My doctor’s response to information on the lack of value for dexa scans is a model for good medicine.
I sent her these three links to studies of bone fractures and bone density:
http://www.nejm.org/doi/pdf/10.1056/NEJM199503233321202 bone brittleness in white women
http://press.endocrine.org/doi/full/10.1210/jc.2004-1568 bone fracture in women without osteoporosis
http://www.bmj.com/content/315/7102/221 -- bone density and risk of hip fracture in men and women
Here is her response:
Thank you so much for all the information you’ve sent! It confirms what I’ve suspected and I’ll be sharing it with my colleagues. I appreciate the detective work you’ve done – I am lucky to learn from patients like you.
I recently read an article claiming that choosing to act mature was far more useful than self-inquiry. It first that seemed like a disconnect.
The more I thought about it, the more I remembered that the thing I like about "enlightened" or "wise" people is how mature they are. They don't anger easily.
And what is it that I find when I do self-inquiry? I find all the things that bug me, all the things that prove I'm not mature.
So, choosing to act mature seems like a logical first step to becoming mature.
If practicing maturity brings the results I want, then that is a step towards outgrowing the immature responses that don't get the results I want.
And if it doesn't, I don't see any negatives. Acting immature doesn't work, so why not try acting mature?
On my recent visit to my dentist, I had a worn out filling that had to be replaced. No new decay. No gum disease. Very little for the hygienist to scrape off my teeth.
My only problem was that the cold water being squirted into my mouth hurt.
I asked the hygienist about it.
She told me that the same tooth brushing and flossing that keeps my mouth disease free damages the gums. Quite simply, the gums are worn down at the base of the teeth and now the cold water can land on exposed roots.
She gave me a tube of temperature sensitive toothpaste. The instructions are to brush my teeth and floss them as I usually do at night, and then smear this paste on them and let it sit all night. She claims in a few months, my teeth won’t be cold sensitive any more, but I have to do this for the rest of my life. Or there is surgery, that will temporarily build up the gums, but brushing will wear them down again.
My neighborhood has had a deluge of teens selling magazine subscriptions. I get magazines in the mail without ever ordering them. I get letters offering to use my unspent airline miles for magazines. If I wanted to read magazines, I would not need to buy them.
With my aging eyes, the computer monitor is easier to read than a magazine printed on glossy paper.
Yesterday’s teen was different. I saw the clipboard and said, “I’m not going to buy any magazines.”
He said, “I’m not selling magazines.”
So, I said, “I’m not in the market for anything.”
Then he said, “Don’t you want me to go to college?”
I said, “I very much want you to go to college if that is what you want. What does college have to do with door-to-door selling?”
He said, “If I sell 100 subscriptions, I have a chance at a scholarship to Penn State.”
I started feeling sorry for him. He reminded me of the time my blue bird leader sat our troop down at a table in front of the grocery store with a stack of vacuum packed cans of peanuts to sell. I hadn’t sat there 10 minutes when a woman came out of the store and said, “The peanuts are cheaper inside.” I felt embarrassed. Blue Birds were supposed to be an upstanding youth organization and here I was overcharging people for groceries.
This magazine selling gig for a chance at a scholarship – not even for a cut of the take – seemed wrong.
I told the young man, “That doesn’t sound legitimate.”
Last Tuesday, May 18 at 7 PM I participated in the Ride of Silence. Hundreds of cities all over the world hold these rides to remember and honor bicyclists who have survived and those who have died in car crashes. The rides begin with a reading of the names of those who have been killed in the previous year. In Philadelphia, where I live, these include a young man who just graduated college, and a young woman who was celebrating her 7th wedding anniversary. The reading of names takes about 15 minutes. Then the group group of riders, all wearing helmets, pedal their bikes in silence for an hour (about 8 miles) on a route through the city, with a ghost bike at the end, to symbolize all the riders who can’t ride with us in body.
The ride runs from 7 PM until 8 PM. My first thought was that’s when I go home to relax. Sure, I ride 8 miles or more in one day. But not in one ride. Such a long ride when I’m already tired seemed daunting. But I decided to try it.
The route was planned carefully. It mostly avoided hills. Police blocked traffic, so we only had to stop a few times. I had no idea how much of the energy of biking is spent stopping and starting. That 8 miles felt more like 4 miles. The pace of the ride is about 10 mph. Not tiring at all.
We attracted small crowds who had no idea why hundreds of bicyclists were hogging the road.
We were silent. They called out, “Are you all the cyclists in the city?” And “Go faster!” And, “Why are you here?” We did not answer. The ride had been announced in every paper. The ghost bike had a sign “Ride of Silence.” If they cared, they could google us from their cell phones.
When we arrived at the ride’s end, younger riders lifted their bikes over their heads. That was one activity I didn’t feel up for joining.
Since we were all silent, I want to take this opportunity to say that we rode through town to get people to notice bicycle riders. Not just once a year for one hour, but every day at all hours. We can only avoid accidents if people see us. Pedestrians have to look for us when they dash out into the street between parked cars. Drivers have to watch out for bikes, especially when they are making turns. They need to be careful not to make a turn into the bike lane. And folks getting out of their cars the street side need to look in the traffic lane for bikes as well as cars, before they open their car doors.
What to do when I’m in pain.
What to do to avoid pain.
So, now, as a geezer I’m having to learn that stuff.
Several weeks ago, I woke up with what felt like bones grinding together in my low back. The last time I felt that I went to the chiropractor who told me I had a slipped disk. I tried the exercises and bouncing on my yoga ball, like he prescribed last time. It didn’t work.
I went back to my chiropractor. This time, he said it was tight muscles. He didn’t give me exercises. He just told me to do exercises that don’t hurt. That meant riding my bike even if I was only traveling a few blocks. The pain continued.
I surfed the web. Two types of exercise seem get the most recommendations: rolling a foam cylinder on thighs and back, and using either tennis balls or pinky balls to apply pressure to trigger points.
The pressure point balls helped in the morning, but by evening the pain was back. I tried the foam roller in the evening. The rolling made me sore. The rolling instructions said if you find a tender spot give it extra rolls. I don’t like pain, so I figured that was a bad idea. I was sore in the morning. Not the grinding sensation. Just all over ouch. I put ice on it. No progress.
I went back to the chiropractor. He seemed to think I was getting better. So, I asked, “Am I doomed to be an old lady for the rest of my life?” He laughed.