The Myth of Osteoporosis

The choice of the word myth in the title of my book ‘The Myth of Osteoporosis’ was to highlight the many myths associated with osteoporosis, but primarily the major myth of the 1992 re-definition of osteoporosis as a measure of low bone density (BMD). Genuine osteoporosis is a relatively rare condition where bones are fragile and fracture on low impact. Everybody loses bone density as they age, and a BMD diagnosis of osteoporosis alone is not a good predictor of whether a person will go on to have fragile bones as it measures the quantity not the quality of bone. The majority of fractures occur in people with normal to high bone mineral density (BMD). A diagnosis of osteoporosis on the basis of low bone density is therefore misleading, and is a myth.



There are many other myths including the myth that half the female adult population will fracture as a result of osteoporosis, that preventive drug treatments (particularly of women or men with osteopenia) will effectively and safely prevent fractures, and the myth that osteoporosis is a killer disease. The book offers evidence-based information that most doctors don’t tell their patients.



I make it clear that genuine established osteoporosis is not a myth and is a very serious condition, and I include information on the disease including secondary risk factors, and in depth information about pharmaceutical treatments, nutrition and lifestyle/exercise choices.



Many thanks,



Gillian Sanson

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With permission from Gillian Sanson, the above is shared from my email contact with Gillian Sanson. Sandi

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I am familiar with Gillian's book and, although I believe the title to be misleading, it offers much common sense information on osteoporosis. The World Health Organization has now recognized, through its Fracture Risk Assessment algorithm, that bone mineral density is a risk factor for fracture and not the only diagnostic information to be used when diagnosing osteoporosis.
I am including here a small paragraph on this subject which I recently wrote to be included in a small pamphlet I self-publish for clinicians called "The Physical Therapy Management of Bone Health A Clinician's Guide."
"I would like to begin by saying that, in my experience, the condition of osteoporosis is no “myth.” It is occurring in all populations and, although some people are more at risk than others, it knows no boundaries regarding age, gender, ethnicity, lifestyle, or any other factor.
It is generally under-diagnosed, under-managed, mis-managed and un-recognized until a devastating fracture, which can change a person’s life in an instant and for a lifetime, occurs.
However, as I say that, I also think that it is a condition that is over-medicated and which is accompanied by fear, anxiety, worry, frustration, depression and many other emotional states as people try to obtain good advice from the medical profession. This is unfortunate because there is much that can be done for bone health without medications and surgery.
How can a more “middle-road” be adopted? A place between the fear and the knowledge that positive steps can definitely be taken so that people can live full lives free of fear of falls and fractures?
I offer The Meeks Method as a place to begin and invite you to become more knowledgeable regarding patient management and then to take this knowledge out into the community and begin to teach, write and spread the word of SAFE movement."
I'd welcome any comments to this point of view as I recognize that, by virtue of my specialty, I see people whose lives have been devastated by this condition and its mis-management. I truely believe that better management by the medical profession will be patient-driven as more and more of us become knowledgeable, can ask questions and take charge of our own health and life.

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I have also seen people that are told they are in such terrible shape that they begin to believe it. I have also seen people thrive on being sick. They love the attention of the Dr's. This holds true for many diagnosis, The sad thing about Osteoporosis is it is being so blown out of porportion. They are making millions off these drugs and are pushing them on everyone.

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It's hard to know what to believe at times...I was diagnosed with severe osteoporosis about 8 years ago. I have had a small spinal fracture and two ribs just broke with no impact. I fell and smashed my coccyx some years ago which is still a pain in the ***!

I've been on Fosamax and Actonel and couldn't tolerate the medication.

I underwent a radical hysterectomy and oopherectomy after having symptoms of loss of weight, chronic tiredness and pelvic and rectal pain. I've always hated going to the doctors, and dentists. I was then told that the hysterectomy and oopherectomy was unecessary and a mistake by local GPs. I was later diagnosed with fibromyalgia and then some years alter found that a lot of doctors don't believe in it. It seems that there are different schools of thought amongst the medical profession which can really have devastating effects on people's lives, through medication or misdiagnosis. It's so refreshing when you come across a medical person that is actually interested in finding out what's happening when our bodies come to a halt, and truly try to heal and can say I don't know when they don't know the cause.

It doesn't help if the implication is attention seeking or all in the mind when a person is struggling with pain and illness. I don't know if medical training encourages competitive diagnoses rather than cooperation to find a possible cause/cure.

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Well when any of you end up bed-ridden, in constant pain, fracturing ribs by sneezing or coughing, have gaping areas in the pelvis where bone should be, have spinal compression fractures spontaneously along with the accompanying muscle spasms, then you can talk to me about the "myth" of osteoporosis and how it's blown out of proportion.

