To walk or not to walk

DEAR DR. GOTT: I am an 80-year-old male, 5’8”, weighing 172 pounds. My medications consist of finasteride, simvastatin, lisinopril, terazosin, omeprazole, plus all types of vitamins including glucosamine MSM for joint pain relief. I also take chelation therapy on a monthly basis. I golf three times a week during my winter months in Florida and walk one or two miles a day.

My problem is I can only walk for ten minutes at a time due to severe pain in both hips. After resting for less than a minute, I can continue for another ten minutes.

I purchased an expensive pair of walking shoes but that didn’t help. I took one 500 mg pill of naproxen a day for two weeks in the event I had some inflammation but it didn’t improve my problem. Last year I participated in a Life Screening program and everything was within limits with only a 10% blockage. My blood pressure readings between my hands and feet were four points different. I don’t have any pain or discomfort other than when I walk steadily. We are planning a trip to Germany in June which will require a lot of walking so I hope you can help. Thank you.

DEAR READER: At 80 you’re nothing short of a miracle and your outlook in planning a trip to Germany is admirable. I enjoy hearing from people who make the best of a situation without complaining, even though they have some medical issues. There could be a number of reasons for your hip pain, to include several forms of arthritis, strain, and more.

Let’s take a moment to review the medications you are presently taking, since many carry unwanted side effects such as joint pain that could explain your problem. The finasteride was either prescribed for male pattern baldness or for symptoms of benign prostatic hyperplasia (BPH). My guess is, it is for the latter. Simvastatin is a cholesterol-lowering drug that was either prescribed for high cholesterol levels or because you had some sort of cardiac event and your physician wants your readings low. Lisinopril is commonly prescribed for high blood pressure, but also for congestive heart failure and post heart attack patients. An uncommon but known side effect is joint pain and stiffness. Terazosin treats hypertension and BPH. Omeprazole decreases stomach acids and symptoms of gastroesophageal reflux disease. Glucosamine helps develop and renew cartilage. It lubricates for better joint movement and flexibility. Finally, chelation therapy — a long-standing treatment for mercury and lead poisoning — can often be used, albeit ineffectively, for heart disease. While unproven, the theory behind this is that the medicine used in chelation binds to the calcium in the plaque in a person’s arteries. Through this process, it is theorized the plaque is then carried away as the medication moves through the bloodstream. As an aside but for readers‘ awareness, the American Heart Association (AHA) doesn’t recommend chelation as appropriate treatment for heart disease.

So, with the plethora of drugs you are on, we can summarize that you have a cardiac condition, excess stomach acid, possible hypertension or an enlarged prostate, and perhaps have been diagnosed with osteoarthritis. Except for the lisinopril, an unlikely culprit, I cannot pinpoint any drug that would trigger your hip pain, which takes us to disorders as we age.

I may have tunnel vision here but you likely have a form of arthritis such as osteoarthritis, a condition that occurs when the cartilage on the ends of bones wears down with age. This degenerative disorder commonly affects the hips and may cause pain during or following movement. Your hip joint may feel tender when you press it with a finger. Your physician did the right thing in recommending glucosamine as a first step toward control.

I suggest you work out an exercise plan with your physician’s approval. You certainly don’t want to overdo and put additional stress on your hips with steady walking that doesn‘t allow for rest periods. You may also wish to try castor oil rubs, over-the-counter pain relievers/anti-inflammatories or speak to your physician about prescription medication. Be aware that anti-inflammatory medications may worsen your excess stomach acid/GERD, especially if taken at high doses. You should continue with your plans abroad but allocate sufficient time in which to plan breaks that will allow your joints to rejuvenate with each time out. I know this isn’t the answer you are seeking but your doctor seems to have everything covered and you have sufficient knowledge to know what’s best for you. Continue on course and enjoy a good glass of Riesling to celebrate your wonderful golden years. Good luck.

Readers who would like related information can order my Health Reports “Coronary Artery Disease” and “Osteoarthritis” by sending a self-addressed, stamped number 10 envelope and $2 US check or money order for each report ordered to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.