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  • Rapid Bone Loss! what causes it?

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    Old 04-21-2006, 03:19 PM   #1
    rodekill4404
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    Rapid Bone Loss! what causes it?

    Ok I need a little help here ….
    I'v had both hips replaced in the last 2 years.
    And now my back has 2 new compression fractures.
    I saw my 13th Dr. yesterday...... Texas Back Institute
    and was told they could not help me.
    That my bones were having rapid cartalige loss,and I could die if continued at the rate it had been.
    And referred me to an Endocrinologist my appointment is April 27th
    I also have a rheumatoidologist appointment tomorrow.
    Seriously!
    I am looking anywhere for an answer.
    If you have any ideas let me know....
    I am running out of options.

    The only RX I’m taking is- Fosomax 35 once a week
    I’m 41 , white, pre menopause

    My symptoms are-
    I’m never hungry!
    Loss of bone mass – 4 ¼ inches in height
    Pain –upper back, lower back groin area, heels,
    I have nonhealing fractures in my pubis bone & back
    Pain in sternum
    Swelling in abdomen
    Blood in urine – moderate/high
    Tingling in fingers-pinky, ring & middle on left hand.
    I’ve had diarrhea off and on for 2 years …mostly on
    Acid Reflux
    A bad cough since November – The Dr. gave me Levaquin 500 mg for 10 days
    For bronchitis .4 weeks ago. But I still have it just not as bad.
    I have stopped smoking & drinking alcohol completely
    I think I may be depressed.
    my eyes are always a little red.
    And I’m getting hairy
    I do have ostiopenia

    Thank you all so much..
    RK

     
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    Old 04-21-2006, 04:07 PM   #2
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    I copied my last few MRI, CT, and DEX scores.
    here they are.
    With no insurance....im really needing some guidance on what to be tested for.
    Every Doctor I have seen has a diffrent oppinion.

    12-2-2005
    TECHNIQUE: Bone densitometry of PA lumbar spine and proximal right forearm was performed using a DXA Hologic bone densitometer in the fast array scan mode.
    TECHNICAL VALIDITY: Images show proper positioning and properly placed regions of interest.
    RESULTS:
    Lumbar spine: BMD is 0.828 g/cm2. T-score is -2.0. Z-score is -1.7. Osre.of>eV\ t~
    Right forearm: BMD is 0.484 g/cm2. T-score is -1.6. Z-score is -1.2 iost eo pen rCL-
    DIAGNOSIS: Since patient is premenopausal, criteria for osteoporosis cannot be applied. However, her bone density for same age group is lower as determined by Z-score. Secondary causes of low bone density should be considered. .

    03/24/2006
    EXAM: MRI, PELVIS WITHOUT CONTRAST MATERIALS DATE OF EXAM
    CLINICAL HISTORY: Low back and bilateral hip pain. There is a history of bilateral total hip replacement.
    TECHNIQUE: T1 and STIR coronal images were obtained as well as T1 and fat-suppressed T2 axial images. T2 sagittal images were also acquired through both hips and the central portions of the pelvis.
    FINDINGS: Please refer to a separate report for description of findings in the lumbar spine. Note is made of some vertebral compressions which show some marrow edema.
    There is substantial metal-related artifact from bilateral total hip replacements.
    There are healing sacral insufficiency fractures bilaterally with linear areas of signal abnormality. There is sclerotic change currently and no evidence of edema. I, therefore, favor a chronic time frame. Plane film correlation might be of some value.
    The iliac wings have a normal appearance. The symphysis pubis and inferior pubic rami are unremarkable. All other portions of the bony pelvis are obscured by artifact.
    There is no gross mass or free fluid in the pelvis. The surrounding structures included are unremarkable otherwise.
    IMPRESSION
    1. SUBSTANTIALLY LIMITED EXAMINATION DUE TO METAL-RELATED ARTIFACTS FROM BILATERAL TOTAL HIP REPLACEMENTS.
    2. OLD HEALING OR HEALED SACRAL INSUFFICIENCY FRACTURES BILATERALLY. THERE ARE SCLEROTIC CHANGES BUT NO CURRENT EVIDENCE OF EDEMA. PLAIN FILM CORRELATION MIGHT BE OF VALUE.

