Osteoporosis-A Bone Disease

Osteoporosis-A bone Disease

Introduction

There are several diseases which are running on rampage in the world but the Osteoporosis is also one of them. This disease has some significant symptoms which show that how harmful is this disease for men and women. The osteoporosis can be defined as a type of disease which is characterized by low bone mass and deteriorates the bone tissues makes them useless or weaker to support the body. It causes increased bone fragility and risk of fracture at large scale , particularly of the hip, spine and wrist etc as they are the important bones of the person for working .it has been general opinion that the Osteoporosis is “the silent thief” because loss of bones appear without showing symptoms which makes it impossible to know the disease at early stage for the person . As the reduced quality of life for that person having osteoporosis is countless and spreads at large scale. The disease has some significant symptoms can result in disfigurement, lowered self-esteem, reduction or loss of mobility, decreased independence and also affects the working capability which is really the big problem for the common man to tackle with it properly As for the statistics, if we take the example of the Canada for hip related fractures, they are really disturbing. Approximately the number of the hip fractures was 25,000 in 1993 only as the official statistics show but the number might have increased to date .About Seventy percent of hip fractures are usually caused of osteoporosis which makes it alarming for the people . The fractures of hip cause in death in up to 20 percent of cases, and the disability in 50 percent of those who manage to survive for the rest.

“Osteoporosis is a condition that causes thinning and weakening of normal bone. The definition of osteoporosis is a decrease of the density of bone mass. When this occurs, a patient with osteoporosis will have weaker bones and have a higher risk of bone fracture. Osteoporosis is not arthritis, which leads to problems within joints due to cartilage wear. Instead, osteoporosis is a problem of the bone, and its ability to adequately support the weight of your body. “_____Kathleen Mayes

The categories and types:

There are mainly two categories of osteoporosis disease, The Type I and the Type II. The Type I osteoporosis occurs only in post-menopausal women, and is due to estrogen deficiency. The Type II osteoporosis appears in both men and women but as compared to men it is frequently caused in women and as it is related to aging and the deficiency of the calcium in the body over many years.

Entomologically the ‘Osseo’ means bone and ‘paresis’ thinning or becoming more porous, so the disease of oroporosis literally means ‘thinning of bone. As mostly it is confused with the word osteoarthritis which is the form of arthritis that results in breakdown of the cartilage covering the ends of bones and the body. Inversely, the osteoporosis is a condition where bone itself breaks down and becomes thinner. The Bones start becoming thin, brittle and can easily be broken. For instance, the sneezing can cause a person’s rib to break or stumbling can lead to fracture of one of the bones in the spine which results critical for the body.

The bones which are mostly affected by the osteoporosis are those in the hip, wrist and back the vertebrae , specially those in the mid-back as they are very important bones for the body and the back . As vertebrae starts becoming thin, they are can collapse from relatively minor forces thus such bones are always get weaker. Commonly the vertebrae break which leads to a state called wedging causes a person to stoop forward and develop a hump-like deformity on the upper spine thus disfiguring the body of the person. Those people who do not develop wedging or any other sort of thing may observe a progressive loss of height as bone collapse appears suddenly .Mostly Hip fractures are also common in people having osteoporosis, and can lead to immobility and hospitalization.

Causes osteoporosis:
As the age of people grows, the amount of bone in their body steadily decreases and thins. Women are especially are affected to developing thin bone because they do not develop as much bone while younger, and the rate of bone loss in women is greater than men. Due to this, the age and gender are the most important risk factors for developing osteoporosis. Both men and women achieve their “peak bone mass” in the third decade of life. After that time, bone mass gradually, but steadily decreases. In pregnant and lactating women, the rate of bone loss will temporarily increase if the increased calcium demands of pregnancy or breastfeeding are not met by increased dietary intake of calcium. In women, there is also a significant decrease of bone mass in the immediate postmenopausal period which is really a concern for them. Other important risk factors that can contribute to developing osteoporosis include Northern European ancestry, hypothyroidism, anticonvulsant medications, and a sedentary lifestyle. Americans are especially prone to developing osteoporosis, the exact cause of this is not known. We do know that this is not entirely related to ancestry, as studies have shown that individuals who immigrate into the United States from other countries develop an American’s higher risk of osteoporosis.

