Good News/Bad News

I have severe osteoporosis and I've fractured both femurs since my spinal cord injury. The good news is that I have matching X-rays. The bad news is that I've learned that I am incredibly fragile.

Osteoporosis is a problem for people who don't bear weight on their bones and I understand that most people with SCI have some degree of osteo. After my first fracture, I learned a lot about osteo, and I've been actively working to reverse my bone loss. I take Actonel regularly. I eat a high calcium diet and take supplements. I stand for 2 - 3 hours each day in my standing frame. I participated in a FES study that created weight bearing exercise.

I went for a DEXA scan today. DEXA scans measure bone density. Often, the practitioner can give you an idea of how "old" your bones are based on their density. Last year I learned that the long bones in my arms were 36 y.o. my right hip was 75 y.o. and my left hip was 85 y.o. YIKES! I'm in my mid-forties.

The good news from today's DEXA, the very, very, very good news is that my spine and right hip have shown improvements. The spine more than the hip but improvement is improvement. The bad news, the very, very bad news is that my left hip has lost about 35% more bone density.

After consultation with the doctor, it appears that may be because of two factors, my most recent fracture was to my left leg. The splint and the support that kept the leg elevated seems to have been a factor in my bone loss. The other reason is that my left hip has twisted from the imbalance of my muscles that should hold it stable. The condition is called a pelvic obliquity and it's caused a severe "swoop" in my spine. It's hard to breathe sometimes because if it. Since I no longer bear my weight evenly on my hips, this seems to be a major factor.

The good news is that we'll get more aggressive on fixing my hip which has caused numerous problems. The bad news is that we'll get more aggressive on fixing my hip.

As far as osteoporosis treatment and prevention; the good news is there are options. I will take a new drug, Forteo and continue to stand in my frame and maintain a calcium-rich diet. The bad news, Forteo is a relatively new drug and there are some concerns about its safety. I think about the drugs that have created safety concerns lately; Vioxx, Avandia... others. I'll be taking this drug that may or may not pose risks by daily injections for two years. The other bad news, I'm no longer eligible for the FES study so I'll be unable to use FES and weight lifting to preserve my bones.

During my rehab I was taught that all of my choices from here on are going to be about weighing risks and benefits in making decisions about my care. I just hope these particular decisions are right in the long run.