Question for dexaguru

shiner2
  • By shiner2 · October 15, 2012 at 5:37 pm · 36 replies
  • In Medication side effects
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Hi dg
I've appreciated all your cautions and opinions over the year and a half I've been following this site.
Here's my question: if you we're personally diagnosed with op, (and here you have to really use your imagination) and were a woman,
What would your course of action be? Please give some real consideration to the comments from this site too. Especially from side of effects of traditionally prescribed meds. I'm not interested in snake oil remedies and I believe you aren't either, which caution i really appreciate but I find choice of treatment is a real predicament. Please share.

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36 replies   

dxaguru

Great question, but this may be like asking the proverbial no-win question in court "Did you stop beating your wife, yes or no", (especially with the "imagine you're a woman" part.) But here goes.

First, I would try to put emotions aside and deal with the fact that I have low bone density. Then approach it logically and rationally. I have found the following passage from Rudyard Kipling's "The Elephant Child " most helpful when approaching a problem or explaining it to someone else.

"I keep with me six strong serving men,
(who taught me all I knew)
Their names are What and Why and When
And How and Where and Who.
I send them over land and sea,
I send them east and west;
But after they have worked for me,
I give them all a rest."

So, first I would find out all I could about What osteoporosis is, Why do people get osteoporosis, When do people get Osteoporosis. How is osteoporosis treated. Where do I go from here, and Who should I trust with my medical care.
Then, I would give them all a rest and come to a conclusion of what seems the best course of action, and stick with it unless something clearly better comes along based on evidence, not emotion.

Before making the decision, I would keep in mind the Serenity Prayer:
"God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference"

If, for example, if my osteoporosis today was caused by being an anorexic as a teen, I need to accept that my low bone mass was my own doing, and since I don't own a DeLorean with a 1.21 gigiwatt flux capacitor in the back seat, I cannot go back in time to change that.
If my osteoporosis was due to the lack of estrogen because I am post-menopausal, and I have no strong family history of breast cancer, estrogen replacement would be my first choice. The benefit to risk ratio is quite good, and the safety of HRT, even in the Women's Health Initiative shown it quite effective in reducing hip fracture risk. Breast cancer is not the deadly disease it once was, and I beleive that the best way to reverse a condition is to reverse the conditions that caused it. (Low estrogen)

Just as if I am chronically underweight, maybe I eat a little more and accept a larger dress size as my bargain with the disease. If I cannot get all the nutrients I need because I have imposed a strict vegan diet upon myself, maybe I reconsider that some meat in the diet is OK. After all, I was born with incisors and canine teeth as well as molars.
If my osteoporosis was caused by high doses of steroids for emphysema due to my years of smoking and I cannot go off the prednisone, then drugs like Fosamax that have been approved for the prevention of steroid induced bone loss make more sense than unproven supplements that, even if they did help with bone density, wouldn't be powerful enough to overcome the prednisone anyway and just be another medical expense I didn't need.

I could go on an on with different scenarios, and each member here has a unique set of circumstances that contain both modifiable and unmodifiable circumstances and conditions. In summary, learn the facts, not people's opinions, take some time to develop your own plan, and then stick with it. Don't stop what you are doing because you read a book after you started, or a post on this forum from someone who thought their way was better. All roads lead to Rome. But if you keep switching routes mid-course you may never get there.

So change the ones you can, accept the onces you can't change, and if that means changing lifestyle in my later years, make some lemonade with those lemons and move on. Life is too short to worry about it to the point of paralysis.

People diagnosed with other chronic illnesses have been doing that for decades. Heart attack surviors, diabetes patients, etc. I would see no reason to treat osteoporosis any differently.

Little-Sparrow

Well, I was curiously waiting to see how you would answer this question, and as expected, you answered it with humour, tact, and intellect. You are a wise man Dxaguru and an irreplaceable asset to this forum.

windblown
  • By windblown
  • Reply 3462900 · In reply to 3462751 by Little-Sparrow
  • October 16, 2012 at 11:38 am
  • Report post

@ LS and DXA, well said Little-Sparrow! I totally concur and appreciate DXA's calm intellect along with yours too!