Diagnosis of osteoporosis:

The Osteoporosis most commonly is found either on routine examination, or following a pathologic fracture due to weakened bone. The X-rays usually show a generalized loss of bone density. The Laboratory studies are not too helpful for showing evidence of the osteoporosis, but they are helpful in showing evidence of conditions that can have symptoms similar to the osteoporosis disease. Studies of Laboratory can show evidence of the osteomalacia, the kidney failure and the parathyroid gland insufficiency or the other related problems that can result the osteoporosis and cause bone weakness. When the osteoporosis is screened tried t o be detected at the early stages of the condition, the most useful test is called the bone densitometry or the so called the DEXA scan. Where as the test urgently require special equipment which should be safe and exposes the patient to small amounts of radiation which is useful in detecting the early stages of the osteoporosis. The Fractures are the most common problems and are associated with disease of bones. The pathologic fracture is said to be the broken bone that results when the bone becomes abnormally thin.

The Treatment or Remedies of osteoporosis:

The treatment of the osteoporosis is just to reduce the risk of pathologic fractures of the bones that have low calcium or run short of the calcium. The three methods of treatment are:

• Weight-bearing exercise:
  The Exercise is an important treatment for the osteoporosis to be healthy with powerful bones. The activities that stress bones have been shown to have a positive effect in maintaining and increasing bone mass and preventing the osteoporosis. The Individuals who live a sedentary lifestyle have weaker bones and are subjected to a higher risk of sustaining pathologic fractures. Where as the resistance forms of exercise are excellent to stimulate bone production, even light aerobic exercise such as aerobics, jogging, walking can greatly help strengthen bones and prevent falling prey to the osteoporosis.
• Nutrition supplementation
  the Calcium supplementation is an important segment of the treatment to ensure oral intake is at least 1200 to 1500 mg every day as it is necessary for the average man . Consumption of this quantity of calcium is considered tube a difficult task but considering that to do this one would have to eat or drink the equivalent of five glasses of milk each day to supplement the task. As many patients at-risk for the osteoporosis should take an oral calcium supplement each day which can be taken with Vitamin D (400-800 Units is recommended) to help increase the absorption in the body. Also the caffeinated substances such as coffee, soda, decrease calcium absorption ,and should therefore be avoided

Medications for the Osteoporosis:
There are several available medicines for the osteoporosis treatment. These include:

· Bisphosphanates (Fosamax)
the Bisphosphanates such Fosamax, Actonel are a type of medication that helps to regulate calcium and prevent bone breakdown in to thinner parts. The Bone turnover or replacement of old bone with new bone is a normal process within our body with passage of time.

· The Calcitonin (Miacalcin)
The Calcitonin is a naturally appearing hormone which is produced by the thyroid gland that can be given as an injection or taken as a nasal spray. The Sold under the trade name of the Miacalcin, the Calcitonin also takes the function of the cells that breakdown the bones the osteoclasts. Calcitonin has long been known to be beneficial in patients with osteoporosis, but the injections were difficult to administer, and had unpleasant side-effects. The nasal spray has greatly improved the use of calcitonin, and it is much more commonly used today. Calcitonin has been shown to slow bone loss, and also decrease pain associated with osteoporosis fractures.

· The Raloxifene
The Raloxifene is a newer kind of medication that has been developed to provide some of the same advantages of estrogen (HRT), without the potential side-effects. Raloxifene is a type of medication called a Selective Estrogen Receptor Modulator, or SERM. The effects of Raloxifene have been shown to be similar to estrogen, including an increase in bone mass and lower cholesterol. However, the SERMs do not have the same effects on the uterine lining, and therefore do not need to be combined with progesterone. Furthermore, there is evidence that Raloxifene may decrease the risk of breast cancer.

