Why is everyone so fascinated about DEXA scans? It tells us nothing about fracturability improvement. Airplane wings have major structural pieces with big holes to reduce weight. Is there an advantage to denser bones as regards fracturabilty? Bone quality is what is wanted isn't it? DEXA doesn't tell us that. Our efforts are misplaced. What we want to know is not yet measureable.
DEXA compares your BMD to a select peer group of the same age group and gives you a T score as to where your BMD is on a bell shaped curve. Nothing about fracturabilty or quality of your bone.
Perhaps BMD is somehow in some cases related to bone quality but at this point we would have to break bones to get the relatiohship and it might be hard to get enough volunteers. DEXA after DEXA is meaningless. Woody at SequoiaHealth doesn't use DEXA as a gauge near asi I can tell. Research based on DEXA needs to be suspect as well.
Sandi: I hope I can still be your friend and not just a "friend". You have my greatest respect and admiration for your dedication to this cause. We see things in different ways. I agree DEXA's are a "flashing yellow" and an awakening but not really good tool for fracturability assessment. Yes it is all we have at this time.
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DEXA SCAN FASCINATION
- By Eamenard
- Posted October 29, 2009 at 12:56 pm · 3 replies
- In Diagnosing osteoporosis
- Shared with the public
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- By sdivas
- Posted October 30, 2009 at 1:02 pm
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Hello Eamenard, when I read all of the posts, I do so with an open and objective mind. Within discussion groups, there will be different viewpoints. We don't have to agree. But I'm not sure, we are so far apart in our views. Please correct me if I'm wrong (smile), but are you against the Dexa itself, or what the Dexa represents with scores; which in turn result in more prescriptions for the drugs currently offered for bone loss. I may have shared my experience in another post or perhaps privately with you. As part of a physical, I requested a dexa. My friend had me proof a paper written on hrt which included osteoporosis. Otherwise, I knew nothing about bone loss. My doctor, at the time, felt I was young and shouldn't concern myself about bone loss, but I persisted and was given the dexa. Surprise! Osteoporosis in the -3 range for both hips and spine. Maybe not such a surprise if we look at my previous lifestyle: other than normal daily walking, no exercise. No calcium, no vitamin D. Beverage choice, diet cola. Nutrition: Fair. Stress: Lived on it - moved fast, talked fast. Having the dexa, becoming aware of my bone loss directed me slowly over time towards a healthier lifestyle. Gone is the brown drinking water. I take vitamins, calcium, vitamin D. Yoga became my calm, as well as meditation and correct breathing. For a few years, I bounced around several gyms; not really happy until I found Pilates Reformer. I've always enjoyed dancing and finally found an adult ballet class of "mature" men/women that were only taking the class for personal enjoyment. I also enjoy free style dancing. With nutrition books spread in front of me, I put into place a new plan which focused on nuts, grains, fish, vegetables, fruits. Sugar was minimized; now very rare for me; although I will not say no if a piece of dark chocolate is around. I was 50 at the time of my dexa; now 62. Without the dexa and knowledge about my bones, I probably would have continued on the same path. Now, I'm healthy, stronger, calmer for overall health as fortunately other than bone loss, I don't have any other health concerns. Maybe I saved myself in time, which I credit the Dexa. I wasn't pressured or given a prescription with my diagnosis. It was suggested that I exercise and take calcium. Not much help for a person that didn't have any idea about bone loss! But on my own, without support groups, and not aware at the time of NOF, I became my own advocate. Yes, after a year, I did chose a med, but I made the decision. My med of choice was not the first choice of my health provider, but my doctor at the time, spent an hour on the phone in order that my choice would be covered. Either way, meds or not, none of us can be sure. There are the scientists point of view, clinician point of view. When I've attended NOF meetings with clinicians that are working specifically in the field of bone loss, I haven't walked away with an "Aha!" moment. If we chose to read a book, report, ect, we may align ourselves with the opinions expressed by the author, speaker; etc. But I have many, many out of the box questions that have not yet been answered by any author, guest speaker, clinical trial. Personally, I think because of most of our nutrition and the environment, a baseline dexa should be given at the peak bone ages; for women again at menopause, with a repeat 5 yrs after menopause. Men could have a similar guideline for age. Not for more prescriptions or for inciting fear; which I am soooo against!!!, but for education and knowledge. Maybe additional bone loss would be prevented. Is the problem the prescriptions that are so often quickly given or are we scared, concerned about being assertive and don't question. Maybe my scores are my "normal". If so, and there isn't any additonal bone loss, medication may not be the answer. Maybe, your feelings about dexa's are misplaced, and what you feel are the results of the dexa and/or what dexa represents. Also, on a personal note, because I have chosen one med does not mean that I would agree on any of the other meds. I think we need boundaries for ourselves; which may depend on where we are with our bone loss. I imagine if we fracture, we may have a different mindset. Overall, I'm not in favor of blanket statements. I respect all opinions and all choices as the end result is that we must take responsiblity for our own health and do what we feel is the best in order to have a good quality of daily life. I consider you and all of the community members my "strong bone friends". We're all in this together! Sandi
- By Eamenard
- Posted November 16, 2009 at 7:48 pm
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Dear Sandi
Sorry for the late reply. My thinking about DEXA is influenced greatly by Gillian Sanson's book "The Myth of Osteoporosis". She very throughly researched many things and (in my opinion) it should be required reading for all doctors treating "osteoporosis" and all patients they diagnose. I have reread it again and it is about the most researched book about Osteo that makes sense to me .
Perhaps you might reread it and see if you agree.
Thanks Sandi for your continued support
Ed
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