Got Bones? » July 2006

July 31, 2006

Sally Field Calls Baby Boomers to Boniva Action

Sally Field is not just a paid spokesperson for Boniva. No, she is part of a "campaign" to "raise awareness" about osteoporosis. She is spearheading "a new kind of 60s revolution" according to the drug company, Roche Pharmaceuticals.

Shortly after she began taking a drug to prevent bone fractures, she was approached about joining a campaign to raise awareness of this silent condition ... Calling baby boomers to action on osteoporosis has allowed Field to reclaim membership in a generation that, in some ways, she missed out on. "I was in The Flying Nun and everybody was out eating granola ... and protesting, and I was kind of stuck," she says.

Comparing being the spokesperson for a drug company to protesting the Vietnam war? Trade your granola for Boniva! Baby boomers, if her campaign is successful, we might just have to rename you the Boniva Boomers.

Small wonder

Posted by Tracy at 2:23 AM | Comments (3)

July 28, 2006

FVFG on LH: Avascular Necrosis of the Hip

With osteonecrosis (also called avascular necrosis) being so much in the news because of the link between Fosamax and jaw osteonecrosis and Floyd Landis having osteonecrosis of the hip, I thought I'd direct anyone who's interested in the subject to a blog in the Health Diaries archives called FVFG on LH. (those acronyms stand for "Free Vascular Fibula Graft on Left Hip") Star wrote a lot about her hip surgeries and the challenges that someone dealing with avascular necrosis of the hip has to live with.

FVFG on LH

Posted by Tracy at 2:14 PM | Comments (0)

July 26, 2006

Oral Surgeon Warns of Fosamax Problems

Oral surgeons, who happen to see firsthand the jaw problems that bisphosphonates can cause, are being much more outspoken about the Fosamax problems than many primary care physicians. It's all well and good for doctors to tell you that osteonecrosis of the jaw is a rare side effect and not to worry about it, but perhaps they'd be singing a different tune if, like oral and facial reconstructive surgeon Dr. Gregory Lutcavage, they had to treat the patients with exposed bone and deal with the situation firsthand. Speaking about his patients with jaw necrosis, he said:

"We just try to get them comfortable again," he said. "It's going to get to the point where people will have to live with exposed bone because we don't have the treatment."

He also had some words about the drug companies and how they've handled the situation:

The whole process has been very frustrating, Lutcavage said, especially witnessing patients suffering and drug companies delaying going public about the risks and ramification ... "One drug company did not come out with the update to their circular until about three or four months ago," he said. "We were seeing this three years ago."

I applaud those doctors who have their patients' best interests at heart and are willing to tell the truth about these drugs.

Doctor warns of drug's side effects

Posted by Tracy at 5:52 PM | Comments (1)

July 25, 2006

Floyd Landis Wins Despite Osteonecrosis of the Hip

Floyd Landis has amazed everyone by winning the Tour de France despite suffering from osteonecrosis of the hip. Landis sustained a femoral neck fracture of the hip during a car accident in 2003. This kind of fracture often leads to osteonecrosis (also called avascular necrosis) because the blood supply is cut off from the hip joint. If the blood can't get through, the result is osteonecrosis or "bone death" and eventual collapse of the joint.

Landis didn't make his osteonecrosis public until halfway through the Tour de France. He plans to undergo hip replacement surgery in California next month.

"It's really sad," Landis said, "if [my cycling career] is over now. This is what I've been doing a long time. But I can say that, having won the Tour, I'm a little more calm about it, for some reason. As long as there aren't any complications in surgery, I think by next spring, I'll be back racing, though probably not at this fitness level."

Landis says he's been "kind of racing every race like it's the last one" because of his osteonecrosis. If only we could all live each day like that.

Landis at peace before hip surgery
Hip, hip hurrah for true champ

Posted by Tracy at 11:00 AM | Comments (1)

July 21, 2006

Kyphoplasty for Vertebral Compression Fractures

The foremost cause of vertebral compression fractures is osteoporosis. 700,000 cases occur every year. The fractures lead to a curvature of the spine. Patients become malnourished as compression of the stomach leads to a false sense of fullness that prevents them from eating and eventually leads to an overall deterioration of their bodies. And then there is the horrible pain.

The majority of patients respond favorably to traditional treatment which can include bed rest, analgesics, back-bracing, physical therapy, and muscle relaxants. But some patients suffer from prolonged pain and immobility that can persist for life.

