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Ask the Medical Expert Archives 2000-2004

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March 2000

Q. I have been diagnosed with osteoporosis. I am a 70 years old female and have otherwise been in pretty good shape. I have been on Premarin and Provera for several years, along with Calcium and Vitamin D. I recently had to slam on my brakes in the car, and suffered severe back pain. I didn't even hit any car. An X-ray showed I have a vertebral compression fracture in my lumbar spine. Is there anything else I can do?

A. Unfortunately, Osteoporosis predisposes to fractures, often with relatively little trauma. You are to be commended on having been doing all the right things to try to treat your osteoporosis. I assume you are a non-smoker as well.

Yes, there is more you can do. Although the data is still pending, we believe some patients benefit from combination treatment with more than one osteoporosis med. I would suggest you continue with your HRT. (Of course I assume you are getting your yearly mammograms).

In addition, I would suggest considering adding Miacalcin. This is a hormone that helps to decrease the breakdown of bone and increase calcium deposition in bone. It also may help decrease some of the pain associated with your fracture. It is administered via a nasal spray once per day. If you are allergic to salmon, you should not take it. It may cause some nasal irritation, but otherwise is usually well tolerated.

The other possibility may be to add Fosomax to your HRT. Of course, pain meds may be needed until the fracture heals, which may take several months.

It will be very important to check yearly DEXA bone density scans to monitor the effect of therapy.

Good luck.

For more info: The National Osteoporosis Foundation: 1-800-223-9994

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