A Concerning Diagnosis
I've been wondering why I seem so prone to rib injuries (3 separate incidents in 8 months) so I scheduled a bone density scan for this past week as a way of ruling in or ruling out any bone-related issues. A bone density scan is typically recommended for women at age 65 but it's not something men are normally screened for unless there's a history of fractures. I got my results in an email yesterday and my heart sank as I read them. I have osteoporosis—and not a mild case of it, either.
Bone density test results are reported in a measurement known as a “T-score.” A T-score of minus 1 or higher is normal. A score of minus 2.5 or lower is osteoporosis. The range between normal and osteoporosis is considered osteopenia, a condition where bone density is below the normal range and puts a person at higher risk for developing osteoporosis. Osteopenia also raises the risk for breaking a bone. My lumbar spine T-score is -3.3 and my left and right hip scores range from -2.4 to -2.7. I'm a very active person so those numbers are worrying to me and have caused me to rethink everything about the way I go about my life. Obviously, my cycling is a big concern for me. Can I do group rides anymore? I don't think so. Nor can I ride aggressively (for me) on the trails—something I enjoy.
The reason for my bone loss is likely due to the excessive amount of the steroid prednisone I've had to use over the past 30+ years to help me through my occasional bouts of cluster headaches. I knew there was a risk for bone loss with the drug but the headaches can be so severe that I'm left with little choice but to use it. I believed that whatever bone loss I experienced, I would eventually get it back. Given my new bone density results, I don't see that prednisone is an option for future headache cycles and the thought of that is an unsettling one.
There's also this complicating factor for me: the fact that I'm a very active cyclist.
And one other equally important point to make note of: I have low testosterone. Low testosterone plays a major role in osteoporosis. Adult males over 50 years of age with testosterone levels between 300-500 ng/d are considered to have low testosterone. My most recent test 7 years ago gave me a value of 184. I consulted with my doctor about testosterone replacement therapy then but he ruled it out because of my Factor V Leiden blood clotting condition. Even though I'm anticoagulated, there was still a higher risk for blood clots than he was comfortable with. I've already had enough experience with those to last a lifetime.
I've begun taking calcium supplements and I hope to meet with my primary care physician to discuss a course of action on how best to proceed to stop the deterioration of my bones and hopefully, begin to build back what's been lost—if that's even possible.
I like to live my life by the motto that things happen for a reason so perhaps there's a silver lining in my recent rib injuries. Had it not been for them, I wouldn't have sought out the bone density scan. My hope is that I didn't wait too long.
I can't close out this blog post without mentioning what's happening in Ukraine with Russia's invasion of that sovereign, friendly nation. It appears to be backfiring somewhat spectacularly (at least for now) on Russia's dictator Putin. Ukrainian forces and their citizens are standing their ground and pushing back mightily against the much better equipped but evidently ill-prepared Russian military. Europe is united in leveling sanctions against Russia, Putin, and numerous oligarchs who benefit from the corrupt regime. Ukraine isn't out of the woods yet but most of the world is standing with them as Russia finds itself isolated in a way that will only lead to more protests in their streets and possibly even the ouster of Putin before it's over. That's my hope, anyway. I'm hearing concerns, tho, that Putin is not his normal self, going so far as to put his nuclear defense forces on high alert today. It's anyone's guess how this will ultimately end.
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