While you are currently at high risk, you may be experiencing minor aches or pains, have decreased perfomance, have started to lose height, and have hunching of your spine. Many of you will have already had a fracture and be taking medication that has sapped your bone density over the years. Such medications include prednisone and thyroid medication. Progressive bone loss is very likely if not inevitable as you age further increasing your risk for pain, suffering, and disfunction that arise with osteoporosis. Many people lump bone loss and osteoporosis into the classification of arthritis which is also common. However, treatments for arthritis beyond pain medications are few whereas there are many good treatments available to reverse bone loss.
   Indeed, some doctors prescribe two different medications to increase bone density. The good news is there are many ways to reverse your current situation. Even though this screen classifies you as at high risk it is impossible to accurately access ones bone mineral density with any written screen. One needs a DEXA bone density to best access ones current bone status and osteoporosis risk. While this screen is not perfect by scoring in the high risk group we strongly suggest you call your doctor without delay and schedule a complete medical evaluation and DEXA as soon as possible. You can take this questionnaire and the education we provided to serve as a basis for discussion.

FACTS AND STATISTICS
Early bone loss is often silent
Bone loss is inevitable
Aesthetic loss and decreased performance occur at younger ages than fractures.
All men and women are at risk.

Early bone loss is often silent.
     Many aches and pains, back pains attributed to over use or strain could be early warning signs of bone loss in any adult. Since individuals old or young have no reference for what some one else feels, or what normal discomfort is for a given amount of exercise we all tend to over look these early warning signs of bone loss.

Bone loss is inevitable
     If you live to be 70 statistically most will have significant bone loss. All one needs to do is to think of any 70 year old, even the most active one, and they will notice that they do not look or preform as well as an average young adult. However, by minimizing bone loss and reversing existing bone loss many people will be better able to improve their performance and prevent what would other wise have been a progressive decline and loss of function.

Aesthetic loss and decreased performance occur at younger ages than fractures
     Other reasons to find out your current bone density include early prevention of pain, lost function, and the aesthetic losses bone loss produces. While many doctors do not mention them these are often more important to individuals than the extreme consequence of fracture. Fractures usually occur in old age, but pain and lost performance can occur now. Loss of teeth which sit in bone, need for dentures and denture re fitting, as well as the slow progression of curvature in the spine and lost height are other issues many would prefer to avoid. If you have already had a fracture now more than every you need to seek help as bone gain is possible with existing medications.

All men and women are at risk.
     While this screen shows that you have high risk of having significant bone loss, it does not quantify how much bone you have lost. People can have significant bone loss and have no or few symptoms. Our suggestion is to discuss bone loss with your doctor or a osteoporosis specialist and establish a prevention plan to prevent bone loss starting with a DEXA scan.

PREVENTION AND TREATMENT
     While we can not give you a plan, a DEXA bone density test is essential for determining your bone density now. Since you are at high risk your chances are very high that you already have significant bone loss. If a bone density test reveals higher than average bone density you will sleep better. If on the other hand your bone density is less than average for your age, your compliance with a prevention and treatment plan will be heightened knowing that your bone density is already less than average, and that you are much more likely to age, have increased aches and pains, and have lower function, than others of your age. The DEXA is the basis for the plan.

Why haven't I heard of this before?
What is a prevention or treatment plan?
When to start?

Why haven't I heard of this before?
     For less severe cases some doctors say that the test will not change my treatment and all should "JUST" take calcium anyway so the DEXA is not needed. However the frequency of future tests is a variable that would change based on the results of the initial DEXA as would the work up for the causes of bone loss and the medications prescribed including the dose of calcium offered if the bone density is low. Many specialists would check other blood tests and review the diet and behavior and medications much more closely if the bone density were low. Fortunately, there are many prescription medication as well as environmental treatments including exercise, diet and vitamin supplements available to treat even moderate bone loss. For more advanced bone loss some specialists even prescribe more than one mediation to increase bone density more quickly. However, all medications should be taken while under supervision of a doctor and part of a structured bone loss prevention plan including provision to maximize function and minimize falls.

What is a prevention or treatment plan.
     We use this term to describe a complex plan that includes many different modalities of treatment including :
- Prescription medication - blood test and DEXA bone density,
- using environmental therapies and adaptive devices to improve function and maximize pain control.
- behavior counseling to modify risky behaviors like drinking and smoking,
- exercise to improve over all wellness, strength, ability to adapt when one is injured, and minimize falls.
- diet to maximize calcium and vitamin intake without worsening weight gain ( many calcium rich foods are also calorie rich )
- finally, maximizing emotional suppoort and reassurance that the disabilities are reversible.

When to start?
     It is never to late or early to start as this is a process we all will get or already have. To be more informed early and to have the plan in place goes a long way to staying active and well. Likewise getting treatment helps reverse an other wise progressive process with pain full and devastating consequences of pai, immobility, lack of function, reliance on others, and loss of self esteem. Indeed, many end up in nursing homes needing help with basic functions like, bathing and walking.

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