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Questions to Professor M.S. Phaneesha, Senior Consultant Orthopaedic Surgeon

1. What is osteoporosis and what part of the body does it affect?

Osteoporosis refers to the gradual thinning and weakening of bones, which makes a person very prone to fractures. It is often referred to as the “silent disease”, because many men and women are unlikely to find out that they have osteoporosis until they suffer a painful fracture. Osteoporosis is much more common in women, but men are at risk, too. In fact, about 25% of men over 50 will have an osteoporosis-related fracture. Osteoporosis may be under-diagnosed in men because it is often considered a "woman's disease" and men may not be tested. Even though it affects the entire skeleton, the risk of fracture is mainly at the spine, hips and wrists.

2. How can osteoporosis change the life of an active 35 year old woman?

Bone loss is a natural part of aging, but not everyone will lose enough bone density to develop osteoporosis. However, the older you are, the greater your chance of having osteoporosis. At the age of 35, a woman can develop osteoporosis only if she has any hormonal problems or has undergone removal of ovaries due to which she is on drugs that cause osteoporosis. The implications of osteoporosis are so bad that patients can develop fractures of the spine, hip, wrist and other areas and may have to undergo surgical treatment, suffer from pain, deformity and disability throughout their lives.

3. What exactly happens in the body of a person suffering from osteoporosis?

Our bones are constantly being rebuilt throughout our lifetime. Bones are made up of collagen, a protein that provides the basic framework, and calcium phosphate, a mineral that hardens the bone. As we age, we lose more bone than we replace. The greatest change in a woman's bone density comes in the five to seven years after menopause. Women who are thin and have a small frame are more likely to develop osteoporosis. Heredity plays a role, and so does ethnicity. Some conditions, such as type 1 diabetes, rheumatoid arthritis, inflammatory bowel disease, and hormonal disorders are also linked to bone loss.

4. What actions should be taken for the prevention of osteoporosis in terms of behavior and lifestyle? What changes are needed in terms of nutrition?

Smoking, an inactive lifestyle, and a diet low in calcium and vitamin D can place you at a greater risk for osteoporosis. Corticosteroids, which are anti-inflammatory drugs used to treat asthma and other conditions, may increase your risk of bone loss. Eating disorders (anorexia nervosa or bulimia) can also take a toll on bone health.

On the other hand, weight-bearing exercises can help you build bone density and maintain it. This includes walking, jogging, tennis, and other activities where you move the full weight of your body. Using small weights in many different activities helps your bones. Research has found that women who walk just a mile a day have four to seven more years of bone reserve.

Eating calcium-rich foods can help protect your bones no matter what your age. You need the equivalent of about three and a half 8-ounce glasses of milk a day. Fish such as salmon, tuna, and herring also contain vitamin D, which helps us absorb calcium, and leafy green vegetables provide magnesium, which also helps maintain good bone quality.

Some foods and drinks are also fortified with calcium and vitamin D. A glass of vitamin D-fortified milk is one of the best ways to get your calcium. Other dairy products vary in their calcium content. Yogurt and cheese are better choices than ice cream or frozen yogurt. Fortified foods, such as cereals and orange juice, can also provide a lot of calcium.

Certain foods can sap your body's calcium. Minimize salty foods such as canned soups and processed meats. Caffeine can decrease your body's absorption of calcium, but the effect is minimal unless you drink more than three cups of coffee a day. Heavy alcohol use can also lead to bone loss.

5. What are the symptoms which should prompt a patient to seek treatment?

You might not even realize you have osteoporosis until you have a fracture or an obvious change in posture. In fact, you could have significant bone loss without even knowing it. Back pain, caused by changes in the vertebrae, may be the first sign that something is wrong.

All post-menopausal women and those who have higher risk of osteoporosis must undergo DXA Scan once every 3 years.

6. Can osteoporosis be treated? If so, how?

Most medications for osteoporosis reduce bone loss or slightly increase bone density. If you are diagnosed with osteoporosis, you may be prescribed a biophosphonate, medication which can reduce bone loss and fracture risk and may actually help build some bone density. Hormone replacement therapy, once used widely for menopause symptoms, is also an option for osteoporosis. However, it is easier to prevent osteoporosis than to treat it. Healthy habits as a child or teenager can pay off years later with stronger bones. Young people can build their bones by eating calcium-rich foods, getting enough vitamin D (through sunshine or diet), and exercising regularly.

Avoiding fractures is also essential to keeping your bones healthy, whether you have bone loss or not. To prevent a fall that could cause a fracture, minimize clutter and be sure that your area rugs are anchored to the floor. Wearing sturdy, rubber-soled shoes also can reduce the risk of falling.

Your doctor may also suggest DXA testing to determine your risk of getting osteoporosis in the future. This test measures your bone mineral density test. It may be a good idea to get tested if you're over 50 and have broken a bone, or if you are a woman over 65 or a man over 70.The DXA test may also be recommended if a woman is going through menopause or past menopause and have risk factors. It also concerns men aged 50-69 with risk factors. The DXA Bone Density Scan uses low-dose X-rays to measure bone density in the hip and spine. The test takes less than 15 minutes.

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Juste quelque mots pour vous remercie de votre acceuille chaleureuse, toujours competent avec les patients, surtout les infirmieres pediatriques, pour Sooreeta, Dr Kevin Teerovengadum, Dr Joomye, Mr Joe, Infirmiere Dorothe, ange gardienne Reshma et la chirurgienne Dr Reshma. Moi je suis fidele a l'hopital Apollo depuis 2009 par l'acceuil et leur sympathie. Je remercie tous les services. Meme ma fille, T., la patiente, elle veut pas quitte l'hopital.

M.S Abdallah
20.03.2017