During my annual physical my doctor cited my age (somewhere north of 60, not that it’s any of his business) to support his recommendation that I get a bone density screening test. I argued that I didn’t need a test for osteoporosis because I already knew my skeleton was as dense as concrete.
“I’m descended from a long line of hardy, thick-boned people,” I told my doctor. “According to family legend, when my father’s ancestors became 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?” my doc said.
“Well, instead of tossing horseshoes, they’d toss an actual horse.”
The doctor stood and ran to the treatment room’s door, perhaps to call for security.
“Wait, don’t go!” I said. “The truth is, no one in my family has ever had osteoporosis. So I don’t need that bone density screening test.”
“I’m happy for your relatives,” the doc said, “but you shouldn’t assume you don’t have osteoporosis just because no one in your family does. It’s smarter to back up assumptions about health with actual facts.” He exited the treatment room and returned with a printed order for the test.
Although I respect my family physician, I tend to err on the side of skepticism when it comes to medical tests. I always ask:
- Is the test necessary?
- Is the cost to my employer’s health insurance plan (and my bank account) justified?
- Does the test pose a medical risk?
My doctor answered yes to the first two questions and replied “extremely negligible” to the third. Still, I’m a control freak so I prefer to do my own research. I cruised the World Wide Web to find out more about the proposed osteoporosis test.
Ugh, I thought, X-rays can be risky because they are cumulative. I’ve had several in my life, beginning when I broke my fingers catching a bad football pass at age 12, and up to and including the full-mouth scan I received at the dentist’s office earlier this year. In prior research I discovered that X-rays are officially classified as a carcinogen by the World Health Organization’s International Agency for Research on Cancer. Would another one turn me into a human-sized radioactive lava lamp?1
A few more mouse clicks led to information on the bone density screening test my doctor had ordered, the “dual energy X-ray absorptiometry,” or DXA. The radiation used in DXA is less than one-tenth the exposure of a standard chest x-ray.2 Hence, my doctor’s reply of “very negligible” to my question about risks.
I ran out of excuses and scheduled the test.
The procedure was no big deal. I relaxed on my back on a table and focused on the things that make me happy: my family, my cats, home renovation shows on HGTV, eating out, and my favorite dessert—a double-scoop hot fudge sundae with a boatload of cherries. (Note that two of my five favorite things involve food). Meanwhile, that low-dose DXA machine moved back and forth as it looked for pot holes in my bones. I actually fell asleep during the test. I may have snored a little, and perhaps drooled.
In case you’re wondering, the bone density screening test measures the grams of calcium and other minerals present in segments of bone, like the lower spine and hips. (See “More Resources” below). 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. While heredity can be a factor in healthy bones, they also need calcium and vitamin D. I grew up on a farm in Wisconsin, a state heralded as “America’s Dairy Land” on its license plates. The consumption of milk, cheese and ice cream is practically a religion there. I love me some dairy products and have slurped them down my entire life.
Two days after the bone density screening test, a nurse from my doctor’s office called with the results. “Great news—there was absolutely no evidence of osteoporosis,” she chirped.
“I already knew my bones are healthy,” I replied smugly, “thanks to my ancestors in Norway and Ireland.”
“Oh dear, the doctor told me about those poor reindeer and horses,” the nurse whispered, and hung up.
Yay—there’s no osteoporosis in my immediate future. I celebrated confirmation of my bone health with a double-scoop hot fudge sundae, heavy on the cherries and slathered in whipped cream. OK, I didn’t do that. I ate a reduced-fat, calcium-rich frozen yogurt. Then I went for a long walk in search of a herd of reindeer to bench press.
1 PubMed.gov, “Radiation-Reduction Strategies In Cardiac Computed Tomographic Angiography”
2RadiologyInfo.org, “Bone Densitometry (DEXA), What Are the Benefits Vs. Risks?”
National Osteoporosis Foundation, “What is Osteoporosis and What Causes It?”
National Institutes of Health, Osteoporosis and Related Bone Diseases, “Juvenile Osteoporosis”
WebMD, “Osteoporosis: Treatment and Care” [use logo]
PubMed.gov, “Radiation-Reduction Strategies In Cardiac Computed Tomographic Angiography.”