Report: Osteoporosis Case Study and Pain Management for Mr. John

This report presents a case study of Mr. John, a 59-year-old man suffering from osteoporosis. The study delves into the medical illness, detailing its causes, symptoms, and impact on Mr. John's quality of life, particularly focusing on pain management. It explores the physiological changes associated with aging and osteoporosis, emphasizing the imbalance between bone formation and resorption, hormonal influences, and lifestyle factors like smoking and diet. The report examines the importance of calcium and vitamin D intake, along with the effects of medications. Recommendations include exercise, osteoporosis treatments like bisphosphonates, and lifestyle adjustments to improve Mr. John's condition and minimize pain, offering insights into dietary and therapeutic strategies for managing osteoporosis. The report aims to provide a comprehensive analysis and practical recommendations for improving the patient's condition.

REPORT

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
MR. JOHN.......................................................................................................................................1
RECOMMENDATIONS FOR MR. JOHN.....................................................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6
APPENDIX......................................................................................................................................1
Appendix A............................................................................................................................1
Appendix B.............................................................................................................................1
Appendix C.............................................................................................................................1

INTRODUCTION
Osteoporosis is the fragile bone illness which occurs when body of individual loses bone.
The present study will discuss case study of Mr. John. It will describe medical illness of the
person. Study is based on medical illness Osteoporosis which creates many problems for
individuals. Report will focus on pain management, as Osteoporosis causes huge pain to Mr.
John due to which his happiness and quality of life get affected. Assignment will pay attention
on managing pain of person by meeting with medical needs. It will explain the causes, symptoms
and treatment options of Osteoporosis. Furthermore, report will describe theories and ageing
physiological changes. The paper will adopt person centred perspective for Mr. John so that
medical needs of person can be fulfilled. At the end of study, necessary recommendations will be
outlined for improving condition of Mr. John.
MR. JOHN
Mr. John is suffering from Osteoporosis medical issue. He is 59 years old men who was
able to play golf and cricket in his young age. Now, his knees are not performing well and he is
unable to play games and walk properly. He suffers from huge pain which impacts on his sleep
and general irritability. Mr. John has to bear huge pain whenever he walks.
As per the views of Cosman and et.al, (2014) Osteoporosis is the condition in which
bones of the person become too weak and it increases chances of breaking. Lerner, (2016)
argued that Osteoporosis is known as the porous bone. When healthy bones are seen at
microscope then it looks like a honeycomb but in the Osteoporosis condition abnormal tissue
structure form in the human body. It is medical illness in which bones of person have low bone
mass and it becomes weak. This increases the risk of fractured in hip, spine and wrist. This is the
medical illness which takes place majorly in women. Two out of one predicted to suffer with
Osteoporosis medical illness.
According to Black and Rosen, (2016) the main cause of Osteoporosis is imbalance
between new bone formation and old bone resorption. After a certain age, human body fails to
form a new and old bones do not to perform their work effectively. Minerals help the young
people in forming new bones and giving strength to body. Calcium helps in the smooth
functioning of organs, brain, etc. If in the bone adequate amount of calcium is present, then it
supports in maintaining blood calcium level. By this way, other organs form their work
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significantly. But if human body fails to absorb enough calcium then it creates difficulty in bone
creation, that is the resona of bone fracturing.
As per the view of Papapoulos and et.al., (2015) Osteoporosis causes due to some
hormones. It occurs in women due to estrogen whereas, in men, it occurs due to androgen
hormones. If body of women fails to generate adequate estrogen level then due to lower
estrogen, level of risk of Osteoporosis gets increased in women. Imbalance in hormones create
difficulty for the person and that affect their medical condition to a great extent. Bruyère and
et.al, (2014) declared that one of the major causes of occurring Osteoporosis is age. With the
increasing age, individuals have to suffer with bone loss and there is inadequate intake of
calcium and vitamin D. By this way, human body fails to perform their endocrine functions
properly and it may weaker the bone. As per the views of Kemp and et.al, (2017) over use of
corticosteroids, thyroid issues, poor use of muscles etc. impact on calcium level and create
disease of Osteoporosis in the human being.
Wade and et.al., (2014) stated that bone tissues are renewed and new bones are being
replaced with old and damaged bones. This is the way through which body mass remain maintain
and individual becomes able to perform their daily work effectively. Bone density and integrity
affect the medical condition of individual to great extent. As in the case of Mr. John he is
suffering from huge pain due to his Osteoporosis disease. In this condition his body fails to
renewed new bones thus, existing bones get damaged. That increases risk of fracture and
breaking of bones immediately if the person get engaged in any kind of heavy exercise or
activities.
