Cannot believe my test results- no OP

I'm in a state of shock! Today I had a Dxa bone scan. This was done at the same location, same machine, and I asked the tech to review my last reading Oct/2010 before she did today's scan. Two years ago my classification for my AP Spine T-score was - 3.0, my Dual/Femur T-score was -0.9.

Today I do not have OP, yet I do have Osteopenia, my AP spine T score is -2.2 and my hip T score, left side total is -0.6, and the right side (not as good) is -1.0 total score.

I have a question for dxaguru, does this sound TRUE? I never expected my bones to reflect that huge of a change in two years. I was hoping for a slight change, but this sounds too big. DXAGURA, have you seen changes similar to mine in just a two years span?

I am happy with my report, yet concerned that the tech did something wrong while taking the scan. She told me she is accredited and mentioned the names of her credentials, CMA/RT. She said she has been doing these scans for 25 year. After leaving the office, I noticed that she had my former weight on the results. I currently am 8 lbs more than two years ago. Yet, my height is the same. DXAGURA would that throw off the reading?

If anyone is interested in what I have done since my last scan, I've improved my diet, I try to be aware if I have eaten enough calcium, protein, and dark leafy green veggies. I am not taking any special pills. I do take calcium citrate, and vit. D. I do weight bearing exercises on machines twice a week at a gym. Depending on what machine I am using the weight varies from 20 lbs, or 30 lbs, or 40 lbs. I lift or push these weights between a count of 30 and 45 on each machine. I do daily exercises at home, and I do a Silver Sneaker hour exercise class twice a week at the gym.

I am happy with my results, but I still cannot believe such an improvement in my bones happened so quickly. I've been getting scans once every two years since 1999. Originally, the AP spine was -2.6 and each scan thereafter no improvement and THIRTEEN YEARS OF FOSAMAX. Oh well, maybe now that I've recently gone off Fosamax, maybe it has finally kicked in!

By Bjoliver
Reply 3483111
October 23, 2012 at 7:54 pm
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Wow, that is amazing! Congratulations! I am new to this site and have been struggling with digestive issues and osteoporosis since about 2004-2005. I am 58 years old and just been diagnosed with additional "collapse" of my two compression fractures due to unskillful lifting at the grocery store... I have finally been able to fix the diarrhea with change in diet to mostly vegetarian (i am lactose i tolerant and gluten sensitive, but not celiac - been tested twice) and take calcium citrate and Vitamin D. I started bio identical hormones in 2008 after a long year of injury after trying to compost in my backyard. My skeleton and muscles were not strong enough to handle this kind of work... I also had a hernia which took forever to diagnose... I originally tried taking Actonel for 9 months back In 2004-2005 but my digestive issues forced me to stop and I felt terrible while taking it... My T scores were -3.8 at the
Lumbar spine L2-3 and -3.2 Bilateral hips at the femoral neck,left. They tried putting me on Forteo in 2008 after finally diagnosing my T7 compression fracture (6 months after it happened). Forteo caused my blood calcium to skyrocket and made me extremely nauseous... So I quit that after 6 months. My body is very sensitive to medicine. They wanted me to try the Infusions of Reclast or Boniva but I decided to try bio identical hormones and exercise. They also discovered I had rheumatoid arthritis in my hands/wrists and tried to put me on medication which made my ears ring so much I though i was going crazy!

But the biggest problem is that I am extremely deconditioned due to an earlier back problem - herniated L5 In 1998 and the doctors/PT's scared me so much that I stopped lifting (including my 1year old daughter) and bending... FEAR has been a huge factor in my health decline. I have been trying to walk, lift very small weights (2-3 lbs) and do stretching exercises daily, but this is obviously not enough... I also have a history of anorexia as a teen/young adult. I don't know if I will ever be able to lift the amount of weight that you are lifting - I wonder how old you are? I know I need to put on some weight (I am 5'3" and weigh 105 lbs) and do more weight bearing exercise, but I am afraid of hurting myself... I got a little complacent this past year because I seemed to be doing so well. They just did a bone density test and it hasn't changed from 2 years ago (not done on the same machine or same place- is this important? Should I have it done again at the same place?). My L2-4 lumbar spine is -3.8 and my left femoral hip is -3.6. That was improved from -4.2 and -3.8 in 2008. I was at The BMD density in grams is the same as two years ago... I am looking for any feedback on how to proceed and mostly hope that I can begin to turn this around, so this is great news to read FrailGail, even though you are in much better shape than me...

