Mrs. M had never known a day’s illness. She was 62, exercised regularly, and was energetically pursuing her tailoring business; her order book was fully saturated for the next three months. She did not smoke, was largely vegetarian, and indulged in a glass of red wine at a social gathering; what she could not understand was the reason for the pain in her back.
That pain had appeared mysteriously, and thinking back, she recalled coughing when she was stooped over her bathroom sink, brushing her teeth. It was just a niggle, but it seemed to worsen over the next month and had become worse. It was the pain that led her to the spine specialist.
Her doctor listened to her problem, and other than a tender spot in her back, noted that she was developing a stooped back. He ordered an MRI Scan, a DEXA test, and a blood test. She was anxious about so many tests, but the pain was troublesome, and she felt that she should go along with her doctor’s advice.
The doctor had prescribed some pain medicine and rest in bed, but the orders had to be fulfilled, and she felt that work took precedence over her pain. So after taking the pills, and some alternate medicine given by her neighbour, who was regarded as a walking repository for all things medical.
Despite all these, getting out of bed the next morning was so painful, she persuaded her neighbour to accompany her and managed to get the tests done. With the results, she met the doctor. He took a look at the MRI Scan and told her bluntly that she needed a spine operation. She was horrified and wanted to run away, but the pain was so intense that she weakly assented and was admitted. The doctor explained her problem. He said that she had osteoporosis or weak bones and which had led to a spinal fracture. He said it is a silent disease, and while any bone can be affected, commonly it is a fractured spine, hip, or wrist that draws attention to it.
Osteoporosis is an asymptomatic bone disease and often presents dramatically, both amongst men and women. It is detected by the DEXA test. The peculiarity is that the bone is normal, but the quantity or mass of bone is reduced, and over time, the weakened bone, unable to bear the load placed on it, weakens further and collapses. Sometimes this collapse may be due to a minor fall, or may be due to the innocuous event of a mere cough.
Osteoporosis is made worse by the deficiency of vitamin D, which is responsible for maintaining the strength of the bones of our skeleton. A sedentary life with little physical exercise, early onset of menopause, smoking, excessive drinking, intake of steroids for a long time, bizarre diets, endocrine problems, and chronic illnesses can hasten and badly impact osteoporosis.
Osteoporosis is often considered to be a disease of women; this is not true. Osteoporosis affects men as well. Because men are physically stronger and have more bone than women, osteoporosis may affect them later.
Osteoporosis is easily diagnosed with a DEXA scan and with blood tests.
How to reduce the effects of osteoporosis and mitigate its complications?
1. Consume a balanced diet rich in calcium- milk and dairy products such as dahi and paneer; soya, ragi and green vegetables.
2. Exposure of the skin to sunlight promotes the formation of vitamin D in the body.
3. Regular weight-bearing exercise, like walking, strengthens the bones.
4. Avoid smoking and excess consumption of alcohol
5. Prevent falls - use a night light. When waking up at night to use the washroom, sit first in bed for a minute to allow the blood pressure to regulate itself (a drop in blood pressure can trigger a fall), and then use the washroom. Always use a commode. Fit rails on the wall to assist in sitting and standing from the commode. Do not lock the washroom door from inside. Fit non-skid tiles on the floor. Fit an alarm bell, so other members can be alerted if needed. Always put on underwear and trousers when seated.
It is better to take medical advice to detect, assess, and treat osteoporosis. A host of drugs are available, other than the routine calcium and vitamin D medications.
What happened to Mrs M? She underwent her surgery; doctors injected bone cement into her fractured bone, and that took away the pain. She was treated with daily injections, which she took by herself, and medications. She has recovered and is running her business again.
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