Her skepticism about a bone density screening test led to a better understanding of osteoporosis… and a confirmation of personal wellness.
The offer was too good to pass up. My company’s health & wellness program incents employees to get an annual physical exam, a dental checkup, bloodwork and other screening tests, and exercise regularly. The reward? Earn enough points and get a reduced health insurance premium the following plan year. There’s another big payoff for being proactive about one’s health & wellness: finding out, sooner rather than later, if there’s a hidden medical problem. Take osteoporosis, for example.
During my annual physical my doctor cited my age (somewhere north of 60) to support his recommendation for a bone density screening test. But I argued I didn’t need the test because I already knew I had good bones.
“I’m descended from a long line of hardy, thick-boned people,” I bragged. “According to family legend, when my father’s ancestors got bored of snow-shoeing up and down the mountains of Norway, they’d catch a herd of reindeer and stack them up to see how many they could bench-press.”
“Uh-huh,” my doctor replied with a raised eyebrow.
“Yes indeed,” I said. “Both sides of my family have bones like tree trunks. My mother’s Irish ancestors also enjoyed games of strength.”
“As in?” doc said.
“Well, instead of tossing horseshoes, they’d toss an actual horse.”
My doctor stood quickly and headed to the door, possibly to call for security.
“Wait, don’t go,” I said. “The truth is, no one in my family has had osteoporosis. So I don’t need that bone density screening test.”
“I’m happy for your relatives,” he said, “but you shouldn’t assume you’re healthy just because they are.” He exited the treatment room, returned with a printed order for the test and instructed me to schedule it.
Although I like and respect my family physician, I tend to err on the side of skepticism when it comes to medical tests.
I always ask, “Is it necessary? Is the cost to my employer’s health insurance plan (and my bank account) justified? Are there risks?”
My doc answered yes to the first two questions and replied “extremely negligible” to the third.
Here’s what I found:
- Osteoporosis causes bones to become fragile and more likely to fracture. The disease often goes undetected until a fracture occurs.1
- 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk for fractures.2
- In older people a serious fracture can lead to a downward spiral in physical and mental health. Hip fractures are associated with a significantly increased risk of death.3
- A bone density screening test is recommended for all women age 65 and over.4
Those statistics are sobering, but it was something more personal that really got my attention. A woman in my social circle died a few months after breaking a hip in a fall. Osteoporosis was cited as a contributing factor in her death.
Still, the bone density screening test is an X-ray, which can be risky. I’ve had several in my life, beginning when I broke my hand catching a bad football pass at age 12, and up to and including the full-mouth scan I received at the dentist’s office this year. X-rays are cumulative; would another one turn me into a human-sized radioactive lava lamp?
A few more mouse clicks and I found information on the bone density test my doctor had ordered, the “dual energy X-ray absorptiometry,” or DXA. The radiation used in the test is considered very small, less than one-tenth the exposure of a standard chest x-ray. Hence my doctor’s reply of “very negligible” to my question about risks. Moreover, the DXA can calculate the risk of a break. 5
I ran out of excuses and scheduled the test.
The procedure was no big deal. I relaxed on my back on a table and fantasized about things that make me happy, like a double-scoop hot fudge sundae with a boatload of extra cherries. Meanwhile, that low-dose DXA machine moved back and forth above, scanning my spine, hips and other bones. I actually fell asleep on the table. I may have snored a little.
In case you’re wondering, the screening test measures the grams of calcium and other minerals present in a segment of bone, like the lower spine or hips. Osteoporosis, which means “porous bone,” develops when the body loses too much or makes too little new bone. When that happens, they become weak, brittle and can break easily.
A couple of years ago I tripped on a buckled sidewalk and fell hard on both hands. No broken wrists, thanks to my big-boned ancestors. Heredity can be a factor in healthy bones, but they also need calcium and vitamin D. I grew up on a farm in Wisconsin, America’s dairy land, where the consumption of milk, cheese and ice cream is practically a religion. I love me some dairy products and have slurped them down my entire life.
Two days after the bone density screening test, the nurse called with the results. “Great news, you passed the osteoporosis screening with flying colors,” she said.
“Of course I did,” I replied, “thanks to my ancestors in Norway and Ireland.”
“Oh dear, the doctor told me about those poor reindeer and horses,” she whispered, and quickly hung up.
Circling back to my company’s health & wellness program…in addition to getting the annual physical exam, I log my daily steps and other exercise on a nifty platform called EPIC Lifestyle Solutions, and completed several other “metrics-bearing” activities. That’s wellness-speak for doing things that support health, like getting blood tests, immunizations and such. And presto, I earned enough points to qualify for a reduced health insurance premium the following year. The money I saved more than covered the copay for the bone density screening test. Most importantly, the test verified what I thought I knew: my bones are indeed like tree trunks.
I celebrated my good health with a double-scoop hot fudge sundae, heavy on the cherries. OK, I didn’t do that. I ate a reduced-fat, calcium-rich frozen yogurt, then went for a long walk.
1National Library of Medicine, “Osteoporosis Overview”
2National Osteoporosis Foundation, “Osteoporosis Fast Facts”
3NCBI.com, “The Burden of Bone Disease”
4WebMD.com, “Osteoporosis and Bone Density Tests”
5RadiologyInfo.org, “Bone Densitometry (DEXA), What Are the Benefits Vs. Risks?”
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