Thanks Rneb!
As is far too often the case, it appears that my mental model for understanding this process is an oversimplification ....
Forums
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DanielR - Name: Daniel Riebow
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: 12/2012
- Age at diagnosis: 59
Re: Zometa side effects - what can be done about them?
I also have decided not to have Zometa infusions. My bones seem to be healing on their own and, as long as I have no active disease in my bones, I don't want to put yet another drug into my body. Side effects from Revlimid are enough.
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hfilipiak - Name: Heather-Dawn Filipiak
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: July 2012
- Age at diagnosis: 67
Re: Zometa side effects - what can be done about them?
Daniel:
Gee, now if I could find a nice, concise article on how Zometa beneficially
plugs-in to the OsteoClast / Osteoblast / promyeloid precursor scheme of things--I might actually make some sense!
Have a good weekend.
Gee, now if I could find a nice, concise article on how Zometa beneficially
plugs-in to the OsteoClast / Osteoblast / promyeloid precursor scheme of things--I might actually make some sense!
Have a good weekend.
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Rneb
Re: Zometa side effects - what can be done about them?
This video makes the concept behind Zometa a bit easier to understand than what you will find in much more technical articles.Note that the video ends with a good recitation of the cautions and considerations when receiving Zometa.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Zometa side effects - what can be done about them?
Hi DanielR,
There's nothing at all wrong with your mental model. It's basically dead on, and I don't know why anyone would suggest otherwise.
Osteoclasts "resorb" (break down) bone. In fact, they are the only cells capable of doing that, according to the review article from 2014 I've listed below. ("Osteoclasts, the only cell capable of resorbing bone, are giant multinucleated cells arising from hemopoietic precursors.")
Osteoblasts, on the other hand, are responsible for building up the bone structure.
Maybe osteoclasts can help a bit with bone building (the "overlap" alluded to in an earlier post), but I don't think any specialist in bone biology would argue against describing osteoblasts as being the cells primarily responsible for building bones.
As I understand it, bisphosphonates like Zometa and Aredia work primarily by preventing osteoclasts from doing as much bone destruction as they normally would. Although there is some evidence that the drugs also encourage more bone building by osteoblasts, my sense is that this effect is not considered as important as the impact the drugs have on osteoclast activity.
I hope this clarifies things a bit.
Here's the reference I mentioned earlier:
T John Martin, "Bone Biology and Anabolic Therapies for Bone: Current Status and Future Prospects," Journal of Bone Metabolism, Feb 2014 (full text at PubMed)
There's nothing at all wrong with your mental model. It's basically dead on, and I don't know why anyone would suggest otherwise.
Osteoclasts "resorb" (break down) bone. In fact, they are the only cells capable of doing that, according to the review article from 2014 I've listed below. ("Osteoclasts, the only cell capable of resorbing bone, are giant multinucleated cells arising from hemopoietic precursors.")
Osteoblasts, on the other hand, are responsible for building up the bone structure.
Maybe osteoclasts can help a bit with bone building (the "overlap" alluded to in an earlier post), but I don't think any specialist in bone biology would argue against describing osteoblasts as being the cells primarily responsible for building bones.
As I understand it, bisphosphonates like Zometa and Aredia work primarily by preventing osteoclasts from doing as much bone destruction as they normally would. Although there is some evidence that the drugs also encourage more bone building by osteoblasts, my sense is that this effect is not considered as important as the impact the drugs have on osteoclast activity.
I hope this clarifies things a bit.
Here's the reference I mentioned earlier:
T John Martin, "Bone Biology and Anabolic Therapies for Bone: Current Status and Future Prospects," Journal of Bone Metabolism, Feb 2014 (full text at PubMed)
Re: Zometa side effects - what can be done about them?
Heddleandhook,
I'm sorry to hear about your problems with Zometa. Before I started on my Zometa infusions, I had read that hydration was important. I asked my onco if I could have IV fluids when I was having Zometa on its own. He agreed. I get 500 mL of IV saline (250 before and 250 after) and I have never had any fever, headaches, or cramping. It might be worth trying this if you can get your doctors to agree.
