Strength training can be done indoors

Dear Dr. Roach: I am a healthy 79-year-old female who recently underwent a right total knee arthroplasty. In a routine postoperative X-ray there was indication of early osteopenia in my long bones. I live in Montana and walk regularly during the summer months, but during winter it is more difficult. I have an exercise bike and can change the resistance level when biking. Is this the same as “weight bearing” exercise?

K.L.

Answer: Before I even consider it, I’d want to know if you have had a bone density test, often called a DEXA. Plane X-rays are not reliable indicators of osteopenia or osteoporosis.

The best type of exercise is a matter of debate, but a review looking at multiple studies found that for people with osteoporosis in the long bones (like your femur), strength training is highly effective. You can do strength training by raising the resistance on your exercise bike.

You don’t need specialized equipment to do weight-bearing exercise. Jumping rope, callisthenictype exercises and dancing are all choices that require little more than floor space.

Dear Dr. Roach: I have had numerous discussions with people about prescription dosage instructions and wonder if you could clarify. If a medication says “three times daily,” to me that means every eight hours. If it’s “four times daily” I take it every six hours, etc. Other people tell me I am WAY too precise, that it means “morning, noon, night” or even “breakfast, lunch, dinner.”

I think it would be better to keep an even amount in one’s system throughout a 24-hour period, so I just set a timer so as not to miss. Any comments?

L.L.

Answer: On prescriptions, “three times daily” means something different from “every eight hours.” A medicine written three times daily has enough leeway in its dosing regimen that it may be taken morning/ noon/night at the patient’s convenience.

A medicine that needs exact timing would be written every eight hours, sometimes with exact instructions, such as 7 a.m. / 3 p.m. / 11 p.m.