OSTEOPOROSIS: DIET AND EXERCISE KEY TO KEEPING BONES HEALTHY

This phantom scan is used for equipment calibration at WomanCare.

Elva Noisworthy of East Prairie took a step down not too long ago "and I guess I missed a step, because it really hurt my right foot and right calf and the pain came up in my leg."

Her doctor took some X-rays and, while no fractures were found, referred Noisworthy for a bone density scan.

Noisworthy, 70, and a cook for Alta Barge Lines, learned several years ago that she had osteoporosis, a gradual loss of bone matter that makes bones brittle and susceptible to fractures.

"I'm not too worried about it," Noisworthy said. "I don't take chances with slipping and falling, and I'm very careful on the boat."

Now she's waiting for test results to show how much bone density she has lost.

The National Osteoporosis Foundation estimates that 8 million Americans have the disease, including half of all women over age 65, and another 17 million are at risk for osteoporosis.

According to the foundation, 80 percent of the people affected by osteoporosis are women.

Dr. Philip Taylor, a Cape Girardeau rheumatologist, said women are at much greater risk for developing osteoporosis for several reasons.

"The main reason is they have smaller skeletons than men," Taylor said, so any loss of calcium will have a greater effect overall.

"If a woman loses a little bit of calcium, she's at more risk of osteoporosis than a man would be," he said.

In addition, the loss of estrogen after menopause causes rapid loss of bone, he said.

"The best treatment at that point is to take estrogen replacement therapy, because that prevents that bone loss," Taylor said.

Women also drink less milk -- a prime source of calcium, which is what bones are made of -- than men, which means their bones may not be as strong as they should be before osteoporosis sets in, he said.

Some medications, including steroids, can also cause bone loss, he said.

Osteoporosis can be prevented, Taylor said. Getting sufficient dietary calcium while your bones are still growing and forming will make sure they're strong and healthy before menopause.

Exercise is also important. Weight-bearing exercise -- jogging, walking, aerobics and the like -- help prevents bone loss.

After menopause, Taylor said, hormone replacement treatments help prevent bone loss.

Getting the recommended daily allowance of calcium is also important, and so is continuing exercise habits, he said.

There are medications available to treat bone loss, Taylor said. They're recommended especially for women who, for medical reasons, can't or won't take estrogen.

Alendronate helps increase bone density and prevent fractures.

Calcitonin, now available as a nasal spray, is a naturally occurring hormone that has been shown to reduce bone loss in people with established osteoporosis.

Osteoporosis can cause deterioration of the bones in the spine, leading to the so-called "dowagers hump" some older women have.

But the real danger is in bone fractures. Bones become so brittle because of calcium loss that no trauma -- such as a fall -- is necessary for a fracture to occur.

Fractures from osteoporosis occur most often in the spine, wrist and hip, Taylor said.

"The most serious are fractures of the hip," he said. "They can kill."

As many as 20 percent of the people who suffer hip fractures will die from complications from that fracture, said Barbara Crowell, coordinator of women's health services at St. Francis Medical Center. Some will develop blood clots, some pneumonia and others will die during surgery to repair the fracture.

Osteoporosis is responsible for 1.5 million fractures a year, according to the National Osteoporosis Foundation, including more than 300,000 hip fractures.

One out of every two women and one out of every eight men have osteoporosis-related fractures.

Bone density scans can help determine how much bone has been lost, predict the risk of fracture and monitor the effectiveness of treatment.

The scans compare a patient's current bone density to a mathematical standard.

The tests are painless, said Padge Haman, an X-ray technologist at St. Francis Medical Center.

"A lot of people, when they hear the word scan, get nervous," she said.