1. There is not enough scientific evidence available at this time to support any benefit of electromagnetic therapy to the bones. Consequently, it is likely that insurance would not cover this.
2. If you had your ovaries removed, you are considered postmenopausal. Some of the osteoporosis medicines contain hormones or affect hormones, including raloxifene (Evista), calcitonin (Fortical, Miacalcin) and teriparatide (Forteo). Obviously, estrogen therapy and hormone therapy also affect hormones. Please read the following information to learn about the different FDA-approved osteoporosis medications that are currently available http://www.nof.org/aboutosteoporosis/managingandtreating/medicinesneedtoknow .
Finally, you are not alone in feeling that you have lost control of your life as a result of a disease you have. This frequently happens to people with cardiovascular disease, cancer, or Parkinson's. Women with osteoporosis often feel this way as well although it rarely gets articulated because of the belief that weak bones are a consequence of old age, with no opportunity to do anything about them.
Congratulations on recognizing that this is a serious and debilitating disease that can have negative consequences. Until we recognize these challenges, we can't do anything to control them. You are several steps ahead of many women who just ignore these feelings. What you now need most is to talk with other women with osteoporosis, hear their stories, learn their tricks for coping with it, and know that they still have very high quality of life.
A support group would be ideal. There may be local support groups for osteoporosis, so ask your physician or check with NOF. If you can't get to a face to face group, the National Osteoporosis Foundation (NOF) has an online community for this purpose (http://www.nof.org/community/otherevents ).
In addition, you should probably consider short-term counseling with someone trained to help you with coping with chronic illness. In my opinion, you would be best off with a clinical social worker. Again, your physician might be able to provide a name of someone who can help. Also, NOF has some online resources to help you at http://www.nof.org/aboutosteoporosis/positivethoughts/qualityoflife .
Although none of these will make you feel better instantly or alleviate the challenges of osteoporosis, they should help you start down the path to good bone health and to cope with these problems.View Thread
I'm so glad we were able to provide you with helpful advice. I hope you have better luck with the yearly infusion. Keep us posted on your progress. But if it doesn't, don't give up. There are still other alternatives.View Thread
No treatment choice is right for everyone. Much more information than just knowing you have osteoporosis or osteopenia is necessary before determining which medication to try first. This decision should be made together with your healthcare provider, looking at multiple factors that are unique to you (e.g. your medical history and personal preferences). The National Osteoporosis Foundation recommends treatment for postmenopausal women and men age 50 and older who have osteoporosis (this includes people who have broken a bone in the hip or spine or those who have a T-score that is less than or equal to -2.5 in the hip or spine). At this time, there are no non-FDA approved treatments like strontium that are proven to be safe and effective for reducing the risk of fracture in people with osteoporosis. More studies are needed before any conclusions can be made. It's important that you work with a knowledgeable healthcare provider who can help you develop a treatment plan that is appropriate for you. It should also be one that you are comfortable with. Finally, if the treatment you choose first doesn't work (for whatever reason), don't give up. We now have 9 FDA-approved medications for osteoporosis, each with a different set of outcomes. Sometimes it takes trying two or three before you find what works for you.View Thread
First, let me say I am so very sorry you are experiencing chronic pain and grief as a result of what's happening with your body. Aging can be wonderful when you are 100% mentally and physically healthy but awfully difficult to manage when either of those arenas aren't functioning ideally. Nobody gives us much warning in advance, do they?
I have several responses to different parts of your post, but I want to start with a question: Who told you that there was nothing that could be done about your osteoporosis? One of NOF's mantras is that "It's NEVER too late to treat osteoporosis," and I believe that with deep conviction. So if a healthcare professional told you that, I would be concerned lest the healthcare professional might not be an osteoporosis expert. If this came from your primary care provider or orthopedist, I would urge you to see an osteoporosis expert. Some of the treatments build bone while reducing the risk of fractures. You need to make sure you're getting the correct message.
That said, it is virtually impossible to treat osteoporosis without prescription medication. You must get adequate calcium (1,200 mg daily) and vitamin D (800-1000 IU daily). Exercise is also important in preventing and treating bone disease, but I'm talking specifically about bone health exercises. See a physical therapist who focuses on bone health or purchase Boning Up on Osteoporosis . This is an excellent book about living with osteoporosis and includes safe exercises.
Consider medication. Calcium, vitamin D and exercise just aren't enough to battle osteoporosis. I'm not a physician and have no hidden agenda here. But I have seen thousands of women really improve using the medications available for this disease. Again, seek expert advice on this.
