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First, Deal With Bone Density of Doctor's Skull

Posted on: Thursday, 12 May 2005, 18:00 CDT

HOME & FAMILYQ: I am 65, female and just had a "wake up" call. I had a bone density test last year and was unable to get the results from my doctor, after calling several times. Therefore I assumed the result were normal. Wrong! They were not. I found this out after getting another test this year and learned that I am pre- osteoporosis, and lost a lot of bone mass this past year. I am trim, exercise, eat well ... and am shocked that my bone density is not normal, and angry that I lost a year of "bone health" because of lack of feedback on test results. Your thoughts?

-- D.H.

Dear D.H.:

With changes in medical offices, new personnel, moves and often lack of communication, sometimes things do go adrift. However, there is no excuse for not reporting abnormal results to a patient. Your experience teaches us to be persistent and to make no assumptions until we receive results. Your frustration and extreme irritation is understandable.

Let's first talk about bones. Dr. Felicia Cosman, Clinical Director of the National Osteoporosis Foundation writes in her book What Your Doctor May Not Tell You About Osteoporosis (Warner Books, 2003), that we often think bones are similar to fingernails or hair. Actually, bone is living tissue that has cells, blood vessels and nerves. And bones encase bone marrow, an important organ that is responsible for making blood cells.

Osteoporosis is typically defined as a bone disease characterized by low bone mass and the deterioration of the bone structure. The good news is that it can be prevented, diagnosed, as well as treated.

In his book AgeLess (Rodale Books, 2003), Dr. Edward Schneider, dean emeritus of USC's Andrus Gerontology Center, explains the bone- loss process. Our skeleton has cells that create new bone called osteoblasts. We also have cells that remove bone called osteoclasts. During the first part of our lives, the osteoblasts (the good guys) build bone faster than the osteoclasts (the bad guys) take it away.

After about age 30, the bad guys take the lead and start slowly draining density from the bone -- something that continues for the rest of our lives. For women, the bone loss increases after menopause.

The problem is that declining bone density results in brittle bones that break easily, increasing chances for fractures. Among the 300,000 Americans a year who endure hip fractures, more than 20 percent die within a year of the fracture; about 20 percent are in a nursing home within a year and 25 percent can walk only with assistance. Direct cost for hip fractures is about $18 billion a year.

A key intervention and prevention is calcium. When our bodies don't get enough dietary calcium, it gets stolen from our bones and is never returned.

The National Academy of Sciences recommends that women 50 and older take in 1,500 mg of calcium and men 1,000 mg daily. In general, we obtain about 50 to 70 percent of calcium through food. The rest comes from supplements -- specifically, Vitamin D. This vitamin is important because it transports calcium from the intestine to the bloodstream. Without it, we would only absorb about 10 percent of the calcium we ingest. Fortunately, our bodies produce some vitamin D and many foods are fortified, such as milk and some orange juices.

Cosman recommends three steps for bone health:

First, reduce risk factors such as smoking, excessive alcohol and falling. The latter can be caused by medication, poor vision or a cluttered house. Second, improve nutrition with adequate calcium and Vitamin D. The third step is exercise. If we are not physically active, we will lose bone mass as part of the normal aging process. Exercises that are weight-bearing (running, walking), aerobic and resistive to increase muscle strength are highly recommended.

Pilates has been recommended to build muscle tissue and to increase strength. OsteoPilates (New Page Books, 2003) by Karena Thek Lineback provides background material and recommended exercises. For classes, call Beach Cities Health District at 310- 374-3426, Ext. 212. It is important to see a physician before starting any exercise program; also discuss whether calcium will interact with any of your current medications.

D.H, thank you for your important question. For more information, go to www.hhs.gov/surgeongeneral/library/bonehealth/ factsheet1.html.

With good nutrition, exercise, eliminating risk factors and following the directives of your physician, you should be in good shape. And don't forget to ask for results.

Helen Dennis is a specialist in aging, with academic, corporate and nonprofit experience. Send her your questions and concerns in care of the Daily Breeze Today section, 5215 Torrance Blvd., Torrance, CA 90503-4077; or fax to 310-540-7581, or e-mail to features@dailybreeze.com.

Source: Daily Breeze

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