    03/24/2006
    EXAM: MRI, LUMBAR SPINE WITHOUT90NTRAST DATE OF EXAM
    TECHNIQUE: T1 proton density and T2 weighted sagittal images are obtained along with T1 and T2 weighted axial images.
    CLINICAL HISTORY: Low back pain not otherwise specified.
    COMPARISON: None.
    FINDINGS: Virtually all of the lumbar and the visualized lower thoracic vertebral bodies demonstrate an abnormal appearance. The vertebral bodies are somewhat diffusely decreased in height relative to the vertical dimension of the disc spaces. Is there any underlying diffuse osseous syndrome? In addition
    to these findings, there are linear foci of signal abnormality in multiple vertebral bodies worrisome for subacute compression deformities. This is most evident involving the inferior end plate of T11 and T12 as well as a linear cleft in the midportion of the L5 and, to a lesser extent, L4 vertebral bodies. There is also a linear cleft paralleling the inferior end plate of theL3 vertebral body. These clefts demonstrate
    hypointense T1 and hyperintense STIR signal and are most compatible with subacute or nonhealed compression deformities. There is apparent marrow edema in the posterior elements at T10 though T12.
    There is no significant retropulsion of any of the lumbar vertebral bodies. Overall, the AP dimension of the canal is within normal limits.
    L1-2: There is no focal disc bulge or disc protrusion at this level. There is no central spinal stenosis.
    L2-3: The posterior annular contour appears relatively normal. There is no focal disc bulge or disc
    protrusion. There is no significanJ central spinal stenosis.
    L3-4: There is mild ann'ular bulging with slight flattening of the posterior annular contour. Left, greater than right, facet arthropathy is present. There is no focal disc protrusion or significant central or foraminal stenosis.
    L4-5: There is diffuse generalized annular disc bulging. There is facet arthropathy and ligamentum flavum hypertrophy. There may be a synovial cyst on the left related to the L4-5 facet joint and projecting into the posterolateral canal on the left. This is about 4 mm in size. There is no high-grade central or foraminal stenosis.
    L5-S1: There is no focal disc bulge or disc protrusion. There is no significant central or foraminal stenosis. The conus has its tip at the mid-L 1 level. The conus appears normal. There is a small Tarlov-type perineural cyst in the sacral canal which should be incidental.
    IMPRESSION:
    1. There is a diffusely abnormal appearance to the lumbar vertebral bodies virtually all of which are diminished in height relative to the adjacent disc spaces. In addition, there are linear clefts of signal abnormality paralleling the end plates at multiple levels including the inferior end plates of T11, T12, L3 and L4 and the superior end plate of L2 and the mid portion of the L5 vertebral body. All of these clefts demonstrate linear hypointense T1 and hyperintense STIR signal and would be compatible with subacute or non healed compression deformities. There is no significant retropulsion of any of the posterior end plates. There also appears to be edema in the posterior elements at T10, T11 and T12.
    2. There is generalized annular disc bulging at L4-5 along with facet and ligamentum flavum hypertrophy. There is no high-grade central or foraminal stenosis at this level. There may be a developing synovial cyst on the left slightly impinging on the posterolateral thecal sac.
    3. No focal disc protrusion is evident at any lumbar level. There is no mass effect on the conus.
    4. Is there any history of underlying osseous syndrome?

    04/04/2006 EXAM: CT OF PELVIS WITH CONTRAST
    HISTORY: Pelvic pain. History of pelvic fracture in the past.
    TECHNIQUE: Following intravenous and oral contrast administration, 5 mm thick axial CT images were obtained from the iliac crests through the pubic symphysis. Images were reviewed at bone and soft tissue window and level settings.
    FINDINGS: The lower portion of the pelvis, base of the bladder, the hips and pubic bones are largely obscured due to artifact from bilateral hip prostheses.
    The uterus is enlarged and nodular in contour suggesting the presence of leiomyomata. It measures approximately 7.3 x 7.6 cm in greatest AP and transverse dimensions respectively. The ovaries are unremarkable. No pelvic mass or free fluid is seen.
    Evaluation of the bony pelvis is limited as detailed above. There is deformity of the right inferior and superior pubic rami suggesting old healed fracture. Unfortunately, acute process is difficult to exclude in the region of the hips and lower portions of the pelvis due to the artifact. I see no obvious acute injury. Mild degenerative changes are seen in both sacroiliac joints.
    IMPRESSION:
    1. ENLARGED UTERUS, LIKELY DUE TO FIBROIDS. FURTHER CHARACTERIZATION WITH
    ULTRASOUND SHOULD BE CONSIDERED.
    2. EVIDENCE OF OLD HEALED FRACTURES OF THE RIGHT SUPERIOR AND INFERIOR PUBIC RAMI AND BILATERAL HIP PROSTHESES IN PLACE. NO OBVIOUS ACUTE CHANGES ARE SEEN ALTHOUGH EVALUATION IS LIMITED DUE TO STREAK ARTIFACT FROM THE HIP PROSTHESES.
    3. MILD OSTEOARTHRITIC CHANGES IN THE SACROILIAC JOINTS BILATERALLY.

