“Thirty-five year old Donna Duckworth is learning how to care for her newborn of five weeks, when she bends over the baby’s crib and feels something give in her back. The next day and the following week, the pain becomes unbearable in her back. She is breast-feeding and does not want to take any medication so she lives with the intense and continuing pain. Within a few weeks, she can no longer stand it so she goes to see her physician who orders blood work, does a complete physical and as a result, sends her to see an orthopedist who x-rays and does a bone density study.
The diagnosis comes back as osteoporosis and it is found she has fractured three of her lumbar and four of her cervical vertebra.”
Osteoporosis is a disease that affects the inside of your bones. Osteoporosis can affect anyone at any time in his or her life, but mostly in his or her later years.
After reading, one can know what the signs and symptoms of osteoporosis are, what the probable diagnosis is, if it is treatable, what the prognosis is, what a health care practioner would do, who can be effected, what can be done to prevent it, and what new treatments are available. (NOF, 2010)
“A person that has osteoporosis has bones that have lost substances as well as calcium, and other minerals” (UCSF Medical Center, 2010). Osteoporosis has signs and symptoms that one can look for within them. Osteoporosis is not gender selective.
There are no symptoms of osteoporosis in its early stages, but there are symptoms that occur late in the disease. Some of the symptoms that occur late in the disease are bone pain or tenderness, fractures, loss of height, lower back pain due to fractures, neck pain due to fractures and curvature of the spine (The New York Times, 2010). Even though any bone break could be a sign of osteoporosis, one is most likely to have a compress fracture in their spinal vertebra. “These bone fractures are a result of weakened bone cracking from the normal pressure of a person standing upright” (UCSF Medical Center, 2010). The spinal vertebra breaks often result in the curvature of the spine at the shoulders (UCSF Medical Center, 2010). “The curvature of the spine is sometimes called a ‘widow’s hump’” (UCSF Medical Center, 2010). (NOF, 2010)
“Pregnant adult women need an extra 400 milligrams of calcium daily” (Willis, 2010). “That’s about 50 percent more than recommended for women 25 and older” (Willis, 2010). “If there is not enough calcium in the mother’s diet, the fetus may draw calcium from the mother’s bones” (Willis, 2010). “Calcium deficiency in pregnancy may result in osteopenia (decreased bone density) in the mother” (Willis, 2010). Ms. Duckworth was in the standing position at the time that she felt something give in her back. Considering Ms. Duckworth gave birth within a year and her age, the likelihood of her having osteoporosis probable due to the improper amount of calcium intake.
Diagnosis is crucial in osteoporosis. One of the best ways to determine if one has osteoporosis is by doing a bone density test. There are different types of techniques that can be performed in order to diagnose osteoporosis. Some of the different techniques are dual X-ray absorptiometry (DXA), ultrasound, quantitative computerized tomography (QCT), and lateral radiographs (UCSF Medical Center, 2010). DXA is a can of the spine with a low-dose X-ray (UCSF Medical Center, 2010). (NOF, 2010)
Ms. Duckworth should have a DXA of the spine and hip areas as well as the blood and urine tests. If necessary, a QCT should be ran based on the results of the DXA. These tests will determine the severity of Ms. Duckworth’s bone density issue. It will tell if she has osteopena due to pregnancy or a more severe case, osteoporosis. “Almost 80% of bone density is determined by heredity and 20% by lifestyle” (WebMD, 2010). “Bone mineral density tests (BMD) shows how dense bones are and whether you have osteoporosis” (WebMD, 2010). “This information helps determine which prevention or treatment steps are needed” (WebMD, 2010). There are different laboratory tests that can be ran by doctors that helps in diagnosing osteoporosis. These tests are run with samples of blood and urine from the patient. Some of the tests are blood calcium levels, 24-hour urine calcium measurement, thyroid function tests, parathyroid hormone levels, testosterone levels in men, 25-hydroxyvitamin D test to determine whether the body had enough vitamin D, and biochemical marker tests, such as NTX and CTX (NOF, 2010).
Osteoporosis is a treatable disease, but not a curable one. There are different types of treatment for osteoporosis. Some of the medications that can be taken for treatment of osteoporosis are estrogen, bisphosphonates, calcitionin, raloxifene, parathyroid hormone, and testosterone replacement (UCSF Medical Center, 2010). Some of the more common names for bisphosphonates are Fosamax, Actonel, Boniva, and Reclast (Mayo Clinic, 2009). These treatments are taken orally once a week or once a month. In addition to the medications, there is also the treatment of exercise and diet. With a diet high in calcium, stopping unhealthy habits, like smoking and drinking, and regular exercise can reduce the likelihood of bone fractures in people with osteoporosis (The New York Times, 2010). In Ms. Duckworth’s incident, it would be recommended that she increase the amount of calcium in her diet and exercise, and depending on the severity of the osteoporosis, medication.
