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My first DEXA at the age of 41 showed severe osteoporosis. My doctor concluded that I was in a vulnerable group (white, petite, small-boned, Europesn ancestry).and that my steroid asthma inhaler and the occasion use of oral steroids caused the severe osteoporosis so early. When first introduced, the steroid asthma inhalers were believed to not have any "systemic" effects as was the case with oral steroids. However, when I read the full prescribing information for the inhaler, I saw that there was a statistically significant increase in fractures in the group of people who took the drug compared to those who not taking the drug. I guess that there ARE some systemic effects. But I have to breathe. I now also use a steroid nasal inhaler, and I use steroid eye drops to prevent rejection of my cornea transplants. So, "the deck is stacked against me."
After 20 years of treatment, my bone mass has increased enough that I am technically classified as osteopenia. I can still be treated because my original diagnosis was osteoporosis. Thank you for asking. I didn't realize that this would confuse anyone. I have been "anything but normal" for most of my life.
I was already being seen by a rheumatologist for early onset osteoarthritis He was doing research on osteoporosis. I had an unexplained stress fracture in a foot. I initially saw a different doctor because my doctor was out of town. I asked him about osteoporosis, and he dismissed it. When I saw my doctor for a follow-up, HE brought up osteoporosis before I did and wanted to do a DEXA, which I readily agreed to. I still remember his comments when he back with my DEXA results: "I'm so glad that we did this." I'm lucky that he was my doctor. He left the practice and assigned me to another doctor. She has said that she would never have ordered a DEXA for a stress fracture in a foot because "people get stress fractures all the time."
Now, regarding drugs–i was on Fosamax for several years. My bone density initially went up, but then it started to go back down. By this time, I was under the care of the second doctor. At this time, I presented a problem because I was premenopausal. My doctor wanted to use Forteo, but since I was premenopausal, I had to have a major bone fracture (fingers and toes didn't count). I remembered that I had a freak accident in a hotel room in Atlanta, Georgia, where I bumped into a sharp corner on a cabinet and broke a rib. That was a major bone fracture. It was approved by my insurance company, and I was on it for two years. I am very thankful that I was on it before I was old enough to be on a Medicare prescription drug plan. I hit the max on my drug copay very quickly as I was on another, very expensive monthly injection for asthma. As with most people, I had a big increase in bone density while on Forteo. After the two years of Forteo, I was on Reclst for several years. I had some small increases. I have been on Prolia for 6 years, and it was on this drug that I have finally moved into osteopenia. I have an appointment in two weeks where I have another DEXA, and based on the results, we will determine a strategy going forward.
Just a quick comment–i was diagnosed with severe osteoporosis at the age of 41. My doctor said that I was the right "type"- -White, Europeam ancestry, and my steroid asthma inhaler put me "over the edge." My bone density was worse than my mother's when I finally dragged her to the doctor in her early 80's. 4 years of treatment were not enough to keep her from breaking her hip. However, 20 years of treatment HAS been enough to push me into osteopenia, so I'm hopeful that i won't break a hip in my 80's