She's the author of two books of non-fiction: Getting Hooked: Fiction's Opening Sentences 1950's- 1990's
and
Living With Big Cats: The Story of Jungle Larry, Safari Jane, and David Tetzlaff
For ordering information, click here.

To read more about these books, participate in an ongoing joke contest, surf on over to
www.rendell-smock.com .
The author currently lives on Florida's Space Coast.

Shara is the Featured Author for October 1997
at Authorlink!

Medical Treatments

Estrogen

Hormone replacement therapy, usually undertaken by a woman during and/or after menopause, helps prevent osteoporosis. However, estrogen is not a treatment for osteoporosis.

In fact, estrogen is not for everyone. Although estrogen replacement works well for the majority, some people (one young woman I know personally), had the unusual, but potentially fatal side effect of blood clotting. After taking the standard daily oral dose of Premarin longer than one year, this woman had a pulmonary embolism. She had to be hospitalized for days, then submit to a months-long blood thinner medication. Trying to tolerate at least some estrogen, she and her doctor decided for her to take 1/10 the usual dose of topical Estrace.

It's now five years later. She still takes no oral estrogen. She has tolerated the Estrace. As her lab tests indicate that she is not prone to clotting, the embolism was almost certainly a side effect of the Premarin.

Sometime during the five years when she had essentially no estrogen, and no calcium program, she developed osteoporosis.

This woman was fortunate she "just happened" to have a dexa scan. By discovering this bone disease now, she can take action. She's a prime candidate for taking medicine to halt or reverse osteo.

Years ago the medical field had no answer for osteoporosis. We are fortunate that recent years have opened two very different treatment options. If you have osteoporosis, ask what your doctor recommends for you. Like a lot of things, though, osteo treatment is a good news/bad news scenario.

Calcitonin

Miacalcin (calcitonin) is a drug that can prevent further bone loss. It does not rebuild the affected bones.

This drug is administered via a nasal spray. Some people tolerate it well. Others may have side effects, of course the most common one being nasal irritation. The passages can become quite inflamed and sore. Some side effects are severe enough to warrant stopping the medication.

For many people, Miacalcin is an excellent way to stop bone loss.

I can't stress enough the fact that neither Miacalcin nor Fosamax is a replacement for calcium! It's imperative to take 1200-1500 mg calcium daily, to provide your body with the ongoing supply it requires.

Alendronate

Fosamax (alendronate) is the osteoporosis drug of the '90s. It is a well-tested, new drug that can stop osteoporosis and actually start to rebuild bone.

A study of medication's efficacy in rebuilding bone indicate that oral Fosamax improved bone by an average of 10%, which led to a 50% reduction in fractures.

If you are prescribed this oral medication, your physician (and probably the pharmacist too) will stress the routine you must follow to minimize side effects. One thing about this medicine-you must take it in the morning, and you must remain upright after taking it. If you lie down or bend over (say to weed the garden), within a few hours of taking this medicine, you can develop what amounts to a burned esophagus. Sit, stand, or walk: Do not nap. This most likely will result in no problems with the esophagus.

So, you're OK on the esophagus? It seems not too hard to get past that. But then you have to watch for side effects farther down the system: The intestines can become irritated, causing symptoms such as burning, and diaherra.

For my friend's intestinal problems, her doctor recommended a tradeoff. To retain the Fosamax benefits, she takes the drug for five days, then takes a two-day break from it. (I've heard some people actually may switch to calcitonin when taking a break from Fosamax-ALL the while continuing the calcium, of course.)

My friend's prognosis? "Take "Fosamax and calcium for one year and you'll likely have repaired and very strong bones. After that, just keep up with the calcium."

Not bad, considering that two decades ago osteoporosis treatment basically was not an option.

Experts say a strategy to arrest osteoporosis includes a combination of exercise, diet, medication, and safety.

Safety

The huge risk with osteo is what happens after a fall. Each year more than a million fractures are attributed to osteoporosis. One quarter of these breaks are hip fractures, comprising the twelfth greatest cause of death in postmenopausal women. Annually nearly 50,000 hip fracture patients die from complications, usually from blood clots that develop after hip replacement surgery.

Anyone can fall, especially when tired or ill. Beyond that, the risk of falling increases for anyone with a history of any of the following:

• falling, fainting, or losing consciousness
• weakness, dizziness, balance problems
• medication use for high blood pressure, nerves, sleeping, or depression
• impaired vision; or problems with muscle coordination.

Many wellness centers offer complete safety assessments, as well as consulting. For now, here are a few tips to decrease your risk of falling. Look at your home with a fresh eye. Many simple things can increase safety.

• Clear the walkways: Don't partially block a path with furniture
• Don't store anything near a landing or threshold
• Ensure carpets are not loose. Get rid of or tack down throw rugs
• Use rubber-backed mats on the floor outside the shower
• Use a night light if you tend to get up at night
• Install railings outside and in the bath area
• Use a cane or walker if you need to
• Buy a portable phone so you do not need to hurry to answer a ringing phone

And a heads-up for outside the home: One common fall is caused by inattention to those cement car stops in parking lots!

These are inexpensive precautions compared to the cost and pain of a fracture.

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