Pain: With Bone Loss, It’s Not All Physical

PJ Hamel Health Guide August 30, 2012
  • Osteoporosis is often called the “silent disease.” Its outward symptoms are hard to detect, and for many, especially those with a minor case, it’s virtually painless – unless it results in a broken bone or includes osteoarthritis. But being diagnosed with bone loss at a young age can cause personal issues, including emotional pain that’s every bit as difficult as a fractured wrist.

    Osteoporosis.

    Old ladies’ disease, right? Despite the gorgeous silver-haired, tennis-playing women in those magazine ads for Fosamax and Boniva, for most Americans osteoporosis inspires a mental image of a frail, white-haired woman, back hunched nearly double, slowly inching along with a walker.  


    Well, it ain’t necessarily so.

    I was diagnosed with osteopenia at age 48. No gray hair. No grandkids. No tennis, either, but plenty of chasing around after kids, working long hours, and making regular visits to my “favorite” hangout: the gym.

    Thus I was shocked when a DEXA scan, taken as a baseline during breast cancer treatment, revealed low T scores.

    A year later they were even lower, the result of the aromatase inhibitors I was taking to prevent the cancer from returning. Reluctantly, I researched a selection of bisphosphonate drugs that would hopefully slow down this bone loss, and chose Actonel.
     
    After taking Actonel for a year, I quit, convinced I’d rather suffer potentially weak bones than the severe digestive issues I was experiencing with this caustic drug.

    But I didn’t just wave goodbye to bisphosphonates without saying hello to something else: weight-bearing exercise paired with self-induced, mild bone stress.

    After 3 years of lifting weights 5 days a week, plus jumping rope (or jogging on a treadmill), my bone loss has slowed considerably. In fact, the most recent T scores for my spine were no lower than those taken 2 years ago, and only fractionally lower in my hip. When you’re dealing with bone loss – this is progress!

    But progress is measured in many ways. And it’s not always a straight path: for most of us, dealing with bone loss is a series of zigzags and dips as we learn to handle not only the physical, but the mental and emotional challenges of weak bones.

    As with any disease, osteoporosis brings with it a sense of loss. That good health you never thought twice about? Gone. The ability to take casual risks – the fast bike ride, the pickup ice hockey game, the tricky yoga moves? Disappeared.

    Confidence in your own body, and its ability to effectively and painlessly move you through life?

    Shattered.

    I never really thought about growing old, until cancer gave me a kick-in-the-gut look at my own mortality. Who among us imagines ourselves dying young – unless we’re suddenly handed a concrete cause, a statistic-laced wakeup call that yes, you might be dead before your 50th birthday?

    Well, I recovered from that particular blow. Time heals, both physically, and mentally. I no longer worry much about dying from cancer; it’s not something I can control, and I simply shelve the thought like a dusty old book, unwanted and unread.


  • But I’ve had a harder time getting past the fear induced by those “bad” T scores. Even though they’re worsening only very slowly now, they’re still dropping. And I find myself thinking twice about certain physical activities: bike riding, for instance.


    In an earlier post on this site, I wrote about riding my bike, and how it had changed since my diagnosis of osteopenia –

    “…As age has redefined my abilities and pared down my opportunities, my only speed comes behind the handlebars of a bike. I used to make split-second decisions – is the curb too high to jump? Is that car going to turn? – and react to the consequences.  I was careful, cautious – but not scared.

    “Now I’m afraid. Talk of a broken hip, spinal fractures, broken wrists make me think twice about taking chances. Quicksilver has turned, well, not quite to lead, but certainly to something safe and stable. Speed is a thing of the past.



     

    “Except on those mornings, like today, when I say to hell with it and ride my bike as fast as I can make it go. Almost. I apply the brakes going downhill, a prickle of unease sharing space with the wind in my face. I watch for sand, for leaves, for the groove between sidewalk and grass waiting to grab my tire. And the visceral fear of injury – of broken bones – slows my pumping legs. 

     

    

“For an ex-jock, I’m way too young to be old. 



     

    “For someone with thin bones, I’m way too smart to be stupid.



     

    “Mind over heart. Sometimes it hurts.”

    For many of us, pain is more than the sharp stab of a spinal disc injury, or the long, slow ache of arthritic bones. Fear is pain. Frustration is pain.

    And loss, whether it comes in the form of weakening bones or the treasured activities they deny us, is the worst pain of all.