to be a life sentence.'' Those words of comfort come from Dr. Christiane Northrup, Editor of the monthly medical newsletter "Health Wisdom for Women'', who wrote a two-part article on the disease in the April and May 2001 issues.

"Unfortunately, all too many American women are living into that diagnosis,'' Dr. Northrup wrote.

"By the year 2020, it is estimated that as many as a third of all older women will sustain a hip fracture by age 90. Of those who sustain hip fractures, 12 to 20 percent will die of related complications. Of those who don't die from complications, 50 percent will never regain the ability to walk.

"Osteoporosis also increases the risk for wrist and vertebral crush fractures, which can result in pain, disability and disfigurement. Vertebral crush fractures lead to the shrunken, hunched-over posture, complete with `dowager's hump' and pot belly that is so common in older women. If your mother or grandmother looks like this, you may be seeing your future unless you act now.'' "You will also be glad to know that just because you've been diagnosed with osteoporosis doesn't mean you'll inevitably break a bone or suffer a deformity,'' says Dr. Northrup.

"Low bone density alone does not necessarily result in fractures. In Japan, for example, hip bone density is markedly lower than it is in the United States, yet the incidence of hip fractures is two and a half times less than it is here (United States). And the Japanese consume less calcium than we do.

Everyone should bone up on osteoparosis "Part of the reason is that Japanese women have a hip angle very different than most Western women. Therefore, many Japanese can be extremely slender, yet healthy. Most Caucasians would have to be anorexic to achieve similarly petite body proportions.'' The other reason, she says, has to do with bone quality.

"Osteoporosis fractures occur because there is something wrong with the bone and its self-repair process, not just because it is less dense,'' Dr. Northrup stated in the article.

"This means that many women who are diagnosed with low bone density will never go on to get fractures.'' She uses an interesting example to describe how the health of the bone changes over time.

"Bone metabolism is a complex process in which construction and demolition crews work side by side. When we're children and young adults, the bone builders usually keep ahead of the bone destroyers.

"But that balance can shift as we get older. A wide variety of conditions, including depression, vitamin and mineral deficiencies and steroid use can allow the osteoclasts , the cells that break down bone, to outpace the osteoblasts , the cells that make bone.'' Bones constantly remodel themselves to adapt to physical stress and strain.

Among the amazing properties of the basic bone cell, the osteocyte, is the ability to act like a strain guage sensor, evaluating the amount of stress placed on a bone.

Ultimately, this ability means that your body will put new bone generated by exercise where it needs to go. All our bones, like every cell in our bodies, are functionally connected to one another. Strain on a leg bone not only helps build that bone, it also helps determine bone density in the spine and shoulders.

Local physiotherapist Shirlene Dill has treated some patients with osteoporisis, treatment that will vary depending on how advanced the disease is.

"When patients do come to us we'll do things to help with pain control if they are really bad, like moist heat to make them more comfortable,'' she stated.

"If they are not bad, but have some softening in their bones and are not in extreme pain, things like exercise programmes can help which physiotherapists can prescribe.

"Any upper body weight training can help quite a bit, so we can teach them exercises to use weights. Bones response to stress, weight-bearing stress, so people who are sedentary are more inclined to get this than people who are active all the time.

"There is also the nutritional factor, where your bone loses too much calcium and doesn't get enough Vitamin D. But primarily physiotherapy will concentrate on exercise programmes and controlling any pain that they may have.

"We get enough vitamin D from a few minutes' sunlight from just walking around town. We're blessed with the sunshine here.'' Added Mrs. Dill: "She (Dr. Northrup) mentioned in the article that they are starting to wonder if the fall isn't what gives them the hip fracture but the osteoporosis that they have that makes a pathological fracture that makes them fall. Did they break first and then fall because of the break?'' HEALTH HTH