Based on her prior bone density scans, Moore had already begun implementing these actions. She doesn’t drink excessively or smoke, she practices yoga and Pilates several times a week, and she tries to be active whenever possible, such as by mowing her own lawn. But she admits that she hasn’t always been diligent about taking her 600 mg daily calcium supplement (it also contains 400 IU of vitamin D). Upon learning the new test results, she is committing herself to be more vigilant. “The new results will motivate me to put the pills by my coffee pot and take them every single morning. I want to do as much as possible to avoid this disease,” she says.
When Medication Is Needed
Women with T-scores below -2.5 and those with better scores but who also have serious risk factors should be prescribed bone-strengthening medications, Siris says. Her own recent study found that in an eight-year period ending in 2008, oral medications alone prevented some 144,000 fractures in the US.
(such as Fosamax®
Common medications include bisphosphonates , Boniva®
, and Actonel® ), as well
as selective estrogen receptor modulators and the hormone calcitonin. There are osteoporosis medications available in pill form, intravenously, and intramuscular injections. Yet many women who could be preventing future fractures by taking medication are not doing so. Some shun these medicines because they worry about highly publicized side effects like jaw-bone problems or unusual fractures of the thigh bone, but Siris says that such events are extremely rare.
10 pause SPRING / SUMMER 2012
“The overwhelming majority of women who take these medications have no problems, and they get important benefits,” she says. Fear about these potential side effects she’d heard
from media stories is what initially kept Miriam Fernandez, 62, from McAllen, TX, from taking the drugs. Although she had pain in her hip that both she and her doctor suspected was from osteoporosis, Fernandez resisted getting a DEXA scan because she feared it would lead to a pill prescription. But two years later she started hearing other stories—these from friends some twenty years her senior, who wished they’d taken medication sooner. “Several of my friends had broken a bone, while others had severe, and progressing, osteoporosis, and they encouraged me to take action to avoid this,” Fernandez says. She also spoke with her doctor, who further allayed her fears. A subsequent bone scan revealed that she did, indeed, have osteoporosis. Fernandez now takes Fosamax®
(alendronate)
one morning a week, along with twice-daily calcium pills and regular exercise. She has had no side effects (not even the more benign bloating or constipation or inflammation of the esophagus the medicine can sometimes cause), and her hip pain has markedly diminished. She has come to appreciate her medication, especially when she learned that her older sister, who also has osteoporosis but lives in Cuba, does not have access to these drugs. Moore, who currently takes daily medication for her type 1 diabetes, is pleased that she doesn’t yet need to add to her pillbox. But she remains open-minded. “I plan to do whatever it takes to remain active and healthy for many more decades,” she says. For now, the road to that future means sticking with exercise and supplements.
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