Sandi-sdivas

Great question with a great reply.
Thanks dxaguru.
Sandi

LilacCat
  • By LilacCat
  • Reply 3463657 · In reply to 3462510 by dxaguru
  • October 16, 2012 at 4:17 pm
  • Report post

Age 55 very active life and just diagnosed with OP. I found this post helpful. I cried all Friday when I heard my Dexa results, just could'nt believe it. I have been reading stuff on line all weekend and for the last two evenings. I live in Uk and my male GP isnt interested in any attempts to gain bone. Cost ? Attitude to 'used up' old biddy ? Who knows. With a spinal t score of -3.1 I need to do something.
Head was in a whizz but I am forming a plan. I feel better knowing that you guys are all out there too and the information on this forum has really helped. I am pretty much decided to pay for a consult with someone who will prescibe hormone treatment and pay for it myself. I found a Gynaecologist who specialises in London. I would rather have an active painfree life than a holiday! I will take supplements and continue with my efforts to keep fit. As Dxguru says I can modify the plan if I need to and reading your post has made me feel I chose well. Thanks.

Sandi-sdivas

LilacCat
Please take a step back and try to relax. Everyone is different, but my experience so far: I was diagnosed in my 50's with -3 range in both hips and spine. I'm 65 and have remained fracture free. All the information on the community can be overwhelming, so take your time. Unless an emergency, there is time before making decisions.
Thanks.
Sandi

Bonesatthebeach

Awesome answer. I concur with your vision. Also, I do believe that finding the right physician who has knowledge and insight in proper diagnosis and treatment, stays current with latest research and practices, encourages people to change what they can through a healthy lifestyle, and communicates as effectively as DXA... It takes a community of healthcare professionals working alongside of the individual, and remembering that the patient should be in the driver's seat with education & support from that team. The individual will hopefully stay on the road [stable or improved outcomes] and not "crash" or end up "in jail".....

newgirlmom

I am 53 years old with -5 in spine and have broken my T10 in a car wreck a year ago which is when I found out I even had severe osteo. My car was totaled. I have not taken medications but it does not mean I won't. I believe each person is different, each body and even each bone different. This is by the grace of my lord and savior (and take that how you may) that I even broke just one bone. According to density scan I should have broken every bone. It is by grace I live each day, I walk on my treadmill, I go to work, I enjoy my family and I breathe. Find joy in your life. Don't let others effect what you know you need or should do. That is only for you to decide. Be kind, treat others like you would like to be treated. Take vitamins, take meds, do what you have peace doing and then move on and try to help others with what you have learned (which by the way I think this site was set up for). Bones heal and if we all remain positive in our journey we can help each other along the way.

FrailGail

Dxaguru, thanks for being on this website. Your opinions are always so valid and you have practical knowledge to share with us. I always look forward to your posts. You are a keeper, bless you.

LilacCat, you mentioned you are active. Do you do weight bearing exercises? Weight bearing exercises helps build muscles and improve the bone density. Do not start an exercise program on your own. Ask your doctor what's right for you and YOUR BODY. Start slow, and stay slow. Bones do not improve overnight, it takes a long time. That is why most get a bone density test every two years. The bone matter doesn't change that much. However, stronger muscles protects your spine, hips, etc your muscles will strengthen with weight bearing exercises. Also better balance, so you do not fall. Once again, check with your doctor about doing some balancing everyday as part of your exercise routine. How's your diet? Do you eat fruits, veggies, lean protein? Maybe a visit or two to a nutritionist might get you started on eating to help improve your bones.

Newgirlmom, you have a good attitude, you are doing what you can to help yourself, and maybe even help others and improve on what you are doing too. Best of luck to you.

