Osteoporosis: a stealth assailant
Staff writer
Fred Helmer, of Marion, walked off his deck five years ago and shattered three vertebrae in his spine. The deck was merely a step or two and his spine broke in three places.
Helmer, in his 80s, has osteoporosis. A person with untreated osteoporosis is constantly at risk of breaking a hip or other bones. A break can occur while a person is walking or performing some other normally innocuous task. The disease is most commonly associated with elderly women, but men are often diagnosed.
Max Hayen, 75, of Marion, knew something was wrong when he started having problems with his knees 15 years ago.
“I played softball until I was 53, and I was playing with a bunch kids in their 20s,” Hayen said. “I could still outrun them, but while I was running, my knees started to feel loose.”
Eventually the strange sensation of loose knees rubbing together evolved into discomfort and eventually pain. Hayen visited Dr. Don Hodson at Marion Family Physicians who advised him to see an orthopedic surgeon in Hutchinson. Hayen learned that all the cartilage in his knees was gone and that he had osteoporosis.
As a remedy, Hayen receives cortisone shots which allow him to live relatively pain free for 10 weeks.
“It’s like pouring a quart of oil on a dry bearing,” Hayen said of the shots.
Hayen has been receiving cortisone injections for years and they continue to provide relief. This may allow him to avoid knee surgery.
“(The specialist told me) as long as you get 10 weeks pain free, I’ll never do surgery on you,” Hayen said.
Hayen has a brother and an aunt who have had both knees replaced and neither has been an advocate for surgery. His brother and aunt are just two examples of family members who have struggled with osteoporotic knees; a condition Hayen said is hereditary.
Although he can move without pain, Hayen is limited by the condition. He said that doctors have encouraged him to walk, but a half a mile makes his knees ache. He can also carry up to 20 pounds nearly any distance, but if he increases the load to 50 or more pounds, it could hurt his knees.
As exercise, one of the best treatments for osteoporosis, Hayen participated in an aquatic aerobics class for five months.
“I always worked in water up to my shoulders to take as much weight as possible off my knees,” he said.
Detection
To detect osteoporosis patients can receive Dual Energy X-Ray Absorptiometry scans, which are most often covered completely by insurance companies as a preventative measure. The test costs $100 without insurance.
“They would much rather have this done than pay increased cost of injury in the hospital,” St. Luke Radiologist Joe Pickett said.
Doctors may ask for a DEXA scan if they know a patient is at risk. For generally healthy individuals, Pickett said that women should start being tested at the onset of menopause — anywhere between the ages of 45 and 58 — and men should be scanned between the ages of 60 and 65.
Pickett has operated a Dual Energy X-Ray Absorptiometry scanner since 2008. Pickett said that a DEXA scanner has only one purpose, which is to check for osteoporosis. Osteoporosis can occur at any age.
Pickett said that he has scanned children as young as 8 or 9 years old because they were asthmatic and used steroids. Certain steroids can cause bone damage. Other medications and diseases can also cause bone deterioration, but generally, osteoporosis affects older patients. Pickett also said that approximately 86 percent of osteoporosis patients are women.
Pickett said that most patients don’t know that they are osteoporotic until they get an X-Ray for a different medical procedure. Pickett gave the example of a chest X-Ray.
“If we can tell by looking at an X-Ray, it’s really advanced,” Pickett said.
Like other diseases, early detection is key to successfully treating osteoporosis. The sooner it can be spotted on a DEXA scan the more likely that diet, exercise, and a drug regimen might stop bone deterioration.
Osteoporosis and osteopenia are conditions that take a long time to treat and show progress slowly, which can discourage patients. It takes a least a year to see any progress on the scanner with an aggressive drug treatment. Pickett said that patients come in for follow up tests and see no change in their bone density and can get discouraged.
“You see it at a -2.5 (initially osteoporotic) and they’re still at a -2.5, that’s a good thing,” Pickett said.
Last modified July 14, 2010