I NEED HELP

• By swifty
• Posted September 15, 2008 at 8:31 am
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oh and need to ask, will building muscle help my mum? i have told her to do some very light weights, she walks every day, in pain, but she walks, i told her to join the gym, and do some very light stuff, but she is worried cos of her hips and doesn't think it will help

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• By windblown
• Posted September 15, 2008 at 3:48 pm
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Hi Swifty: If your mom doesn't like taking tablets, fosamax comes in a liquid form, I'm not sure what the mg is on it, but you can look into that. There's also the infused meds-like Reclast-which you get once a year. I don't know how you feel about any of these choices, but they don't require taking a pill.

Can she get to a Physical Therapist for her hip displasia, pain, and some instruction on exercises that are recommended for osteo. Sounds like her diet and supplements are good, so that's covered.

I don't know what critical stage means, unless she has a very low t-score, but the t-score alone isn't the sole predictor of fracture. Has she filled out the FRAX test? That will give her a percentage of the likelihood of fracture for the next 10 years based on medical history, life style etc.

Not all people with osteo get the dowagers hump. That *can* happen after the fracture of the thoracic spine, but not every one has that problem. Has she fractured any bones? My grandmother had the dowagers hump, and I don't, even though I had low t-scores and frax's, but mine were in the lower back not the thoracic part of the spine.

My scores started out low and now they are really good, so anything is possible.

Hopefully physical therapy will provide some pain relief, plus they offer other things like tens units that can be taken home for a period of time. I think those help the pain some. Ask her Dr if they recommend something else for pain.

Good luck to you both...

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• By swifty
• Posted September 18, 2008 at 4:23 am
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ok her scores are very low i know they are not good, she has had no fractures as yet, it would be good if she broke a finger or something, then the gvt pays for some of it, for some stupid reason here they won't pay for anything unless you break bones, how dumb..

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• By windblown
• Posted September 18, 2008 at 4:09 pm
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Hi Swifty: She has to break a bone before for the insurance/gov will pay for it??? That's terrible... So how are you suppose to get preventative care for osteoporosis?? So sorry that's the situation. I agree, that is really dumb!! Wish I had a solution.

I would look into the cost of an appointment anyway and see if there is some way to make payments. She could look into the cost of a consult, maybe it wouldn't cost that much. I know that the PT's were I live will see a patient and do an evaluation and then send the patient home with detailed instructions on how to do the exercises etc at home. So that may only be 1-3 visits with the PT and then the patient follows through at home with some exercise aids, like therabands, or light weights and a exercise routine printed out with pictures to follow. I'm just guessing here on how many visits it would take to set up an exercise routine, but I know that it can be done that way. If your mom needs treated for her hip, wouldn't your insurance/gov pay for that since it's an existing condition that needs therapy? If they would pay for that, couldn't the therapist then work in an osteo routine at the same time that could be done at their office to start with, to monitor technique, and then could be done at home? Of course the type of exercise would be *entirely* up to the physio therapist depending on her medical condition etc. They may not even suggest weights, I just used that as an example.

Just some thoughts... I hope you find a solution to all of this. Keep up the good work for your mom- your a nice guy!!

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• By MotherGoose
• Posted September 19, 2008 at 11:40 am
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Medicare rquires "medical necessity" as its measure of coverage.
As far as physical therapy coverage is concerned, with her hip dysplasia and subsequent pain, she fits the bill --- we PTs would call it "gait disturbance" -- which it is! Moreover, she is apt to fall because of pain, weakness, and resultant impaired balance. Her osteoporosis is a secondary problem, in this case, which still needs to be adressed by the PT as part of restoring her to a safe and reasonable functional level.
I was the owner and administrator of a Medicare-certified out-patient rehab agency for 17 years and am familiar with coverage issues.
Lucy Buckley PT aka Mother Goose

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• By BoneLady
• Posted September 19, 2008 at 12:13 pm
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MotherGoose,

Swifty is Australian. Medicare is American.

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• By sport
• Posted September 19, 2008 at 2:23 pm
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Check PubMed on osteoporosis and whole body viration for a non-drug idea.

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• By MSGSUZANNE24
• Posted September 20, 2008 at 10:14 am
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My opinion only: There is always an element of a person's psychology related to any disease. Your mother seems to be afraid to try a lot of potentially helpful things. There are many forms of meds as "windblown" pointed out, but here are some other ideas. To get physical therapy you need a prescription. Unfortunately, Medicare pays for very few visits. But the first thing is to find a good rehab doctor (a physiatrist). These doctors are trained in rehabilitation and could give you guidance on the specific focus of an excercise program. Try to get one who is compassionate and patient. Second, there are mental health workers (psychologists, etc.) who specialize in rehab psychology. I trained in this field, but did not continue in it. But I know that these therapist can be very useful in getting people over their fears in working on physical maladies. My favorite story is about a very famous attorney who came into the hospital with a stroke. She recovered very well, but refused to go to physical therapy. She told me outright that she had never gotten so much attention in her life and had no thought of making herself more independent! Everyone is different. Good luck. Michele

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• By windblown
• Posted September 20, 2008 at 7:00 pm
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Hi Swifty: I just wanted to clarify something... I mentioned having a physio consult and then possibly continuing therapy/exercise at home; well that is usually done when you have run out of coverage on PT. Normally when you have an injury you would go to a PT and that may entail 6-8 weeks or so of treatment, depending on how your insurance pays for this, the time they would allow for tx could be completely different in your situation. In my case, my insurance will only pay for a certain amount of PT and then when you reach that point they will only pay if it's deemed medically necessary. So if you've reached the limit on your PT coverage an option would be to do the things I mentioned in the above post. Since you are in Australia I don't know how your govt insurance works, but it would still be good to look into what they may be able to provide, to your mom, even though she hasn't had a fracture. If you can get the insurance to pay for treatment at the PT office that would be great, but there's usually the option of doing a consult, like I mentioned and then continuing it at home if that is your *only* option financially with your insurances limitations.

I agree entirely with MSGSuzanne, about the types of Dr's you should see to get a well rounded type of treatment, but since I don't know how your insurance works, I don't know if they will allow this approach.

Keep us posted on what you find out, I'm really interested in finding out what you might be able to get in the way of tx for your mom with the limitations in her insurance.

Good Luck...

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