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Published July 08, 2012, 11:30 PM

Medications, exercise can help slow or reverse damage from osteoporosis

MOORHEAD - After years of taking medications and supplements to combat her osteoporosis, LuAnn Haugen’s bones kept shrinking and getting weaker, increasing her risk of broken bones that could take away her active lifestyle.

By: Ryan Johnson, INFORUM

MOORHEAD - After years of taking medications and supplements to combat her osteoporosis, LuAnn Haugen’s bones kept shrinking and getting weaker, increasing her risk of broken bones that could take away her active lifestyle.

“I was going to complain because I invested in a full person, and here she is disappearing,” joked Wesley, her husband of more than five decades.

But a new medication means she’s now all back – “just like a refurbished car,” according to Wesley.

“Thanks, I guess,” Haugen retorted about her husband’s take on how a new medicine has helped her bounce back.

Despite taking Fosamax, a common prescription medication that helps many osteoporosis sufferers cut their chances of broken bones, a 2010 checkup showed her bone density had dropped 15 percent in just two years.

She was referred to a specialist, endocrinologist Thomas Moraghan at Sanford’s Southpointe Clinic, and was prescribed Forteo, a newer medication that has improved her bone density by 20 percent in just over a year.

“That’s a huge increase, and as bone density goes up, fracture risk goes down,” Dr. Moraghan said.

Haugen, a retired nurse who said it’s “no big deal” to give herself the daily injections, said the medicine has worked so well that she no longer has osteoporosis.

Moraghan explained that doctors diagnose osteoporosis based on bone density scans, a low-radiation X-ray that compares a patient’s bones to those of a healthy 30-year-old at the “peak of life” when the bones have reached their maximum strength.

The test calculates a t-score, and if the figure is too far below normal, the patient has osteoporosis.

If the test finds decreased bone density, but not enough to be considered osteoporosis, they are diagnosed with osteopenia – a label now applied to Haugen.

“You still have some rather low bone density, but it’s not to the point of osteoporosis anymore,” she said.

A BAD FALL

Like high blood pressure or cholesterol, Dr. Moraghan said osteoporosis is a silent disease that often goes unnoticed until sufferers fall and break a bone.

By itself, the condition won’t cause pain or symptoms that hint at the underlying issue. But Moraghan said it’s important to catch it early on, not after a fall breaks the hip or compresses the spine with possibly “devastating” and life-altering results.

“Sometimes it’s a real tragedy because you get these people that are in pretty good health, worked hard their whole life, and they hit their 60s or 70s and then they get this,” he said. “It takes them from thinking they’re going to enjoy their retirement, or maybe they’re not even in retirement yet, to all of a sudden they live with chronic pain, maybe limited function and live in fear of future fractures.”

Haugen didn’t know she had osteoporosis until 1996, when she fell while exercising and broke her wrist at the age of 63.

Now 79, she said she “wasn’t terribly surprised” by the diagnosis because her mother had it –common among sufferers of osteoporosis, a condition that can run in families and put people at higher risk of developing the weakened bones that affected their parents.

Her condition caught up with her again in 2004 while hiking with friends in Washington’s Cascade Mountains.

Haugen said she was trying to cross a small ditch by walking across a log, but she lost her grip and fell a few feet from the log.

“We were way away from civilization, and I had to be helicoptered to the city to the hospital,” she said. “Nothing like creating a stir.”

Haugen was in the hospital for a few days, and she had to spend a couple of weeks bedridden in a nursing home while recovering from fractures on both sides of her pelvis.

But she was relatively lucky – she didn’t need surgery and doesn’t have any long-term damage.

Moraghan said osteoporosis-related fractures can cause big problems. One in five elderly people who suffer a broken hip are dead within a year, he said, because they have higher risks of complications from surgery and infections or blood clots while bedridden.

“The other part is just the quality of life,” he said. “Even if they don’t die from it, it can take away the independence of someone who was living alone at home.”

STAYING HEALTHY

Osteoporosis is “very prevalent,” Moraghan said, with as many as 25 million to 30 million Americans suffering from either osteopenia or osteoporosis.

But even the experts don’t have consistent guidelines for when, or if, a person should be tested.

Generally, women 65 years and older should consider testing, he said. But post-menopausal women could go in for bone scans even earlier, especially if they have other risk factors like a family history of osteoporosis.

The condition is more common in women partly because menopause can be a time of rapid bone loss as estrogen levels drop.

But Moraghan said it also is related to the differences in development between men and women.

Men typically reach a higher bone mass than women by the time they are about 30, putting women at a disadvantage for bone health the rest of their lives.

“Once we hit our 20s or 30s, we basically hit our peak and then after that we try to preserve it the rest of our life,” he said. “We have cells that make bone and cells that break it down, and it’s basically a matter of trying to keep those cells in balance.”

While women typically develop the condition at a younger age, Moraghan said it can affect men just as much later in life.

“We’re seeing a lot of increased osteoporosis in the male population just because men are living longer,” he said. “As men get in their 70s or 80s, we start to see the rise in their fracture rate.”

Men 70 and older should consider a bone density scan, he said. But no matter the gender, Moraghan said testing should be done if someone suffers a broken bone from a low-trauma fall, such as falling from a chair.

Medical conditions, certain medications and eating disorders can cause osteoporosis much earlier in life, he said, and anyone concerned about their bone health can talk about testing with their doctor to see if they are at risk.

Moraghan said it’s important to know there is plenty of hope in treating the disease, even if it can lead to big problems if left unchecked.

Several types of prescription medicines are available that can halt bone loss or even strengthen bones while cutting the risk of fractures in half, he said, and adding calcium and vitamin D can slow down the effects.

Moraghan said walking or lifting weights also can help keep bones strong, one of the many benefits of regular exercise.

Haugen and her husband walk three or four times each week, making the loop from their Moorhead condo to the Concordia campus where they met 57 years ago, as one way to combat osteoporosis and stay fit.

Moraghan said osteoporosis sufferers also can get professional help to minimize clutter and loose cords in their house, lowering their risk of falls that could lead to broken bones.

But the best thing, he said, is to deal with possible risk factors like smoking, excess alcohol use and low calcium in the diet to cut the risk of developing osteoporosis later in life.

“It’s important we think about it just like diabetes and try to prevent it from the time we’re young,” he said.

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