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Dear Sara Meeks, How do I get a copy of your pamphlet? I have had a very positive response to your postings. You sound like a highly sensible person. I recently (April) broke my left hip when my dog pulled me over and I crashed onto concrete pavement. I was 63, now 64. I had surgery with 3 pins. My surgeon said my bones were solid although I am dx'd with osteopenia and -porosis. All oral meds failed because of esophageal problems. Now Forteo is being recommended. But I want to try less frightening approaches first.

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Somewhere between "nobonesaboutit" and "Floridagal" there is an area to be explored on how people can deal with the diagnosis of osteoporosis. Unfortunately, digging out the truth and finding out what to do can be a "mine field" as one negotiates the confusing world of American medicine.
Medicare, nor any other third party payer that I know of anyway, does not pay for physical therapy until one sustains a fracture. Think of how much better it would be if, when a person is diagnosed with osteoporosis, they could see a physical therapist and learn strategies of balance, exercise, body mechanics, etc. to minimize the risk of a fracture in the first place. One can only guess at how much better people would feel and how much money would be saved by insurance companies.
Make your voices heard for a better tomorrow for osteoporosis management!

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Dear Sandi

Thanks for posting the letter from Gillian. Her most important point is that the DEXA scan does not predict fracturability and we keep missing that point. As an engineer, I would say the DEXA device is useless. The FRAX assessment has its limitations as well but is at least a tool with a statisical formulation and admits that fracturing is problematic.

Why do doctors and patients get taken in with this DEXA "myth"? Well, there is no other "scientific" tool and it certainly helps the industry not to acknowledge this.

For people that have gotten fractures, it is no myth but for the many many others who have not and are taking pills and shots unnecessarily with unforseen complications, it is another tragedy.

Maybe the new 3D scanner now undergoing tests will provide us with a true device to predict fracturabilty. How long will we have to wait to see if it is the "true" predictor? Has anyone seen any data about this device as to how good is it at predicting fractures?

In the meantime, let's acknowledge that DEXA results are worse than useless.

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Eamenard
I am very happy to hear of the new test in the works. I didnt' know about that. Sara has a lot of good points, however I do not think insurance companies will ever pay for pt before they have to. It is not fair that they won't especially if a Dr. would recommend it. Most insurance companies will not pay for much today. Sad but true! If you hear anymore about this test please post about it! Good Luck to you!

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To nobonesaboutit,
I just had the Reclast infusion last Monday. So far have had no side effects, although I'm the type of person who every little twitch might be "something." I have no fractures that I know of. I will keep posting re Reclast as time goes by.

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Hello all

what exactly please is reclast infusion?

Sara Meeks - Can I have some info please about your program for osteop?

thank you thank you

JoanL

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Hi JoanL: Below is a link that explains the Reclast infusion for the treatment of osteoporosis. The article is very easy to understand and explains the use of the drug plus it's clinical trial.

Good Luck...

http://www.inspire.com/groups/national-osteoporosis-foundation/discussion/r eclast-research-info-aka-zoledronic-acid-novartis/

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JoanL: Please log onto my website to find out more information. There is a Consumer Info page and I do consultations over the phone.
The website is quite explanatory and you could contact me through the site for more information.

Regarding the myth. Yes BMD testing does not predict fracturability but there have been some correlations. I'm hoping the new tests that show bone architecture will be more meaningful.

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Jogger56,
How are you doing after your reclast infustion?

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Osteochick,

I had my 2nd reclast infusion about 2 weeks ago. I've had no side effects that I'm aware of. My dexa before the 2nd infusion showed no further bone loss and am hoping that the next one will show improvement.

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What are your DEXA scores? Do you have any other health issues? Do you know what caused the osteoporosis? How much do you weigh? I wonder why some folks are ok with it and others aren't. Thankfully, it worked for you!

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NoBonesAbout It: Like SarahMeeks, I, too, regret that Gillain Sanson entitled her book The "Myth" of Osteoporosis." It's an excellent book. Many of us have read it and liked it. You might, too.

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In your book you state: Small bones automatically register lower on bone density tests even if they are not thinner, which can make small bones look more at risk than they are.

Can you site some facts to back this up? I have extremely small bones, born that way, and I have always wondered about really small boned women and bone scans. My spine is much worse than my hips.

If anyone else has any input to this question, I would love to hear what you have heard or read or know.

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Good morning. As always, it makes sense to check with your insurance carrier before assuming they will not pay for PT when there's no evidence of fracture. After my last DEXA scan put me on the border of osteoporosis in my spine (no fractures) I was able to get coverage for several visits to a PT for help in designing a safe exercise program. I have a PPO policy administered by Unicare.

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OsteoChick, if you would like Gillian to respond to your question, you may have to Message Gillian as she is a member of the community and/or post (reply) directly under her original post.

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