lori_vt Posted May 5, 2015 Share Posted May 5, 2015 I had a laminectomy and fusion of L4-L5 on March 4th. Recovery has been going very well, but I'm still under some pretty strict limitations. I decided to start my third W30 on May 1st, and have been doing fantastic, feeling great. Today, however, I mentioned it to my doctor and was advised that this will inhibit the fusion as I am not consuming any dairy. The calcium is required for a successful fusion. I countered that I'm eating lots - and I mean lots of kale and broccoli, to which the reply was the calcium in plants is not well assimilated for building bone. I got really scared. Obviously I want the fusion to be successful. I will have a 12-week post op visit at the end of May where they take an xray to see how the fusion is progressing. It couldn't be seen on the 4-week post-op visit, not enough time for the fusion to heal. Apparently the bone will continue to "lay down" for 6-12 months, so I am told I'll need additional calcium during this period. Does anyone have legitimate resources for me to explore about the assimilation of calcium from sources other than dairy? I really don't want to take a supplement, but I will if necessary. I'm really kind of bummed now Link to comment Share on other sites More sharing options...
GFChris Posted May 5, 2015 Share Posted May 5, 2015 Before you get too bummed, check out the Whole9 take on calcium. Link to comment Share on other sites More sharing options...
Carlaccini Posted May 5, 2015 Share Posted May 5, 2015 Dairy is not the only food that contains calcium - really. I see that Chris already linked you the page I was going to link you to.... I was also going to add - you might want to consider consuming liver, cold water fish (think salmon and makeral) plus bone broth. From my understanding about bones - besides needing calcium - they need things like magnesium, vitamins A, D, and K2. And the above foods are rich in these vitamins. Having too much calcium is very much like having a metal knife that has been over hardened (metal is very often heat treated to make it stronger - but if it's been overdone then it's no good either) it becomes brittle. I have issues with the cartilage in my knees and hips wearing down so I have been looking at ways to prevent it from happening further. The information that I have mentioned above is based on this research. Link to comment Share on other sites More sharing options...
Carlaccini Posted May 5, 2015 Share Posted May 5, 2015 Also to add that I don't consume dairy at all - I am both lactose intolerant and have a casein allergy. I had been consuming dairy for years - it does not do my body good at all! Link to comment Share on other sites More sharing options...
jmcbn Posted May 5, 2015 Share Posted May 5, 2015 ^ What Carlaccini said!Also notable is that should you have a dairy intolerance in the UK (that's where I am) the GPs will not prescribe an alternative because once weaned humans no longer require milk.Furthermore in the US, where the dairy is consumed in large quantities, calcium deficiency is still very common because of the inflammation caused by the SAD diet which inhibits the body's ability to absorb the calcium. The magnesium & vitamins Carliccini mentioned above help improve absorption - and again, magnesium can often be lacking in anyone eating SAD.You would do well adding sardines to your meals along with the leafy greens..... Link to comment Share on other sites More sharing options...
Munkers Posted May 5, 2015 Share Posted May 5, 2015 http://ajcn.nutrition.org/content/35/4/783.short The purpose of the study was to evaluate current recommendations regarding calcium intake and to also look at how other factors such as age, pregnancy, lacation, presence of other nutrients, etc. impact the absorption of calcium. When consuming smaller amounts of calcium, your body become highly effecient at absorbing and utilizing it which makes sense because your body is going to desperately cling to any resource that it perceives to be scarce. This particular paper didn't find a link between calcium and other dietary factors like phosphorus, protein, oxalate, and phytate. (Oxalate and phytate are the issues that get cited for why plant sources are less than optimal.) It has been known for more than 40 yr that feeding whole wheat products to humans can result in a negative calcium balance. Studies on this topic were pioneered by McCance and Widdowson (53) in England, where the rate of extraction of flour was increased during World War II. The percentage of dietary calcium absorbed was reduced when high extraction (brown) flours compared to white flours, were added to a normal diet in the form ofbread (53). More recently, Cummings et at. (54) observed a similar effect when fiber intake was increased from 22 to 53 g/day by intake of calcium from 1909 to 1976. (Reproduced from replacing white flour products by whole wheat products and high bran foods in a typical Western diet. Although calcium intake was above the RDA (960 and 1302 mg/day from the low and high fiber diets, respectively), the high fiber regimen caused subjects to reduce their calcium balance from +32 to -77 mg/day (54). There's further information in the paper that suggests that fiber from fruits and vegetables can have the same effect as grains and that even "reasonable" additions of plant-based foods can have this impact. In my mind, this seems like a wash since we're eliminating grains and their negative effects, but the increased fiber from veggies could be causing the exact same issue so we're no better or worse than when we started. These are the recommendations I would make: -Bone broth. Tons of it. Google "perpetual broth" and read up on using a crockpot for a constant supply of high quality broth. The calcium content isn't as high as what lots of real-food proponents claim, but it IS full of amino acids and other nutrients that are very, very important for your bones. -Cold water fish with bones. Namely, canned salmon or canned sardines. Bonus: this gets your omega 3's AND vitamin D. And speaking off... -Vitamin D. All the calcium in the world will do nothing for you if you don't have vitamin D. Supplementing with only calcium is like dumping building materials into a field and expecting it to assemble itself. Raw materials are only part of the story. Consider a high quality cod liver oil supplement as well. -Physical activity within your doctor's restrictions. This probably means a lot of walking and not much else. Weightbearing exercise is vital to laying down and maintaining bone mass. Without weightbearing, your body goes "hey, we're not actually using this" and will maintain a lower leve of bone mass. That's no bueno. If you do supplement with calcium (which I think is totally reasonable since your body has an added stress from recent surgery and more stress equals higher nutritional requirements), make sure that you take it along with vitamin D or else you're not doing yourself any good. Also remember that American physicians have very limited training in nutrition and are trained to just cough up the same blanket statements about dietary needs. Your doctor is giving the best recommendations he can with the training and knowledge that he has available to him. Link to comment Share on other sites More sharing options...
