About Those Bones ...
A few years ago I found out I had osteoporosis.
To say I was surprised would be an understatement. Like rheumatoid disease, I’d always thought that osteoporosis was a disease that struck only the elderly. Sure, I was in my early 50s, but I didn’t consider that “elderly.” I reserved that word for people who’d at least passed their 75th birthday. Today, 75 doesn’t sound “elderly” to me, either. I’m an eternal child.
Who is impacted by osteoporosis?
I was wrong about osteoporosis, just as I was wrong about rheumatoid arthritis. It can strike at any age, but more after the age of 30, and it’s most common in people aged 50 and older. Men get osteoporosis, but being female jacks the ante up about 80 percent.
If you’re white or of Asian ethnicity, have osteoporosis in your family, have smoked, or have rheumatoid disease, your chances are even greater that you’ll get it one day.
How does osteoporosis affect our bones?
Bones are made of living tissue, and all living tissue eventually dies. Fortunately, your body replaces your dying bone tissue with brand-spanking-new, strong, dense, robust, and healthy tissue in a continuing cycle that doesn’t end until your death.
Bone loss and brittle bones
But osteoporosis, a progressive disease, makes your bones lose tissue faster than your body can replace it, and eventually, the bone structure itself becomes lattice-like, weak, and brittle. Everyday, simple actions like bending over, pushing something, or even coughing can cause a fragile, osteoporotic bone to fracture.
Is there osteoporosis and rheumatoid arthritis connection?
Rheumatoid disease causes chronic inflammation throughout the body, but focuses mainly on the synovium, that tough, fluid-filled capsule that surrounds the joints. RD appears to trigger bone loss with the cytokines--proteins that control inflammation--that may regulate osteoclast cells, which are responsible for breaking down bone. Having RD increases your risk of osteoporosis.
Other factors that put me at risk
So. I’d managed to have most of the risk factors: I was female, had relatives who’d had osteoporosis (my mother and my aunt), I’d smoked for many years, I was white and over 50, and I had rheumatoid disease. Wow. I had other risk factors, too: I was overweight and I didn’t exercise much. Too much weight puts extra stress on the weight-bearing bones (and osteoporotic bones can break very easily), and lack of exercise hastens bone loss. There are other risk factors as well. You can read about them here.
Getting an osteoporosis diagnosis
My rheumatologist sent me to have a dual energy x-ray absorptiometry (DXA or DEXA, “dex-ah”) scan to measure my bone mineral density (BMD). He made that decision based on my risk factors, and I’m glad he did. The results showed that my bones had lost enough density to suggest that I had osteoporosis. At age 54, after having had RD for 24 years, I could fracture a bone without suffering a fall or a trauma. The bones most commonly at risk are the wrists, hips, pelvis, thighbone, and spine.
He started me immediately on a drug in the bisphosphonate family. These drugs, which include Fosamax and Boniva, work to rebuild bone density. He also suggested that I start doing weight-bearing exercise, like walking or resistance training with weights or bands. These help build bone density at the same time they build muscle strength, which we need to help support arthritic joints, anyway.
He also increased the dosage of the calcium supplement and Vit. D he’d already prescribed for me.
Adding more food-based calcium to my diet
I read up on osteoporosis on the Internet when I got home. (I love the Internet. I’m constantly learning new things!) The National Institutes of Health suggested I eat a healthy, nutritious diet to make sure I got enough food-based calcium (leafy greens like collard greens and kale, broccoli, figs, and bok choy, oily fish like salmon and sardines, and low-fat dairy foods, including yogurt, milk, and cheese). That healthy diet could also help me lose weight if I needed to, and it could help me maintain a healthy weight once I achieved it.
Osteoporosis can be prevented or slowed down
Osteoporosis is a scary disease. A broken bone is difficult for anyone, but for someone who’s elderly or already compromised, like those of us who have rheumatoid disease, it can be catastrophic. It can mean loss of independence, permanent disability, or even death.
You can’t cure osteoporosis, but you can prevent, slow, or stop its progress. You can also do everything you can to prevent falls: remove tripping hazards in your home, like throw rugs, wear proper footwear, and use mobility aids correctly. Consider taking yoga or tai chi, as well as doing your regular weight-bearing exercise. Both can do wonders for your balance, no matter your age or physical condition.
Right now, what RA tips would most be helpful for you?