According to Hernandez Bueno and et.al, (2017) there are many factors that are linked
with the case of Mr. John due to which person suffers from Osteoporosis. One of the major
factor that is the leading cause of this medical illness is family history. If parents have the same
illness, then there is high chances that their children may get suffer from the same disease. Some
times' genes get transferred to the children and child get suffer from the same illness. Mother of
Mr. John was having Osteoporosis hip fracture thus, individual has suffered from the
Osteoporosis medical illness. Reginster and et.al, (2015) declared that if bones are being used in
excess then after a certain period of time these bones fail to perform well. Calcium and
potassium etc. minerals get reduced from the bones and that may weaker these bones. Mr. John
used to play golf and cricket in his young age. These are the games in which individual do more
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exercise which increases load on bones (Passos-Soares and et.al., 2017). When overload is being
place on these body parts then after a certain time these parts fail to perform their work
effectively and these parts start paining which impacts on quality of life of the patients. As per
the views of Usala and et.al, (2015) smoking is considered as one of the leading cause of
Osteoporosis. In the young age and even now as well Mr. John smoke in excess. His diet is
improper, he consumes less calcium in diet and thus, individual suffers from Osteoporosis.
Human body requires proper nutrition and healthy diet in order to become healthy. If body parts
are not getting proper nutrition then it may affect the health of person to great extent. As per the
views of Pietschmann and et.al, (2016) Mr. John is the player and he has to consume high
amount of energy medicines. This toxic effects impact on its bone and reduces its bone mass
(Osteoporosis explained. 2018).
Hegde, Andreopoulou and Lane, (2016) research show that there is no significant
symptoms of Osteoporosis. It cannot shown until bones get fractured. Osteoporosis causes pain
to the individual in knees and other bones but person think that it is normal pain due to age or
some heavy load. Bone loss take place slowly thus, individual fail to analyse the disease and
observe its signs at the right time. Age, sex hormones, bone structure, family history are the
unavoidable factors. But diet, life style choice are avoidable factors, individual needs to avoid
smoking and have to take proper diet in order to avoid complexity.
According to Giangregorio and et.al, (2015) Mr. John is facing the medical illness of
Osteoporosis in which it is essential for the medical professionals that to suggest proper diet
which contains high amount of calcium and vitamin D. Having fish, fortified breakfast cereals
are more beneficial for the patients those who are suffering from Osteoporosis. Vitamin D
supports in absorbing calcium from diet (Lindsay and et.al., 2016). As in the case of Mr. John,
person was taking methotrexate, proton pump inhibitors and steroids which have created this
problem. All these medicines have caused Osteoporosis in the person. If individual consumes
high amount of medicines then these medicines impact on bones and make it weaker.
Krege and et.al., (2014) declared that Osteoporosis impact on the human body to great
extent. Individual has to suffer from huge pain as in the case of Mr. John he was suffering from
severe knee pain. It affects daily life style of the individual because due to severe pain person
fails to perform daily work effectively. Women mostly face heart attack, strokes and breast
cancer if they are suffering from Osteoporosis (Papapoulos and et.al., 2014).
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RECOMMENDATIONS FOR MR. JOHN
It would be great for the Mr. John if he starts doing normal exercise. Though in the initial
phase of exercise individual faces pain in doing exercise but later on it helps in giving strength to
the bones. But he needs not to do heavy exercise that creates burden on the knee. Mr. John is
recommended to take Osteoporosis treatment. As in the age of 59 he may fail doing exercise
thus, it is required for the patient that to take proper Osteoporosis treatment. In this treatment
doctors try to minimize loss of minerals and try to enhance bone density. This treatment prevents
the Osteoporosis patients from fractures. This will be the best way for the Mr. John for
recovering from this medical illness (Mirza and Canalis, 2015).
Family history is unavoidable condition, in such condition children has to suffer from this
medical illness and they cannot do anything. But it is essential for the patients that to take care of
taking proper diet and have to avoid bad habits such as alcohol, smoke etc. All these preventions
will support the person in recovering from this illness soon. Eating proper nutrition support in
preventing from Osteoporosis and improving health condition of patients. This can be applied in
the case of Mr. John as well (Hosking and et.al., 2016). It is essential for the person that to take
vitamins, minerals so that bone mass can be increased. It is recommended that in the age of 59
Mr. John is required to have 1200 mg/day calcium. Vitamin D is another most important aspect
that need to be have by the patient. It enhances absorbing capacity of the bone and these bones
become able to absorb calcium. Vitamin D can be get by eating fish, egg yolks, liver etc. Mr.
John needs to intake 400-800 IU of vitamin D.
There are various therapeutic medication are available that helps the patients with
Osteoporosis to improve their illness and minimize sever pain in bones. There are various
bisphosphonates that have been approved by FDA (Binkley, Krueger and de Papp, 2018). These
are alendronate, ibandronate, etc. Raloxifene is being approved by the concern authorities in
order to provide treatment and care to the Osteoporosis patients. Mr. John has to reduce his
weight by doing normal exercise, if he does not perform any exercise then it will impact on bone
mass thus, it is essential to do exercise and reduce the body weight so that bone becomes lighter
and mass of bone can get increased.
