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Thou Shalt Not Fracture

March 2005
Thou Shalt Not Fracture

Thinning bones, which can be debilitating, is one condition that's definitely a risk for Asian American women. Among all women in the U.S., 58 percent aged 50 to 59 and 74 percent aged 60 to 69 have this condition. But by the age of 70, almost 92 percent of women are reported to have osteoporosis. ?Osteo' stands for bone and ?porosis' means porous. Our bones throughout life go through a process of microscopic breakdown and regeneration. New bone replaces old bone, but the body's various cycles in life may allow breakdown and rebuilding to go out of balance, which can lead to osteoporosis.

Osteoporosis is a silent disease, because there are no symptoms and the weakening of bones is a painless process until a critical level is reached. It can also occur when an injury or other circumstance allows a bone to fracture and cause pain. Normal bone is dense and strong whereas osteoporotic bone, being thin, will break with the slightest trauma. It can even happen while pulling and pushing or while picking up an object. Bone mass peaks between the ages of 25 and 35, but after that it starts to thin and this process accelerates at menopause. In the early years, female hormones help to build and maintain bone strength, but as the hormone levels drop, the bones become thinner.

The following are the risk factors for osteoporosis: (1) History of fractures. (2) Fragile bones. (3) Low body weight or BMI of less than 23. (4) Smoking. (5) Steroid usage (prescription or abuse). (6) Low physical activity. (7) Taking more than the prescribed dose of thyroid drugs. (8) Chemotherapy drugs. (9) Asians and Caucasians.

There are ways to find out if you are at risk. Talk to your physician and see if you should do a simple screening office test, which screens your hand or foot. If the test shows a deficiency, a more sophisticated test called the DEXA scan may be appropriate for you.

A DEXA scan, which measures the BMD, and other tests use either sound waves or very small doses of radiation. The test is painless and results are obtained on the spot. The cost may vary from $500 to $1000. Most insurance policies cover the cost, although HMOs will generally decline at first and require repeated referrals and questioning for risk factors. The National Osteoporosis Foundation recommends scanning for the following groups: All women over the age of 65, younger women with one or more fractures, and postmenopausal women with fractures.

The BMD is reported as a score. Your physician will help you interpret the score.

If osteoporosis is diagnosed, the treatment will include certain drug therapies like Fosomax, Actonel or Evista. Calcium and vitamin D are needed for these drugs to work.

Exercise and weight bearing, especially walking with small weights and impact aerobics, may help to build the backbone. In special circumstances, there are nasal sprays and shots that may be used to build the backbone. Your physician will give you the advice that is most consistent with your condition. Dairy products may cause gas and an upset stomach, but this can be avoided by eating broccoli, spinach and tofu. Your vitamin should have about 800IU of Vitamin D and your diet should also include 1500 mgs of calcium.

A daily exercise regimen of brisk walking for 50minutes, carrying small weights, is ideal. Stair climbing, jogging and dancing will also promote build up of bone mass. Some physicians may recommend hormone therapy, but it should be discussed individually.

Once drug therapy is initiated, yearly scanning will be necessary to see the effect of the drugs. Changes may be recommended as needed. Several health fairs offer the initial foot or hand scanning test at a very nominal charge. Osteoporosis, if untreated, can lead to costly hip replacements and painful back fractures that can cause permanent posture problems and loss of height.

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