Finally, for those of us who have OP, I have questions: Do you have family members with OP too? Do they do anything special to help themselves? Are they living well? Did anything they tried improve their bones?

My mom is 96 -- never broke a bone, yet her spine is curved. She has never gotten a bone density test (refuses to get one), yet I am sure she has OP. PS: her mind is intake. She eats fruits and veggies and lean protein, goes to physical therapy and uses weights. Her sister, (my aunt) is 90 -- has OP, took Fosamax for awhile and stopped taking Fosamax on her own. She broke an foot bone a few years back. Her foot got wrapped around a cord and she stumbled and fell.

So maybe we can think about our family members and learn something from them. What do they do that we can do too? I try not to get overwhelmed with OP. I am just looking to improve on things that I can change...isn't that right DXAGURU?

Sally48
  • By Sally48
  • Reply 3465468 · In reply to 3464968 by FrailGail
  • October 17, 2012 at 9:48 am
  • Report post

Frailgail, I do agree we can learn from our family members. My Mom broke her wrist several times, by reaching out to catch her fall when she stepped in a depression in the lawn. I was diagnosed with OP, I thought of my Mom and then realized that she had asthma, and was on many medications over the years. Steroids. I have never taken steroids or medications, except for OP. My OP was from a gluten and lactose intolerance. So, we can learn from our family members. I do believe that the soils in America are much more depleted than our grandmothers era. Our foods are more refined, and have more sugar and salt. I hope when you think of your family members that you think about the entire picture of their health.

Dolly-CA

Great question and responses! I don't visit this site as often as I used to as I have finally decided on my course of action basically using the process that Dexaguru explained. I am comforted by the fact that my mother has OP and has never fractured. My grandmother also had it and she broke her ankles a few times, but she was morbidly obese which contributed to her accidents. Many of us with OP will never fracture. There are plenty of people walking around with OP that don't even know it. :)

I'm confident in my plan and I'm not going to worry out about it every day of my life. I want to enjoy my family, friends, pets and LIFE! :)

Have a terrific day everyone!

Sandi-sdivas

Dolly-CA
Having confidence in our osteoporosis plan is very important. Confidence can change our perspective and attitude .... both contribute to the way we live our lives with bone loss.
But please continue to visit the community and share your thoughts.
Thanks.
Sandi

LilacCat
  • By LilacCat
  • Reply 3466190 · In reply to 3464721 by newgirlmom
  • October 17, 2012 at 1:40 pm
  • Report post

Nicley put!

LilacCat
  • By LilacCat
  • Reply 3466208 · In reply to 3463695 by Sandi-sdivas
  • October 17, 2012 at 1:43 pm
  • Report post

Thanks for that, it is encouraging to know Im not necssarily about to crumble just yet! It has been difficult to stay calm and objective.

windblown
  • By windblown
  • Reply 3466359 · In reply to 3464968 by FrailGail
  • October 17, 2012 at 2:53 pm
  • Report post

@FrailGail...Finally, for those of us who have OP, I have questions: Do you have family members with OP too? Do they do anything special to help themselves? Are they living well? Did anything they tried improve their bones?

I have family members with OP. My fraternal grandmother/great-aunt (her sister), maternal aunts, maternal great-grandmother (found out through family tree I'm working on) and I don't know if my mom had it or not. All of these family members are gone now, but OP was something I heard about from a young age. My mom used to bug me to stand up straight or I'd have a widow's hump, like my grandma. I didn't really know what that was, but it scared me. Finally, I asked her and she said it happens from bones breaking and falling forward. She thought posture was partially the cause. My mom didn't realize that poor posture is a "result" of OP, not a cause. I had to walk around with a book on my head and took posture classes. I don't think they were called posture class, but a friend of mine from Catholic school remembers this class and her daughter took it as well, so I'm not losing it ;o). My fraternal grandmother and great-aunt both died from hip frax complications. My grandma had to alter her clothes to compensate for the rounded spine. She lost some height too. She was short anyway, but when looking at pictures I'm saving, I can see the difference in her height from year to year.

