Read an Excerpt
Dr. Lani's No-Nonsense Bone Health Guide
The Truth About Density Testing, Osteoporosis Drugs, and Building Bone Quality at Any Age
By Lani Simpson Hunter House
Copyright © 2013 Lani Simpson
All right reserved. ISBN: 9780897936613
Chapter 2: Bone Density Testing – Worthwhile or Worthless?If your car’s fuel gauge is off, the worst that might happen is you’d run out of gas and need a tow.
But if the tools used to gauge your health malfunction, the consequences are much more serious.
Unfortunately, when it comes to testing your bone density, current procedures can be far off the mark – and that can result in the wrong diagnosis, the wrong treatment plan, or the wrong medications.
Consider what happened to Ellen, a woman in her 60s who had gotten several bone density tests because of concerns about osteoporosis.
Ellen called me from her home on the East Coast one day, after a mutual friend recommended she ask me to assess her latest test. Just listening to her over the phone, I could tell something was not right because her most recent exam showed that Ellen had lost 9% of the bone mass in her hip since the previous year. At the same time, however, her spine remained unchanged. This discrepancy raised a red flag for me. As a densitometrist, I know it is highly unusual to see such an extreme loss in the hip and no loss in the spine.
My suspicions were confirmed when I reviewed the stack of paperwork Ellen sent and charted each of her bone density scans. Comparing the two most recent tests, I could tell that the first technician failed to position Ellen’s hip with the mandatory 15-degree internal rotation; but the technician who set up the second test did make that rotation.
What’s the big deal about hip rotations?
If the hip is incorrectly positioned during a bone test, errors in density readings of 5% to 10% can occur!
In Ellen’s case, that mistake led to the erroneous report of a 9% bone loss which, understandably, made her very upset.
What’s worse, none of it should have happened.
Errors were made by at least three people. The first technologist did not rotate her hip properly for the test and neither the technologist nor the radiologist at the facility caught that mistake. Then, the technologist who took the second test did not note the discrepancy in the hip rotation and simply reported a 9% bone loss. Compounding the problem, Ellen’s doctor signed off on the report and told her to take Tums! With such a significant bone loss, further tests should have been ordered. And, virtually all doctors would have put Ellen on serious medications based on active bone loss – but her physician didn’t do any of those things.
Once I was able to guide Ellen in getting an accurate bone density reading, we discovered that her bone was stable, meaning no active loss of bone. Further lab tests verified this finding. And, to date, she has been able to maintain stability by following my recommendations for a bone-healthy nutrition and exercise program that includes appropriate supplements.
I wish I could tell you that Ellen’s case was unusual. But it’s not. I see these problems with bone density testing over and over again in my patients from all around the country. (A whole list of similar problems is explained in the box entitled "How bone density testing can go wrong: Let me count the ways.”)
Why does this happen?
Testing Bone Density: No Certification Required!A glaring fact explains one of the main reasons so many bone density tests are fraught with errors: personnel who give bone density tests are not required to be professionally-trained or certified. Getting trained or certified is strictly voluntary.
Many conscientious health professionals do, of course, make the effort to sit for exams by the International Society for Clinical Densitometry (ISCD) in order to become certified. Completing a certification program, however, can be time consuming and costly. And since this professional level of training is not mandatory, doctor’s offices and testing facilities are not always staffed with people who can properly administer and evaluate bone density tests.
In some cases, the manufacturers of testing machinery may train staff members or offer some form of instruction for using the equipment. But when doctors buy used machines, even that minimal level of training is not given. Then, too, physicians may simply have their untrained front-office staff conduct the tests.
As you can imagine, the lack of proper training for the people handling bone density assessments can result in anxiety for the testers – not to mention problems for patients. I will never forget the phone call I received from a young receptionist who called with questions and concerns about testing patients. "I wish the doctor would send me to get training," she told me, "because I don’t know what I’m doing!"
No one should be put in the position of giving or receiving faulty medical tests. That’s one of the reasons I felt compelled to write this book. I hope to alert you to this problem and add my voice to those working to solve it. In the section on "Steps we can all take to get accurate bone density tests," which follows later in this chapter, you’ll learn more about efforts to require certification for those administering the tests. I hope you’ll read it and join me in calling for improved training for those who give millions of people their bone density tests.
In the meantime, what can you do?
How can you make sure you and your doctor get the correct information about the condition of your bones?
You’ll find answers to those questions in the next section, which covers the basics of bone testing and offers detailed advice in the special sidebar entitled "Steps you can take to get an accurate bone density test."
Continues...
Excerpted from Dr. Lani's No-Nonsense Bone Health Guide by Lani Simpson Copyright © 2013 by Lani Simpson. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
