Isabel’s Story: How she and her family learned about osteoporosis and bone health.

Isabel's Story
Isabel's Family

May 2007

This is a story about Isabel and how she and her family learned about osteoporosis and bone health. The cover has pictures of Isabel, her fall, Isabel talking with her doctor, and Isabel and her family talking a walk.

The next page introduces the characters in Isabel’s Story: Isabel, a middle-aged woman, her husband Juan, her son-in-law Carlos, her daughter Elena, her son Tony, her grandson Néstor, and her mother Doña Carla.

At Isabel’s house… Isabel enters the house through the kitchen door with bags of groceries in her arms. The kitchen is a mess. Popcorn is cooking in the microwave. Its alarm goes “Beep! Beep! Beep!” The refrigerator door is open. A roll of paper towels flows down to the floor. Her dog is barking, “Arf! Arf!” The dog’s food and water are spilled on the floor. The phone is ringing, “Ring! Ring! Ring!” A small rug is out of place and slipping under Isabel’s feet.

Isabel walks into a messy kitchen

Isabel uses her hip to close the refrigerator’s door with a “thump.” Her dog continues to bark, “Arf!” She puts the bags of groceries on the counter and stops the “Beep! Beep!” of the microwave. The phone is still ringing, “Ring! Ring!” Isabel rushes to answer it. She says, “Hello?” The caller—Isabel’s son-in-law—replies, “Doña Isabel, this is Carlos. Please tell Elena I can’t leave work just yet. I’ll be late for the party.” The party is to celebrate the birthday of Isabel’s mother, Doña Carla.

Isabel’s son Tony and his friends walk into the kitchen. Tony greets her, “Hi mom! How was work?” Tony’s friend says, “Hello, Doña Isabel.”

Isabel’s daughter Elena, who is expecting a baby, and grandson Néstor walk into the kitchen. Elena says, “Look what I’ve got, Mom! The birthday cake!” Elena shows the cake to her mom and brother Tony. Isabel says, “Thank you, Elena. Your husband called. He’s going to be a little late.”

Isabel, Elena, Néstor, Tony, and Tony’s friends gather in the kitchen. Isabel says, “Did you see my new camera? I’m going to take pictures at the party.” As she shows her new camera to her family and friends, the phone rings, “Ring! Ring!”

Isabel’s husband Juan is at Doña Carla’s house. Juan whispers into the phone, “Hello, sweetheart. Is everything ready?” Doña Carla stands in the background, putting her coat on. Isabel answers, “Almost. Don’t forget to bring my mother around to the back door.” In the backyard, Tony stands on a ladder to hang a birthday banner.

Isabel's mom demonstrates her height loss

Later… Isabel’s family and friends are gathered in the backyard, waiting for Doña Carla to arrive at her surprise party. The large “Happy Birthday” banner hangs between trees in the background. Carlos says, “Grandma is here!” The family and friends shout, “Surprise!” A family friend calls out, “Doña Carla!” Isabel greets her mother, “Happy Birthday!”

Isabel, Doña Carla, and Néstor are standing by the back door that goes into the kitchen. Néstor says, “Let’s measure your height, great grandmother!” Doña Carla replies, “That’s right …”

Néstor is holding his great grandmother’s hand, and she says, “It’s our family tradition on birthdays, isn’t it?” The family members’ heights are marked on the door frame. Doña Carla stands against the door frame. She holds her hand between the top of her head and the door frame. She says, “I’m not as tall as I used to be. I’ve shrunk over the years.” Isabel wonders, “Could that happen to me?”

Later at the party… In the backyard, Doña Carla and her family and friends gather around the birthday cake. Isabel decides to take a picture. She says, “Wait! Let me get my camera.” She goes into the kitchen through the back door.

Isabel’s family hears a loud sound in the kitchen, “Crash!” They rush into the kitchen and find Isabel on the floor, lying on her side and clutching her wrist. She is in pain. “Are you alright, my daughter?” Doña Carla asks. Elena asks, “Mom, what happened?” Grimacing, Isabel says, “Ow! It hurts! I think I broke my wrist.” Juan says, “I’m taking you to the hospital!”

Isabel is on the floor, hurt

Isabel, Juan, and Doña Carla are in a car. Juan is driving them to the hospital. Isabel holds her wrist in pain.

Two weeks later… Isabel sits on an examination table in a doctor’s office. Her arm is in a sling. Her husband Juan stands at her side. Isabel and Juan are talking to the doctor about her test results. The doctor says, “Remember when you first broke your wrist, and I ordered a bone density test to see how strong your bones were?” “Yes,” Isabel replies.

The doctor explains the results of the bone density test to Isabel and Juan. A bone density test measures bone density, tells you if you have osteoporosis, and is quick, easy, and painless. The doctor tells Isabel, “The results show that you have osteoporosis.” She replies, “How can that be? I feel fine!” The doctor continues, “Osteoporosis has no symptoms. You don’t notice it until you break a bone. Signs that you may have broken a bone include height loss or a curved back which is called kyphosis.

Doctor talks to Isabel about her bone density test

Isabel asks her doctor, “What is osteoporosis?” “Osteoporosis is a disease that makes your bones weak and more likely to break,” the doctor explains. The doctor gives to Isabel and Juan a booklet titled, Taking Care of Your Bone Health. The doctor further explains, “Because you had this fracture, you are at increased risk for another fracture … so it is very important that you take care of your bones.”