Bill Ingram used to love camping and fishing with his wife, Elnora, down in Texas and meeting friends from all over the world, some of whom just sent him cards for his 86th birthday. But those days came to an end when osteoporosis caused fractures in his spine.

Kyphoplasty is a procedure to fix this. Two small incisions are made and a tube is inserted into the spine. A tiny balloon is inserted into the tube and inflated. This creates a cavity on both sides. The balloons are deflated and the cavities are filled with cement. The cement makes the vertebra stronger, the balloon restores its height and shape, and the pain is relieved in 95% of patients.

Breakthrough Procedure for Osteoporosis Patients
Kyphoplasty: A New Treatment for Osteoporotic Vertebral Compression Fractures

Posted by laura at 1:19 PM | Comments (0)

July 20, 2006

Sally Field, Boniva, and Media Ethics

Gary Schwitzer, professor of media ethics and health journalism at the University of Minnesota School of Journalism & Mass Communication, has called attention to an article in the Oregonian in which Sally Field was allowed to sing the praises of osteoporosis drug Boniva without any kind of disclosure that Roche Therapeutics is paying her to do so.

[The Oregonian] ran a story that proclaimed that "Actress Sally Field joins the women who are fighting osteoporosis with medicine, supplements and exercise." Not surprisingly, there was an overt plug for a drug: "Field chose to take Boniva, a once-a-month medication from Roche Therapeutics." And the paper let her get away with this: "I feel it's kind of a miracle."

I'm so glad Schwitzer is calling attention to this. Sally Field can't just go around throwing references to Boniva and how it's changed her life without telling people she works for them. I know it's hard to miss the Boniva commercial featuring Sally, but some people may not know she's the spokesperson.

This whole ad campaign leaves a foul taste in my mouth. She writes a "journal" on the Boniva website in which references to Boniva are not-so-gracefully mixed in with talk about her day to day life. Here's a quote from her June entry:

This month, the whole family is taking a trip together to Hawaii ... I’ll be packing for fun, which means plenty of exercise to keep my bones strong. And I won’t have to pack a load of medication since just one Boniva® (ibandronate sodium) Tablet will help protect my bones for the entire month.

Well, isn't that special!

Schwitzer health news blog
Oregonian article
Sally's June Journal Entry

Related Entry: Rally with Sally Field and Boniva

Posted by Tracy at 6:34 AM | Comments (44)

July 19, 2006

Osteopenia - Is Treatment Necessary?

The definition of osteopenia is bone density that is lower than normal but not low enough to be called osteoporosis. Typically, a T score of -2.5 and lower is classified as osteoporosis, while -2.4 and higher is classifed as osteopenia. There's a lot of controversy over osteopenia. Many people claim it is an invented disease and say it's wrong to place pre-menopausal women with osteopenia on osteoporosis drugs such as Fosamax, especially since these drugs can possibly lead to serious side effects. If your doctor diagnoses you with osteopenia, is it time to panic? Here are a few opinions on the topic:

Because the term “osteopenia” is not useful as a diagnosis and can actually be harmful, I am on a personal crusade to eliminate it from the bone density lexicon. -- Nelson B. Watts, MD, Director, University of Cincinnati Bone Health and Osteoporosis Center
"I've seen patients who come in scared that they will become disabled soon because they have this 'disease' called osteopenia, when in fact they are normal for their age." -- Dr. Steven Cummings, epidemiologist at UC San Francisco.
Osteopenia ... is just another invented illness. In fact, little more than a decade ago, it didn't even exist ... It's another situation in which a bunch of experts got together, set some arbitrary guidelines, and bingo! Millions of people who were healthy the day before woke up with a disease. -- Dr. Julian Whitaker
Osteopenia, however, is not a disease or even a true diagnosis. It merely indicates a state of relative low-side bone mass. You could have "osteopenia" because you never developed a high peak bone mass in your youth. It does not have to mean that you are currently losing bone. You simply could have a low-side bone density. -- Susan Brown, Ph.D.

Posted by Tracy at 2:14 AM | Comments (9)

July 17, 2006

Fosamax Side Effects

We've talked a lot about the link between Fosamax (alendronate) and jaw osteonecrosis, but what about the other side effects of Fosamax? From what I've heard, bone pain is a common side effect of this drug. In fact, many women report such severe bone pain that they are hardly able to function. If this drug is supposed to make women (and men) stronger, why is it making so many weaker? The company lists the following as possible side effects: worsening heartburn, difficult or painful swallowing, chest pain, and severe bone, joint, and/or muscle pain. It says that "severe bone, joint and/or muscle pain" has been reported but is "rare." And does the official Fosamax site say anything about jaw osteonecrosis? Here's what it says, buried deep in the document:

"Rarely, patients have had jaw problems associated with delayed healing and infection, often following tooth extraction."