By windblown
Reply 3483123
October 23, 2012 at 8:00 pm
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Fantastic news StrongGail! I'd wait for dxa to jump in but I had similar improvements in one year on Forteo, so it does happen. Others at my docs office had the same response to Forteo as well. I realize you stopped Fosamax, but I'm not sure how that factors in.

Hope this is a correct reading, and if so, it's stupendous news!

By windblown
Reply 3483162
October 23, 2012 at 8:14 pm
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@ Bjoliver I'm sorry to hear about all your problems and fraxs. Are you taking any corticosteriods for the arthritis? These drugs, taken long-term (over 3 months @ 5 mg) can cause bone loss, but I understand you may need them for your other medical issues.

Sorry the Forteo didn't help and that you had a bad reaction to it, because that's what really helped me. I had 6 spinal fraxs with a -3.6 T-score and improved initially to -1.6 then -1.9 now I'm at -2.3 four years post Forteo.

You can improve your scores and you need to give yourself a break and not worry too much about it. I understand the problems you mention about lifting, so maybe you can find a good Physical Therapist that can help you out in body mechanics and lifting/exercise.

Don't panic and don't give up. It may be an uphill climb, but you'll make it just stay motivated and don't be to hard on yourself, you're doing what you can and probably need some help from a very good PT.

Best of luck to you!

By newgirlmom
Reply 3483253
October 23, 2012 at 8:43 pm
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Bjoliver, I feel your pain (no pun intended, lol) I am 53, 5ft and weigh 110-116. I try to keep my weight up but I am petite and have a good diet but just don't eat that much. I have a -5( you heard right) in spine and am also hesitant to do weights and some other exercises the PT wanted me to do. I do walk almost everyday on my treadmill and I am praying that I will be as blessed as Frailgail. I have not taken any op meds yet but will once I decide on a plan. My docs (internal med, Endo, spine doc and ortho)never had this many docs but I know they are trying to help. My ortho doc actually broke his T10 (the same one I broke in my car wreck). Because It has been a year now and I still have some back pain he was telling me his pain lasted about 18 months (he broke his riding a horse). I want to incorporate weights into my exercise and hope to do so slowly and carefully. I believe we all are different and need to be comfortable with what we put in our bodies and what we do with our bodies. It sounds like you have a great support system and that in itself is a blessing. Good and luck and God bless and let's all continue to encourage each other on this journey.

By Bjoliver
Reply 3483862
October 24, 2012 at 1:30 am
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Thank you windblown and newgirlmom for your comments and support! Wish I had found this site a long time ago... I also eat very healthy - but I have to remember to eat more...maybe I should be eating for two like a pregnant woman! I do not take any corticosteroids or any medications for my arthritis (my husband had a serious reaction to prednisone). instead I have been doing hand and finger exercises daily which has helped tremendously. One of the biggest problems I've found with osteoporosis is the lack of "up-to-date" knowledge by medical professionals. Newgirlmom it sounds like you are working with an internist, endocrinologist, and orthopedic doctors? I have been working with my OB/GYN because she seems the most knowledgeable about bone health... Maybe I should also talk to an endocrinologist? I read Susan Brown's book about 2 years ago and just ordered Your Bones by Laura Pizzorno so I can learn as much as possible before talking to the doctors. One thing I have noticed in the past year since changing my diet and eating lentils is that my fingernails are much healthier and stronger - I thought for sure my bones would be healthier too... Newgirlmom, I started working out with beanbags at first and very gradually worked up to one pound, then two pound weights and had just graduated to three pound weights when I got these new/old fractures. It has taken me over a year and a half to two years so maybe that will be helpful for you. I also have to watch out because I had a double hernia. I agree we all have to go at our own pace and listen to our bodies. I don't really want to take the OP medications, but I have to keep all my options open at this point... Thank you again for all the support!

