Bone density ain’t just for kids
Having old lady bones has made me feel really vulnerable. When my family and I were in Taipei over Chinese New Year, I didn’t see a step and fell down. If you read my first article, you would know I have osteoporosis and osteopenia. Falling down was the opposite of what my doctor told me to do (his advice, verbatim, was, “Don’t fall.”). It was a minor tumble, but the minute I got up I burst into tears. Not because I was hurt, but because all I could think was, “I hope I didn’t break another bone.” The very idea of having to be immobile again for another few months – I love to hike at the weekends and do yoga – made me so scared and upset. And, frankly, a little depressed.
Luckily, I was fine, although I got a minor sprain, according to my physical therapist who treats me twice a month for my collarbone surgery rehab.
But I’m getting ahead of myself.
Let me get back to what happened after I saw my endocrinologist. He examined my test results, and discovered my vitamin D levels were extremely low (vitamin D is essential in assisting calcium to help strengthen bones). Apparently, most Hong Kongers are also vitamin D-deficient, as there are only, on average, only 160 days of sunshine here a year (that’s almost as few as Seattle, which is known for its gloomy weather and has 154 days of sun per year). And because I have lived on the east coast of the United States for 17 years, I didn’t see the sun much there, either.
All that time I was thinking the lack of rays would ward off aging skin. I didn’t think what it would do for my bones.
But my doctor was perplexed about treatment.
“Here I have a healthy woman sitting in front of me,” he said. “So, I don’t want to give you a treatment that will adversely affect you.” (Yeah, me neither, doc.)
What he meant was this: there are a few options one can do to strengthen bones. You can start an alendronate treatment, which is ingesting a drug used to prevent certain types of bone loss in adults. Alendronates belongs to a class of drugs called bisphosphonates, which are commonly prescribed to treat osteoporosis. Here’s the problem, according to my doctor: taking those drugs actually increases the risk for random bone breaks.
Yes, you read that correctly. I could break more bones just by taking the medicine. (Um, no thanks).
The alternative was to take hormone replacement therapy (HRT), which has had a lot of negative press in the past decade or so because it has been shown to increase breast cancer chances in post-menopausal women.
Again, no thanks.
But I couldn’t say no to everything. I had to take one of these options because if I didn’t, I risked compression fractures in my spine.
This was not sounding good.
After weighing my options, I decided on the HRT path. Since cancer doesn’t run in my family, thankfully, I am at reduced risk for getting breast cancer. (Finally, some good news.) Going the HRT route meant I was going to be taking oestrogen (something women lose as they get older) in a gel form and progesterone in a pill form. The idea behind this method is that it will help build bone mass, albeit slowly. I won’t know for at least a year because bone density scans don’t show anything that quickly.
My doctor also recommended I take 5000 IU of vitamin D3 (and then 2000 IU after a lab check to see if my levels have improved) as well as 1200 milligrams of calcium a day.
He said he will check my blood for markers (to see if the calcium, vitamin D and HRT together have been helping), and at that point he would discuss the next step to see if I should continue on the HRT or try another method.
Until then, I tell myself, “Don’t fall.”