2 year post-op bone density scan results

[lsereno 2,525]

My program recommends an annual bone scan, because it's the only way to find out if your body is cannibalizing your bones for Calcium in your blood stream. Your Calcium must be extremely low to show in a blood test, because your body will just leach it from your bones to make up for what you are not getting.

I missed getting this done the first year somehow, so last month, I got my first bone density scan post-op. It's also my first one post-menopause, so not sure how much change is due to that and how much can be blamed on WLS. Last scan was in 2005. I am already walking 4 days a week, so plenty of weight bearing exercise. And I am taking the amount of Vitamin D and Calcium recommended by the Kaiser Fremont Bariatric program, which is 4000iu of Vitamin D per day (800 from 2 Multivitamins + 1500iu from calcium plus D + 2000iu Vitamin D tablet) and 1500 mg a day total of calcium citrate. I was taking the calcium twice per day (3 tablets each time), but I am going to switch to taking it three times per day (2 tablets each time). So we will see what next year brings.

Here's the scoop on the scan:

Dual energy X-ray absorptiometry was performed to obtain bone mineral density (BMD) measurements using the Hologic Discovery bone densitometry unit. For each BMD measurement, Z and T scores are calculated. Z score represents the number of standard deviations of the patient's BMD from expected age matched values. T score represents the number of standard deviations of the patient's BMD from the average peak BMD value at age 30. A FRAX score has also been calculated using the LEFT FEMORAL NECK data.

OSTEOPENIA is defined as a T score from -1.0 to -2.4 representing an INCREASED fracture risk.

OSTEOPOROSIS is defined as a T score more negative than -2.4 and represents a HIGH fracture risk.

T score: Fracture risk comparison to gender and ethnicity matched 30-year-old.

0 = Average risk

-1 = 2 times the risk

-2 = 4 times the risk

-3 = 8 times the risk

LUMBAR SPINE:

BMD = 0.843 g/cm2 g/cm2

T score = -1.9

Z score = -0.7

LEFT HIP TOTAL:

BMD = 0.855 g/cm2 g/cm2

T score = -0.7

Z score = 0

LEFT FEMORAL NECK

BMD = 0.657 g/cm2 g/cm2

T score = -1.7

Z score = -0.6

** IMPRESSION **:

1. Bone mineral density in the LUMBAR SPINE is in the Osteopenic range. Compared to the prior study, there is significant change.The bone mineral density has decreased by -15.0 %.

2. Bone mineral density in the LEFT HIP is in the Normal range. Compared to the prior study, there is significant change. The bone mineral density has decreased by -23.3 %.

3. Based on FRAX, the 10 year probability of hip fracture is 1.0 %.

4. Based on FRAX, the 10 year probability of major osteoporotic fracture is 9.2 %.

[Georgia 2,911]

Hmm. Did they tell you to increase Calcium etc? So from that I gleaned your spinal fracture possibility increased (next 9 years) and your mineral density decreased on both hop and lumbar spine?

[lsereno 2,525]

Hmm. Did they tell you to increase Calcium etc? So from that I gleaned your spinal fracture possibility increased (next 9 years) and your mineral density decreased on both hop and lumbar spine?

Yes, that's right. Doctor said to add weights to my exercise routine and double the amount of calcium I'm taking if it doesn't upset my stomach.

Lynda

[Georgia 2,911]

I need to have it done NOW. At three years out, I am not doing well at taking Calcium. I need to see if I have been affected. Did your insurance cover it?

I had one prior to WLS and was fine so need to check it out now.

[swizzly 901]

I also had pre op dexa scan and two year follow up scan. I hadn't lost any density and am still in the normal to high normal range for my perimenopausal age (46). I take only one calcium citrate cap per day, which I'd thought was 500 but now believe is only 250. However, I do a lot of strength training in the gym and I eat dairy nonstop cos its my favorite food group lol. But...that all said, I'm a pretty big boned girl and the docs have always said that is an advantage vis a vis bone density, so I think genetics play a big role in this. But yes, do some weight lifting with a trainer who knows bone issues, I'm betting it would help a lot!

[swizzly 901]

PS, I know walking is for sure a weight-bearing exercise, but might not be enough weight to bear as you are so tiny? Have you considered to walk with ankle weights or weighted backpack?

[lsereno 2,525]

I need to have it done NOW. At three years out' date=' I am not doing well at taking Calcium. I need to see if I have been affected. Did your insurance cover it?

