What should I tell my family about osteoporosis? Will it curtail activities with them?

If you have been diagnosed with osteoporosis, you should definitely discuss the diagnosis with your partner. First, your partner should know if you are on any new medications so he or she can help support you in following the new regimen and watch for reactions. Second, you and your partner should discuss how your lives might be affected by osteoporosis.

New medications can present some challenges to your schedule and that of your partner. If you are taking one of the bisphosphonates, you will need to establish the appropriate timing for taking your new medication. Sometimes, it's helpful for a partner or spouse to know that you must take the medication on first rising, to remain upright after taking it, and to avoid all other food, drink, and medication for at least 30 minutes to 2 hours. If your children are still living at home, they may help remind you as well. Sometimes, until the routine of taking certain medications gets ingrained in us, we may forget and take all of our medications at one time, which can cause serious side effects or reactions or make the medication less effective.

If your clinician has restricted your activity, discuss these restrictions with your partner or spouse and children. It is unlikely that you will be restricted from specific activities unless they are new to you (e.g., ice skating, skiing, skydiving). If you don't exercise regularly, this is a good time to discuss a new routine of exercising with your partner and children. Osteoporosis should not limit your activities or your thinking. Consider taking a class together for dancing, yoga, or tai chi.

A diagnosis such as osteoporosis also gives you the opportunity to discuss other lifestyle changes that may be helpful to your own, your partner's and your children's bone health and general health. Plan meals that will enhance your calcium and vitamin D intake. Quit smoking together. Make a pact with your partner to restrict alcohol to one glass of wine with dinner, or one cocktail or beer per day.

In addition to routines around exercise and medications, this might be a good time to assess your environment for the risks associated with falling. Take a good look at the inside and outside of your house or living space. Even if you think you're not old enough to be at risk for falling, everyone can benefit from removing clutter and putting up railings and good lighting (see Table 18 in Question 79).

Learning that you have osteopenia or being diagnosed with osteoporosis does represent an opportunity to help yourself and educate others.

My friends are all very health-conscious, and I believe they will think it's my fault that I have osteoporosis. My friends enjoy adventures like hiking, rock-climbing, and cross-country skiing. Must I decline their invitations to go with them?

Like other medical conditions and diagnoses, there are many factors that can put you at risk for osteoporosis. Many of them are factors that you cannot control. Your friends should not blame you for having osteoporosis, nor should you blame yourself. Blame serves no useful purpose. Learning that you have osteopenia or being diagnosed with osteoporosis does represent an opportunity to help yourself and educate others.

People who take adequate calcium and vitamin D and exercise regularly still get osteoporosis. So even though your friends are health conscious, it's possible for any of them to have or develop osteoporosis, too. Depending on your comfort level with discussing personal health information, it may be helpful to discuss your diagnosis with your friends. You might start the conversation with, "I just had one of those tests that measures bone density. Have any of you had one yet?" You will probably be surprised with their answers: "My doctor says I don't need one yet, but he also said I should increase my calcium," or "My mother just started using a nasal spray for a fracture in her back that happened because she has osteoporosis," or "No. How was the test? Was it painful?"

You can let your friends know what your clinician said, for example, about lifestyle changes; medications, foods, and supplements to take; and the types of exercise that are appropriate. Then, if your adventurous friends invite you to an activity that you cannot engage in, you are able to say, "Remember when I got the diagnosis of osteoporosis? I'm not able to go skiing [for example], but I could join you for dinner afterward." Or better yet, suggest and organize activities that you know will not prevent your participation. For example, you could organize a group to join a walk-a-thon, which would not only benefit each of you in terms of exercise and social interaction, but would also benefit worthy charities.

An open discussion of your diagnosis might even prompt your friends to ask their own clinicians about being tested or about making some changes in their own lifestyles. It's a blessing to have friends who want to be active, so don't let osteoporosis interfere with sharing many new adventures with your friends.

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