The Osteoporosis Book A Guide for Patients and Their Families

by Lane, Nancy E.

• ISBN13: 9780195142389
• ISBN10: 0195142381
• Format: Paperback
• Copyright: 2001-05-31
• Publisher: Oxford University Press

Summary

Osteoporosis currently affects 25 million people in the United States, and as the baby boomers enter their fifties, this bone-weakening disease is poised to strike millions more. Because of this disease, many older people will suffer from a bone fracture at some point , and far too many ofthese fractures will result in permanent disability. The good news is that this devastating "silent epidemic" is entirely preventable, and in The Osteoporosis Book, readers of all ages will find everything they need to know to slow, stop, and even reverse the bone loss that causes this crippling disease. Written by Dr. Nancy E. Lane, a leadinginvestigator and clinician in the field of osteoporosis, it is an indispensable guide to the exciting medical breakthroughs that have taken place in the past few years--in bone density measurement, in estrogen therapy, and in our knowledge of the bone cycle--that now allow doctors to predict who isat risk and to monitor these individuals in their fifties, before a fracture occurs. Readers learn to evaluate--and whenever possible, eliminate--the risk factors in their own lives. "What vitamins should I take? Is hormone replacement therapy right for me? And what about exercise?" The answersare here. And for those already affected by osteoporosis, Dr. Lane provides the most effective and up-to-date medical and practical advice available anywhere for coping with its aches and pains and safeguarding against further deterioration. Impeccably researched and reassuringly accessible, The Osteoporosis Book empowers readers to make informed healthcare choices that will enhance the quality of their lives for decades to come. It has been endorsed by the National Osteoporosis Foundation.

Author Biography

Nancy E. Lane, M.D., is Associate Professor at the University of California, San Francisco, and co-director of Clinical Rheumatology at San Francisco General Hospital. A leading investigator in the field, her research on osteoporosis has been funded by the National Institutes of Health and several major pharmaceutical companies. She lives in the San Francisco Bay Area.