· The Estrogen
the Hormonal replacement therapy, or HRT, not only helps maintain, but it can increase the bone mass after menopause and makes it stronger. The studies have shown that the benefits of estrogen therapy, including a lower risk of osteoporosis and fractured bones. In addition to this the other benefits of estrogen replacement in the postmenopausal patient include lower cholesterol, decreased risk of colon cancer and more importantly fewer postmenopausal symptoms in body.

The signs of osteoporosis:

• Many people do not try to realize that they have osteoporosis until they have had it for a long period of time and start feeling the symptoms.
• Anybody having osteoporosis, the first warning sign might be a sudden sharp pain in your back that seems to have come on for no reason. And increases on each passing day
• After a fall or accident if you could get a sharp pain in your back, ribs, hip or wrist that does not go away for the long period. This could be that one of bones has broken and even though one might think that the accident was not minor and not enough to cause a break in the bones

“If one has osteoporosis there might be a long period of time, perhaps many years during which you have no symptoms fort the disease while your bones are becoming gradually thinner. Most people are diagnosed with osteoporosis after having sharp pain in the mid to low back that seems to have come on for no reason. Others experience fractures of the bone in the thigh (femur bone – pronounced fee-mer), hipbone, or the lower arm bone above the wrist (the distal radius – pronounced ray-dee-us) during what seems like relatively minor falls or accidents”_____ Xandria Williams

Causes of osteoporosis :

There are a number of factors which may lead to osteoporosis.

• Bone loss will occur naturally as you get older.
• Some people with osteoporosis have other family members with it. A higher risk of getting osteoporosis may be passed along through the family.
• Bones need exercise to stay strong. If you do not exercise you may increase your risk of osteoporosis.
• Changes in hormone levels can also cause osteoporosis. Hormones are substances produced by the body that help different organs run normally. Certain hormones, such as estrogen allow women to get pregnant. When a woman reaches menopause her estrogen level changes.
• Not eating foods rich in calcium, vitamin D and phosphorous can also cause bone loss.
• Drinking too much alcohol, smoking or having too much caffeine can cause bone loss. Coffee, tea and some sodas contain caffeine.
• Some medicines can stop your body from absorbing calcium. This may cause your bones to weaken.
• Other illnesses or diseases, such over-active thyroid, diabetes and rheumatoid) arthritis may also cause bone loss.

The Aging:
The Bone is a like a living tissue which is continually growing and being removed. The Bones usually reach their maximum mass when people are in their mid-thirties. At about age 40, more bone is removed (about 1% per year) than is made, and so the bones start to become weaker. As regards the bone loss may reach 3 – 5 % per year or higher during the first five to six years after menopause subject to conditions.

The Family history:
There aresome people with osteoporosis having other family members living with them which suggests that heredity may be a factor for the osteoporosis. The Heredity also plays vital role in a person’s body type, physique and growth of the bones having a small frame and bone structure may increase the chances of getting osteoporosis as the time goes by.

Lack of exercise: As bone is a living tissue it needs exercise to stay strong. Normally through the activities of daily living such as walking, bending, stretching, and exercising, forces are imposed upon the bones. Bone responds to these forces by restructuring itself and becoming stronger. If you are not active your bones will become weaker over time because there is nothing for them to respond to. For example, if you had to wear a cast on a broken leg, the complete inactivity or immobility of that leg could result in rapid bone loss in the area. If you do not engage in regular activity and exercise throughout your life you could be more at risk of developing osteoporosis.

Hormone changes: Osteoporosis can also be linked to changes in hormones. Hormones are substances produced by the body that help different organs run normally. Certain hormones, such as estrogen, allow women to get pregnant. Estrogen is also a hormone that is important to maintaining bone strength. Once a woman enters menopause her estrogen levels fall. This affects how her bones process calcium and may lead to a more rapid loss of bone. For the first five or six years following menopause a woman can lose 3% to 5% of her bone density each year. In men, low levels of the hormone testosterone may have the same effect. Engaging in strenuous training and sporting activity can also induce hormonal changes. Despite the building of bone that occurs naturally during exercise, the hormonal changes caused by very strenuous activity may result in net bone loss.

