Bone density test really necessary?

downsouthAugust 1, 2004

I went to my orthopedic for shoulder pain and he gave me a cortisone shot and is sending me for physical therapy, which I don't mind doing. However, he wants me to have a bone density test because he said my bones "feel weak." (just from putting pressure on my hands/arms and making me clench my fists). I am really having serious doubts about why this test is necessary. While researching who is a candidate for this type test, I don't fall into any of the categories which are:

65 and older

postmenopausal female who has had fractures

been on hormone therapy for prolonged period of time

low body weight

history of cigarette smoking

I don't smoke, don't take estrogen (as it causes me to gain weight), I am only 54, I have never had a fracture and I don't have low body weight. I do have arthritis in my neck and spine (DDD) being treated by my neurologist.

This is scheduled for tomorrow at 11:00 a.m. I just don't have the money now to pay for my part and I am dreading how expensive this is going to be. I am still paying on a hospital bill from 3 years ago, I owe my neurologist and now I'm getting orthopedic bills and physical therapy. I'm not working now so we are living off DH's salary.

Should I call the office in the morning and question why this test has been ordered? Is this another expensive MRI type test that is going to end up costing me a fortune out of my own pocket?

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My doctor had me do my first bone density when I was 50. I believe that is the age I've heard recommended to get your first. Mine showed that I had "osteopenea," the beginning of Osteoporisis. She put me on Foxamax. Followup bone density showed a decline, which puzzled her. I upped my daily calcium intake and am drinking more milk. Hopefully next one will be better.

All women over 50 are very prone to Osteoporosis. It has become a national epidemic according to a class I just took. The sooner it is detected the better.

My HMO covered the entire cost of my bone density. I think I have a good plan.

You have to remember, without our health, we aren't much good.

Maybe you could put it off a bit until you've done more thinking about his and more research.

Check the National Osteoporosis Society website.


    Bookmark   August 1, 2004 at 1:40PM
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sammy zone 7 Tulsa

It is pretty important to have a base line test. My daughters are in their middle 30's and I would like for them to have one. Their bones have stopped building density - the natural density as a part of growing up. If they have low bone density now, they could do weight bearing exercises and take additional calcium. If they wait until my age, they will have to take a med. Why don't you discuss the financial concerns you have with your doctor and see what the response is. I had teh Dexa Scan, but I think there is a cheaper anke test that is far less expensive.

    Bookmark   August 1, 2004 at 9:26PM
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No, it's not necessary. BUT, I don't know of any other way to determine if everything is going well.

Once you lose a lot of bone, it is hard, if not impossible to get it back. This will alert you and your doctor as to steps that may need to be taken now.

Since you already are having trouble with arthritis, you don't need to add osteoporosis to your problems.


    Bookmark   August 2, 2004 at 9:09AM
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Why have a test?...Assume you are losing bone mass and do everything ( short of taking Fosomax) to improve the situation.
Walk 2 miles at least 4 times a week, take calcium citrate with vitamine least 1200 mg's a day, and drink a pint of skim milk every day ( or eat the equivalant in cheese)...
Why wait until you have shown bone loss to do these things?
Linda C

    Bookmark   August 2, 2004 at 2:20PM
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Well, what Linda said.
I'm 46, and I've had two, although I believe my bones are very sturdy because of my lifestyle. When I get a mammogram they do it for free. Just the basic one where you set your heel in a monitor of some sort, a machine goes "beep" and you're done. Takes about three minutes. I figure why not?
Maybe there's more comprehensive bd tests I don't know about.

    Bookmark   August 2, 2004 at 10:01PM
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sammy zone 7 Tulsa

Walking is good cardio, but not especially good for building bone density unless you are overweight. You need to lift weights while you are standing. You need to do squats, shoulder, and military presses. Those weights need to go directly to the hip and spine, and you cannot allow the shoulders and thighs to grab the weight.

If you don't have a bone density test, you won't know how safe it is to do strenuous exercises that are best for building bone.

    Bookmark   August 6, 2004 at 11:10PM
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Thanks everyone for your replies. I decided that the doctor knows best and I shouldn't be second guessing him, and I'll just pay my part as I can afford it, so I had it done on Monday. I did call BS/BS to make sure this test was covered before I went and it made me feel better that it is covered.

Ginny, I looked at the form that the receptionist handed me in the office to give to the lady doing the test and "osteopenia" was checked on this form. I have an week so I'll get the results then. The test was for my spine and hip area.

    Bookmark   August 7, 2004 at 12:26AM
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sammy zone 7 Tulsa

Be sure you get a copy of the results. That is your right. It will be about 10 pages if you do have osteopenia. If you have osteopenia, be prepared to ask your doctor about the difference between "Z" scores and "T" scores.

    Bookmark   August 8, 2004 at 1:48PM
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My endocrinologist doesn't think the inexpensive finger or heel tests are a good indicator of bone density, dexa scan is needed. I've had two; my Dr wanted them 18 mo apart, same machine, same techinician for accurate comparison. Then your doctor will know if you are losing bone and at what rate...some of us have bones that have never been especially dense, one scan doesn't tell us everything.

Ladies...My mom picked up a heavy door set aside from a remodel project last Fall, and had a compression fracture of a vertebrae that caused severe pain, inconvenience, dramatic change in her active lifetyle for 10 months. After kyphoplasty this Spring, she is just now beginning to feel like herself again. She'd never had a density scan, it would have been a small price to pay compared to the kink the fracture threw into her life for many, many weeks....Before the door lifting, she had done all her own house and yard work but needs help now...

