Diagnosis: Osteoporosis

Katrina Kenison, Thu, 21 Mar, 2019

A decade ago, I enrolled in a local Kundalini yoga teacher training,
which meant I also made a commitment to cold showers and pre-
dawn yoga practice.  Getting out of a warm bed in the dark, leaving
my sleeping husband, gasping as the icy water hit my body, wrapping
a white scarf around my head before doing fifty squats and chanting
mantras, I felt empowered but also tired and a little silly.  Give it time,
I told myself.  You’ll get used to it.  I didn’t.
Although the training was just one long weekend a month for ten
months, the three-minute cold showers and pre-dawn yoga were
meant to become daily lifelong rituals. I gave it a good try. Yet while
my classmates reported newfound calm and moments of epiphany, I
felt increasingly resentful and exhausted and ridiculous.
I was never going to become a Kundalini yogi. I wanted to wake up
with my husband, not an hour and a half before him. I wanted a hot 
shower.  I felt uncomfortable with my head swaddled in a turban. I
wanted to move my body in ways that felt supportive and good, not
according to a sequence of poses written down years ago by
someone who didn’t know me.
Most of all, I didn’t want to do anything every single day. 
I had my first Dexa scan three years ago, a few weeks before my first
hip replacement. The results: osteopenia.  The news that my bone
density was lower than normal seemed like the least of my worries.  A
dear friend had just died.  I was preparing for two major surgeries. 
My doctor didn’t seem to think the condition warranted so much as a
conversation, let alone an office visit.  I made a mental note to think
about buying some hand weights once my two new hips were in
place and went back to reading about post-op PT. 
Last November, I asked my doctor if it might be a good idea to
recheck my bones. This time, I got a phone call to come in to her
office for the results.

“You have osteoporosis,” the doctor said mildly, without looking
up. “A considerable amount of bone loss, which puts you at a high
risk for fragility fractures, which are breaks that happen
spontaneously, without any warning.  I’ll write you a prescription. You
can take this medication for four years.  After that, we don’t
recommend you continue because there are side effects with long-
term use.”

I didn’t know much about osteoporosis. But, sitting there absorbing
this news as she stared at her computer, I did know one thing: my
doctor was not seeing a person in front of her whose life expectancy
had just grown dramatically shorter, she was seeing some numbers
on a screen.  She would be happy to write me a prescription, but she
had no interest in the long-term health of my bones.  Or in me. I was
going to have to become my own student of bones.
To me the biggest surprise was that I had become so porous so fast,
a fracture waiting to happen. I’d been pretty sure I was already taking
good care of my bones. I exercise and practice yoga.  I do eat well.  I
take a walk most days and turn my face to the sun. And yet,
according to the numbers, my 60-year-old bones are equivalent in
mass to those of an average 85-year-old woman.  In three short
years, I’d lost 27% of the bone density in my wrist and forearm.  I was
at risk for more bone loss, fragility fractures, and kyphosis.  Suddenly,
the possibility of a slip in the kitchen or a fall on the ice were
terrifying.

When I first sat down with my Dexa scan results in front of a website
that helped me translate all the various measurements, I went from
shock and disbelief to anger. Why had the doctor completely ignored
the osteopenia three years earlier?   Why had no physician ever
talked with me in the past about my own high risk for osteoporosis
and how to prevent it? Would I have listened? If I’d known twenty
years ago, at forty, what I now know at sixty, could I have avoided
this condition altogether?
I suspect the answer to that last question is yes. There is so much I
could have done, had I only known what to do. I also realize there’s
no point in looking back with self-reproach to all the collard greens

and almond butter I didn’t eat, the weights I didn’t lift, the Vitamin D I
didn’t take.
Over these last months, I’ve learned a lot about who’s most at risk for
osteoporosis, why bones become brittle and how spontaneous
fractures happen, why this condition, although invisible and painless
until fractures occur, can’t be ignored, and how medication, though
sometimes necessary, creates its own set of risks and problems.  I’ve
changed doctors and I’ve changed my diet.  I’ve started a regime of
supplements and vitamins. I’ve also changed the rhythm of my days,
the way I spend my time, and even my attitude about being alive and
growing old.

One of my first internet searches was “yoga and osteoporosis.” One
click, and I was ordering Dr. Loren Fishman’s groundbreaking book
Yoga for Osteoporosis, which offered exactly the encouragement I
was desperate to hear: namely, it is possible to treat osteoporosis, in
part, with the thing I like to do most.  According to Dr. Fishman’s
research, a regular practice of a series of twelve classical poses has
been proven to strengthen bones and help prevent fractures. (He’s
done a clinical study.  It works. YAY!)
What I didn’t quite grasp, until a friend and I took a weekend
workshop with Dr. Fishman a few weeks later, was that just going
through the motions wouldn’t build our bones.  Therapeutic yoga
poses for osteoporosis have to be done every day, seven days a
week, for maximum benefit.  Poses have to be held, ideally, for a full
minute.  Held with full-on effort, precise alignment, and maximum
resistance.  Held with every muscle engaged, every breath complete,
every ounce of intention and energy summoned and brought to bear
while you work harder at your yoga practice than you have ever
worked before.  (Gentle yoga? Forget it.)
For two days, we repeated the same twelve poses with every
possible modification.  We held them as if our lives depended on it,
which, in a way, they do. We left on Sunday afternoon exhausted and
exhilarated and hopeful, and feeling the very opposite of fragile.

“You have osteoporosis,” is not good news to receive, but it’s a far
cry from a terminal diagnosis.  I am just one of the eight million other
women in this country with low bone density. For me, however, this
new reality has been a wake-up call.
Osteoporosis has brought home to me, in a way that even three
years of arthritis pain and two hip replacements did not, the fact that
life is finite and so am I.  It has revealed that my body and I (“I” being
that voice inside my head) are in a partnership, and that we must
work together for the greater good of us both for as long as we are
able.  Osteoporosis has given me no choice but to take charge of my
own health, to learn all there is to know about how to take better care
of myself, and to make well-informed choices about what medications
and supplements I take, what I eat, and what I do.
Maybe this is how enlightenment works.  You get the wake-up call,
the clunk on the head, the message that is too loud and too insistent
to ignore.  And then you have a choice.  You can turn away and go
back to sleep, or you can dive in deep and allow the current of your
life to carry you to places you never expected to go.   As the time in
front of us grows shorter, life’s beauty comes into sharper focus. 
There is something energizing about seeing the truth of one’s own
mortality more clearly.

And there is this. Ten years after my failed attempt at pre-dawn cold
showers and Kundalini kryas, I’m doing something I never thought I
could: thirty minutes of intense, challenging yoga a day.  Every day.  I
stand in tree pose, unwavering, for a minute, breathing steadily.  I am
stronger than I’ve been in years.  I’m not quite ready to say that my
low T score was a gift, but it may turn out to be.

Katrina Kenison is the author of three memoirs and a collection of
essays exploring the stages of womens’ lives. She became a yoga
teacher at age 52 and is currently training to teach Dr. Fishman’s
yoga for osteoporosis. She blogs at https://www.katrinakenison.com,
where the complete version of this essay first appeared.


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