Them Bones Them Bones

Them Bones, Them Bones Gonna Rise Again

I just want mine to keep me upright for the remainder of my time above
ground. Judging from the results of recent tests, I think they might. I've just
viewed a chart that shows that bones inevitably "thin" or diminish in density
as one ages. Osteoporosis. Porous bones. Hunched backs and fractured
hips. Caucasian and Asian women are most at risk, as well as men who
have taken steroids.

A Dexa Scan last month shows I've actually increased the Bone Mineral
Density (BMD) in my spine- only by one-tenth-of-one-percent, but I think
any increase is significant.I would have been happy if the numbers had
stayed exactly the same as the first scan showed. But alas, they didn't.
The BMD loss in my left hip increased by -.9. (They didn't have a machine
that scanned both hips in 2004; this time they did.)

Bones change so slowly that Medicare will only pay for a Dexa Scan, also
known as a bone scan, every two years.The two scans I've had show that
I have osteopenia, which means some loss of BMD.

The doctor who ordered the scans prescribed Fosamax, a bisphosphonate,
which has increased bone mass in some people, but not all. After researching
osteopenia, osteoporosis, bisphosphonates, and trying to decipher the Dexa
Scan report, I've decided not to take the medication. I've learned that my
amount of BMD loss increases my risk of fracture by one-percent. Therefore
I don't think the even greater risk of known side-effects of bisphosphonates
is justified.

The University of Washington has an accessible course in bone physiology
which includes a lot of information on understanding the Dexa Scan and
on osteoporosis, including methods of prevention.

Here are my T-scores: Spine: -.9
Left Hip: -1.3
Right Hip: -1.2
My spine is considered "Normal", according to the technician who did the
scan, and according to material available on osteoporosis. T-Scores of +1
to -1 = normal; -1 to -2.5 =osteopenia; -2.5 and higher = osteoporosis.
The yardstick is the BMD of a 30-year-old woman.

So my hips are only -.4 and -.3 points higher in bone loss than my spine,
or those same amounts less than "normal".

Bisphosphonates have been linked to osteonecrosis of the jaw bone,
commonly called "Dead Jaw" and also "Rotting Jaw". A lawsuit was filed
against Merck, maker of Fosamax, in April in Florida. There are other
brand names of biophosphonates: Actonel, Boniva, Zometa, Aredia.
Many of those affected are cancer patients, some having received the
bisphosphonates by IV, and some receiving large doses.

A local pharmacist wrote that "the threat [of 'dead jaw'] is not nearly as
alarming as it might sound. About 94% of the reported cases...occurred
in patients with bone cancer...The incidence is much lower in patients who
take oral bisphosphonates. It's probably less than one case per 100,000
patients per year." And he urges "patients" to continue taking the drug "as
your physician ordered. The benefits probably outweigh the risks."
(Cook's Pharmacy advertisement in The Trion Facts, Wednesday, August
23, 2006)

Unlike Cook's Pharmacy, I find the threat alarming. I would feel more assured
by such a message if it were not from someone who profits from selling the
drug patients are urged to take. And by someone who didn't pepper the
message with the word "probably". I can do my own conjecturing: Probably
Cook's would not so blithely dismiss the risks of osteonecrosis if they or
someone close to them suffered from it.

Attorneys soliciting clients for further lawsuits claim a large percentage of
bisphosphonate-related jaw damage has gone unreported.

I am just as concerned by reports that bisphosphonates can and have caused
visual disturbances, aching joints, and that, if taken for ten years or more, can
actually cause bones to become more brittle and at increased risk of fractures.
But most disturbing of all is that it remains in the body and in the bones for ten
years after one ceases to consume it. Five or six years from now it may be
linked to more, and possibly even worse side effects, and the millions, mostly
women, who will have it in their bodies for years, will be able to do nothing
but wait to see if they will be inflicted with such horrors.

So no thanks, I'm not taking it.
I believe if I work harder at staving off osteoporosis that I can prevent
further BMD loss, or keep it at a very small amount. I believe some of
my BMD loss was caused by my curtailed mobility much of last year
because of sciatica and an injured foot. I stayed active and continued to
work out, but I didn't walk as much and I kept the weights lower on
the leg machines at the gym.

The two main weapons against osteoporosis are taking calcium and weight-
bearing exercise. Walking is a good weight-bearing exercise, but I don't
think it's enough. I'll keep lifting weights at the gym and, thanks to a
chiropractor's help, I'm no longer hampered by sciatica so I have for some
time been using heavier weights on the machines. I don't need to increase my
daily calcium intake, with supplements and dairy products I get enough. I do
need to never get so busy that I forget to take the supplements, so I've made
a note to myself to never skip a day. I also take magnesium. I have read many
articles about how magnesium and calcium need to be in balance, just as do
salt and potassium. Articles on the Magnesium Website show that a high
calcium intake without sufficient magnesium can cause many problems, and
that frequently what appears to be problems caused by a lack of calcium are
actually symptoms of magnesium deficiency.

Another article on the Magnesium Website claims that primitive man, with no
access to dairy products, did not consume a lot of calcium. Our bodies have
changed little since those times, but our diets have changed drastically. The
article implies that it is because of the low-calcium diet in ancient times that
our bodies store calcium. Magnesium, however, was plentiful from whole
grains and green leafy plants. And so, according to the article, primitive man
had a diet much higher in magnesium than in calcium. But we aren't told what
effect this magnesium-calcium balance had on his health, there's just the
implication that this is the natural way to eat. Other good sources of
magnesium are nuts and legumes.

Health care providers routinely tell women to take Tums as a source of
calcium. But reading the fine print on a Tums label shows that 1,000 mg
of calcium carbonate per tablet actually means only about 400 mg of
calcium, and no or very little magnesium.

Some other interesting things I've learned: the diuretic action of coffee
causes some calcium loss from the body. Yet a recent report shows the
value of coffee as an antioxidant and the amount of calcium lost because
of a cup of coffee can be replaced by drinking one-and-a-half tablespoons
of milk. Those who add milk to their coffee are safe.I've always liked mine
black. People who eat a lot of animal protein have denser bones and so do
people who are overweight. Weight loss can cause a loss in bone density.

So one could gobble up the meat, pack on the pounds, and have high
cholesterol and maybe heart disease and strained joints and whatever
other illness baggage that comes with obesity, but have great bones.

I think I'll stick to the plan I've been following, although I will
increase my magnesium intake. It'll be another two years before I have
another bone scan. The results then and any new information I've managed
to gather in the interim may send me back to the drawing board for a
revision.I do know that wellness is not totally a matter of luck: one has to
work at it. We have to learn about our bodies and take charge of our own
health.

At least I have the information that allows me to plan. Thousands of
postmenopausal women in their 40's and 50's without medical insurance or
with inadequate insurance do not. By the time they are able to get the medical
attention they need, many will already have developed osteoporosis and have
no choice but to take the risky bisphosphonates in an attempt to rebuild that
which they have lost. Here in the only industrialized country with no national
health insurance, that hundreds of thousands are broken and debilitated from
untreated illnesses is a national disgrace.

The charge for my last Dexa Scan was $379.00. The imaging facility had to
accept the reduced amount Medicare would pay, but those who do not qualify
for Medicare or who do not have adequate insurance would be responsible for
the full amount, as much as a third or more of the monthly wages of many
women who are already stretching each dollar as far as it will go.

When I went back to the clinic a few days ago for a mammogram I saw a
new sign at the desk. It stated that patients with no insurance must now pay
BEFORE they can see the doctor.