It's All in the Bones: Update

     

     In my article It's All in the Bones I discussed the concerns with bone density and a disabled child.  I discussed the complications of the Ketogenic Diet, certain medications, and late weight bearing have on bone density.  Since my article was written Nadiya saw an Endocrinologist.  The news was encouraging.
               Doctors are concerned about middle aged woman who have low bone density and rightfully so.  A middle aged woman will go through menopause and her production of estrogen will decrease making the bone density problem worse eventually resulting in fractures if not treated.  A girl with low bone density will go through puberty where her estrogen will increase and she will rebuild bone.  In the meantime there are things that can be done to prevent fracture and further loss of bone density.
               A Dexascan alone is not an accurate test for a child.  If the child is small like Nadiya their bone age may be considered younger than her 9 chronological years.  If that is the case the Dexascan must be interpreted differently.  Doctors order blood work which helps to determine the bone age.  They also check the child's vitamin D level to make sure it is adequate.  They also do a bone age x-ray.  All of this information is then interpreted together to decide what the bone density is.  Nadiya was actually getting too much vitamin D so we cut that in half.  She will have the bone age x-ray and another Dexascan in the spring.  Additionally the doctor was very please with the weight bearing opportunities and the fact that Nadiya has never suffered a fracture even after her fall in the Kidwalk. 
               All of this is good news.  The key is adequate Calcium and Vitamin D supplements and sufficient weight bearing opportunities.  Children on the Ketogenic Diet long term should especially be aware of this.  If managed early the outlook is good.