lori_vt Posted May 5, 2015 Author Share Posted May 5, 2015 Thanks for the link Munkers, that's exactly what I was looking for - some scientific study(ies) that look at calcium intake and bone production. I'm going to print this out at work and review it carefully. I've had osteopenia for many years now, and have done all the alternative stuff to help build stronger bones. I was a competitive bodybuilder and runner, have never had a problem with dairy products, but the osteopenia continued to progress. If I hadn't had a fusion, I probably would have continued with my regular supplementation (K2, potassium citrate, magnesium, D3, kelp, selenium, ALA, tyrosine, plus others), but because the surgeon won't go back in if the fusion fails, I'll be stuck with continued back pain and I can't imagine a failed fusion would be a good thing. After all this, I want the surgery to be successful. If I have to postpone my W30, so be it. I have come this far modifying my lifestyle to allow my back to heal, it is simply not worth it to me to jeopardize it for the sake of a W30. I am 55 years old, post-menopausal, 5'3, 126 lbs and normally very active, excellent lipid profile, yada yada. I don't have food allergies, no GI issues, overall exceptionally healthy. Except for the poor bone density and osteoarthritis (5 surgeries, 2 fractures). I typically eat very close to a W30 on most days, other than dairy. I printed out the Whole 9's statement on calcium a couple of years ago, but that is not the science I'm looking for - I need some peer-reviewed, scientific literature to support my decision. After menopause, the bone density in my spine decreased by 28% and by 14% in my femur - in just 7 years. I'm due for another bone density test this year, so we'll see if the osteopenia has become osteoporosis If you are aware of any other studies or clinical findings about the role of calcium in building NEW bone in post-menopausal women with osteopenia, I would love to know the citation. In fact, I may have to do a lit search at work tomorrow... ps. I Love Sardines!! I usually have them a couple times a month - guess I'll bump that up Link to comment Share on other sites More sharing options...
Moderators Tom Denham Posted May 5, 2015 Moderators Share Posted May 5, 2015 Your doctor says that calcium from plants is not well assimilated. I am sure your doctor is quoting a research paper in saying this. Probably the research was funded by the Dairy Marketing Association. I know this sounds cynical, but it is probably true. The problem is that research papers "prove" all sorts of things that are not true. The paper Munkers cited above makes eating fruits and vegetables sound absolutely terrible for your bone health. However, if you are not a real scientist with some knowledge of the area, you can't distinguish between the crap and the good stuff. Your doctor probably can't make the call between good and crap science either. Around here, we can't advise you on all the science. What we can tell you is that many of us have not consumed dairy in years and our bone health is excellent. I have not consumed meaningful amounts of dairy for the past 5 years. A few years ago, I ate a few cartons of goat's milk yogurt and a few carton's of greek yogurt until I discovered that any dairy degraded the quality of my sleeping. I have eaten lots of dark leafy greens and large quantities of salmon with bones. My personal impression of my bone health is of course complete speculation on my part, but my doctors have been thrilled with my health ever since I went Whole30 5 years ago. And I got a series of X-rays and and an exam by an orthopedic surgeon a while back when I developed a shoulder injury that lingered so long I sought help. The ortho doctor thought my bones looked good. He and I did not talk about my diet. Link to comment Share on other sites More sharing options...
lori_vt Posted May 5, 2015 Author Share Posted May 5, 2015 I should clarify - the "doctor" is not an actual physician, but rather my physical therapist who is more knowledgeable about nutrition than nearly every doctor I know. I didn't want to make a hasty decision, however I want to explore this, since there is only a brief window of time for the fusion to "take." If it hasn't set or taken within 6 months, I believe it is considered "failed." I don't want to be that statistic. Link to comment Share on other sites More sharing options...