    I don't have a written report from yesterday.
    The Dr. did show me new fractures in my back.
    I'm sorry if all of this is too much.....I JUST NEED ADVICE!
    And this board is always very Insightful.
    Thanks again
    RK

     
    Old 04-21-2006, 06:20 PM   #3
    nr2go
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    Re: Rapid Bone Loss! what causes it?

    You mention several symptoms that could indicate hyperparathyroidism. If you visit parathyroid.com and check the symptoms you'll see what I mean.

    Did the doctor tell you why he/she is refering you to an endocrinologist?

     
    Old 04-21-2006, 06:41 PM   #4
    taape
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    Re: Rapid Bone Loss! what causes it?

    You said that your taking Fosamax and I wonder if your also taking calcium supplements and eating some foods that contain calcium. Which doctor ordered the Fosamax? Are you going to see a spine specialist who could explain the MRI and CTscan results with you. Let us know what you find out.

     
    Old 04-21-2006, 06:54 PM   #5
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    NR
    Thanks, after seeing a posting on here about hyperparathyroidism I kind of think the same thing.
    I’ll check out the site.
    And he really didn’t say why hes sending me there.
    I refered myself to the rheumatoidologist that just sounded like someone I should see.
    RK

     
    Old 04-21-2006, 07:13 PM   #6
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    taape
    Yes im taking
    Calcium + D 600
    OS-CAL
    Ostieo Bi- Flex
    And a Multi Vitamin
    I’m eating….. Whatever mostly heat up TV dinners, I am never hungry.
    The one who put me on Fosomax also put me on sleeping pills,2 kinds of muscle relaxers,a nerve modulator,and everything else mentioned above….And never prescribed anything for my bronchitis ….I got rid of everything but the fosamax and sleeping pill
    THANK YOU!

     
    Old 04-21-2006, 07:40 PM   #7
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    To be diagnosed with hyperparathyroidism would be a blessing!
    Thats a GREAT SITE! Thanks

    I had blood test in Nov.
    Alcaline Phosphatasen was 150
    Glucose was 117
    those were the only ones high
    calcium was 9.7

    I'm sure I will have lots more Thursday.
    I'll let yawl know what the out come is!
    Thanks............so much!

     
    Old 04-22-2006, 08:04 AM   #8
    Aleta145
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    Re: Rapid Bone Loss! what causes it?

    Rodekill, it's nice to see you here again, but I'm sorry you're still in so much pain. I still think the accident caused some of or at least aggravated existing problems.

    You might ask your doctors whether it's too late to have kyphoplasty done on your collapsed vertebrae. They put a balloon into the vertebral space, blow it up to expand the vertebra to its normal height, and then inject a fast-hardening plastic cement to keep it there. People experience almomst immediate pain relief from the procedure, but there's a time limit when you can have it done.

    Good luck, dear. I'll be thinking about you.

    __________________
    Dx 5/04, age 49: Spine -3.0, Hip: -1.9
    5/05: Spine -2.7, Hip -2.1
    Current treatment: Evista

     
    Old 04-22-2006, 08:20 AM   #9
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    The Doctor at the TX Back Instatute mentioned it and said he wouldn't try it untill I have been diagnosed with what is causing my bone loss.
    Sounds expencive.

    I'm trying to get insurance now.I'v got SS disability now and they put me disabled as of October 2004 so I'm not elidable for anymore SS ....Medicare?....Medicade? ....assistance untill next October.

    I also started Ozone Therapy yesterday.I'm going to go 40 minutes every day.
    My neighbor who invented the back buddy.....has the machine at her house and said I could use it for $10.a day.
    Anyone have thoughts on this?
    Sounds like it couldnt hurt.
    Thanks Again,
    RK

     
    Old 04-22-2006, 10:55 AM   #10
    nr2go
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    Re: Rapid Bone Loss! what causes it?

    Rodekill, I'm in agreement with your doctor about finding the underlying cause of your problems before they do any surgery. My guess is that if it is your parathyroid then all the calcium supplements you are taking aren't helping. In fact they could be aggrevating the problem more so. I was diagnosed a year ago with hyperparathyroidism and had to be off calcium supplements and foods high in calcium until after my surgery.