Osteoporosis is known as the “silent disease.” At first, osteoporosis has no symptoms. Often it is not diagnosed until after there has been a fracture. There are a few warning signs, such as loss of height or a curved back.

Isabel and her husband look at the results together

Juan says, “Doña Carla has lost height. Maybe she has osteoporosis, too. She needs to see a doctor!” If you have any of these warning signs, talk to your doctor about getting evaluated for osteoporosis.

Isabel and her husband are reading the booklet about bone health. Juan says, “This has good information for you, Isabel, about how to prevent fractures in the future.” Isabel replies, “These tips are good for the whole family! We need to make sure that you, our children, and grandchildren have healthy bones.”

Doctor

The doctor tells them, “Although osteoporosis can affect anyone, some people are at greater risk.”

Osteoporosis risk factors include:

  • Sex: being a woman
  • Lifestyle:
    • A diet low in calcium and vitamin D
    • Too little exercise
    • Smoking
    • Drinking too much alcohol
  • Heredity: a family history of osteoporosis
  • Age: the older you are, the greater your risk
  • Medical history:
    • Premature menopause
    • Prolonged use of certain medications
    • Certain diseases, such as diabetes and anorexia nervosa.
Isabel

Isabel reads a list on how to prevent falls. She learns that it is very important for people with osteoporosis to prevent falls.

To prevent falls:

  • Wear low-heeled shoes
  • Have regular eye exams
  • Tell your doctor about any medications that make you dizzy
  • Make sure rugs are skid-proof
  • Keep floors free of clutter
  • Keep hallways and stairs well lit
  • Use night lights in the bathroom and bedroom
  • If you need eye glasses or hearing aids, make sure you use them.
Isabel walks into a clean kitchen with groceries

Three months later… Isabel and her husband walk into their kitchen carrying groceries. Isabel carries one bag, and Juan carries one bag. The kitchen is clean and tidy. There are no rugs on the floor. Smiling, Isabel tells her husband, “I love my kitchen now that the clutter is gone!” Her husband replies, “…so you won’t fall again.”

Isabel is in the kitchen unpacking the groceries. Her daughter Elena stands next to her, holding her newborn baby. Isabel’s son Tony is looking in the refrigerator and says, “We’re out of sodas, Mom.”

Isabel pulls a milk carton out of a grocery bag and replies, “I’ve got something much better for you right here!” As Tony pours the milk into a glass, Elena says, “You never used to buy so much milk and cheese before.” Isabel responds, “Now I am always thinking about our bone health. It’s never too late—or too early—to take better care of our bones. I even found healthy snacks for the kids!”

Here are good tips for getting enough calcium in your diet:

  • Eat foods rich in calcium, especially milk, cheese, and yogurt, preferably low-fat or fat-free.
  • Also include almonds, sunflower seeds, canned salmon and sardines with bones, and green leafy vegetables like broccoli.
  • Take calcium supplements, if needed. Ask your doctor if you need a vitamin D supplement, too.
  • Drink fruit juices and eat breads and cereals fortified with calcium.
foods filled with calcium

Here is Isabel’s shopping list:

  • Milk
  • Calcium supplements
  • Tony’s cereal (calcium-fortified)
  • Frozen yogurt for Juan
  • Elena’s favorite yogurt
  • Orange juice
  • Fish
  • Broccoli
  • Cheese
  • Corn tortillas
  • Pudding for Néstor
  • Almonds for Mom
  • Figs for me.
Isabel instructing her children on how to keep bone healthy

Isabel is in the kitchen with her son and daughter, who is holding her newborn baby. They are all smiling. Tony tells his mother, “Mom, you know so much!” Isabel responds, “I know lots of ways to take care of our bones.”

5 Steps to Bone Health

  • Increase your physical activity. Good activities include:
    • Walking
    • Jogging
    • Climbing stairs
    • Playing tennis
    • Dancing
    • Lifting weights
  • Get enough calcium and vitamin D.
  • Don’t smoke.
  • Talk to your doctor about your bone health.
  • If needed, take an approved medication to prevent or treat osteoporosis.

Isabel’s family is in the kitchen with their dog. They are all smiling. Juan tells Isabel, “Your walking partners have arrived. Let’s go!” Isabel replies, “And let’s see if we can find someone to take our picture!” Isabel’s family and their dog go to the park to walk.

To learn more about bone health and osteoporosis, talk to your doctor and call 1-800-624-2663 (a toll-free call).

The End—of the story.

The Beginning—of better bone health for Isabel and her family.

NIH Publication No. 06-5575

NIH Osteoporosis and Related Bone Diseases ~ National Resource Center

2 AMS Circle
Bethesda, MD 20892-3676
Phone: 202-223-0344
Toll Free: 800-624-BONE (2663)
TTY: 202-466-4315
Fax: 202-293-2356
Email: NIHBoneInfo@mail.nih.gov
Website: http://www.bones.nih.gov

The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center provides patients, health professionals, and the public with an important link to resources and information on metabolic bone diseases. The mission of NIH ORBD~NRC is to expand awareness and enhance knowledge and understanding of the prevention, early detection, and treatment of these diseases as well as strategies for coping with them.

The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from:

The National Institutes of Health (NIH) is a component of the U.S. Department of Health and Human Services (HHS).

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