Porous Bones; "I Can Go No Further, Sir. My Old Bones Ache." William Shakespeare (1564-1616), English Dramatist, Poet. Gonzalo, in the Tempest, Act 3, Sc. 3, L. 1-2

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Porous Bones; "I Can Go No Further, Sir. My Old Bones Ache." William Shakespeare (1564-1616), English Dramatist, Poet. Gonzalo, in the Tempest, Act 3, Sc. 3, L. 1-2


IT's not like people go around knowing they have weak bones.

It's not like bad eyesight or bad breath (well okay some people don't know they have bad breath). Osteoporosis or "porous bones" is a condition that happens over time leading to the unexpected: Broken bones on just falling off a chair, or after bending or coughing.

Causes. Think of the bones as hard tissue -- living hard tissue. It is not static architecture from which our muscles just drape over. Rather, it is constantly changing because it is deposited and resorbed at the same time. Just like money in the bank, we at least wish that even if it does not grow, the amount remains constant (money in = money out). Bone in a way behaves like money in the bank. We want to save as much as we can when we are young so that there's some to spend in our twilight years. With bone, the body tries to deposit as much as it can too -- called peak bone mass -- and this occurs between ages 25-35. After a certain age, usually at the time of menopause in women when estrogen production diminishes markedly, bone loss overtakes bone deposition. This is when osteoporosis starts.

Risk Factors. The risk of osteoporosis is higher in women (twice as often in men), in Caucasian and Asian women, and in older women. Frame size has been implicated for the simple reason that those with small, thin bones have less bone mass to start with. Osteoporosis can run in families so the mother you are taking to the emergency room with a broken hip is you in thirty years. Smoking (tobacco use) can cause weak bones. Chronic alcoholism is the leading risk factor for osteoporosis in men. Finally some drugs used for long periods affect the strength of bones. These include thyroid medications, diuretics, and corticosteroids.

Screening and Diagnosis. The persons most likely to benefit from screening are those on chronic drug use mentioned above, postmenopausal women over 50, and women over 65 who have had no osteoporosis screening. Major hospitals offer a screening tool called DEXA (dual x-ray absorptiometry) which is a quick and painless test that gives a picture of the status of bone density. Many doctors can treat osteoporosis -- family medicine practitioners, rheumatologists, endocrinologists, rehabilitation medicine specialists, and orthopedic surgeons.

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Porous Bones; "I Can Go No Further, Sir. My Old Bones Ache." William Shakespeare (1564-1616), English Dramatist, Poet. Gonzalo, in the Tempest, Act 3, Sc. 3, L. 1-2
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