Diet: The Bones need nourishment from calcium, vitamin D, and phosphorous. The poor diet lacking foods that contain these vitamins and minerals contributes to bone loss. Foods rich in calcium are especially necessary to maintaining healthy bones. Dairy products are a good source of calcium. Excessive use of alcohol or caffeine-containing products such as tea, coffee or some sodas can stop your body from absorbing calcium. Smoking also contributes to bone loss.

Medication: According to Some medications, when taken in high doses, can influence how your body deals with calcium and so contribute to bone loss. These medications include cortisone/corticosteroids, anticoagulants, thyroid supplements, and some anti-convulsive drugs.

Other illnesses: Other illnesses or diseases, such over-active thyroid, diabetes and rheumatoid arthritis may also cause bone loss. A disease such as anorexia nervosa or bulimia can cause changes in a person’s estrogen level and lead to osteoporosis.

If your doctor thinks you have osteoporosis, he or she may perform a physical examination and certain tests.

• Treatment is done to reduce the rate of bone loss and build up new bone.
• Learn as much as you can about this condition. Speaking with your doctor or other people who are specialists in osteoporosis and arthritis care can provide you with the information you need.

To Prevent the osteoporosis is much easier than curing it. Recognizing that this condition can occur, young people should take measures to prevent osteoporosis. If a person builds excellent quality bones when young, he or she will have bone reserves that may be able to withstand changes that can occur later in life, such as taking medicines, inactivity, etc. The critical age to be building good bones is between 10 and 30 years of age. It can be much more difficult to start improving bone health later in life.

How to Protect Body:

• Be kind to your body. After doing heavy work, or doing the same task over and over, stop. Slow down by doing an easy task, or by taking a rest.
• Use your back, arms and legs in safe ways to avoid putting stress on joints. For example, carry a heavy load close to your body.
• Use helpful devices such as a cart to carry your grocery bags, or an enlarged handle that fits over a knife handle so you can hold it easily. A cart will help you to walk more safely. A grab bar, which attaches to a shower, will help you to get in and out of the tub more easily.
• Be careful when doing activities that could increase your risk of falling.
• Maintain a healthy weight to avoid putting extra stress on your bones.

To Protecting once body means using it in ways that avoids excess stress. There are a number of ways by which one can protect body .

The Osteoporosis is type of disease in which the bones become fragile and more likely to break dues weakness and shortage of the calcium. If it is not provided , prevented in well manner or just left untreated the osteoporosis can progress painlessly until a bone starts breaking . The broken bones are also known as fractures; occur typically in the hip, spine, and wrist. It is not for nay particular bone but due osteoporosis any bone can be affected or weakened and prone to breakage but of special concern are fractures of the hip and spine.

THE ROLE OF NURSES:
As the nature of the nurses suggest that the profession, nursing plays a significant role in the prevention and detection of osteoporosis , as well as in the management of osteoporosis patients at large scale with care and dedication and proper attention and encouragement . There is an increased awareness that the osteoporosis is an international health care concern that affects millions of individuals worldwide. Injuries and the resulting potential disabilities related to osteoporosis, admissions to hospitals, nursing homes and long-term care facilities are burdening the health care systems of nations due to the significant costs associated with care and treatment.