I had one prior to WLS and was fine so need to check it out now.[/quote']

Yes, but I still had to pay around $400 out of pocket. I have a Kaiser Nor Cal individual plan with $1500 deductible, which i haven't met this year, and 3k max out of pocket.

Lynda

[lsereno 2,525]

I also had pre op dexa scan and two year follow up scan. I hadn't lost any density and am still in the normal to high normal range for my perimenopausal age (46). I take only one calcium citrate cap per day' date=' which I'd thought was 500 but now believe is only 250. However, I do a lot of strength training in the gym and I eat dairy nonstop cos its my favorite food group lol. But...that all said, I'm a pretty big boned girl and the docs have always said that is an advantage vis a vis bone density, so I think genetics play a big role in this. But yes, do some weight lifting with a trainer who knows bone issues, I'm betting it would help a lot![/quote']

I'm going to do what the doctor asked. I'm now post-menopausal so I ascribe some of the loss to that. I had stronger than average bones per-op.

Lynda

[Georgia 2,911]

Well, Swizzly, I ought to be okay as I am 5' 7" and larger framed. . My exercise of choice (except my Gazelle) is walking. I'm going to get my Calcium out and start taking. I just had blood work done in early July. Vit D was only thing a little low. I don't remember if calcium shows up on that or not.

Lynda, you ARE tiny and I am jealous. LoL.

[swizzly 901]

Georgia, I'm just slightly shorter than you I think. About 5' 6.5 or so.

My scans were included in my overall program which all gets somehow billed to insurance differently to a one off scan at a clinic or so. So I didn't have out of pocket cost for mine, but do have 1500 annual deductible which I've usually already reached by like April each year lol.

Lynda, do you already belong to a gym or is the doc anyhow sending you to physio? Meaning, will the treatment be covered by insurance too? Did s/he prescribe Calcium so you can get that covered too?

[lsereno 2,525]

Georgia' date=' I'm just slightly shorter than you I think. About 5' 6.5 or so.

My scans were included in my overall program which all gets somehow billed to insurance differently to a one off scan at a clinic or so. So I didn't have out of pocket cost for mine, but do have 1500 annual deductible which I've usually already reached by like April each year lol.

Lynda, do you already belong to a gym or is the doc anyhow sending you to physio? Meaning, will the treatment be covered by insurance too? Did s/he prescribe Calcium so you can get that covered too?[/quote']

No he just said to add weights to my routine, which I know I should be doing. Just been slacking on that because I haven't found an early am class and I hate exercising on my own. But fear of bad bones will probably be motivation enough. He also didn't prescribe the Calcium, just said to double it.

Lynda

[lsereno 2,525]

PS' date=' I know walking is for sure a weight-bearing exercise, but might not be enough weight to bear as you are so tiny? Have you considered to walk with ankle weights or weighted backpack?[/quote']

Well I am we'll within normal range, but no matter you're size, what's recommended is weight-bearing exercise, such as walking, that makes you work against gravity while staying upright and muscle-strengthening exercise, such as weight lifting, that makes you work against gravity in a standing, sitting, or prone position.

Lynda

[lsereno 2,525]

Well' date=' Swizzly, I ought to be okay as I am 5' 7" and larger framed. . My exercise of choice (except my Gazelle) is walking. I'm going to get my Calcium out and start taking. I just had blood work done in early July. Vit D was only thing a little low. I don't remember if calcium shows up on that or not.

Lynda, you ARE tiny and I am jealous. LoL.[/quote']

Thanks!

[lsereno 2,525]

I also had pre op dexa scan and two year follow up scan. I hadn't lost any density and am still in the normal to high normal range for my perimenopausal age (46). I take only one calcium citrate cap per day' date=' which I'd thought was 500 but now believe is only 250. However, I do a lot of strength training in the gym and I eat dairy nonstop cos its my favorite food group lol. But...that all said, I'm a pretty big boned girl and the docs have always said that is an advantage vis a vis bone density, so I think genetics play a big role in this. But yes, do some weight lifting with a trainer who knows bone issues, I'm betting it would help a lot![/quote']

Swizzly, I'd up your Calcium. I eat Greek yogurt daily, walk 4 days per week, had been strength training for several years ( recently slacked on this though) and had much better than average bones. Women can suffer a sharp bone loss post-menopause, even without WLS, which is a known contributing factor, even with good habits.

Lynda

[swizzly 901]

I will take more Calcium now I think, thanks!