Diagnosis Osteoporosis

by
Virginia Ramage Smith

Osteoporosis - the last thing I expected, but recently I have become personally and sorrowfully aware of its true meaning.

Also known as brittle bone disease, osteoporosis is a degeneration of bone density. As the disease progresses, bones become soft and spongy, easily broken and bruised.

Although doctors have been aware of osteoporosis for years, until recently little was done to treat the condition, doctors considering it a disease that develops naturally as people age. In 1962, Dr. M. L. Ricotelli wrote in The Journal of American Geriatric Society, "Osteoporosis is such a common condition that comparatively little attention is paid to it."

Fortunately, serious attention is now given to this condition. Dr. Kenneth Cooper calls it a silent enemy to health, difficult to detect before great damage has been done. While the disease is commonly believed to be incurable, changes in diet, vitamin supplements and regular bone-strengthening exercise can do much to prevent further deterioration.

Who Is At Risk?

Not everyone is equally prone to develop osteoporosis. Those most likely to become victims are white, elderly, thin and female. Because men have more bone mass, they are less likely to lose bone mass quickly. Dark-skinned people appear to have some built-in protection. Young people are unlikely to develop the disease unless they are severely calcium deprived. However, children can suffer bone damage from lack of calcium in their diet; their disease is called rickets.

Bones are strongest in people from the ages of 25 to 40. After the age of 40, cell reproduction ceases to overcome cell depletion, and bone deterioration begins. It is very likely to occur in women after menopause, especially in those who experience early menopause. After the age of 60, 40% of women have some degree of loss of bone density after 75, perhaps 60% have osteoporosis, and after 85, it will be seen to a degree in everyone.

Common Symptoms

Although osteoporosis can progress painlessly, there are some physical characteristics that signal problems. Sufferers may begin to lose height noticeably, even as much as six to eight inches. Compression of the discs in the upper spine may cause the creation of a hump in the back, familiarly referred as the dowager hump.

When my sister-in-law began to lose height, she also developed the dowager hump. Another dear friend also became very misshapened, bent over by bone loss.

Several years ago Southwestern Medical Center invited individuals to participate in a study concerning prevention and cure of osteoporosis. My friend underwent testing to determine her suitability for this study, but her disease had progressed too far for her to be accepted. Her condition has worsened so much that most normal activity is impossible for her.

Last fall my gynecologist insisted I take a bone density test. I was not looking forward to the test since I knew from experience that they could be time consuming, and even unpleasant. The DEXA test was a pleasant surprise. It was convenient because the mobile unit came to our hospital and parked right at the back door. It was unnecessary to undress, and the entire non-invasive process was complete in 10 minutes.

Results in hand, my doctor announced that my hips are very spongy and my lower spine is somewhat involved. The fact that I am unaware of anyone in my family with the problem is the only thing I have going for me, he says, because I have the classic precursors of the disease: I am white, thin, old and female.

Protecting Yourself from
Osteoporosis or Lessening Its Effects

Maybe You Can't be Too Rich, but You Can be Too Thin

Experts believe that a layer of fat on the body has a protective usefulness for osteoporosis, a distinctly new idea for me.

To help me gain weight, my doctor has recommended exercise, calcium and estrogen therapy.

Ingest Adequate Levels of Calcium

In the past 20 years or so, many of us have become afraid of dairy products because of the high content of animal fat. Excluding them from our diet lowered the supply of calcium often to a dangerous level. We need between 1000 and 1200 mgs of calcium daily, according many specialists, to offset bone loss. Eight ounces of yogurt and 8 ounces of non-fat milk will supply up to one half of that amount. Vegetables like kale, cabbage, spinach, broccoli and turnip greens are also excellent sources of calcium, and some contain small amounts of valuable magnesium.

Vitamin D is required for Calcium Absorption

To be sure to have what I need, I take a supplement of 1000 mg of calcium and vitamin D daily. Since my husband, Fred, is an Alzheimer's suffered, we spend much of the day indoors; in order to get more vitamin D, I now make time to be outdoors more. While I am now aware that we need some sunshine, I am careful to protect Fred's head and face; several years ago he had a melanoma removed from his nose. Otherwise we enjoy the pleasures of the outdoors within reason. Dr. Robert P. Heaney says that sunscreens block the helpful rays of the sun that help our bodies create vitamin D, while a modest amount of sun will not cause cancer.

Estrogen Therapy

Estrogen therapy must be a decision made for each woman individually by her physician. He will want to know if menopause occurred at an early age. Does the addition of estrogen cause painful breasts, or present other difficulties? He will also consider the strength of the dosage. This is not a decision to be made by the patient alone.

Weight-bearing Exercise

Exercise improves the condition of the entire body; specific types of exercise are particularly beneficial for bone structure. Any weight-bearing exercise (such as walking, jogging, weight lifting, and aerobic dancing) done with regularity will help maintain strong bones.

Walking is likely the most popular of these exercises. It requires no special equipment and can be done at any time of day. If you are just beginning such activity, Dr. Cooper suggests starting slowly, one mile in 24 minutes. Increasing a small amount each week, he recommends 2.5 miles in 45 minutes.

My husband and I walk every good weather day in our local city park where there are convenient paths for walkers and joggers and often something interesting to watch. Jogging is not recommended for people who have been sedentary. However, if you have maintained exercise over time, it is an excellent weight-bearing exercise.

Weight lifting offers the extra benefit of building strength. You can minimize any dangers connected to lifting weights if you are careful to begin slowly with some instruction. Beginning weight lifters require no special equipment in the beginning; a pound bag of beans will serve as an excellent weight. Be sure the bag is tightly closed; a cotton material for the bag is a good choice as it will not slip in the hand.

I have been exercising with weights since my diagnosis and have progressed to 5-pound weights. One advantage of using heavier weights is that desired gains come much faster. With regular practice, adding more weight slowly is easy and safe. A very real benefit that accrues to weight lifting is that building strength in bone and muscle is protection against injury in case of falls or bumps. A further advantage is that it can be done sitting.

Exercise to Improve Balance

Exercises that improve balance are important to avoid falling and breaking a hip or other bones. Tai chi and yoga, both of which also improve mental concentration, are great for improving balance. Instruction in these exercises is valuable because they require a different approach to the use of our muscles. Finding a compatible group for learning and improving your ability in these exercises can be a wonderful an incentive to continue.

Guard Against Injury

For those of us who need to guard against injuries due to osteoporosis, Dr. Cooper offers some guidelines that may be of benefit as well as providing comfort.

When sitting:

• Use foot rests to avoid strain on the back;
• Use a back support to avoid slumping;
• Hold the telephone in your hand, not resting on your shoulder; and,
• Avoid remaining in the same position for long periods of time. Get up and move around at least every hour.

When standing:

• Use a support when possible; lean against a table or a wall to steady yourself;

  • Change positions frequently.
  • Stand on a mat or cushion when the flooring is hard; and
  • Wear cushioned shoes.

When lifting:

• Keep your load directly in front of you;
• Get down on the level of the object you are lifting;
• Use your legs, not you back.
• If an object is too heavy for you - don't lift it!
• When turning, turn your entire body, don't twist. The body is not made to twist.

There is a general agreement among specialists that progression of existing osteoporosis can be slowed or even halted by following adhering to their advice about exercise, diet, supplements and a positive attitude. It might even add bone density used early enough.

It's really worth the effort.

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