UGANDA: Boost your bone bank to fight osteoperosis

. KAMPALA, Uganda / The Daily Monitor / Health & Living / August 27, 2009 The major challenge with osteoporosis is that it presents no symptons and progresses without pain until the person gets a fracture, writes Agnes K. Namaganda. Osteoporosis may seem like a disease of the old but its prevention starts before old age strikes. Knowledge about it and measures taken before the disease reaches a dangerous stage can go a long way in lessening its effects. Of the elderly patients admitted at Mulago’s orthopaedic department, about half are osteoporosis patients. Florence Kyomuhendo (not real name) had never heard of the disease until she was diagnosed with it at Mulago Hospital. “It was such a simple fall on the steps as I was getting out of the house; I can’t believe it got my hip fractured,” remarked the 58-year-old dressed in a cast and speaking from her hospital bed. Dr Tito Beyeza the head of the Orthopaedics Department at Mulago Hospital explains that osteoporosis is a condition characterised by loss of normal bone density. Bone density refers to the combination of the thickness of the bones and their mass. “The bones become soft and fragile and in the end, this can result in fractures,” the doctor explains. He says it commonly occurs among elderly females who are past their menopause and elderly men. But the major challenge with osteoporosis is that it presents no symptoms and progresses without pain until the person gets a fracture. Dr Beyeza says that these fractures (medically referred to as pathological fractures) are caused by minor violence and he explains: “A normal activity that is not much exerting such as turning in bed can cause a fracture for someone suffering from osteoporosis.” He gives another illustration of just a bit of stumbling or someone stepping out of the car and getting a fracture in the ankle. “When such a movement causes bone breakage, then it means the bones are too weak and the person has osteoporosis.” Sometimes, the person may not even know they have gotten a fracture, but constant pain from that area will be the pointer to the problem says the doctor. On an interesting note, Dr Beyeza says that orthopaedic surgeons are usually called upon to give expert advice in court cases where say, a simple push or shove resulted in a fall causing a bone fracture. “For some complainants, the fractures are usually as a result of osteoporosis with the bones too weak.” But when exactly does this condition start to develop? Normally, bone density accumulates during childhood and reaches a peak at around age 25 according to www.medicinenet.com. Bone density is then maintained for about 10 years. After age 35, both men and women will normally lose 0.3 per cent to 0.5 per cent of their bone density per year as part of the aging process. Risk factors Certain situations increase the risk of suffering from osteoporosis and these include; Post-menopausal women: Menopause brings on a lot of uncomfortable conditions like mood swings, hot flushes and loss of skin suppleness. Osteoporosis also develops right about this time. Dr Beyeza attributes this to the reduction of the estrogen hormone- a byproduct of ovulation, that is important in preserving bone density. “Because there is no more ovulation after menopause, estrogen levels drop and this causes a rapid loss of bone density.” Old age: The surgeon says that osteoporosis should also be highly anticipated in elderly women-above the age of 70, and elderly men-above the age of 80 Lack of exercise: Patients who suffer chronic illnesses that keep them bedridden for long periods of time are at risk of developing osteoporosis in spite of their age according to Dr Beyeza. “Even a normal person can do it as an experiment. Just stay in bed for six months and see if you will not become osteoporotic,” says Dr Beyeza who attributes the strength of bones to activity. Smoking, doing drugs and alcoholism: Excessive involvement in any of these interferes with processes in the body that ensure the metabolism of the compounds necessary to maintain bone structure according to Dr Beyeza. He says that bone tissue is made of proteins, salts and water but that cigarettes, drugs and alcohol can inhibit their absorption. Poor nutrition: Feeding on diets low on minerals like calcium which is responsible for bone strength can also cause osteoporosis. Because Vitamin D helps in the absorption of calcium, its deficiency means that the body cannot absorb adequate amounts of calcium to prevent osteoporosis. Other risk factors, according to the medicine.net website include; thin and small body structures, family history of the disease in parents and chemotherapy which can cause early menopause due to its toxic effects on the ovaries. When amenorrhea (loss of the menstrual period) happens in a young woman for one reason or another, osteoporosis can result. Women like athletes. who undergo vigorous training, usually suffer from amenorrhea thus being predisposed to the disease. Medicinal drugs: Long term use of some drugs like prednisone and those used to treat seizures can also cause osteoporosis. Dr Beyeza says that osteoporosis cannot occur in children. “The condition that causes the softening of bones in children has a different cause and a different name.” He says children’s legs may become soft and bend due lack of Vitamin D, a condition called Rickets. Prevention According to Dr Beyeza, old age, the major predisposition to osteoporosis, cannot be prevented but onset of the disease can be delayed by, “Eating a balanced diet rich in calcium and phosphates.” Foods that are a good source of calcium and other minerals include green leafy vegtables, eggs, fish, soya beans, milk and other dairy products, cod-liver oil, nuts like almond, sardines Keep physically active by walking and jogging if you are the kind that spends an entire day seated, advises Dr Beyeza. Other exercises that are exertive on the bones like rope-skipping, also help to strengthen the bones. Dr Beyeza says that Hormone Replacement Therapy (HRT) that is used by some women to alleviate some of the side effects of menopause also prevents the development of osteoporosis. Intake of calcium supplements, but only as prescribed by a doctor, could be an option although Dr Beyeza has some reservations about this. “The body requires only a certain amount of calcium.” If this calcium is obtained from the appropriate food sources, then taking more by way of supplements is not necessary as the excess will only be passed out. Because the lack of Vitamin D in the body inhibits the absorption of calcium, it is important that people are adequately exposed to the sun which is the major source of the vitamin. As stated above, osteoporosis has no symptoms but the expert surgeon says that diagnosis can be carried out at any of the major laboratories in hospitals around the country. Early diagnosis can help a patient take the necessary treatment and precautions to avoid fractures. [rc] © 2009 Monitor Publications Ltd