In order to enable nurses to think and for the proper treatment of the disease which really demands care from the nurses to do this noble job of taking care of the patients and giving them the medicines on time with diet suggested by the doctor , it will help a lot for the improvement of the Osteoporosis affected patients and will encourage them to execr9ice well and try to fight with calcium shortness. The key roles include the enhanced knowledge of osteoporosis within the curriculum of nursing programs for proper medication and precaution suggested by the doctor and keeping them bound for doping them .The ongoing professional development opportunities are very essential in order to shape the career of nurses and making them friendly with patients and speak polite words as the patients are case sensitive an worried due to the tension of disease which they are suffering from and will need such person who can take care of them property and give them satisfaction to be health issues as these issues need special; attention . And the nurses can also play role whenever there is female patients and well aware of the problems of the females which are being faced by them at large scale. The Osteoporosis has to assume that its prominent place along with other key chronic illnesses, such as cardiovascular disease, diabetes, and others. It is common that the Various nursing roles avail themselves to the prevention of osteoporosis through the education of groups of individuals regarding bone health and the improvement with proper acre and precaution. In the community settings and schools depending upon the resources available and the priorities of individual healthcare systems, nurses can play a key role in the education of children, youth and parents regarding healthy lifestyles to promote bone health for the future. A renewed emphasis on physical activity and calcium intake is important, as youth become more sedentary and dietary preferences tend to exclude sufficient amounts of calcium need to achieve optimal bone health. In specialized roles, nurses have the opportunity to provide outreach education to various community and professional groups regarding bone health. These can include healthcare providers, employee health and wellness initiatives, community health forums, seniors’, women’s and cancer survivor groups, to name a few.Nurses play an integral role in facilitating the detection of osteoporosis, through their involvement in the assessment of patients at various points of contact within the health care system – primary care settings, emergency departments, fracture clinics, and the admission of individuals to various levels of healthcare (acute, chronic, long-term care, community home care). Incorporating simple questions into standard patient assessments or admission processes can facilitate the earlier detection of potential osteoporosis, by including, for example, a history of height loss or a fragility fracture (a broken bone that occurs as a result of minimal trauma, such as a fall from a standing height or less), and other common risk factors for the development of osteoporosis. The Following the diagnosis of osteoporosis, nurses plays a significant role in supporting individuals in the treatment and management of this condition through ongoing assessment, teaching and counseling. Where resources exist, an interdisciplinary approach to providing care is optimal, and may include a nurse, physical therapist (exercise), occupational therapist (fall and fracture prevention), dietitian (calcium and vitamin D intake) and pharmacist (medication), working with the physician. Where these other resources are not readily available, it is within the scope of practice for the nurse to initiate counseling and teaching regarding these issues and lifestyle factors, and to coordinate and refer to other healthcare providers and community services, as available. Nurses are instrumental in providing psychosocial support for individuals with osteoporosis. For many, this is yet another chronic condition that they are faced with, leading to anxiety regarding the diagnosis, treatment and prognosis. Nursing assessment and support assists individuals in maintaining their commitment and compliance to lifestyle modifications and treatment over the course of their lives, and in the modification of approaches as other conditions emerge. Nurses play a role in enabling individuals to cope with chronic illness through the development of coping strategies and, as required, pain management. With the bone health of individuals being monitored over a longer period of time, as compared with other chronic illnesses, nurses often provide ongoing remote telephone counseling and support, which poses its own unique set of opportunities and challenges. The interplay between various health conditions requires a coordinated approach to optimize the health and wellness of individuals. The above examples have highlighted some of the nursing roles in the clinical specialty of osteoporosis; however, the opportunities for new innovations are endless

Conclusion:
Finally it is clear that the osteoporosis is very dangerous disease which can be cause by both heredity and other means such shortage of calcium which is very essential for the bones to get stronger and more effective . The doctor suggest that precaution is much better than cure as long as this disease is concerned as the treatment is very costly and may not be affordable for the most of the people who need the treatment on urgent basis but the prevention is such specially and most affective thing to get rid of this bone related diseases and keep yourself at distance from falling prey to t this disease . Moreover the proper treatment and the exercise may play vital role for the treatment of this disease as the exercise makes the bone s work and make them stronger as compared to other medication methods. The methods like Weight-bearingexercise are very important treatment for the osteoporosis to be healthy with the powerful bones. Such activities that stress bones have been shown to have a positive effect in maintaining and increasing bone mass and preventing the osteoporosis. And secondly the method of Nutrition supplementation such as the Calcium supplementation is very much important segment of the treatment . As many patients at-risk for the osteoporosis should take an oral calcium supplement each day which can be taken with Vitamin D (400-800 Units is recommended) to help increase the absorption in the body. lastly the role of the nurses is key and requires special attention because the nurses can play good role for the treatment process therefore they should be trained and well mannered so that the patients may not think a lot about illness. Moreover the nurses can guide the patients but at first they should trained to guide the patients with extensive training with modern methods.