    Has any of these doctors checked your calcium levels more then once? With hyperparathyroidism your calcium levels will fluctuate. Did any of them check your PTH and ionized calcium levels?

    Keep us posted on what the endo has to say and what tests he/she does.

     
    Old 04-22-2006, 04:44 PM   #11
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    I called to make a Rheumatoidologist appointment and when I told to girl taking the appointments I didn’t have insurance she suggested I go to the Prime Care Clinic…they only charge $30. per visit. sure beats the $200.it was going to cost to see him at his office.
    So I make the appointment w/ prime care and when I show up, today I end up seeing the same Doctor (#14) I had originally called, just so happens he works two days a month at the clinic. Cool hu?
    He to asked ……why the Doctor from the TX Back Institute was sending me to the Endocrinologist?
    He suggested I come back to the clinic on Monday for blood test there.
    So I will be canceling my Endocrinologist appointment for Thursday.
    That would have been another $300.at the least…… (which I’m thinking of as money I would have spent anyway….Now I’m just spending it on blood tests!

    He didn’t want to check
    • Parathyroid hormone level
    Because it cost $180. “I don’t care what it cost.. I’m having it”
    He did say the blood test Monday would be for
    • Calcium
    • Diabetes screening
    • Vitamin D
    The below tests were suggested here on this board
    “I will ask about getting them also”
    • PTH
    • Ionized calcium levels
    I know yawl have a lot of experience with blood tests.
    So please tell me what else, yawl think, I should have checked while I’m there.

    He also took me off Fosomax and wants to start me on Forteo.

    He says I do not have rumatoid arthritis.

    And says that I do have osteoporosis & a pain management problem.(he will have a RX for pain for me Monday)

    I will appreciate & consider anything yawl have to say.

    I also went to my second Ozone Therapy today….the towels I wiped off with were really grey……guess that’s a good thing .I don’t feel any different but I’m going to keep going. Who knows it may help.

    I really do think I’ll get better…..I’m holding on to the motor cycle and golf clubs just incase there is a light at the end of the tunnel…..
    Everyone have a great weekend!
    And thanks again,
    RK

     
    Old 04-22-2006, 05:13 PM   #12
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    Jeeeeeezzzzzzzzzzzzzzz!
    Just checked out the website below on Forteo
    fda.gov/cder/foi/label/2004/21318s004lbl.pdf

    and it says it should not be prescribed to people w/ unexplained high
    Alkaline Phosphatase levels mine was 150 back in December.
    The Doctor I saw today had December blood results in his hand when he told me he was putting me on it.
    Now I don’t feel quite so confident that this is the right Doctor.
    Do I just point it out to him?
    Or wait to see what my Alkaline Phosphatase levels are on Monday?
    Then say something if they are high!

     
    Old 04-22-2006, 05:39 PM   #13
    Aleta145
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    Re: Rapid Bone Loss! what causes it?

    I'd wait and see the blood test results. Has anyone looked into why your ALP level is so high? Because one of the causes can be osteomalacia, a condition in which the bones become soft. Symptoms include weakness, lack of appetite, weight loss, pain, and bones that fracture easily. Or it could be hyperparathyroidism. Either way, I still think an endocrinologist would be the right doctor to see.

     
    Old 04-22-2006, 08:58 PM   #14
    nr2go
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    Re: Rapid Bone Loss! what causes it?

    I'd also wait on the Forteo and express your concerns about taking it since your Alkaline Phosphatase levels were so high.

    The diagnoses for Hyperparathyroidism is based on clinical evidence (blood serium calcium, ionized calcium, and PTH levels.) Get the tests done. Just keep in mind that CA levels can fluctuate. Check out the "diagnose" link on the parathyroid web site. This is an underdiagnosed disease and most doctors are not familar with it. Print out the page and take it with you the next time you see the doctor.

    Does the clinic have an endocrinologists that you can see as well?

    Keep us posted.

     
    Old 04-24-2006, 06:17 PM   #15
    rodekill4404
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    Re: Rapid Bone Loss! what causes it?

    These are the only tests the Doctor ordered today

    Profiles/Tests

    899 -TSH [SERUM]


    6399-CBC (INCLUDES DIFF/PLT)[BLOOD]


    10231 -COMPREHENSIVE MET ABOLIC PANEL [SERUM]


    I'm still going to the endocrinologists Thursday.

     
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