“Diagnosed” with Osteopenia

Fragile label

Every year, courtesy of my company, I get a free medical check-up. Considering that we don’t get any bonuses – no, not even the 13th month bonus – a free check-up is better than nothing, I suppose. Typically these check-ups cover the basic items – blood test, urine test, EKG (cuz I’m old enough), eye exams (which I routinely have problems with), a physical and chest X-ray.

This year, the hospital they got to do the check-up was notable for two things. The two guys in charge of drawing blood were so bad at it that it hurt big-time and we’re all still severely bruised many days after. The second thing was the hospital provided a bone mineral density (BMD) test using the Alara Metriscan. This was certainly new.

I put my left hand on the platform and the machine was supposed to measure my BMD from three fingers. As the technician started pressing buttons, I protested as I saw her keying in “Caucasian”. “But I’m not Caucasian, you should be choosing Asian,” I told her very politely, thinking that perhaps she had trouble understanding the English machine. “We always set it to Caucasian,” she replied with finality.

After a few minutes, the results were ready. She wrote it on a photocopied form. T-score = -1.65. Normal is zero and a T-score of -2.5 or worse is considered osteoporosis. She continued to scrawl in Thai: กระดูกบาง or thin bones. I suddenly felt fragile like Samuel Jackson’s Mr. Glass in the movie Unbreakable. But most of all I was puzzled because milk and cheese are part of my regular diet.

Turning to Google, it turns out that “thin bones” is known as osteopenia. According to WebMD a.k.a. my 24-hour doctor, “Bones naturally become thinner as people grow older because … existing bone cells are reabsorbed by the body faster than new bone is made. As this occurs, the bones lose minerals, heaviness (mass), and structure, making them weaker and increasing their risk of breaking. All people begin losing bone mass after they reach peak BMD at about 30 years of age.”

Things that increase the risk of osteopenia include:

  • Being white (Caucasian) or, to a lesser degree, being Asian – See, I was correct in telling the technician to put me as Asian.
  • A family history of osteoporosis – Grandma might be a culprit
  • Being thin – hah, can certainly strike this off!
  • Long-term use of corticosteroids, such as prednisone or hydrocortisone for inflammatory conditions, or anticonvulsants, such as carbamazepine (Tegretol), phenytoin (Dilantin), or gabapentin (Neurontin) for pain or seizures – don’t know any of these
  • Eating disorders or diseases that affect the absorption of nutrients from food – my only eating disorder is eating too much and having an uncontrolled sweet tooth
  • Being inactive or bedridden for a long period of time – I sort of like exercising
  • Smoking – never
  • Drinking excessive amounts of alcohol – allergic to it
  • Having a diet low in calcium or Vitamin D – love dairy, love the sun even more

It’s really baffling. I honestly don’t have any of the risk factors perhaps except for the genes. So I’m left with a few options:

1. Get a second opinion from a more reputable hospital (one that doesn’t try to stab you with a blunt needle). Apparently, a proper BMD test will take the readings from your arm and/or your hip. But it’s not gonna be cheap – $150.

2. Do the ostrich and ignore it. After all, how can they measure the BMD in my entire body from just three fingers? Plus I type so much and play the piano, so the bone density in my fingers must be definitely screwed up. And, more importantly, many consumer websites are saying that osteopenia was “invented” by pharmaceutical companies who want to push their calcium pills. Apparently, they are also the ones providing these small portable machines to measure BMD, at least in the U.S.

Being the enlightened or should it be foolhardy consumer, I shan’t fall for such tricks. Besides I now have the perfect excuse to eat more ice-cream – I need the calcium!

Image

How not to do draw blood: Look at the bruising we’re still nursing more than five days after the medical check-up.

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2 thoughts on ““Diagnosed” with Osteopenia

  1. Sorry to hear about your diagnosis. What your doctor probably didn’t tell you, is that it’s really hard to get an accurate bone density unless they’re doing a three dimensional scan. If you’re a smaller person (not necessarily thin, just small – small boned), you have less bone surface than bigger people. Naturally with less surface to measure, you’re automatically going to come up with a lower T-score. The true measure would either be a bone biopsy (invasive & expensive) or what’s known at a QCT scan. Quantitative Computed Tomography. It’s sort of like an MRI. It is hereditary, so you might be able to pin in on Grandma. Sugar is actually thought to contribute to bone loss, so you might want to rein in that sweet tooth. Exercise promotes stronger bones, but if you’re exercising a lot – like running six miles a day or so – you could be depleting your stores of magnesium and potassium and other minerals necessary for bone formation. It’s a complicated puzzle. The trouble is, no one ever thinks to do a bone scan on us when we’re at peak bone mass – around 18 to 22 years old. So we don’t know how dense our bones were to begin with. Without that starting score, how do we know if -1.65 (in your case) or -3.1 in my case is super horrible or just normal for us. Keep on exercising, maybe look into bone supplements, and at the next bone scan, look and see whether you’ve held steady or if you’re losing mass. Good luck!

  2. Hello Raye, thank you so much for your comment! I’ve probably learnt more from it than all the websites I’ve been scouring. Thank you for taking time to leave the note. Your journey is amazing too, I’m going to be keeping tabs and learning from you… but the reining in the sweets bit, that’s going to be really tough. 🙂 Good luck to you too!

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