Sorry, I can't answer anymore of your questions. DXA's weren't around back then, but bone loss sure was! I was looking for something on OP and found the word in an old dictionary from 1829, interesting.

Best of luck to you and all here on your bone health journey!

shiner2

Thanks dg for your input. I have gone through the process pretty much as you've suggested. For the last month and a half I've been on hrt. (Lower hormone levels seem to be when I lost bd at a quick, progressive rate.) So your response (about sticking to it and identifying when the decrease sped up Has helped me have a bit of confidence in this decision to return to hormone therapy. I'll stick with this approach for a couple years and see what happens.
Also, what is your opinion on strontium? I so dislike taking new things. Seems like there are always side effects, which I guess is the whole point of taking it... To get the good side effects but darn there always seem to be negatives too.

FrailGail

Windblown, you have a lot of history in your family who had or has OP. Can you recall if they had other health issues which might have contributed to poor bone health? I think we tend to overlook other reasons why we have OP. I think I know some of mine: small frame, never did much exercising, sat in an office for 41 sunless years, not great eating habits, and lots of stress. Have I made changes to my lifestyle, YES! However there is always room for me to improve and I will keep on trying to do better everyday.

You also reminded me that I had forgotten to mention in my earlier post that all of us should be checked for height when we are at the doctor's office. Don't be ashamed to ask for a height check. They generally weigh you, so why not record height too? Also, keep your own record of your height. Best of luck to you Windblown and to all reading the post.

windblown
  • By windblown
  • Reply 3466507 · In reply to 3466433 by FrailGail
  • October 17, 2012 at 3:51 pm
  • Report post

@FrailGail, all of my relatives hip fraxs were a fall from a standing height, so they were fragility fraxs. My grandmother was a gourmand, and excellent cook. I don't ever recall seeing her eating junk food, no sodas except scotch and soda. :o) My great-aunt lived with her so their diet was identical. Not sure about exercise. They both were retired when this happened so they weren't sitting at a desk. My maternal aunt was very athletic, she was in the WAC's during WWII, and always exercised after that, had 4 kids and her hip frax was also from a standing height. The same for my other aunt. If any meds were taken it would have been hormones. My one aunt had thyroid problems but not sure what they were.

My mom's family grew up on a farm in MN, so they were working most of the time, when not in school (walked to school in snow-knee deep-over 30 miles :o)). When WWII came along they came to So CA, so plenty of sun.

They were all of Irish or German ancestry. Grandmother was 5'2'' (much shorter than that when she died), my maternal aunt was 5'8" (the one in the Women's Army Corp). Well I don't know if that answers your questions, but if I think of anything else, I'll sure let you know.

alwaysgrateful

Dolly-CA,

Glad to hear all is going well. but I just want to let you know that you have been missed. There were some discussions lately where I know you would have had good input. I was wondering where you were!

I agree with Sandi who has encouraged you to continue to visit and share your thoughts. You might not need us so much, but we need you, especially with all your perspective and training in nutrition. Your posts were always so informative and educational.

From time to time I feel like I have resolved all my issues, and my time and energy could better be spent elsewhere. But I continue to learn new things from this site, and once in awhile I make a contribution to someone (either in this group or in a couple of other groups to which I belong) which I feel made a significant difference.

There are other people who used to post all the time who no longer seem to be active, and I do miss them. There are so many new members with osteoporosis that it is a shame to lose older ones who could contribute their experience and help them out. This is especially true because some days the number of new discussions is large, and unfortunately some do not get very many replies.

So here's hoping you will continue to check in once in a while!

All the best to you,
Uma

Dolly-CA

Sandi and Uma,

Thanks for your kind words. I'll make a point to try to visit more often. :)

Warmly,

Dolly :)

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