Gym Rat

Okay, I'm not a gym rat yet, but I plan to join a gym. Believe it or not, this doesn't have a lot to do with vanity or not being able to find jeans that fit. It is about health. My bones' health, specifically.

Nine and a half years ago I was diagnosed with thyroid cancer. It was really no big deal. I had surgery to remove my thyroid and radiation to kill any lingering thyroid or cancer cells. Since then I have been on a fairly high dose of thyroid replacement hormone. The idea is to suppress the production of TSH which can fuel any cancer cells that escaped radiation. The problem with long-term suppression of TSH is that it can lead to accelerated bone loss and osteoporosis. The problem with not doing long-term suppression is that thyroid cancer can be tenacious and come back even after 15 or 20 years. A definite balancing act is in order.

Unfortunately for me, I have risk factors other than thyroid treatment for osteoporosis including my build (small boned and thin*), family history of osteoporosis (my father has a hump now), and European descent. Even nursing can leach needed calcium and lead to bone loss. Because of my risk factors, I've had three bone density scans since my initial thyroid cancer treatment. The first, my baseline, came soon after treatment and showed that I already had comparatively low bone mass for my age. My second bone scan was similar to my first; I still had ostepenia, but it looked like I was holding my own. My third test, done last winter, was dismal. I had lost bone mass in both my hips and my spine. In fact, I had lost over 20 percent of my already low bone spinal bone mass in just four years: I'm closing in on osteoporosis.

At my appointment a few weeks ago, my endocrinologist/ oncologist said that she was alarmed by my results. She wants me to think about using one of the bone building drugs and to increase my calcium intake (my blood calcium is always a bit low which is common for thyroid cancer patients, particularly if the parathyroid glands were traumatized during surgery, which mine were). She also backed off my thyroid replacement dose a bit with the stipulation that if my labs change (protein cancer markers), then they will have to be amped up again.

I'm not wild about the bone building drugs. I've pored over the research, and it seems that this class of drugs is not the best idea for premenopausal women. Instead, I want to make a concerted effort to increase my calcium and vitamin D intake. I also want to get religious about strength training and weight bearing exercise, both of which preserve bone mass. Thus, my desire to join a gym.

I have narrowed my gym search to three facilities, but I'm having a hard time choosing among them.

The first is a family wellness center not far from our home, but about six miles from my office. We were members there for a year, but we let the membership lapse because we weren't using it enough. The center is large, has a pool, and there is a free nursery. There are free weights, two sets of nautilus equipment, plenty of cardio equipment, and a wide range of classes. The problem with this center is that to use it, I will either have to drive to our downtown campus to drop E off and then drive back out to the gym or try to leave her in the gym nursery. She used to flip out about the gym nursery so I'm just not sure if this will work.

The second facility is only a block from my office. It is sleek and new. The cardio equipment is awesome and the weight equipment is easy to use. It is incredibly clean. There is no pool, no childcare, and fitness classes are limited, but that doesn't concern me too much because of the convenience. With it so close to my office, it would be easy for me to work out several mornings a week. The biggest negative (and possible deal breaker) is the shower in the facility. I signed up for three free visits over the summer and was horrified at the shower situation. There was no water pressure and the water temperature was unpredictable--lukewarm one day and scalding hot the next. Those were the worst showers I have ever taken. I told the staff about them, but an acquaintance told me that nothing has been done. I'm not sure that I can join a gym where I can't get a decent shower.

The last gym is a few blocks from my office. There is no childcare and no pool, but there are yoga and pilates classes. The facility has a ton of cardio equipment as well as free weights and nautilus. The showers appear to be functioning well. However, there are several problems with this facility. First, it is the most expensive of the three. Second, the cardio equipment is situated along a window that overlooks a busy sidewalk and street--to exercise there is to be on display. Third, it doesn't seem like they are fastidious about making sure the machines are wiped clean and disinfected. Given the surge in nasty superbugs, I prefer a clean gym. Finally, this gym is very popular with the student set and I'm not sure that I could work out there without feeling self conscious and old.

So I'm stuck. I just can't make up my mind. Will I really use the family center if I have to take E downtown to campus and then drive all the way back? Will I use the beautiful center a block from my office and just deal with the trickle of water and unpredictable water temperatures? Or will I take stock in purell, get over my self-consciousness and join the gym where there a lot of student types? What would you do?

*Yes, yes. I have been complaining about my weight, but extra pounds on a small frame make a difference.