By FrailGail
Reply 3484010
October 24, 2012 at 5:45 am
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Bjoliver, welcome to this site and all the support and good ideas you will get here. You may consider seeing an endocrinologist. I think that is a good idea. Regarding your comments, you appear to be fighting several issues with your health at one time. My heart goes out to you because while you may "fix" one issue, it might not be good for another health concern.

If you can decide which health issue you want to get under control first, perhaps some of the other health issues may lessen. Yet, I don't know which issue is the one you need to address first.

Something you may want to consider in the future, would be to ask your doctor for a referral to see a physical therapist. Whether you go for OP, or maybe some other issue first, perhaps that might become a turnaround point and you will begin to feel better. You may have PT coverage under your insurance plan . Call them, check out how many PT visits you can have.

Best of Luck to you.

By SusieHathaway
Reply 3484223 · In reply to 3483111 by Bjoliver
October 24, 2012 at 7:59 am
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Hi Bjoliver,
Windblown had excellent advice about seeing a good physical therapist(PT) who is experienced with osteoporosis. Make a few phone calls to make sure that you get the right PT.
With exercise, start small and work your way up with strength training and cardiovascular exercise. Walking with good posture is a wonderful place to start with the cardio.
In my strength training classes, I encourage everyone to act as if they have blinders on the sides of their eyes so they don't compare themselves with others. Get the PT to give you a good strengthening program. The amount of weight that FrailGail is using is for machines and it doesn't translate directly to free weights, which will be much lighter. The NOF has guidelines of lifting no more than five pounds in each hand if you have osteoporosis and recommends that you ask your doctor about weight limitations for your particular situation.
Best of luck in getting good guidance to move safely! http://www.nof.org/live/moving-safely
Susie

By dxaguru
Reply 3485908
October 24, 2012 at 5:01 pm
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Comment on results as stated: "Two years ago my classification for my AP Spine T-score was - 3.0, my Dual/Femur T-score was -0.9. Today I do not have OP, yet I do have Osteopenia, my AP spine T score is -2.2 and my hip T score, left side total is -0.6, and the right side (not as good) is -1.0 total score."

As a rule, I do not like to compare T-scores. Even if on the same machine, a change in the normative databases than can happed during a software upgrade can change them even if the bone density results in grams per square centimeter hadn't changed. Percentage changes can also be misleading, because an increase of 0.1 g/cm2 is a 10% increase if you have normal bone density, but represents a 20% increase if you have low bone density. IOW, if your bone density is low, seemingly large percentage increases may not statistically significant and well within the error of the measurement.

So, with the T-score caveat in mind, in regards to the hip results, the first report was for "dual-femur" of T = -0.9. Your second scan gave them separately, but the average is -0.8 +/- about 0.1 because they round the real T-score to the nearest tenth of a unit. So I would have to conclude that there was no change at all in your hip results.

To go from -3 to -2.2, on a Ge-Lunar scanner from L1-L4, using a US manufacturer specific normative database, is a BMD change of approximately going from 0.820 to 0.916, (again due to the rounding of T-scores that make them less accurate). This would represent a BMD increase of about 11-12%. Before accepting this rather robust increase, as a technologist I would be skeptical, and first examine the actual spine images to insure the same four vertebral bodies were analyzed. Often in people with six lumbar, different sets of four could be accidentally compared to each other and account for the results. I would then look at the four individual vertebral level bone density and area values. The areas of each vertebral body should have not changed much at all, and the increase in BMD at each level should all be around the same 10-12% range. If three of them didn't change and one went up 30%, that would be some sort of artifact, perhaps a compression fracture or other technical error like a button or zipper that was not removed, etc. A calcified aorta can increase BMD but it would not progress fast enough in two years to account for that.