Hope this helps.
Bluebell
I'm sorry to hear about your problems with Zometa. Before I started on my Zometa infusions, I had read that hydration was important. I asked my onco if I could have IV fluids when I was having Zometa on its own. He agreed. I get 500 mL of IV saline (250 before and 250 after) and I have never had any fever, headaches, or cramping. It might be worth trying this if you can get your doctors to agree.
Hope this helps.
Bluebell
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bluebell
Re: Zometa side effects - what can be done about them?
I'm getting Zometa for the second year now, monthly. I'm in stringent remission after a stem cell transplant and VCD (Velcade, cyclophosphamide, and dexamethasone). Now I'm on Revlimid 5 mg maintenance for two years (one year done). I have had bad months and good months after Zometa. The good months are when I have drunk a lot of fluids before and after the infusion, when it goes in over 30-40 minutes, and when more than 500 ml of IV saline is included before and during the Zometa infusion.
The months that I'm bad with a fever, and aches and pains in my back, hips, and legs, and general fluey feeling are when we have been in a hurry to make it to my consultant's appointment and we reduced the infusion time to less than 30 minutes and the fluid intake was also lower.
I've also reduced the Zometa dose from 4 mg to 3 mg as my creatinines were a bit too high and the dose reduction helped that. But, even with the lower dose, I still need to have a full 30+ minutes and lots of fluids.
The months that I'm bad with a fever, and aches and pains in my back, hips, and legs, and general fluey feeling are when we have been in a hurry to make it to my consultant's appointment and we reduced the infusion time to less than 30 minutes and the fluid intake was also lower.
I've also reduced the Zometa dose from 4 mg to 3 mg as my creatinines were a bit too high and the dose reduction helped that. But, even with the lower dose, I still need to have a full 30+ minutes and lots of fluids.
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R Poole
Re: Zometa side effects - what can be done about them?
I must be the exception to the rule.
On my first infusion, I experienced some tight muscles in my legs, making it difficult to climb stairs, but since then I have nothing as a symptom. I feel nothing – only that I have to use the restroom with a large amount of urine because of the amount of saline they use to clean the lines to ensure I receive all the product. I have the IV taken a longer time and I make sure that I drink plenty of liquids before and after.
Guess I feel luck at this part of my treatment. I am now only getting this quarterly.
On my first infusion, I experienced some tight muscles in my legs, making it difficult to climb stairs, but since then I have nothing as a symptom. I feel nothing – only that I have to use the restroom with a large amount of urine because of the amount of saline they use to clean the lines to ensure I receive all the product. I have the IV taken a longer time and I make sure that I drink plenty of liquids before and after.
Guess I feel luck at this part of my treatment. I am now only getting this quarterly.
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Big Bill
Re: Zometa side effects - what can be done about them?
My experience is the same as Big Bill. I drink a lot of water prior to and after. My only complaint is that I usually have to stop and use a restroom on my one hour drive home! I get Zometa quarterly with a 15 minute infusion time.
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Mark11
Re: Zometa side effects - what can be done about them?
Thanks everyone, especially Bluebell.
I know I definitely am VERY well hydrated! But the infusion time was only 15 minutes. Ran it by nurse yesterday, who I hope I will have the next time, as she says she does run it for 30 minutes. So I will insist! Also she mentioned the Claritin thing. So lots to try next month.
I know I definitely am VERY well hydrated! But the infusion time was only 15 minutes. Ran it by nurse yesterday, who I hope I will have the next time, as she says she does run it for 30 minutes. So I will insist! Also she mentioned the Claritin thing. So lots to try next month.
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heddleandhook - Name: heddleandhook
- Who do you know with myeloma?: self
- When were you/they diagnosed?: Jan 2015
- Age at diagnosis: 68
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