finally, someone understood what I was going through.

One of the medical referral agencies referred me to an endocrinologist at Hadassah Hospital who specializes in vitamin D deficiency. He listened patiently, occasionally nodding his head in sympathy as I related my tale of woe. When I finished, he smiled and showed me a small bottle of baby vitamins, the same type that I used to give my children. “Drink a bottle every week for six weeks, and then a bottle every two weeks. Within six months you should be feeling like a different person.”

Huh? That was all? A little bottle of vitamins could cure my disease?

“But what about the abnormal bone scan? And the blood tests showing that I'm losing muscle tone?”

The doctor explained that the abnormal scan showed multiple hairline fractures that, in this particular case, were a result of my bones being extremely fragile from the lack of vitamin D. As for the blood tests, he was positive that once my vitamin D levels would go up, the blood levels would also return to normal.

“I had one patient who couldn't sit up in bed without assistance. Today she's fine. I'm not a magician, and I can't promise anything, but wait for the vitamin D levels to become normal before addressing your other problems. Meanwhile, have patience and take your vitamin D.”

Progress was slow, but steady. At first, the pain increased, which I later learned was a result of my bones healing. But then I suddenly found myself able to do things again; I was thrilled to be able to wash my dishes! And then there was the first time that I danced at a wedding. I'm sure my simchah was contagious. Eventually the pain and weakness disappeared and I was so busy living that I barely remembered that I had been sick. There was no cutoff point between being almost an invalid and being healthy again. It was a gradual change, imperceptible yet constant.

Erev Pesach, I decided to scrub my floorboards (no, I'm not advocating scrubbing floorboards, but we all tend to overdo it). Without thinking about whether I would be able to get down on the floor, I grabbed a bucket of sudsy hot water and got down on my hands and knees to begin scrubbing. Suddenly I realized the significance of the moment. It had been years — yes, years — since I could sit on the floor. I scrubbed and sang, grateful to be able to make Pesach, grateful to be able to clean my house again, grateful to be healthy and energetic enough to take care of my family. And then, most amazing of all, I was able to get up afterwards! A true miracle. 

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