A July Fourth Lesson
Hair

The Endocrinologist

For the past six weeks, I have been struggling with (or rather against) my primary care doctor’s recommendation that I take Fosamax for my osteoporosis.

I do everything I can to keep my bones strong—I take calcium and vitamin D, lift weights and exercise vigorously, but I still have osteoporosis.  My primary care doctor did not buy my argument that I don’t need to worry about my bones because when I was hit by a car and thrown from my bike in December, nothing broke.

My situation is complicated by the fact that because of my celiac disease, I may not absorb medications when I take them.  In addition, I worry about  possible side effects of Fosamax, including heartburn, necrosis of the jaw, and/or a broken femur.

When I asked the doctor who had diagnosed my celiac disease for advice, she recommended that I see an endocrinologist.  He asked me to get a new bone density test and some blood tests before our appointment.   

When I saw the endocrinologist Tuesday, the blood tests showed that I had adequate calcium and vitamin D in my system.  Good news.  But the bone density results had not arrived.  He asked his assistant to get them faxed over from the testing center.  While we waited, we discussed my options.

If my bone density had improved (as a result of parathyroid surgery I had three years ago), or if it stayed the same, we would do nothing.  But if it was worse, we probably needed to consider medication. 

I sat outside his office anxiously waiting for the results.

When they arrived, we looked at them together.  My numbers were not worse.  They were not the same.  They were a teeny bit better, although I still have osteoporosis.

So we’ll repeat the tests next year.  In the meantime, I get a year’s reprieve from worrying about heartburn, necrosis of the jaw, or a broken femur.

Comments

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Bruce

Look into the European perspective on osteoporosis. They take a different view, instead of massive calcium and D, they eat greens (K2 perhaps?) and emphasize other minerals like magnesium. I have no doubt that Fosamax has a serious downside to it and you are right to be extremely wary of it.

Mary Brick

Hooray! Your approach to proper health care is refreshing.

Dr. Brenda Berretta

I am not a medical doctor, but I try to limit the drugs that I take to the absolutely necessary ones. Load-bearing exercises do more for bone density; I have not been walking because of a back problem and worry that my bones will suffer. I used to take Fosamax but stopped with all the negativity publicity.

Donna Pekar

Hi -- I found your blog by way of As Time Goes By. I'm a fellow elder blogger. I had ovarian cancer at age 43, and I'll be 57 in September. No estrogen in all that time has contributed to bone density problems. There's some good info on these sites:

http://courses.washington.edu/bonephys/

http://gilliansanson.wordpress.com/

I do not take bisphosphonates. I corresponded with Dr. Susan Ott, who is considered an expert in these matters. She did not recommend taking the drugs. I know it's hard to decide what to do.

Jess Hobart

Hi Judy, It's been a long time! Found your blog because I googled you and Seth. It seemed like someone who is that much fun and that articulate would have to be your kid : ) Anyway, was just having this same conversation with my PCP yesterday about if/when bisphosphonates since I have (at 43) osteopenia from my chronic disease. Her strong opinion was against them as well. For menopause-related osteoporosis she said she's choose estrogen replacement (with all its consequent concerns) over bisphosphonates. Since I'd have to start them young and the research is mostly on older women, I'm wary. (Though interestingly, there's now some research on younger women on the drugs because it is used for some people with eating disorder-induced osteoporosis). In any case, nice reading your blog. Thanks, Seth, for mentioning it on his blog!

Regards,
Jess

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