A Woman's Place Is in the Gym

Who's at Risk?
Postmenopausal women are at highest risk for menopause because their
bodies produce less estrogen, a hormone that protects bones.
Osteoporosis in men is becoming more common, however.

Other Risk Factors Include:

• Broken bone from a minor injury
• Age greater than 65 years
• Low body weight
• Family history of bone fractures
• Cigarette smoking
• Sedentary lifestyle
• Excessive alcohol intake (more than two drinks a day)

How Can It Be Prevented?

• Eat a balanced diet rich in calcium and vitamin D.
• Perform weight-bearing exercise three to five times per
  week.
• Do not smoke.
• Limit alcohol consumption.
• Test bone density, when appropriate.

Good Sources of Calcium
In decreasing order of calcium content:

• Calcium-fortified milk or fruit juice
• Milk, whole or skim
• Yogurt
• Calcium-fortified cereal
• Cheese
• Sardines
• Ice cream
• Bok choy
• Turnip greens
• Tofu
• Broccoli

Nurse practitioner Cindy Smith was finishing a long day of working at a
health screening fair in Fayette County, W.Va, when, just for kicks,
she decided to have her own bone density tested. As a non-smoking
33-year-old woman, Smith considered herself to be a low risk for
osteoporosis.

Admitting that she was a little overconfident, Smith was
horrified to be told that she had osteoporosis.

"You could have knocked me over when I heard the number. I
always drank lots of milk and was doing everything right except getting
enough exercise," she said.

Osteoporosis occurs when the body loses bone at a rate faster
than it can be replaced. By far the most common patient -- 80 percent
-- is a postmenopausal woman.

Osteoporosis puts the patient at risk for spine curvature
("dowager's hump") and broken bones. Although broken bones are not
fatal, one in five patients who suffers from a broken hip dies within a
year.

Smith was well-versed in these facts. She knew the dangers she
was facing. Hoping for a mistaken diagnosis, she was tested again, with
the same discouraging result.

At 4 feet 11 1/2 inches, Smith was also not looking forward to
the height loss most patients experience.

Osteoporosis often runs in families, so Smith insisted that
her mother and younger sister be tested. Although her mother was mildly
affected, the shock was that her 30-year-old sister was also
osteoporotic.

"The news about my kid sister really threw me for a loop. She
was 30 years old, but she had the bones of an 80-year-old woman," Smith
said.

Smith sees many osteoporotic patients in her practice, but she
and her sister were exceptionally young to experience serious bone
loss.

Her family was not unaware of the ravages of the disease.
Smith's grandmother has endured two broken hips and many other broken
bones. Bone injuries are often the result of falls, but she broke her
hip by simply turning around. Smith recalls hearing about a great,
great aunt who couldn't get out of bed without breaking bones.

At first, Smith said she denied the diagnosis. "I was angry. I
wondered how it could happen to me," she said. She began taking
medication, knowing that even the best drugs will only result in a 2
percent to 5 percent improvement.

A normal bone density score is zero. A score of minus 1 to
minus 2.4 is considered osteopenic, defined as thinning of the bones. A
score of minus 2.5 and lower is osteoporotic. Smith's score was minus
2.5.

Medication alone was not going to sufficiently improve her
score, so Smith decided that it was time to follow her own advice and
begin an exercise regimen.

Weight-bearing exercise helps slow bone loss. Walking,
jogging, tennis, dancing and working out with weights are all good
weight-bearing exercises.

Armed with that knowledge, Smith headed to the Charleston
YMCA. She developed her own weightlifting program, but the staff
includes trainers who can help anyone come up with a bone-strengthening
exercise plan. The YMCA also offers an osteoporosis training program.

Smith is a faithful exercise convert and works out nearly
every day despite her busy schedule as a nurse practitioner at
Charleston Family Practice Group.

"When a patient comes into the office bent over with
osteoporosis and barely able to breathe, that is my motivation," she
said. "Exercise is a priority. I go every day after work."

She also took an aikido class, which, among other things,
taught her the proper way to fall. By falling a certain way, she can
avoid breaking bones.

She hadn't been at the exercise program for a full year, but
she couldn't resist the temptation to test her bone density again.
Normally, she would never recommend retesting for at least one year
because the changes are so gradual.

Once again, the tests results were astounding.

"I was floored. My score was completely reversed," she said.
"I've never seen results like that. The best I have seen is one of my
patients who is in her 60s improved her score by one point. I lost 2.5
points."

Her score was zero -- normal. Smith did not expect a
turnaround like that, but she attributes her phenomenal success to
exercise and encourages women to exercise.

She hates to hear women say that they are intimidated to work
out at the gym with bodybuilders and serious lifters. They are missing
a great path to stronger bones and improved coordination and balance,
she said.

"I always tell them that a woman's place is in the gym," she
said. "Women really can make these changes and get the benefits. They
are empowering their own health care."

Smith is thinking about discontinuing her medication and hopes
the exercise alone will keep the osteoporosis at bay. The long-term
effects of the medication on young patients is not known, she said.

"I worry about being on the medication. I would like to have a
family someday, and I don't know how the medicine might affect that,"
she said.

In her work as a family nurse practitioner, Smith is an
enthusiastic advocate of preventive medicine. By living her own
philosophy, she improved her own chances for a healthy future.

"I am so grateful that I found it," she said. "It's
heartbreaking to see severe cases that could have been prevented if it
is caught early enough."

Source: Sunday Gazette-Mail;
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