Re: Sammy's Dexa scan

[TonyB]

"RStevrock" <rstevrock@aol.com> wrote in message
news:20030821065207.00734.00000295@mb-m02.aol.com...
> I started a new message so that I could save the others as unread. I am
truly
> lost. Later today I want to type in the numbers in the back of the
papers.
> They have boxes that describe BMD, T, and Z.
> Under a picture (X Ray), is written Hologic QDR-4500C The logo HOLOGIC
is
> everywhere on the report. Above the word HOLOGIC are 4 bars that go
across and
> run into a black ball. Perhaps that can help identify the machine.
>
> (This is in reference to my Dexa scan report)
> As far as I know patients do not see this doctor. He has one machine.
The
> person who runs the machine does not seem to be the person who works up
the
> report. In my opinion the doctor is now quiet elderly. He is a research
> doctor and has given much responsibility to the people in his office. I
think
> everyone gets the same advice whether they have quite advanced
Osteoporosis or
> some degree between that and normal. His initial report indicated that
since I
> smoke for 10 years between the ages of 18 and 28 that I may never have
achieved
> full bone density.
> I appreciate your input and will type in more later today where
maybe you
> can help me decide if this is inaccurate.
> I don't like like this style of medicine. When I go to the doctor,
I go
> with my list of questions and then do not bother the doctor again until
the
> following year. I feel strong and understand that osteoporosis can be
quite
> deceiving. I am beginning to think that for my personality I need to see
a
> metabolic endocrinologist.
> Sammy


Sammy,
I assume you are female but how old are you? What is your ethnicity?

Even without that info I am reasonably sure they have made a mistake & your
score should probably be -0.19 not -1.99. This puts you in the normal range.
Please raise this issue with your tech as you may be receiving treatment you
don't need.
TonyB

[RStevrock]

>Sammy,
>I assume you are female but how old are you? What is your ethnicity?

I am a white (German, French, British, Irish, Dutch, etc.) woman 61years old.
In the back of the report is a chart. I am going to type it across because I
don't think my email will format a chart.
L1 BMD 0.675 T(30.0) -2.28 73% Z -0.97 86%
L2 BMD 0.807 T -2.01 79% Z -0.55 93%
L3 BMD 0.879 T -1.86 81% Z -0.33 96%
L4 BMD 0.911 T -1.87 82% Z -0.29 97%
L1-L4 BMD 0.828 T -1.99 79% Z -0.51 94%

It also says that 6/13/00 BMD 0.808
7/24/03 0.828

My doctor said that she was giving me the increased Fosamax because the total
hip went from 0.952 to 0.927 total
Neck(hip) 0.794 now 0.812
Troch 0.722 now 0.688
Inter 1.144 now 1.105
Ward 0.740 now 0.761

Thanks for any advice.
Sammy

[TonyB]

"RStevrock" <rstevrock@aol.com> wrote in message
news:20030821193136.25303.00000279@mb-m15.aol.com...
> >Sammy,
> >I assume you are female but how old are you? What is your ethnicity?
>
> I am a white (German, French, British, Irish, Dutch, etc.) woman 61years
old.
> In the back of the report is a chart. I am going to type it across
because I
> don't think my email will format a chart.
> L1 BMD 0.675 T(30.0) -2.28 73% Z -0.97 86%
> L2 BMD 0.807 T -2.01 79% Z -0.55 93%
> L3 BMD 0.879 T -1.86 81% Z -0.33 96%
> L4 BMD 0.911 T -1.87 82% Z -0.29 97%
> L1-L4 BMD 0.828 T -1.99 79% Z -0.51 94%
>
> It also says that 6/13/00 BMD 0.808
> 7/24/03 0.828
>
> My doctor said that she was giving me the increased Fosamax because the
total
> hip went from 0.952 to 0.927 total
> Neck(hip) 0.794 now 0.812
> Troch 0.722 now 0.688
> Inter 1.144 now 1.105
> Ward 0.740 now 0.761
>
> Thanks for any advice.
> Sammy

Hi Sammy,
Now I'm confused - there was a figure of 0.929 that you quoted for your
lumbar spine but that doesn't appear in the chart.

Your L3 & L4 are within the normal range quoted by the Turkish paper, the L1
& 2 are a bit below but I wouldn't have thought osteoporotic.

Just to advise you what the figures mean:
T-score compares your bmd with a young healthy pre-menopausal group
database. If they use the wrong database like using coloured database for
white women you will appear to be osteoporotic because coloured folks have
higher bone density, one of the reasons they don't appear as competitive
swimmers very often, despite being superb athletes in track events.

z-score compares your bmd with people of your own age, again relying on the
correct database to be used.

The percentage figure gives the strength of your bones compared to the
reference database group.

Approximate fracture risk is to say that your risk doubles for each standard
deviation of T score so for example you quote your L2 T-score as being 2.01
so your risk of fracturing your L2 vertebra is approximately 4 times that of
a 20-30 year old woman, but again relies on the correct database being used.

Hope this helps a bit
TonyB

[RStevrock]

>Now I'm confused - there was a figure of 0.929 that you quoted for your
>lumbar spine but that doesn't appear in the chart.
>

That was 0.828 . I didn't type it correctly. That is a problem with the
numbers having no meaning to me.
In the cover letter the doctor said that the lumbar vertebrae was
osteopenia. It also said that compared to 2 years ago there is a -2.6% decline
in the right total hip and a +2.5% increase in the lumbar vertebrae.
I never have seen the Dexa doctor. But when he sent the report to my
obstetrician, her nurse said for me to switch to the Fosamax 70mg because of
the decline in the hip measurement. She didn't seem to be as concerned with
the numbers themself as the change in the hip measurement.
I have the year 2000 report and the 2003, but cannot get them to send me
the 2001. That is the one she is comparing to this one.
I don't mind taking the weekly Fosamax -- I don't have a problem with it,
but I'd like to be sure I had good numbers so I can see whether I am improving.
Sammy

[TonyB]

"RStevrock" <rstevrock@aol.com> wrote in message
news:20030823172137.15843.00000383@mb-m12.aol.com...
> >Now I'm confused - there was a figure of 0.929 that you quoted for your
> >lumbar spine but that doesn't appear in the chart.
> >
>
> That was 0.828 . I didn't type it correctly. That is a problem with the
> numbers having no meaning to me.


Oh dear, that makes a big difference, in that case it is osteopaenia.

Further, the treatment now seems perfectly reasonable, you need to treat the
weakest bones, it then doesn't matter if you are treating the normal bones
as well.

Sounds like Fosamax is a good idea, the bones only change slowly though, so
we'll look forward to hearing your next results in due course!

Best wishes
TonyB