Sunday 21 December 2014

'I had a fracture at six and told I had osteopenia at 27'

Since childhood Rav Jeawon has been breaking bones. After years visiting A&E departments, he was diagnosed with osteopenia, which leads to osteoporosis, a disease associated with older people, writes Shane Cochrane

Ravind Jeawon

RAV Jeawon had a history of breaking bones. "It happened when I was running backwards, training for hockey. And it happened when I was out, socially. I'd had a few drinks – to be honest with you."

But this had been going on since childhood. Every trip or fall required a visit to A&E. When he was 27 years-old, he was diagnosed with osteopenia, the precursor to osteoporosis.

"People were shocked," he says.

"My friends and colleagues couldn't believe it."

They were shocked because we still regard osteoporosis as an old woman's disease – a wasting of the bones brought on by the menopause.

According to the Irish Osteoporosis Society, 300,000 people in Ireland have osteoporosis. However, 85pc of that number are unaware they have the condition. Many of those who have the disease are otherwise fit and healthy and, contrary to popular belief, many of them are young men.

We all lose bone density as we get older, but this process is accelerated in those with osteoporosis.

Their bones become so fragile that, in extreme cases, coughing or sneezing can break them.

Despite the severity of the condition, it's relatively symptomless and can remain undetected for years. There are some signs, such as sudden and severe back pain. Becoming shorter is another. We normally associate this with old age but, according to the Irish Osteoporosis Society, it's not normal to lose height at any age. Height loss is a sure sign of fractured vertebra.

But for most sufferers, the first indication that something is wrong is a fracture from a minor trip or fall – known as a low impact fracture.

"I have had a history of these fractures," says Rav. "I was probably about six years old when I had the first one."

Rav would suffer fractures from relatively minor incidents, such as tripping over a toy, or falling during hockey practice.

"They were all so low impact. I'd think, 'that can't have been a fracture.' But then I'd get the swelling and the pain."

Rav's doctors failed to recognise these low impact fractures as a definite sign of osteoporosis.

A DXA scan is a special type of x-ray that measures bone density, and is regarded the "gold standard" for diagnosing osteoporosis. The scan produces a T score: a negative T score indicates a problem, and the number provides an indication of the severity of the problem. A T score of -1.00 to -2.49 is osteopenia, while a score of -2.49 or higher is osteoporosis.

The scan detected osteopenia. Blood tests also revealed that Rav had very low levels of vitamin D, the vitamin essential for healthy bones.

Pete Watts was in his 50s before he was diagnosed with osteoporosis. He too had a history of low impact fractures. One incident, in particular, sticks in his mind.

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