In general, changing the weight input in the scanner biographical information will not affect the scan results. But, a real change in your weight could. A large increase in weight (from fat) could increase the measurement of BMD as an artifact.

By dxaguru
Reply 3485914
October 24, 2012 at 5:03 pm
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CAMRT is the Canadian version of the American Registry of Radiologic Technologists or ARRT. Is is a general x-ray certification, and not necessarily a specialty certification in bone densiometry. The ARRT version allows the tech to add (BD) to the end of their credentials. I am not sure what the CAMRT designation is, if they even have one.

By hueso1200
Reply 3486628
October 24, 2012 at 10:01 pm
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FrailGail.....Be very careful about lifting that much weight. From everything I have heard/read, that's too much weight and not necessary for resistance training. But it's true that the machine weight is different from the free weights and bands----not the same. I guess you should check with a a PT schooled in working with OPers. Free weights done correctly and therabands are better for people with OP.

By FrailGail
Reply 3487126 · In reply to 3486628 by hueso1200
October 25, 2012 at 4:48 am
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Thanks hueso1200 for the info. I did see a PT 18 months ago. He is the one that put me on an exercise program with the weight size I mentioned. Yet, last year I wasn't on this site and now I am being to question lots of issues. I am going to follow up with my insurance company to see about another PT in the area (my doc suggested the current PT). I'm in a small town. It is hard to find a doctor, or a PT with a wellrounded knowledge of OP. Heck, there isn't even a woman OB-GYN within 40 miles of where I live. I know, I checked with the insurance company.

By 2lessparathyroids
Reply 3489190
October 25, 2012 at 5:41 pm
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Bjoliver. Have you been tested for hyperparathyroidism? Doctor should do blood work to see what your serum calcium and Parathyroid hormone are. If serum calcium is in the 10s you could have hyperparathyroidism. This disease causes osteoporosis.

By hueso1200
Reply 3491795 · In reply to 3487126 by FrailGail
October 26, 2012 at 2:37 pm
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FrailGail. If there is a really good PT or someone trained/educated to do exercise with OP patients, it might worth your while to travel an hour--one time and take a video of exactly what she suggests you do....and then try to do it correctly on your own. It would have to be someone nice and generous who would not mind your taking video (with your camera) while she is talking. If that is possible, I would suggest it---since you live far away from good options.
I would think very seriously about using resistance bands (rubber in different colors)--look on amazon under exercise bands or similar phrase.
We use those and 2 to 4 pound weights in our OP exercise class here in NYC with an absolutely phenomenal teacher specially trained in this--She is 65 years old and has been doing it for a long time. MAKES SENSE TO ME.

ALSO...Re: VITAMIN SUPPLEMENTS VS FOOD---.TO everyone on the site: Read the 4th paragraph of this article on why Ikarians live so long. (Paragraph starts with "Genetics." ---echos my feelings about food vs supplements
http://www.motherjones.com/tom-philpott/2012/10/ikarian-greek-island-diet-h ealth-benefit

By FrailGail
Reply 3492044
October 26, 2012 at 4:25 pm
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Thanks Hueso1200 for your information and concern. I'll be seeing my PCP next week. I'll ask about the weight size. I do use the bands for leg and arm exercises in the SilverSneaker classes I attend. I use 3 lb. free weights for exercising in those classes. The PT guy from last year (and also on WOR radio 710 (NY) Dr. R. Hoffman) commented on using higher weights to help build bones. Yet, I've decided to examine each weight bearing exercise I do. I'll cutback on the weight size till I get some answers.

Thanks again for writing and stay safe to those on the northeast coastline who might be getting some nasty weather over the next few days.