Sheena812 Posted May 6, 2015 Share Posted May 6, 2015 I took a calcium supplement after my fusion. I was able to find one that is as compliant as possible at a natural foods store. I don't have it in front of me so it may be completely compliant. Link to comment Share on other sites More sharing options...
lori_vt Posted May 6, 2015 Author Share Posted May 6, 2015 I picked up a carton of calcium fortified orange juice yesterday, and will look to see if any of the almond milk products are compliant as well, since they boast a 45% RDA for calcium. I figured if I consume 3 servings of the OJ with meals that should satisfy some of the extra calcium I need without adding dairy. I'm still conflicted about this, but haven't bailed on my W30 - just really scared about a failed fusion and want to be sure I don't shoot myself in the foot here. Thanks Sheena812, I'm going to look for a compliant calcium supplement as well. Link to comment Share on other sites More sharing options...
MeadowLily Posted May 6, 2015 Share Posted May 6, 2015 How about Bone Broth every day for your fusion? Calcium fortified orange juice or almond milk will do little for healing. How about some awesome grilled Salmon eaten with even the tiniest of bones still in there..difficult to remove. There's herring, sardines, spinach, kale and other greens when eaten in combination with fish would be optimum for healing. Orange juice is almost pure fruit sugar. My vote is for Salmon, kale and spinach. In 30 days, you can add the juice and almond milk back if you really want to. I haven't had either of those drinks in over a year. My bone density is great. I eat fish - morning, noon and night..along with beef, bison, and other wild proteins. Link to comment Share on other sites More sharing options...
imullmau Posted June 1, 2015 Share Posted June 1, 2015 I've had 6 spinal fusions over the past 3.5 years and I'm currently fighting the fact that I need two more (it is why I started the whole30 and today is my first day!). My L4-L5-S1 anterior and posterior spinal fusions had bone cadaver placed in-between the vertebrate. The bone cadaver pieces were imbibed in bone morphogenic protein that aided in bone growth. Did your doctors mention this? I also had C3-C4-C5-C6-C7 fused but in the neck they don't use bone morphogenic protein in the cadaver discs. It can become constrictive. From my experience, eating healthy is the best medicine and my surgeons never mentioned calcium. Exercise, a healthy diet, and a positive attitude was all they were concerned about. Good luck in your recovery. I hope you get your question answered and it sounds like you're doing great. It's not easy. Link to comment Share on other sites More sharing options...
lori_vt Posted June 3, 2015 Author Share Posted June 3, 2015 it sounds like you've had quite a time of it imullmau - I hope you are feeling like things are improving for you. I am incredibly grateful for my surgeon and physical therapist and osteopath. They helped me correct imbalances and gain strength before surgery so my recovery has been optimal. At my 12-wk post-op visit, they showed me the early bone formations around the hardware, the fusion was a success! And they are encouraging me to be active - running, biking, gardening, lifting weights - in order to continue to build the bone density. I've been taking a calcium supplement, having some calcium-fortified oj and cashew milk, taking K2, potassium citrate, vitamin D3 and magnesium as well. And I recently read about Diatomaceous Earth and the silica within can help with osteopenia (among other things). So I've begun taking that on an empty stomach, first thing in the morning. My diet regularly includes kale, broccoli, sardines, salmon (w/bone) and almonds. I should think I have it covered, but I still had a moment of freak-out when my p/t said I shouldn't cut out dairy. After a bit of research, I feel like I made the right move. I was able to complete my W30 successfully! And I have a DEXA scan scheduled for later this month. Link to comment Share on other sites More sharing options...
imullmau Posted June 5, 2015 Share Posted June 5, 2015 Thanks, Lori. I had a doctor appointment today and it didn't go great. I'm trying to delay the next two fusions and I'm hoping an anti-inflammatory diet will help with the degenerative discs and my arthritic spine. I rode my bike today 20 miles and hiked yesterday 7 miles. I've always been active but my spine is taking me down. The doctor said I was doing better then 95% or her patients, but that didn't help me psychologically. I wish I didn't have to be at the doctors in the first place. I'm hoping the w30 helps, though. I completed day 4 and it was hard, but I completed it. I'm hoping it helps. It can't hurt, that's for sure. As a side note: my youngest son flew in for the week from San Francisco. He had friends over tonight and we all cooked together in the kitchen. I gave them a lesson on opening a young coconut, draining out the water and blending it with the meat to make coconut milk and cream. ( The book talked about how easy this was, so I tried it last weekend. It is so easy!) They had fun and we made curry together. I love the 25 -35 year olds. They are so open minded and appreciate cooking whole foods. Well, I hope you have a successful next couple of days. Link to comment Share on other sites More sharing options...
JBPoole Posted September 29, 2015 Share Posted September 29, 2015 Well, okra, broccoli, green beans,almonds, and fish canned with their bones are also good source of calcium. Link to comment Share on other sites More sharing options...
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