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CONCLUSION
From the above study, it can be concluded that Osteoporosis is the bone illness in which
individual suffers from severe pain. This is the issue that creates difficulty in the human life and
person fails to live life happily. It impacts on his sleep as well. The major factors that are linked
with Osteoporosis are smoking, family history, heavy load exercise and poor nutrition. In such
condition, person may suffer from the issue. Mr. John needs to pay attention on their diet and
have to intake calcium and vitamin D in food. This will give strength to their bones and new
bones will be recreated. Medicines such as alendronate and ibandronate are considered as the
best treatment for patients who are suffering from Osteoporosis.
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REFERENCES
Binkley, N., Krueger, D. & de Papp, A. E. (2018). Multiple vertebral fractures following
osteoporosis treatment discontinuation: a case-report after long-term Odanacatib.
Osteoporosis International. 29(4). 999-1002.
Black, D. M. & Rosen, C. J. (2016). Postmenopausal osteoporosis. New England Journal of
Medicine. 374(3). 254-262.
Bruyère, O. & et.al., (2014, December). An algorithm recommendation for the management of
knee osteoarthritis in Europe and internationally: a report from a task force of the
European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis
(ESCEO). In Seminars in arthritis and rheumatism (Vol. 44, No. 3, pp. 253-263).
Elsevier.
Cosman, F. & et.al., (2014). Clinician’s guide to prevention and treatment of osteoporosis.
Osteoporosis international. 25(10). 2359-2381.
Giangregorio, L. M. & et.al., (2015). Too Fit To Fracture: outcomes of a Delphi consensus
process on physical activity and exercise recommendations for adults with osteoporosis
with or without vertebral fractures. Osteoporosis International. 26(3). 891-910.
Hegde, V., Jo, J. E., Andreopoulou, P. & Lane, J. M. (2016). Effect of osteoporosis medications
on fracture healing. Osteoporosis International. 27(3). 861-871.
Hernandez Bueno, J. A. & et.al., (2017). Efficacy and safety of bazedoxifene in postmenopausal
Latino women with osteoporosis. MENOPAUSE-THE JOURNAL OF THE NORTH
AMERICAN MENOPAUSE SOCIETY. 24(9). 1033-1039.
Hosking, S. M. & et.al., (2016). The role of health literacy in the treatment of osteoporosis.
Journal of Bone and Mineral Research. 31(10). 1909-1909.
Kemp, J. P. & et.al., (2017). Identification of 153 new loci associated with heel bone mineral
density and functional involvement of GPC6 in osteoporosis. Nature genetics. 49(10).
1468.
Krege, J. H. & et.al., (2014). PINP as a biological response marker during teriparatide treatment
for osteoporosis. Osteoporosis International. 25(9). 2159-2171.
Lerner, U. H. (2016). Bone remodeling in post-menopausal osteoporosis. Journal of dental
research.
Lindsay, B. R. & et.al., (2016). Patient-reported barriers to osteoporosis therapy. Archives of
osteoporosis. 11(1). 19.
Mirza, F., & Canalis, E. (2015). Management of endocrine disease: secondary osteoporosis:
pathophysiology and management. European journal of endocrinology. 173(3). R131-
R151.
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Papapoulos, S. & et.al., (2014). Eight years of denosumab treatment in postmenopausal women
with osteoporosis: results from the first five years of the FREEDOM extension.
Osteoporosis International. 25(2). 46-47.
Papapoulos, S. & et.al.,(2015). The effect of 8 or 5 years of denosumab treatment in
postmenopausal women with osteoporosis: results from the FREEDOM Extension study.
Osteoporosis international. 26(12). 2773-2783.
Passos-Soares, J. D. S. & et.al., (2017). Association between osteoporosis treatment and severe
periodontitis in postmenopausal women. Menopause. 24(7). 789-795.
Pietschmann, P. & et.al., (2016). Immunology of osteoporosis: a mini-review. Gerontology.
62(2). 128-137.
Reginster, J. Y. & et.al., (2015). The position of strontium ranelate in today’s management of
osteoporosis. Osteoporosis International. 26(6). 1667-1671.
Usala, R. L. & et.al., (2015). Hyponatremia is associated with increa
Wade, S. W. & et.al., (2014). Estimating prevalence of osteoporosis: examples from
industrialized countries. Archives of osteoporosis. 9(1). 182.
Online
Osteoporosis explained. 2018. [Online]. Acvailable through
<https://www.medicalnewstoday.com/articles/155646.php>
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APPENDIX
Appendix A
Mr. John is 59 year old person, he is suffering from Osteoporosis. He used to have smoke
and do heavy exercise. As he was the golf and cricket player thus, he used to do high exercises
which impacts on their bones. As he was the player thus, he always took energy medicines that
impacts negatively on their health. His mother was the Osteoporosis patients thus, family genetic
issues have causes this difficulty in the person.
Appendix B
 Alendronate (Fosamax)
 Zoledronic acid (Reclast)
 Ibandronate (Boniva)
 Risedronate (Actonel)
Appendix C
Mr. John was the social person, he used to take smoke with his friends. He likes to have
fast food with friends and spend huge time on internet for knowing more about golf and cricket.
He always does competition with friends of weight lifting and exercises timing.
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