Prognosis for osteoporosis is that the disease is treatable, but not curable. There is not one simple treatment for this disease. If one has the markers for osteoporosis, then the amount of risks should be kept to a minimal. Prevention is the best way to lower the odds of obtaining osteoporosis. One should make sure that the amount of calcium needed is in their diet. They should also develop an exercise program that avoids the risk of falling or could be considered high-impact, as that those could cause fractures. Ms. Duckworth future could turn to one as beneficial as it was before the spinal fracture. With proper diet with high calcium intake, an exercise program to reduce the likelihood of fractures, medication, and check-ups Ms. Duckworth could be back to her normal activities.
As a healthcare practioner, Ms. Duckworth would be advised to increase the amount of calcium in her diet and add an exercise regiment. Based on Ms. Duckworth’s blood and urine analysis, it would also include medication if necessary. Ms. Duckworth would also be scheduled for routine check-ups to see the progression or recession of the osteoporosis. Family history would also need to be looked at for Ms. Duckworth. As previously stated, 80% of persons with osteoporosis obtained the disease through hereditary genetics,
20% obtain it through life choices and medical conditions. If Ms. Duckworth were suffering from osteoporosis from hereditary, treatment with medication would be probable, instead of just diet and exercise. Osteoporosis most commonly is diagnosed in women and men over the age of 50. Osteoporosis is considered a health threat for 44 million U.S. women and men aged 50 and older (NOF, 2010). The following chart gives an indication of the prevalence of osteoporosis in women and men in the U.S. through the year 2020 (NOF, 2010). Prevalence of Osteoporosis and Low Bone Mass in People Aged 50 and Over 200220102020
Osteoporosis and Low Bone Mass in Women and Men43,600,00052,400,00061,400,000 Osteoporosis in Women and Men10,100,00012,000,00013,900,000 Low Bone Mass in Women and Men33,600,00040,400,00047,500,000 Women With Osteoporosis or Low Bone Mass29,600,00035,100,00040,900,000 Women With Osteoporosis7,800,0009,100,00010,500,000
Women With Low Bone Mass21,800,00026,000,00030,400,000
Men With Osteoporosis and Low Bone Mass14,100,00017,300,00020,500,000 Men With Osteoporosis2,300,0002,800,0003,300,000
Men With Low Bone Mass11,800,00014,400,00017,100,000
Even though there are several different ways to prevent progression of osteoporosis, they are not a guarantee that it will stop the progression. With the medication as treatment for the osteoporosis, there are still occasions that bone fractures can occur. “The Food and Drug Administration issued a warning linking long-term use of popular osteoporosis drugs to an unusual fracture of the thigh bone” (Wilson, 2010). With the profound results of the bisphosphonates slowing the loss of bone mass, they have been proven to have nagging safety concerns that are jaw osteonecrosis, arrhythmias, and esophageal cancer (Wilson, 2010). Drug makers are working to find new ways of treating osteoporosis. “The Food and Drug Administration (FDA) approved a new injectable osteoporosis treatment for post menopausal women” (FDA, 2010). “Prolia is a treatment for postmenopausal women with osteoporosis who are at high risk for fractures”
Osteoporosis is an unforgiving disease. It cannot be cured, but can be slowed in its progression. Prevention is the way to proactive. One should be sure to consume calcium in their diet that is adequate for their needs and to be in an exercise regiment that will aid in reducing fractures. One should also be careful in putting himself or herself at risk by smoking, drinking, being off balanced, or doing rigorous exercising that could possibly cause fractures. If one does these things and has regular check-ups, then they should be able to reduce the likelihood of severe osteoporosis. Total Words: 1,422
U.S. Food and Drug Administration (FDA). (2010, June 1). FDA Approves New Injectable Osteoporosis Treatment for Postmenopausal Women. Retrieved from FDA.gov:
Mayo Clinic. (2009, August 27). Osteoporosis Treatment Puts Brakes on Bone Loss. Retrieved from MayoClinic.com:
National Osteoporosis Foundation (NOF). (2010). Diagnosing Osteoporosis. Retrieved from nof.org: National Osteoporosis Foundation (NOF). (2010). Prevalence Report. Retrieved from nof.org :< http://www.nof.org/print/219> The New York Times. (2010). Osteoporosis Overview. Retreived from nytimes.com: UCSF Medical Center. (2010, October 29). Osteoporosis Diagnosis. Retrieved from ucsfhealth.org:
UCSF Medical Center. (2010, October 29). Osteoporosis Signs and Symptoms. Retreived from ucsfhealth.org: UCSF Medical Center. (2010, October 29). Osteoporosis Treatment. Retreived from ucsfhealth.org: WebMD. (2010). Osteoporosis Guide Diagnosis & Tests. Retreived from webmd.com: Willis, Judith Levine. (2010). All about Eating for Two. Retreived from childbirthsolutions.com: Wilson, Duff. (2010, October 13). Prescriptions. Retreived from nytimes.com: