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Photograph by Amanda Stevenson
"The results of your dexascan have shown that you have severe
osteoporosis. Please call the office immediately so that we can discuss
a treatment program." The word severe was underlined in red to
underscore the dire seriousness of the situation. Severe, those six
letters with the bright red, jagged line underneath, jumped up at me
from the paper.
It was not until I had a
bad fall, perpetrated by my overly rambunctious chow-golden retriever
dog, requiring me to go the emergency room of the local hospital, that I
agreed to have a dexascan. At the hospital they ordered an x-ray of my
spine to make sure that I was still intact. The technician who took the
x-ray looked at the developed film and said, "You don't drink any milk,
do you?" "Well no," I replied, "but how can you tell?" "Your bones look
really thin," she said. "You better see a doctor about this very soon."
My husband, who is a
physician, and my internist, whom I see for a physical every year, had
been urging me to get a dexascan for a couple of years. I had always
avoided it because of the radiation. Also, since I have always been
small boned and on the thin side, I rather expected that the test
results might indicate that I am somewhat below the normal range of bone
density for my age. However, I was totally taken aback by this
devastating diagnosis.
As I sat slumped
dejectedly in my desk chair with the ominous letter from my doctor in
hand, the first question which came to mind was "How could this happen
to me?" a person who has followed the macrobiotic way of life for so
many years. According to macrobiotic teaching, osteoporosis is a disease
that is caused by an acidic condition brought on from eating too much
animal protein and dairy products.
Beside fish, there has
been absolutely no animal protein or dairy in my diet for many years.
Sugar, which is also reputed to be one of the causes of bone
demineralization, had not been a part of my diet. What could have
happened to cause my bones to become so weak? Walking over to the full
length mirror, I took a good objective look at myself to see if I looked
like I had weak bones. The reflection that I saw was just my same old
self.
"Strange," I thought, "I
look perfectly fine… a little bit on the thin side… but isn't that
supposed to be healthy?" Osteoporosis is called the silent disease. What
that means is that your skeletal structure, the formation which holds
you all together and keeps you in an upright position, can be steadily
dissolving and you will not know it until you suddenly break a bone. If
the bones are very weak, a fracture can occur with only minimal trauma.
Osteoporosis is a
condition in which normally dense bone tissue becomes less dense. When
this occurs, the bones have holes and spaces where there was once solid
strong bone. Our bones are constantly in a cycle of breaking down and
rebuilding. Osteoporosis happens when the buildup of bone does not keep
up with the breakdown. At that point, the bones' protein structure and
mineral content are lost. As the condition continues to progress, bone
mass becomes lower and lower, the bones becoming more porous, weaker and
lighter. With weak bones, the risk of fracture greatly increases.
SEEKING MEDICAL ADVICE
With feelings of gloom and doom resonating from every pore, I arrived at
the office of my doctor. Would she gloat and say "I told you so," I
wondered. Dr. Lillian Cohn, who is my internist, has been urging me to
take calcium and Vitamin D supplements for years. She also wanted me to
take the dexascan test several years ago. My defenses were down; I felt
scared and insecure. How could I continue to argue that my macrobiotic
diet was providing all the nutrients that I needed?
Dr. Cohn was sympathetic
and not surprised when I told her that I did not want to take the
recommended medicine for my illness. She knows that I have my own health
agenda. "You are too young to have so much bone loss," she says. "You
really should take Fosamax or Evista; they will help your bones to
stabilize. You are in grave danger of fracturing your spine. Your diet
has not worked for you this time." I sat feeling weak and defeated,
staring at the package inserts for the drugs. The models on the
literature looked to be about my age, but they were smiling and strong,
not, like me, unhappily sitting, fighting back tears, wondering which
way to turn.
The pharmacologic agents
which are used to halt the devastation of osteoporosis stop the process
of bone demineralization by inhibiting the natural cycle of bone removal
(resorption) and formation (remodeling). The drugs create stronger bones
by stopping the body's ability to lose bone mass through the calcium and
Vitamin D supplements which are also taken.
Pretty good deal; the
medical establishment has lots of statistics that say these drugs are
effective and cut down on the incidence of fracture. Just not good
enough for me, who, using macrobiotic thinking, realizes that when you
interfere with any metabolic system of the body, you could be in for
bigger trouble on a different level. "Would these drugs affect my
nervous system?" I wondered. When you chemically trick the body to stop
performing one of its main functions, isn't there a price to be paid?
Rather difficult to express this to my doctor, who is sitting with the
statistics on her side, worrying that I could possibly spontaneously
fracture my spine because of my, here is that word again, osteoporosis.
I really feel badly for her. She is trying desperately to help me and is
frustrated that I will not follow her advice. The road less traveled,
which I have always taken, sometimes becomes very rocky.
She starts to lose it when
I explain that I also do not want to take supplements. "Why in the world
not?" she stammers. "What is wrong with taking calcium and Vitamin D?"
she asks. "You cannot get enough of these nutrients in your diet; you
are acting very foolishly." I weakly agreed that I will at least
consider that option.
I think of trying to explain the macrobiotic view of supplements is that
if we continually feed our bodies with readily available nutrients in
pill form, the body becomes lazy and loses the ability to absorb
nutrients from food and can become more and more deficient, even though
nutritious foods are being eaten. I change my mind; my bravado about
macrobiotics is at a low ebb. I have been diagnosed with a serious
degenerative disease; grandstanding seems inappropriate right now.
THE MACROBIOTIC CONSULTATION
Denny Waxman took one look at the x-ray of my spine and said, "You had
better act quickly or there will be nothing left of you. You will just
disappear." Oh great, I thought, the doctors are right and everyone is
in agreement that I am one big weak mess. Denny said that I could cure
myself with the macrobiotic diet but that it would take time, perhaps a
year and half. Not so bad, if it works, I thought. One year and a half
to get back to my old fighting form. Not so bad.
