On the morning of February 23, Ada Rodriguez, 77, got out of bed and walked to the bathroom for a glass of water to take her high blood pressure medication. As he was looking for the glass, he felt a very sharp pain in his left hip.
Her screams of pain caused her husband to run from the kitchen to help her. He tried to help her sit on the toilet, but it was very painful to move.
She was taken by ambulance from her Westchester home in Miami to West Kendall Baptist Hospital, where she learned that she suffered an atypical fracture of the femur, the long bone of the thigh.
Rodriguez had been diagnosed with osteoporosis a few years ago. According to the National Osteoporosis Foundation, this is a bone disease that occurs when the body loses too much or develops too little bone. The bones are weakened and can be broken by a small fall or, in severe cases, even by simple actions such as sneezing or tripping over a piece of furniture.
According to the National Osteoporosis Foundation, 54 million Americans suffer from osteoporosis and low bone mass that puts them at risk for osteoporosis. Studies suggest that about one in two women and up to one in four men aged 50 or older will suffer from a broken bone due to osteoporosis. The most common fractures related to this condition occur in the hip, wrist or spine.
To treat osteoporosis, Rodriguez was prescribed a bisphosphonate, which includes the drugs Fosamax, Actonel and Boniva, used to strengthen bones and prevent fractures.
Dr. Roberto Miki, the orthopedic surgeon at Miami Hand Center, says that bisphosphonates can help a lot of patients who have osteoporosis. “This drug saves lives,” says Miki.
25 percent die in the first year and 50 percent do not have a normal life again. The medical costs for a patient who has suffered a hip fracture can be $ 100.00.
But bisphosphonates have side effects. People can suffer minor ailments such as heartburn, diarrhea and muscle and bone pain. In exceptional cases, they may experience a spontaneous fracture of the bones, such as the atypical fracture of the femur that Rodríguez experienced.
In 2010, the United States Food and Drug Administration (FDA) warned patients and health care providers of a possible risk of atypical thigh bone fracture (femur) in patients who were taking bisphosphonates Although at that time he reported that it was not clear if bisphosphonates were the cause, the FDA indicated that the fractures could be related to the use of bisphosphonates for more than five years.
There are several recommendations to prevent fractures in these cases.
After the use of a bisphosphonate for five years, a patient with osteoporosis should be re-evaluated and changed to another medication other than bisphosphonate or have a medication break, where the use of a drug is stopped for a period of time to decrease the risk of suffering a rare fracture, says Dr. Lauren Crocco, orthopedic trauma surgeon at the Miami Orthopedics & Sports Medicine Institute in Baptist Health South Florida, and Rodriguez’s physician.
The use of bisphosphonates is suspended when a patient experiences an atypical fracture of the femur. In Crocco’s experience, an atypical fracture of the femur can heal more slowly because the bisphosphonate changes bone biology and prevents bone resorption. It usually takes six to ten months for a patient who uses bisphosphonates to heal an atypical fracture of the femur compared to a patient who suffers a regular hip fracture and who does not use it. This will usually heal in a period of two to three months.
Patients who take bisphosphonates
They need a dental extraction or surgery of the gums, should also be cautious. Another rare side effect of the use of bisphosphonate is osteonecrosis of the jaw, where sections of the jaw bone deteriorate after a dental procedure and do not heal. According to the American Academy of Rheumatology, the study results range from less than 1 in 100,000 who develop osteonecrosis of the biphosphonate therapy jaw to 1 in 263,000.
Patients should inform the dental professional about the use of the medication and if there has been a change since the last visit, says Dr. David Genet, a periodontist with practice in Aventura.
Based on the recommendations of your doctor, a patient may need to change the medication or have a pause in its use. Genet says he continues to perform surgery on patients who take bisphosphonates because osteonecrosis is less likely compared to infection of a tooth. If contracted, osteonecrosis is treatable with medication or surgery.
People can take steps to protect bone health with a balanced diet rich in calcium and vitamin D, which absorbs calcium in the womb, says Dr. Alejandro Badia, an orthopedic surgeon and CEO and medical director of OrthoNow Orthopedic Urgent Care Centers in Miami. A patient can take calcium and vitamin D supplements, if necessary.
People should perform exercises in which they load their body weight such as walking, running and Zumba. This type of exercise focuses on the bones, making them stronger.
According to the National Osteoporosis Foundation, you should also avoid smoking and limit alcohol to two or three maximum drinks per day.
These recommendations not only help bone health but also cardiovascular health. An appropriate balance of nutrients and minerals, such as calcium, is needed for contraction of muscles, including the heart, says Dr. Adam Splaver, a private-practice cardiologist in Hollywood and Miami Beach.