Bone health
Breaking the silence — tips for talking to your doctor about bone health
by Dixie Mills, MD, FACS, with Dr. Susan E. Brown, PhD
Just the other day my old college roommate, who uses me as her medical second opinion,
called with some good news. For the past five years, her bone density tests indicated
osteopenia, and each time she discussed the results with her doctor, she had to
explain that she didn’t want to take a bone drug. She eats well, practices
Pilates regularly, and her bone density levels have remained stable. The good news
was that, finally, her doctor got the message. She told my friend she didn’t
need to continue testing annually and felt okay with her decision to remain off
of prescription bone drugs.
How is it that so many women who are recommended bone drugs are in their late 40’s
to mid-50’s and facing menopause, when this group is actually at a very low
risk for fracture? Women often call to ask, “Should I take this medication?
I don’t really understand why I need it.” And in most cases, they don’t
have to take prescription drugs to save their bones, because there are several different
options they can explore first.
Too often, it seems that the subject of bone health comes out of the blue at the
doctor’s office, and many of us are unprepared and feel sideswiped into getting
tested or taking a pill. My friend’s steadfast ability to say “no”
to her doctor isn’t all that common, and Susan and I both hear from women
all the time who come away from a doctor’s appointment feeling frustrated
and unfulfilled. So it’s important to prepare yourself about the subject,
and know what it is you want or don’t want. Sometimes it helps to find a new
practitioner, but other times it’s simply a matter of knowing how to engage
with your doctor in a more productive, helpful way. Most practitioners genuinely
want to help you find the path that is right for you, but it can be difficult for
them, given significant time constraints and our current one-size-fits-all medical
model.
Perhaps you’re simply concerned or curious about your bone health, or maybe
you’re already on a prescription medication for osteoporosis. Either way,
now may be the perfect time to learn more about your options and get some guidance
on how to get the most out of visits with your practitioner. In four different scenarios,
we’ll cover the top methods for evaluating and addressing what is really going
on with your bones. Wherever you find yourself today, we hope you’ll be inspired
and empowered to create a better partnership with your practitioner, and in the
process obtain everything you need to enjoy better bone health throughout your life.
When I talked to Dr. Brown about this topic, she offered me her four strategies
for dealing with the different possible scenarios she often sees.
Strive for an equal partnership
More than likely, your practitioner wants to help you in any way that works for
you. The doctor-patient dynamic is an ever-changing one, given unprecedented advances
in modern medicine, the tangle of health insurance reform, and information and misinformation
overload via internet access. But for each partner’s needs and expectations
to be met, this relationship should be based, as with all relationships, on mutual
trust and respect. You may not know more science than the doctor, but you do know
your body and lifestyle habits better than he or she does.
If you believe that a prescription bone drug would not be the ideal course of action
for you, do your best to communicate that you are willing to go above and beyond
the average patient to keep your treatment plan as natural as possible. If that
means starting a new way of exercising, eating, or a natural supplement regime,
make it clear that you are willing to make those changes. With this information,
your doctor can trust that you’re taking your health seriously and personally.
In the best of all possibilities, shared communication is key. Talk things over
and formulate a plan together for healthy bones — what steps can you put in place
today, and which ones will you begin tomorrow? What additional measures would be
helpful in another few years? You stand to learn a lot from one another, and no
matter what you decide is best for your bones, having an open and honest discussion
with your practitioner is so important for your health — and your peace of mind.
Both you and your doctor have valuable information to bring to the table, so make
the most of your relationship. We hope you leave your doctor’s office feeling
not so much like you’re “in good hands,” but more like you are
holding hands in an equal partnership.
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Last Modified: 04/18/2011
Principal Author: Dixie Mills, MD, FACS & Dr. Susan E. Brown, PhD