Stand Strong Against Osteoporosis

Case Histories

Janet McCombs, Pharm.D., Age 43
Pharmacist, Clinical Assistant Professor, Osteoporosis Patient

Five years ago, Janet McCombs, Pharm.D., a clinical assistant professor at the University of Georgia College of Pharmacy, experienced sudden, severe pain in her foot while sightseeing in Washington, D.C.

"I couldn't imagine what was causing the pain. I really never considered that it might be a broken bone," says Janet. "I even cooked for and served a dinner party the next day while elevating my sore foot."

A few days later, Janet consulted an orthopedist regarding the pain and was surprised to learn she had suffered a stress fracture. Several fractures later, Janet decided to look into the cause of her fragile bones. Thinking her fractures might have been the result of an underlying health condition, Janet consulted an endocrinologist.

Janet's endocrinologist tested her bone density, and the low results indicated osteoporosis as the cause of her fractures. Then 37, Janet was shocked to hear she had osteoporosis - she was not yet near menopause and led a healthy and active lifestyle.

"I am an active, young woman who walks everyday. I am not who you think of when you think about osteoporosis," says Janet.

To increase her bone density, the endocrinologist prescribed medication and calcium. He also stressed the importance of exercise and urged Janet to continue her fitness routine.

Under the care of her endocrinologist, Janet has suffered fewer fractures and believes the treatment regimen her endocrinologist has prescribed will continue to improve her quality of life.

Patricia Smith, Age 71
Homemaker, Nurse, Osteoporosis Patient

Patricia Smith enjoyed an active lifestyle for years until back pain began to slow her down. In her mid-60s, when the pain became constant and more severe, she consulted an internist who prescribed medication, but did not address the possibility of osteoporosis. After a year of unsuccessful therapy, Patricia inquired about other treatment options, but was told nothing more could be done for her condition. At that point, Patricia decided to get a second opinion from an orthopedist.

An X-ray of Patricia's back revealed the cause of her constant pain: Patricia had fractured nine vertebrae and lost three inches in height. She was immediately referred to an endocrinologist.

"People always joked with me about getting shorter. Of course, I had no idea the height loss was due to my bones compressing," says Patricia. "My doctor even joked about my ribs sitting on my hip bones."

The endocrinologist's review of Patricia's health history showed the odds were not in her favor when it came to osteoporosis. First, she suffered from kidney stones from a very young age and had been advised by her primary care physician to maintain a low calcium diet.

"Kidney stones may be a strong indication of high calcium excretion, which can lead to bone loss," said Nelson B. Watts, MD, FACE, chairman of the AACE Osteoporosis Awareness Initiative, and director of the Osteoporosis Program at Emory University. "Given this history, we suspected osteoporosis was the cause of her numerous fractures and confirmed this with a bone density test."

In addition, after early menopause at age 45, Patricia's gynecologist had advised against hormone replacement therapy, which is known to have bone-boosting benefits. Dr. Watts also learned Patricia's mother had likely suffered from osteoporosis, which predisposed her to the condition.

Patricia's health has improved tremendously since her endocrinologist identified and began treating the underlying conditions affecting her bone health. Her current treatment regimen includes hormone replacement therapy, calcium, vitamins, exercise and medications to improve bone mass and decrease urinary calcium loss. Under her endocrinologist's care, Patricia's bone mass has increased by 38 percent, her calcium loss has decreased significantly, and she has not suffered any new fractures.

"My quality of life has improved 100 percent," says Patricia.

There's more good news: armed with information about osteoporosis as a hereditary condition, Patricia encouraged her three daughters to undergo tests for the disease, and two are currently being treated.