Scanning early, and determining ways to help reduce bone loss is better than relying on drugs to build it back later....most of those drugs can be somewhat hard to take and they aren't cheap. The tech at the imaging center where I have my scan done really pushes those Viactiv chews for a good calcium source, one with lunch, one with dinner as calcium is better absorbed later in the day and with food.

    Bookmark   August 11, 2004 at 11:05AM
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I am very down right now. I spent half a day at the Social Security office answering questions and filling out forms for disability. My orthopedist called when I got home and told me that this test showed I have severe osteoporosis (and this is "in addition" to the degen. disc disease.) He wants me to give myself shots, EVERY day, for 18 months. I have never given myself a shot. I asked him if there wasn't a pill I could take, but he said it wouldn't work as well as the shots. The side effects of the medication (something like Fomo or Fomeo?) are stomach upset and can possibly lead to cancer. I was so shocked, I told him I would call him back in the morning. I wish I had gotten the name of the medication spelled right so I could look it up on the Internet.

I know people have received worse news, but I need my disability before I can pay for these shots every month. I will call back in the morning and find out how much they are. He said he would give me the first month's supply to get me started.

    Bookmark   August 25, 2004 at 5:17PM
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This is probably what your doctor was suggesting, I didn't find any information as to the cost. I'm sure that was upsetting news, but at the same time, think of it as having your treatment 'in your own hands'...literally.

"Low-Dose Parathyroid Injections. Although high persistent levels of parathyroid hormone can cause osteoporosis, daily injections of low and intermittent doses of this hormone actually stimulate bone production. Unlike most treatments for osteoporosis, including bisphosphonates, the benefits may persist even after the injections have been stopped. Teriparatide (Forteo), an agent made from selected amino acids found in parathyroid hormone, has now been approved for treatment of osteoporosis in postmenopausal women. Studies suggest it significantly lowers the risk of fracture and increases bone mineral density. In one small study, parathyroid hormone significantly reduced spinal fractures compared to hormone replacement therapy. Although not yet approved for men with osteoporosis, it may be effective for these patients as well.

Although the treatment requires injections, experts believe that patients will get used to them, just as people with diabetes grow accustomed to insulin shots. Side effects are mild and include nausea, dizziness, and leg cramps. No significant complications have been reported to date. Of concern are early studies reporting bone tumors in mice who were given parathyroid long-term. Such effects have not been observed in humans to date. (Of note in this regard, persons with Paget disease, a disorder in which bone thickens but also, oddly, weakens, should not take parathyroid hormone, since they are at higher than normal risk for bone tumors.)"

    Bookmark   August 26, 2004 at 11:56AM
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Yes, that is the medication. My DIL found it on the Internet as well. I have a call into his office and he is supposed to call me tomorrow regarding the cost. I have had two people tell me that its around $700 a month (before insurance) so if that's right, I'll proceed with the injections and learn how to do them. I just hope Forteo injections aren't $700 every two weeks.

    Bookmark   August 26, 2004 at 10:54PM
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sammy zone 7 Tulsa

I am sorry about your diagnosis, but glad you can treat it. Don't worry about the injections. I have given myself allergy shots for 25 years. I give them in the side of my thigh, and have gotten used to it. I think your bigger question is what else can you do to help with the treatment. How much calcium. Vit. D, and Magnesium with it? Read the dosage if it is Citracal because a serving is 2. What is safe and what isn't? Keep us posted.

    Bookmark   September 5, 2004 at 10:39PM
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I would have it done just to know the condition of my bones and what I was in for. I would also like to have it done for a very petty reason. My Sis had it done and the doc said, "whatever you are doing, keep on doing it." She takes an awful lot of calcium and something else. I told her that doesn't mean a thing until I have a bone test. If my bones are in good condition, it just means we have good genes. I haven't done a thing to prevent it.

    Bookmark   September 8, 2004 at 9:37PM
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I'm 52, and just had a bone density test (I'm postmenopausal). I was diagnosed with osteoporosis in my neck, spine and hip. I'm just devastated right now. My doctor sent me for more bloodwork to evaluate my Vitamin D, parathyroid hormone, etc. She will prescribe Boniva.

Have the test done! I thought I'd develop osteoporosis later in life, not now.

    Bookmark   November 21, 2007 at 8:38AM
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Sammy- As suggested by a poster, walking IS good for osteoporosis- any weight bearing exercise helps to make bonestronger. That is the first thing we tell patients who are getting out of a cast. Downsouth- you will be surprised at how used to doing the injections you will get! You will use a small gauge needle- you will get so you will not feel anything- I promise! If you are taught good technique, you will look at it as just a 'part of your day'. It takes a bit to get the mind used to doing something like that when you have not had to do it before! Aren't you glad you did the test! Also, see about getting enrolled in the 'Chronic Disease Program'. It provides the medication if you qualify- it does not take long to apply- the docs office must do the initial contact. If they do not know about it, email me.

    Bookmark   November 24, 2007 at 11:40PM
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I just had a scan of my hips, and it showed worse osteoporosis than is normal for my age. I'm not surprised. European ancestry, small frame, underweight most of my life, fair skinned, didn't eat or drink a lot of dairy. I've already had a broken elbow, and I'm scared to death of falling and breaking something else.

    Bookmark   November 29, 2007 at 9:16PM
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For my shoulder pain I went to a chiropractor.
It seems like 'catch 22' by having an "aorthopedic for shoulder pain and he gave me a cortisone shot". Cortisone depletes bone mass.
If you don't believe in a chiropractor then try a massage therapist. They are trained to relieve pain in shoulders.
It seems as though there is so much peer pressure here to go to a medical doctor instead of trying a homeopathic doctor. IMHO

    Bookmark   December 3, 2007 at 12:58PM
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