View Full Version : Persistent HO condition
I have a C6 complete injury, 1 1/2 year post. I took didronel for 6 months and my alk. phos. was down to 150. After 2 months it shot up to 640. Back on didronel for 6 months, and my alk. phos. was down to 170. Now after 3 months it is up to 240. My Dr. is concerned about taking didronel for over a year. Is there a different drug or treatment that can be used? I have started a stem cycle program, will this help?
Rand
SCI-Nurse
10-06-2001, 07:35 PM
While the printed directions on Didronel caution against using it for more than 6 months, if you stop it too soon (before the HO is "mature") this can actually cause a rebound effect, making the HO get worse. We have many patients who have taken HO for 3-4 years. The only way to tell if the HO is mature is to do serial bone scans. Alkaline phosphatase tests alone are not sufficient.
Is your physician a SCI expert? HO treatment is so complex and the potential for complications so high that is is important to work closely with an SCI physician to be sure it is properly treated.
What is a stem cycle program?
(KLD)
Mike C
10-07-2001, 04:33 AM
Could you explain what a HO condition is and why it needs to be treated?
My home Dr. is not a SCI expert, but he communcates with my dr. from Craig Hospital
The stim cycle is some times called an ergometer.I am using the Orion Stim Master.By using electric stimulus on the ham. glut. and quad. muscles I peddle at about 50 rpm. Presently I am at 15 min. plus 1 min. warm up and 2 min. cool down.
Rand
SCI-Nurse
10-08-2001, 06:46 PM
Randy...sorry, I thought it had something to do with stem cells since you had spelled it that way. Stim cycle is a FES bike! Any stretching that you get with this will help maintain your ROM in spite of the HO. I know of no evidence that FES either worsens or improves the natural progression of HO.
Mike C, HO is heterotopic ossification, sometimes called PAO (periarticular ossification) in Europe. It is an abnormal growth of bony type material in soft tissues (muscles, ligaments and tendons) around joints. Symptoms usually include loss of ROM in spite of regular stretching, and sometimes swelling of the joint or limb. It is most common in the knee and hip in people with SCI, and more common in the elbow or shoulder in those with TBI. It is unclear what causes it, but it is associated with prolonged bedrest during the acute phase and also appears to be able to be triggered by acute infections and pressure ulcers.
You can get some more information about it at these sites:
http://calder.med.miami.edu/pointis/sciman.html (check under Medical Complications)
http://www.state.ar.us/ascc/fact1.html
http://www.spinalcord.uab.edu/show.asp?durki=21485
(KLD)