I understand as well as anyone the challenges of dealing with chronic pain. When I was 15, I broke my neck. By the time I was 30, I'd had multiple surgeries and everything else I could think of (acupuncture, physical therapy, etc.) to try to cure it. An insightful neurologist told me I needed to stop seeking a cure and instead try to learn how to manage the pain that wasn't going away. I went to another neurologist who specialized in chronic pain, and he changed my life. I still hurt daily, but have tools to manage the pain: biofeedback, exercise, getting sufficient sleep, eating well, meditation and others. I also take medication, but it is only a part of the treatment paradigm. I deeply believe that, if you reject medication out of hand for either the osteoporosis and/or chronic pain, you will find it difficult to see your quality of life improve. How you take the pain medication also makes a big difference. You must follow a schedule that never allows your body to be without medication (time dependent use rather than pain dependent use). It's much harder to reduce levels of pain than to keep them down. Counseling from pain experts can also be helpful.
You may have to change your lifestyle somewhat to accommodate the changes in your skeleton. You noted that you are an artist and want to take your work to shows. The part that you cannot do is to carry your own work. But you would be amazed at how helpful others are and how spending a little money for paid help can minimize the trauma on your body. Instead of saying, "I can't do this," you should think about ways in which you can modify the activity so that you CAN do it. You shouldn't go sky diving or bungee jumping, but you can likely find ways to participate in many of your usual activities.
The scientific literature on coping says that there are three ways you can view the problem with which you need to cope. You can see it as a threat. You can see it as a loss. Neither of those is a useful view. You can also see it as a challenge, and it is that perspective that will provide you with the best opportunity to continue to live your life with high quality.View Thread
You know yourself better than anyone else. You know if you are likely to fall playing tennis or golf or any of the other sports that are not specifically forbidden for people with osteoporosis (like sky diving, bungee jumping or ski jumping)!
If you have played tennis for many years and have been safe, then you may well be fine with continuing it. It is all a matter of risk. The problem with tennis is that you can fall, slide, and get hit really hard by a ball. Maybe doubles is a better approach, where your area of responsibility is smaller.
On the other hand, if you prefer to walk and work with weights, that is great too! It IS important to enjoy your exercise but to also be sure that it is safe.View Thread
Great question. There is no doubt that the fewer the people around, the less likely it is to fall. Someone in a crowded mall can easily bump into you just as you are picking up your foot to turn. Instead of continuing to walk, you can just land on the ground and break a wrist or a hip. This is not just advice for those who are frail and fragile... it is sound advice for all of us.
If you have no risk for osteoporosis and fracture, this may not be necessary. But if you do, protect yourself as much as you can by carefully choosing where you're going and at what time. The payoff in fracture avoidance can be huge!View Thread
Many people are able to live well with osteoporosis by making healthy lifestyle choices and maintaining a fracture prevention program. Unfortunately, other people have broken one or more bones because of osteoporosis. These individuals face additional challenges and have a greater chance of breaking more bones than those without broken bones. Whether you have osteoporosis or are taking care of a person with the disease, it's helpful to understand the many complex issues of this disease that influence a person's quality of life.
Staying active with osteoporosis
People who have broken a bone due to osteoporosis may avoid their regular daily activities because of the fear of breaking more bones. In doing so, people with osteoporosis may abandon activities that are essential to their well-being. Others stop exercising to avoid the risk of breaking a bone. Here are some tips to help you or the person you care for, to stay active, exercise and enjoy life:
1. Break activities into smaller time and effort segments.
2. Work with a physical therapist (PT) to develop a safe exercise program. A PT can help people at all levels learn exercises that are safe and appropriate for their individual needs. Exercise can help individuals prevent more bone loss, improve posture, prevent falls and can have a positive impact on a person's mental health.
3. Take a tai chi class. Tai chi can help people improve their balance, prevent falls and improve a person's mental well-being. Let your instructor know that you have osteoporosis as well any other concerns you may have.
4. Learn how to move safely and prevent falls. Taking steps to protect your spine and prevent falls is essential for preventing broken bones. Contact the National Osteoporosis Foundation (www.nof.org or 800-223-9994) for comprehensive information on these topics.
5. Make sure to get outside often. Do activities like shopping or going to a movie during less crowded times. Stop and take as many breaks as you need.View Thread
If only we knew all factors which contribute to our risk of this disease...! I can remember talking with a patient who said that her mother had experienced spinal fractures and, as a result, she herself had done everything right: calcium and vitamin D, weight-bearing exercise, whatever. When it came to her first bone density test, she had low bone mass; when it came to the second one, she had osteoporosis. She was angry because she had done everything right and STILL had problems. And all I could think was, "Imagine how severe the disease would be without those efforts on your part!"
The historical low weight in your family certainly may play a part in this. We will know more about you when you have a second bone mineral density test which should either tell us that you just have low bone mass or you are still losing.