Table of Contents

Foreword	xiii
Why Is This Book Important?	xv
Introduction	3	(1)
Why Write a Book on Osteoporosis?	3	(1)
What Is Osteoporosis?	4	(1)
Who Gets Osteoporosis?	5	(1)
Topics in This Book	5	(4)
Part I Understanding Osteoporosis
Understanding the Life Cycle of Bone	9	(10)
What Is Bone Tissue Made of?	9	(1)
How Do We Gain and Lose Bone Throughout Life?	9	(1)
How Does Age Affect Your Bones?	10	(1)
Is the Bone Life Cycle Different in Women and Men?	11	(2)
What Happens in Menopause?	13	(2)
What Happens as We Age? Type I and Type II Osteoporosis	15	(1)
Medical Conditions That Can Cause Osteoporosis	16	(1)
How Does the Body Maintain Its Calcium Level?	17	(1)
Summary	18	(1)
Who Is At Risk of Developing Osteoporosis?	19	(14)
What Is Bone Mass?	19	(1)
Age, Sex, and Race	19	(1)
Family History and Reproductive Factors	20	(1)
Body Type	21	(1)
Birth Control Pills	22	(1)
Lifestyle Factors	22	(5)
Drugs That Cause Osteoporosis	27	(5)
Summary	32	(1)
How Do We Diagnose Osteoporosis?	33	(15)
How Can I Tell If I Have Osteoporosis?	33	(1)
How Is Osteoporosis Detected?	33	(1)
What Are the Signs and Symptoms?	34	(1)
Techniques for Measuring Bone Mass	34	(6)
How Do We Measure Bone Loss and Gain Over Time?	40	(1)
Can Blood Tests Diagnose Osteoporosis?	41	(2)
Cases
Bone Mineral Density Scan of the Lumbar Spine with the Clinical Interpretation	43	(1)
Bone Mineral Density Scan of the Hip with the Clinical Interpretation	44	(2)
Bone Mineral Density Scan of the Forearm with the Clinical Interpretation	46	(1)
Summary	47	(1)
Bone Fractures and Osteoporosis	48	(10)
Risk Factors in Elderly Persons	48	(1)
The Biomechanics of Falling	49	(3)
Hip Fractures	52	(1)
Vertebral Fractures	53	(2)
Forearm Fractures	55	(1)
Assessment of Fracture Risk	56	(1)
Summary	56	(2)
Do Men Get Osteoporosis?	58	(9)
Risk Factors	59	(1)
Idiopathic or Age-Related Osteoporosis in Men	60	(1)
How Do We Prevent Osteopofosis in Men?	61	(1)
Summary	62	(5)
Part II Prevention and Treatment of Osteoporosis
Prevention of Osteoporosis and Management of Menopause with Hormone Replcement Therapy	67	(19)
How Do Hormones Prevent or Treat Osteoporosis?	67	(1)
How Long Must I Stay on HRT?	68	(1)
Are There Other Risks and Benefits of HRT?	69	(3)
Estrogen Therapy and the Management of Menopause	72	(2)
The Many Types of Estrogen Therapy	74	(3)
Tamoxifen and Raloxifene: Estrogen Lookalikes, Agonists, and Antagonists (Selective Estrogen Receptor Modulator [SERMs])	77	(1)
How Are Phytoestrogens Different from HRT Medications?	78	(1)
If HRT Is So Good, Why Don't Women Stay on It?	79	(1)
Summary	79	(1)
Cases	80	(6)
Debra: A Case of Early Menopause	80	(1)
Laurie: A Family History of Osteoporosis	81	(2)
Judy: Entering Menopause	83	(1)
Georgia: Low Bone Mass at 75 Years of Age and High Cholesterol	84	(2)
Medications Other Than Hormones to Prevent and Treat Osteoporosis	86	(28)
Calcium	86	(6)
Bisphosphonates	92	(5)
Calcitonin	97	(2)
Deciding Which Therapy to Choose	99	(1)
When Is a Bisphosphonate Preferable to Calcitonin?	99	(1)
When Is a Bisphosphonate or Calcitonin More or Less Effective Than HRT?	100	(1)
Summary	100	(1)
Cases	101	(13)
Patricia: Preventing Osteoporosis in Middle Age	101	(1)
Marion: A Premenopausal Woman with Habits That Put Her at Risk of Developing Osteoporosis	102	(1)
Frances: Alternatives to Estrogen---Bisphosphonates or Calcitonin for the Treatment of Postmenopausal Osteoporosis	103	(2)
Jane: The Medications a Postmenopausal Woman Can Take to Prevent Osteoporosis When She Must Stop Using Estrogen	105	(1)
Helen: A Case of Established Osteoporosis	106	(4)
Martha: Adding Calcium to the Diet of an Older Adult	110	(1)
John: A Man Who Fractured His Hip	111	(3)
The Role of Vitamin D	114	(6)
Bone Diseases from Vitamin D Deficiency	114	(1)
The Role of Vitamin D in Maintaining Healthy Bone	114	(3)
Vitamin D and Skeletal Development	117	(1)
The Genetics of Osteoporosis	118	(1)
Summary	119	(1)
Exercise, Bone Health, and Osteoporosis	120	(17)
Exercise and Bone Mass	120	(1)
Exercise in the Older Adult	121	(1)
Exercise in Women of Childbearing Age	121	(3)
Exercise in Women with Osteoporosis	124	(1)
Importance of the Type of Exercise Performed	125	(2)
Special Problems of the Female Athlete	127	(7)
Summary	134	(1)
Cases	135	(2)
Margie: Low Bone Mineral Density and a Family History of Osteoporosis	135	(2)
Bone-Building Agents: Are There Any ``Magic Bullets''?	137	(5)
Fluoride	138	(1)
Parathyroid Hormone Fragments	139	(2)
Growth Factors: The New Frontier	141	(1)
Summary	141	(1)
Prevention and Treatment of Secondary Osteoporosis	142	(12)
Smoking and Alcohol Use	142	(1)
Calcium and Vitamin D Intake	142	(1)
Diet	143	(1)
Drugs	143	(3)
Summary	146	(1)
Cases	146	(8)
Michelle: Osteoporosis from Steroids Used to Treat Rheumatoid Arthritis	146	(1)
Lisa: Steroid Use and Osteoporosis	147	(2)
Mark: Asthma, Steroid Treatment, and the Risk of Osteoporosis	149	(1)
Marian: Alcoholism and Osteoporosis	150	(1)
Anne: Overactive Thyroid	151	(1)
Joan: Anorexia Nervosa	152	(2)
Treating the Pains and Problems of Osteoporosis	154	(23)
The Osteoporotic Fracture: Treating Actue Pain	154	(3)
The Osteoporotic Fracture: Treating Chronic Pain	157	(7)
Preventing Falls	164	(1)
The Quality of Life After an Osteoporotic Fracture	165	(4)
Summary	169	(1)
Cases	170	(7)
Martha: Treating the Aches and Pains of Osteoporosis	170	(3)
Elsa: Preventing Falls at Home	173	(1)
Alice: The Full Treatment After a Hip Fracture	174	(3)
Appendix	177	(4)
Bibliography	181	(14)
Index	195