After I received my
dietary recommendations, I realized that my intuition about how to alter
my diet for my condition had been wrong. I had started to load up on a
lot of calcium containing foods like sea vegetables and sesame seeds. I
ate so much broccoli that I swore I must look like a broccoli stalk
myself. Denny said that osteoporosis is a yang condition. "You have to
relax the organs of your body so that they can begin to absorb the
nutrition that you are taking in," he advised.
"Don't think calcium, just
think of good strong nourishment at this time." Denny stressed the
importance of good eating habits. "The bones like regularity and they
dislike chaos and stress. You have to be a good macrobiotic now and you
will get better," he said. When I asked him about taking supplements
just until I was out of danger of having a fracture, he told me that
calcium pills would harden my condition and make me worse.
CONVERSATION WITH MICHIO KUSHI
In preparation for this article, Michio Kushi agreed to a telephone
interview on the subject of osteoporosis. Beside myself, there are two
long-term macrobiotic leaders who also have this condition, as well as
some other people in the macrobiotic community. One of the leaders has
suffered multiple fractures to the lumbar spine and the other has too
much pain to even walk up a flight of stairs. I was anxious to hear
Michio's viewpoint.
Michio was very busy, so I
cut to the chase fast. "Why are long-time macrobiotic people getting
this disease?" I asked. "Because they are eating in too narrow a way,"
he said quickly. "People must have a lot of flexibility in their diet.
Think of the macrobiotic diet not in terms of old Ohsawa diets #6 and 7
but in a new, wider international way. The Mediterranean diet is also
part of the new macrobiotic way of eating."
I quickly reflect on my
way of eating. I have enjoyed good health for a long time, so I more or
less have gotten into the habit of eating whatever pleases me within the
framework of the macrobiotic diet. We go out to restaurants a lot, and I
always order the healthiest food on the menu, but I have not for many
years really concentrated on making sure that I was eating in a balanced
way.
Michio said that
osteoporosis was generally not caused because of absorption problems but
was brought on by an unbalanced diet which was mineral deficient. He
said that it could be cured with the macrobiotic diet if the practice is
very good and that it is necessary to seek guidance from a counselor so
that the dietary choices are correct for the particular person. He said
that if a person is very sick with the disease and tries to cure himself
with the diet he might not get better.
"In four months there will
be improvement in the bone density, if you are doing everything just
right. If you want to do weight-bearing exercises to help bone growth,
make sure that you use light weights," he emphasized. When he said that
he did not have objections to using calcium supplements for a short
while, from two weeks to six months, and that drug therapy can be safely
used for 2 weeks to three months, my brain began to flood with
confusion.
All the medical advice
that I had received from my internist and subsequently from an
osteoporosis specialist had been consistent. The macrobiotic opinions
differed in respect to the use of supplements and drugs and also in
regard to what was the cause of osteoporosis. The ball was in my court
in respect to choosing the best treatment for myself. Should I take the
supplements and the drugs until I am stronger or just stick to the
dietary path which I have thus far taken?
The whole process of
handling a chronic illness such as osteoporosis is challenging and
requires that you spend some time studying the options which are
available and understanding what the medical tests are actually
indicating. For instance, the dexascan test results are based
comparatively on the bone density of a 30-year old woman. This is the
age when bones are at their optimum density; after that it is all
downhill, bone-density-wise. No matter what age you are when you take
the test, your bone density is measured against that 30-year old model.
So a reading which is slightly lower than this standard should not cause
you to panic. As we get older, we simply lose a percentage of our bone
mass.
However, a reading which,
like mine, was way below the norm, is cause for concern and must be
taken very seriously.
It has been two and a half months since my diagnosis and I have been
cooking up a storm since that time. I had to give up a couple of nice
trips so that I could stay home and be able to cook for myself. In
general, my life has changed dramatically because I must put my health
and taking care of myself ahead of other priorities. It will take time,
but I am hopeful that I am getting better and stronger, one good
home-cooked meal at a time.
"Wouldn't it be easier to
just take some medicine and supplements instead of having to do all this
cooking all the time?" my husband asks. "Yes," I reply, "but if I can
cure myself the macrobiotic way, I am really cured and over the disease.
I do not want to be on medicine for the rest of my life." He is a
doctor. He smiles warily, but I know that he is pulling for me and
wishes me luck. I am thankful for his support because I know that at
this point I need all the luck that I can get.
Originally published in
Christina Cooks Autumn 2001
Recipes
TURNIPS AND TOPS
One cup of turnip greens contains 229 mg of calcium. The following is an
easy and quick recipe for preparing this nutritious dish.
Rinse one bunch of turnips and their greens. Finely chop the turnips and
the tops. Place them in a pot (roots under the greens). Add a small
amount of water and a pinch of sea salt. Cover and steam for a few
minutes. Add a few drops of shoyu and simmer for 1 minute.
HIZIKI WITH VEGETABLES
Once cup of hiziki contains 610 mg of calcium.
1/2 package hiziki
1 carrot, cut into matchsticks
1/2 onion, cut into half moons
1 tablespoon sesame oil
1 tablespoon shoyu soy sauce
1 cup spring water
Rinse the hiziki and soak it for about 10 minutes. Discard the soaking
water. Put the hiziki into a pot with the cup of spring water. Bring to
a boil and simmer with the lid on for about 1/2 hour.
In a skillet, sauté the onion and the carrot in the sesame oil. Add the
vegetables to the hiziki and simmer lightly for about 5 minutes. Season
with the shoyu and simmer for another three minutes. You can add peanut
butter and sauerkraut after the dish is cooked for added richness.
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