Regardless, stick to the high road. There has been a great deal written about the impact of caffeine on bone health, but I don't think we have enough evidence to suggest to people that they should drink no coffee, no soda, no chocolate shakes!
The NOF offers something called the Professional Partners Network. In it, we list certain specialists by state. You should certainly consult that site at http://www.nof.org/ppndirectory/index.asp. You also might consider looking elsewhere on the NOF website (for example, at the Board of Trustees http://www.nof.org/aboutnof/gov_boards.htm) for other names. There are many excellent specialists who devote their careers to fighting this disease and who could be of major help to you.
Best wishes. Please let me know if there are other ways I can help.View Thread
One of the most common causes of low bone density in premenopausal women is low peak bone mass. Having lower peak bone mass increases your chance of getting osteoporosis. This is because women with low peak bone mass have low bone density. All women lose bone density after menopause and later in life. For women who start with lower peak bone mass, this age-related bone loss is more likely to lead to osteoporosis.
When premenopausal women are diagnosed with osteoporosis, it may be due to an underlying medical condition or a medicine that causes bone loss. Osteoporosis that is caused by a medical condition or a medicine is called secondary osteoporosis. If a premenopausal woman has osteoporosis, it is important to determine if this is the case. A list of many of these conditions and medicines is located at http://www.nof.org/prevention/risk.htm .
Diagnosing osteoporosis in premenopausal women is not straightforward and can be quite complicated. A diagnosis of osteoporosis in premenopausal women cannot be made based on just one bone density test alone. Many women have low bone density before menopause; that is not necessarily osteoporosis. A diagnosis of osteoporosis means that a woman is losing bone over time. Two BMD tests at least one year apart can help to determine if a person is actively losing bone or just has low bone density to begin with. A diagnosis of osteoporosis may also require looking at a person's medical history as well as other tests. These may include x-rays, lab tests and a physical exam.
To answer your questions about why BMD tests are not routinely recommended for young women, here are some reasons:
"022 Most premenopausal women with low bone density do not have an increased risk of breaking a bone in the near future. Therefore, having information about their bone density may only cause unnecessary worry and expense.
"022 Some premenopausal women have low bone density because their genes (family history) caused them to have low peak bone mass. Nothing can or should be done to change this.
"022 DXA tests can underestimate bone density in women who are small and thin. Therefore, a DXA test may indicate that a small person has low bone density, but the bone density is actually normal for the person's body size
"022 Osteoporosis medicines are not approved or advised for most premenopausal women, except when secondary osteoporosis is caused by glucocorticoid (steroid) use. BMD tests are used to help guide decisions about treatment.
Most of the osteoporosis medicines available at this time are not approved by the FDA for use in premenopausal women. But, as noted above, women who have taken steroid medicines for a long time and have osteoporosis, three osteoporosis medicines are approved for the prevention and treatment of glucocorticoid-induced osteoporosis.
In very rare cases, a healthcare provider may recommend that a premenopausal woman consider taking an osteoporosis medicine for other reasons. Examples include when a woman breaks a bone because of low bone density or has severe bone loss due to a medical condition.
Make sure you are getting the recommended amounts of calcium and vitamin D every day. It's also important to eat plenty of fruits and vegetables, exercise regularly and avoid having too much sodium (salt). Don't smoke or drink too much alcohol. These lifestyle habits can help you protect your bones. Talk to your doctor each year about what steps you can take to monitor your bone health and prevent fractures (broken bones).View Thread
Treating osteoporosis requires a combination approach that includes lifestyle modification, appropriate diet and exercise, and the start of medication therapy. Sticking with a treatment plan can be a challenge because so much is required at the same time. However, in order to achieve the best results, all of these treatment variables need to be addressed together. Osteoporosis treatment requires following a plan designed to ensure that you get enough calcium and vitamin D, engage in regular weight-bearing and muscle-strengthening exercise, eliminate any modifiable osteoporosis risk factors and start medication therapy. In order to achieve optimal bone health, you need to precisely follow the treatment plan and recommendations of your healthcare provider. This also includes continuing to take your medication as long as it has been prescribed for you. Medication alone may not be enough; this is also true for diet and exercise. In order for you to achieve the maximum benefit from a medication or other therapy, it is important to fill your prescription and follow the dosing schedule and directions exactly, continue the medication for the full course of treatment, and check with your healthcare provider before you stop taking it. To find out how well your treatment is working, your healthcare provider will probably repeat your BMD test every two years. Because osteoporosis is a silent disease, you will not feel your bones getting stronger. This can make it hard to stay on a treatment plan. If you decide that a treatment is not right for you, don't just stop taking the medication. First, discuss your concerns with your healthcare provider.View Thread