Just diagnosed - what questions to ask doc? - Osteoporosis Message Board

lurudolph · 04-04-2008, 04:05 PM

Hi, I'm a 77-year-old male and just got the news that my DEXA-scan report shows that I have oteoporosis. My T-scores(?) are: left femur -3.7, spine - 2.7, neck -2.6. I don't know if that's bad or good, but it sounds bad to me. These were read over the phone to me. I've requested a copy of the scan report but don't have it yet.

In the last nine months I've lost 60 pounds that were weighing me down and feel great (no symptoms of anything), but I'm wondering now if maybe I lost bone as well as blubber. Anyway, I see my PCP on the 18th and wonder what questions I should ask him.

Thanks in advance for your advice and help.

Aleta145 · 04-04-2008, 05:28 PM

Hi Lurudolph,

Yes, that's a pretty low score at your hip. The other ones aren't too bad at all. Your weight loss could have something to do with your bone loss. On the one hand, lugging all that extra weight around put pressure on your hips, which kept them strong. Once you lost the weight, those bones didn't need to be so strong any more. On the other hand, maintaining a healthy weight will extend your life, so good for you for losing the blubber!

If I were you, I would ask for a referral to an endocrinologist. They're the ones who look at all your metabolic systems and can recommend a course of therapy. Are you getting any exercise? Do you take extra calcium? Does your diet include good sources of calcium?

There's an excellent site on bone physiology that has lots of information on osteoporosis. It has a page that explains what the DXA numbers mean, another that shows all the different treatments available, and lots of little animations of how bones are remodeled. If I were you, I'd bone up

on all the info before going to see the PCP.

Copy and paste:
courses.washington.edu/bonephys

lurudolph · 04-04-2008, 06:27 PM

Hi Aleta,

Thanks so much for your response. I've already stumbled upon the Wahington U site and it's very helpful. I'll certainly see about a referral to an endocrinologist. As foe exercize, I go a fitness center twice a week and work out with weight machines for maybe 40 minutes. No, I haven't taken extra calcium. My diet contains cheese and soy milk if that's sorce of calcium.

I keep seeing references to Forteo that look intriguing. What do you think?

Quote:

Originally Posted by Aleta145

Hi Lurudolph,

Yes, that's a pretty low score at your hip. The other ones aren't too bad at all. Your weight loss could have something to do with your bone loss. On the one hand, lugging all that extra weight around put pressure on your hips, which kept them strong. Once you lost the weight, those bones didn't need to be so strong any more. On the other hand, maintaining a healthy weight will extend your life, so good for you for losing the blubber!

If I were you, I would ask for a referral to an endocrinologist. They're the ones who look at all your metabolic systems and can recommend a course of therapy. Are you getting any exercise? Do you take extra calcium? Does your diet include good sources of calcium?

There's an excellent site on bone physiology that has lots of information on osteoporosis. It has a page that explains what the DXA numbers mean, another that shows all the different treatments available, and lots of little animations of how bones are remodeled. If I were you, I'd bone up

on all the info before going to see the PCP.

Copy and paste:
courses.washington.edu/bonephys

Aleta145 · 04-04-2008, 08:36 PM

Hi again,

It sounds like you are doing the right things. I won't presume to advise you on exercise...that's something you should discuss with your doctor. I think you are at high risk for hip fracture so you have to be careful.

As for calcium, my husband and I take 500 mg of calcium+D along with 250 mg of magnesium with each meal, so three times a day. We also have yogurt every day, and eat lots of green vegetables and dairy products.

My husband is in his third month of Forteo. He's 57, and seven years of Fosamax didn't improve his bone density, so Forteo was a last resort for him. As you may know, Forteo is recombinant parathyroid hormone, and it actually grows new bone. (Other treatments like Fosamax don't grow new bone, they simply slow down the resorption process.) It is a daily subcutaneous injection, taken in the belly or thigh. What you may not know is that it is very expensive: one pen (28 days' worth) costs anywhere between $750 and $950, depending on where you shop. Our insurance (Blue Cross) pays 80%, but that's still a lot.

When you see the endo, ask about the Forteo. It might be a good option for you because it works pretty quickly.

lurudolph · 04-05-2008, 12:46 PM

Thanks again.

I checked on the cost of Forteo through my Healthnet Medicare HMO and found that for "Forteo Prefilled Pen Solution for Injection (Inj 750 mcg/3ml)", it would cost me $78 for a 90-day supply. It looks as if this is the standard dose -- at least I hope so, because that's the maximum dose my HMO will provide me at that price.

One of the side effects that concerns me is lightheadedness/dizzyness. I have pretty low blood pressure (105/68 typically) and already get lightheaded somtimes if I leap to my feet from a sitting position :-), or when I'm climbing out of a pool. Has your husband had this -- or any other side effects?