WEEK 5: Numerous Needles

Lena T -

Hello~ Welcome back to Week 5!!

Where should I even begin?

Let’s start off with FLEXCARE! I went into Flexcare on Tuesday morning, and it was an amazing shadowing experience. I would like to shout out to the nurses at the Flexcare Infusion Center for letting me tip-toe every two steps behind them and hover over their shoulders.

There are three main Osteoporosis/ Osteopenia treatments at this facility:

  • Evenity
  • Prolia
  • IV infusion (aka Zoledronic Acid)



Iv bro

Evenity and Prolia are injections and patients have the option to choose where to be poked. The three main locations are the belly, the thigh, or the back of the arm. As for IV infusions, the patients got to choose which hand to be flushed out with the IV. Evenity helps Osteoporosis patients to build new bone and they would need to come back once a month for two injections which is 210mg, and one injection per side. For example, if you chose the belly one injection would go on the left and the other would go on the right. For Prolia, it is a bone density stabilizing treatment, which is 60mg and it helps patients maintain that bone density level. Without Prolia, the bone density in an Osteoporosis patient would continuously decline but Prolia helps them stay at that constant level without dropping. Patients typically come back once every 6 months for Prolia and will be on it for the rest of their lives. For Zoledronic Acid, it is an older drug, and it has shown relatively good results for Osteoporosis patients. They would need it once a year and it is important to drink at least two bottles of water two hours before this treatment due to its harsh make-up of the drug on the kidneys.

I would definitely need to research more into Zoledronic Acid because I didn’t know it was an IV infusion and it was my first time being introduced to it at the facility. Ideally, a female patient would start off with Evenity to build their bone from its drastic state and then get on Prolia for the rest of their lives to maintain their new bone density. Skipping Prolia can be detrimental as it brings the risk of fractures again. Treatment for males is a little more different… they do not use Evenity instead they use JUST Prolia. How can gender create a difference in treatment plans? Another observation I made was that after two Prolia injections, the patient must get blood work done to see their Calcium results. Sometimes, Prolia can absolutely tank a patient’s Calcium level. I wonder how Prolia can work against Calcium. Referencing off my recent research from Hole’s Anatomy and Physiology, how does Evenity manipulate Osteoclasts and Osteoblasts activity by building new bone? Another scenario popped into my head while being at the facility, I wonder how these treatments can affect pregnant women. From the beginning, I assumed that women after menopause could only get Osteoporosis, I overlooked the fact that some can get the condition before going through menopause.

Evenity and Prolia injections took about 5-8 minutes for the patient to receive the shot and be out of the door. IV infusion took about 30-45 minutes using a pump which the provider can manipulate the speed of. I was provided with a general medication guide that are usually given to the patients to learn more about the medications and the risks it comes with, and I noticed that all three of the treatments share multiple common side effects like:

  • Hypocalcemia (low calcium levels)
  • Kidney issues
  • Jaw problems
  • Unusual thigh bone fractures
  • Bone, joint, or muscle pain
  • Headaches
  • Fevers
  • Infections
  • Allergic reactions (hives, redness, rash, blisters)

Aside from my shadowing learning spree, I got an additional 15 surveys this week so big whoop-whoop!! Getting participants for my surveys is definitely my biggest challenge but I can manage. I will update you guys after I have done more research into recent progressions in treatments for the ‘silent disease’ and share it~

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