Watch out for Osteoporosis

Osteoporosis 

Osteoporosis is a medical condition that leads to weakening of the bone structure in your body. The condition makes bone more fragile and increases your chance of sustaining a broken bone.

Cancer treatment can make us prone to this disease, so I was sent for an annual DEXA Scan to check my bone density.  After one review my Oncologist mentioned “your Scan shows Osteoporosis”, and left it at that.

Back home, I googled (as one does) and got worried. So phoned to ask my Oncologist at The Royal Marsden what I should do, and was told “nothing you can do”.  Luckily I discovered there IS a lot we can do.

House of Lords highlights condition

Introducing a debate on osteoporosis in the House of Lords, Lord Guy Black – whose Mother suffered from the condition – highlighted how “broken bones seriously impact the lives of the elderly, causing significant ill health and premature death,” and said “many arise unnecessarily as a result of undiagnosed or inadequately treated osteoporosis.”

“One in five women who sustain a fracture have to break three or more bones before diagnosis and fewer than half of women sustaining a hip fracture after the age of 50 receive treatment for osteoporosis the following year.”

These are “unacceptable figures, with huge costs to the NHS” and Black called on the Government to take action to ensure that “patients are identified, treated and managed effectively in primary care, including proper access to fracture liaison services.”

So when my Oncologist said there was nothing I could do, he couldn’t have been more wrong.  I contacted the Hospital Chaplain (fountain of knowledge) who suggested I went off to Casciane Terme Centre in Italy, where “they know all about it”.

Italian Treatment

Come 8 am at Casiane Terme, coach loads of OAPs start rolling in from the surrounding countryside, filled with patients coming to do exercises.  From what I could gather, the Italian health service is keen to encourage self-help, and if you don’t participate you might be left to sort yourself out and could be off the programme.

• The Italians go for weight-bearing exercise programmes – ranging from strenuous gym sessions to tailored exercises in the hydrotherapy pool.  Pool exercises were ideal for me, as after a couple of nasty falls I didn’t want a repeat., and water would ensure a ‘soft’ fall, with minimum chance of breaking more bones!  Although the best exercises are weight bearing ones on dry land, the Italians had tailored the programme to fit in with hydrotherapy, and we were soon doing
• Star Jumps
• Walking briskly up and down the pool (using arms)
• and running on the spot – hard

Carrying on with exercises and hydro when I returned to England, my next DEXA Scan showed a marked improvement in bone density!

After that, I became a member of the Royal Osteopororis Society to keep up-to-date, and make ‘use’ of their very usefull Helpline Nurses.  details below

During Covid-19 lockdown, sadly hydro pools have been closed.  I have noticed this definitely has made me less mobile, so I can’t wait for hospital hydro pools to re-open.

Understanding Osteoporosis

• Osteoporosis is more likely to ‘attack’ women, although men suffer too.  There is accelerated loss of bone following menopause. The two most critical factors in determining who gets osteoporosis are how much bone mass an individual accumulates in their teens and twenties, and how quickly they lose it thereafter.
• Half of women over age 50 will sustain a broken or fractured bone resulting from osteoporosis.
• The major complication of osteoporosis is a fractured bone.
• Many fractures resulting from osteoporosis can have major health implications. Spine and hip fractures are notorious for leading to significant declines in function and overall health.
• After the age of 30, you lose bone rather than gain it. That said, there are steps that you can take to slow the rate of bone loss. This is why bone health in young people, particularly young women, is so critical. If they don’t build bone in their teenage years, they will have an increased chance of developing osteoporosis later in life.
• There are ways to control osteoporosis. While some aspects that determine bone density are out of your control (race, gender, etc.), there are others that you can influence (diet, exercise, etc.) Studies show that factors you can’t control account for 75 percent of the condition, but the other 25 percent is up to you.

• Female gender
• Caucasian race
• Advanced age
• Slender build or fair skin
• Poor nutrition
• Tobacco use
• Some specific medications (e.g. steroids)
• Some medical conditions (e.g. thyroid abnormalities)

Treatment

The condition can’t easily be reversed, but it can be slowed down. Treatments are focused on efforts to maintain bone density and prevent continued loss of bone. There are some instances where bone density can actually increase, but again, the emphasis is usually placed on efforts to prevent further bone loss.

• Regular exercise, especially weight-bearing, where you are up on your feet
• Quit smoking
• Eat healthily
• Ensuring you have an adequate intake of essential nutrients, including calcium and Vitamin D, or taking supplements if you don’t consume an adequate amount of these

Medications can be effective treatments for osteoporosis, and there are a number of options for different situations. You need to consult a Rheumatologist or specialist consultant to ask their advice.  Don’t believe your GP (or in my case, my Oncologist)  if they say there is nothing to be done.  There is.

Broken bones are often the end result of osteoporosis. The goal of treatment is to prevent sustaining a broken bone, especially a broken hip.

Any broken bone can be the result of osteoporosis. While broken bones are typically the result of major trauma to the body, such as car accidents or falls, in people with osteoporosis, they are more likely to happen and be severe. Depending on the severity of osteoporosis, people can sustain broken bones by falling from a standing position—or even with no known trauma at all.

Diet

Ensuring that you eat a healthy diet rich in vitamins and minerals is essential for all aspects of health, but it can also aid in reducing osteoporosis symptoms and bone loss. There are three specific minerals you want to pay attention to: vitamin D, calcium, and phosphate

Calcium and phosphate aid in the formation of new, healthy bone, and vitamin D acts as a catalyst for these minerals. Without adequate vitamin D levels, the body will not absorb calcium or phosphate properly. People with osteoporosis should also focus on getting sufficient levels of other nutrients, including:Protein

• Potassium
• Magnesium
• Vitamin K
• Vitamin C

Each nutrient plays its role in bone health, so getting enough is vital for people who want to reduce bone loss or increase bone strength

Exercise

While it may be challenging to exercise with osteoporosis, it’s a necessary lifestyle habit that can help strengthen the bones. When a person adopts a more active lifestyle, their bones become more vigorous.

See the special article on exercise