There's a big difference between "delayed healing and infection" and osteonecrosis of the jaw. The vagueness of the phrase "jaw problems" would be amusing if so many people weren't suffering from these "problems."

What about the woman who ended up with her jaw bone in a bucket?

We'd like you to post your Fosamax side effects here. Just click on the "comments" link and let us know what your experiences have been. This page will be a spot where people can share their experiences, both good and bad, so others can decide if they want to take this drug and other bisphosphonates. If you've had no side effects we'd like to hear from you, too.

Posted by Tracy at 10:55 PM | Comments (262)

July 16, 2006

Hip Fractures in Elderly Don't Have to Lead to Disability

An amazing thing is happening in Australia. The National Health and Medical Research Council has funded the Hip Fracture Intervention Trial, or Hipfit. It is designed to help elderly people recover after hip fractures through strength and balance training. One woman who has gone through the program says she's in better shape now than she was before her hip fracture.

"A year after a hip fracture," says Dr Nalin Singh, a staff specialist in aged care at Balmain Hospital and one of the study's researchers, "one-third to one-half of people who break a hip are in a nursing home or more disabled than they were before the fall. The aim of Hipfit is to change that trajectory."

A dose of strong medicine

Posted by Tracy at 1:43 PM | Comments (0)

July 14, 2006

Dancing Builds Strong Bones

If you want your children to have stong bones as they age, you might want to encourage an interest in dance. A recent study published in Osteoporosis International found that dance training, especially in pre-adolescent children, had overwhelming positive effects on the skeleton. It optimized bone mass, reduced the risk of osteoporosis, and set the kids up for a lifetime of good bone health.

Brisbane endocrinologist Margaret Williamson, who has a special interest in osteoporosis, said studies such as the Melbourne one suggested that specific forms of exercise when done by pre-pubescent children could be beneficial in maintaining bone density long term.

Other types of exercise, including walking, running, and games like tennis and golf are also good. However, care should be taken to not take exercise to an extreme. If girls exercise too much once they're through puberty they may switch off their hormone production and lose their periods. The fall in estrogen could then cause a loss of bone.

Dancing for strong bones

Posted by laura at 2:39 PM | Comments (1)

Osteoporosis in Men

New research shows that men, especially those over 75, are at risk for osteoporosis. Declining levels of estrogen weakens bones and makes them prone to fractures. If you are a man over the age of 70 you might consider having a bone density test. The study also showed the rates of hip fracture greater for Hispanic men but the reasons for that are not known. The researchers studied 5,995 men.

Men face risk of osteoporosis

Posted by laura at 8:26 AM | Comments (0)

July 13, 2006

Does Fosamax Build the Wrong Kind of Bone?

Perhaps you think lawyers are blowing the Fosamax dangers out of proportion just to make a buck or two. Maybe you think that the risk of osteonecrosis of the jaw is so rare that it isn't something you should worry about. After all, many people on these drugs have no side effects and their bone density scores have risen. Yes, these osteoporosis drugs may increase your bone density scores, but is it just window dressing? Are your bones really stronger or is it just the scores that are stronger?

John Abramson is a family practice physician on the clinical faculty at Harvard Medical School. In his book, Overdosed America, he writes about osteoporosis, Fosamax, and the kind of bone it builds:

The new bone, formed as a result of taking the osteoporosis drugs, is then formed primarily on the outer part of the bone, the cortical bone. This increases the score on the bone density test but does not necessarily contribute proportionately to fracture resistance.

For the full excerpt on osteoporosis and Fosamax as well as more information about Dr. Abramson and his book, visit the link below.

Excerpt from Overdosed America

Posted by Tracy at 5:37 PM | Comments (3)

July 12, 2006

Radiation Therapy Side Effects May Include Bone Damage

Researchers at Clemson University, in a study published in the Journal of Applied Physiology, say they have discovered that radiation exposure causes mice to incur significant bone loss. This has obvious implications for cancer patients undergoing radiation therapy. Researchers say this side effect also applies to astronauts since they are exposed to large amounts of radiation in space.

"We were really surprised at the extent of bone loss,' said lead researcher Ted Bateman. 'We're seeing bone loss at much lower doses of radiation than we expected."