By Sandi-sdivas
Reply 3492138 · In reply to 3491795 by hueso1200
October 26, 2012 at 5:06 pm
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hueso
Taking a video of the exercise and instruction is a very good idea for a private class. If there are other class members, the instructor may have to ask permission.
Thanks
Sandi

By windblown
Reply 3492203 · In reply to 3491795 by hueso1200
October 26, 2012 at 5:36 pm
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To all...you can look up Physical Therapists at their web site at: http://www.apta.org/ You may also want to contact Sara Meek's to see if she's trained anyone in your area. She was one of the brilliant contributors here at Inspire a while ago @ http://www.sarameekspt.com/products.asp She has osteopenia (I believe) maybe OP and trains PTs in the Meek's method. Author of Walking Tall, and other books on this topic. She's an excellent resource and I wish she still posted here, like some of the other professionals in Yoga, Pilates and Physical Therapy. If Mother Goose (Lucy Buckley) is still a member here, you could pm her for some ideas, she was listed as Mother Goose. She's a great PT and also used to post here. Check the member listing and look for her name.

By Bjoliver
Reply 3492764
October 26, 2012 at 10:16 pm
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To 2lesspararthyroids, I think I was tested for serum calcium and PTH about 4 years ago, but I will have my doctor check again... I am compiling a list of things to discuss and ask for when I meet with the doctor -either endocrinologist (I'm starting the search) or my internist. I was having so many problems 4 years ago with elevated serum calcium from taking Forteo, particularly nausea, that I had to stop the Forteo... That is when I decided to try bio identical estrogen and progesterone -both very low dose because of my sensitivity to drugs in general... I can't even tolerate pain relievers, except for Tylenol, which is why I don't want any more fractures!

As for physical therapy, I have been doing some PT but I only get so many visits with my insurance and a lot of PT's use FEAR instead of encouragement, which I don' t need more of right now... There is a good PT about 45 minutes away (but a winding road through the mountains) here in the Bay Area (CA) that is also a Pilates instructor and wrote a book called 'The Osteoporosis Exercise Book' which you can find at Amazon or her website: www.TheraPilates.com if anyone is interested. It is very basic exercise and very "safe" for someone just starting out. I think she also had videos for sale that I haven't tried yet. Just purchased her book last fall after she gave a talk at my local library which was "packed" (I realized how many other people are searching for answers too).

By alwaysgrateful
Reply 3493194 · In reply to 3483111 by Bjoliver
October 27, 2012 at 6:01 am
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Bjoliver,

I was intrigued by what you said "I also had a hernia which took forever to diagnose... "

May I ask how you were diagnosed and what the outcome was?

I am asking because I have had inguinal pain for almost three years (usually low level but at times intense). I read an article in the New York Times about hernias in women and thought I might have one. The symptoms came about a couple of months after I sold my mom's house, which involved an extended period of lifting and hauling to empty it out. I weigh only about 90 pounds and am really out of shape so it is very likely I could have strained myself.

I had a colonoscopy and a pelvic sonogram which showed nothing. I have talked to so many doctors about this, and once they hear I have had these two tests, they basically lose interest. The feeling is that if it didn't show up on the tests, then it is nothing. My primary care physician said there would be a bulge, but my understanding from the article is that this may not be the case with women.

I did see a back doctor who thought the inguinal pain might be related to muscle and nerve issues in my spine which I am going to have physical therapy for in March once I am on Medicare which will cover the sessions (my current insurance covers PT only post-hospital or post-surgery).

I also mentioned this issue to the technician X-raying my kidneys, and she said a CT scan of the inguinal canal would be indicated. But when I subsequently mentioned this to a doctor, he was not interested. I have had a lot of tests this year and am not looking to increase my radiation exposure unless absolutely necessary, so I did not persist.

Anyway, I am all ears about your hernia experience.

Thanks,
Uma

By alwaysgrateful
Reply 3493198 · In reply to 3491795 by hueso1200
October 27, 2012 at 6:05 am
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hueso1200,

Regarding "We use those and 2 to 4 pound weights in our OP exercise class here in NYC with an absolutely phenomenal teacher specially trained in this--She is 65 years old and has been doing it for a long time."

May I ask where this class is and how much does it cost? Is there a website?

I live in Mount Vernon (just north of the Bronx) which is about 20 minutes from 125th Street and 30 minutes from Grand Central. I am in Manhattan every week because all my doctors are there (as well as for other reasons).

Thanks,
Uma

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