Although results of a mouse study cannot be directly applied to humans, Bateman said both mice and humans lose bone after radiation exposure, so the results raise a red flag.

Radiation Therapy Might Harm Bone
Study: Radiation might destroy mouse bones

Posted by Tracy at 5:59 PM | Comments (3)

July 10, 2006

The Body Hunters: Drug Companies Find New Guinea Pigs

I was just flipping through the latest issue of Utne magazine and came across an article about drug companies going overseas to find cheap human guinea pigs. One example given is Pfizer and their trial of an osteoporosis drug called Oporia (lasofoxifene). I found it reprinted online so I can quote:

In Latin America, says Pfizer's Julio Camps, "you can have fast recruitment . . . at a very reasonable cost." ... Pfizer's trial of the osteoporosis drug lasofoxifene, for example, required experimental subjects to be "treatment-naive," that is, never treated for the condition. Argentina was "the number one recruiting site," Camps said, calling the country's ability to provide willing guinea pigs "amazing."

The author of the article, Sonia Shah, has written a book about this issue called The Body Hunters: Testing New Drugs on the World's Poorest Patients that will be released this month.

Walking Test Tubes

The Body Hunters: Testing New Drugs on the World's Poorest Patients

Posted by Tracy at 4:26 PM | Comments (2)

July 8, 2006

Mastering the Art of Drug Unswallowing

There's a must-read opinion piece by Stephen Strauss on the problem of biased evidence in the pharmaceutical world and how P & G, the makers of osteoporosis drug Actonel, fudged the data on a study of the effectiveness of the drug. I love his idea of the wish to master "the art of drug unswallowing."

Ah, you think as the water flushes the supposedly healing pharmaceutical down your throat, good to know that there must be unbiased evidence that taking it is good for me.

Nice belief. But if you had been at a recent lecture at the University of Toronto you might well have also wished you had mastered the art of drug unswallowing.

Inconvenient truths

Posted by Tracy at 4:29 PM | Comments (1)

Causes of Osteonecrosis

Dr. Paul Donahue answers a question about osteonecrosis or bone death. He explains what it is and gives various causes.

"The causes of osteonecrosis are many. People with sickle cell disease can get it. So do those who have lupus or gout. Pregnancy can bring it on. Cigarette smoking and heavy alcohol use have been implicated. A hip fracture or hip dislocation can lead to it. For many, no cause is ever found."
(Twin Cities Pioneer Press)

Posted by laura at 9:17 AM | Comments (0)

July 6, 2006

Bone Drugs for Every Aging Woman in the World?

This passage from an article in yesterday's Monterey County Herald brings up the concern that doctors are prescribing bisphosphonates like Fosamax and Boniva to women who don't really need them, putting them needlessly at risk for jaw problems and other side effects:

... many postmenopausal women taking the pills may not really need them. Low bone density does not automatically progress to osteoporosis, and even when it does, a debilitating fracture is not inevitable.

Crystal Baxter, a former University of Pittsburgh professor of prosthodontics who now practices in Arizona, said she is very leery of doing elective dental implants in patients who have taken oral bisphosphonates.

"The scary thing," she said, "is that these drugs are being marketed to practically every aging woman in the world." (Monterey County Herald)


Posted by Tracy at 1:38 PM | Comments (1)

Dr. Weil on Strontium Ranelate for Osteoporosis

Back in December, a woman who was suffering side effects from Fosamax asked Dr. Weil if strontium ranelate was a good alternative. His response is an interesting read. Here's a brief excerpt.

A number of studies have shown that it can strengthen bone and reduce the risk of fractures, even among women 74 years of age or older when risks are highest. Use of strontium ranelate to strengthen bone and prevent fractures has been escalating since the positive results of a three-year clinical trial were published in the January 29, 2004 issue of the New England Journal of Medicine.

Strontium: A Better Drug for Osteoporosis?

Posted by Tracy at 1:00 PM | Comments (1)

July 2, 2006

Dr. Peter Gott on Fosamax

Dr. Peter Gott, a well-known doctor, syndicated newspaper columnist and author, is advising his patients not to take Fosamax, Boniva, or Actonel:

" ... they – especially Fosamax – can cause a serious side effect called mandibular necrosis, or decay of the jawbone. Consequently, I have encouraged my patients to stop taking these drugs and have been searching for an appropriate substitute." (spokesmanreview.com)

Update: The above link no longer appears to be working.

Posted by Tracy at 4:21 PM | Comments (1)


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