share: Two Broken Femurs and a Broken Back Caused by Fosamax!
How can anyone describe the pain associated with a fractured (snapped in two!) femur? Each individual is different to be sure, but with every description I have read or heard about, the person has stated it is “the worst pain” they have ever experienced—and for women that includes labor and delivery!
Breaking a femur, the largest and strongest bone in the body is traumatizing, but when one simply snaps the moment haunts you for years to come. The year 2009 was a very traumatic year for me. The physical pain is one thing, the mental pain and flashbacks are quite another. I took the blame for breaking my femur the first time, (i.e. being clumsy, not watching where I was walking…) but I soon learned it was not my fault and it was not bad luck—it was bad medicine! And it was a medicine that had been prescribed for me to prevent my bones from becoming osteoporotic and brittle. The result from taking Fosomax for 10 years is bones so brittle I am fearful that anything else could “snap” at any moment for absolutely no reason at all!
I tripped (I thought) and fell March 21, 2009 outside my home in a nearby field. (We live in a not-too-populated area on a river in the country) I was home alone and my husband was not expected back home until the next evening. However, I heard my leg snap before I fell and hit the ground!! After the initial shock, I knew I had to at least try to get back in the open so I could be visible before nightfall, which was fast approaching. I crawled (rather, scooted on my left arm and side) as far as I could, grabbing at twigs and tall grass or anything I could get a hold of and screaming for help while also waving a small tree limb I picked up along my “crawl path.” Finally, (and I really have no idea how long I had been crawling and screaming) an “angel” heard my cries from across the river. He got some neighbors and came to help me, when they saw the condition of my body with my leg going in two different directions, he immediately called 911. It took a long time to get me onto a backboard and out of the field so they could transport me to the local hospital. I had a complete break of the right upper femur. Other x-rays revealed a pre-existing stress fracture on the left leg in the exact position. I was life-flighted by helicopter to a larger city where I was taken into surgery immediately so the doctors could inserted a small rod through my knee, then strung weights from it on each side of my leg for traction to stabilize the bone and muscles that were spasming and twisting the two bone segments even more. The next day I had more surgery to insert a titanium intramedullary rod and pins into the femur.
I have had several other surgeries in my life, including seven on my spine, but this has been the most hellish and painful year in my life! After three days in the hospital, I was sent to a rehab center for another 2 1/2 weeks for intensive physical therapy, and then had four weeks more of outpatient therapy.
About a week after my therapy ended, I was in our garage when I tripped (I had recently been promoted from a walker to a cane) and twisted around trying not to fall again. I heard a “pop” in my back, but thought nothing of it, I was really much more concerned about my legs. However as time passed, the pain set in and would not let up. Ultimately after seeing two doctors and having x-rays (which did not show anything damaged) over a three-week period, one of the doctors ordered an MRI. The result of that “pop” was a fracture at lumbar disk one. I was put in a turtle-shell-style back brace and suffered a few more weeks of severe pain. However, that is not the end of my story …
I was freshly “released” from wearing the back brace and it was a beautiful sunny day! It was Sunday, July 5th, when I was coming in my backdoor, I felt my left leg twist and throw me off balance and again I heard that familiar “snap!” My left leg broke like a piece of chalk, sending me screaming to the floor with the pain that I had hoped I would never experience again. This time my husband was home so I got immediate help. The EMS transported me to the local hospital where I was again life-flighted to a larger city (this time Fort Wayne, Ind.—the first break, I was life-flighted to Toledo, Ohio). A subsequent second intramedullary rodding surgery took place after I was in traction and stabilized for two days. I needed two pints of blood this time around, and the surgery was a bit longer, though the break appeared identical to the first one. When I was released from the hospital, I went to the rehab center again for another 2 1/2 weeks with intensive physical therapy and more after my release. It is now eight months after the second fracture and I have been in and out of physical therapy and am now walking with a cane. I wear a Fentanyl pain patch and take muscle relaxers as needed to get through the days and nights that are riddled with pain.
There had never been any mention from Merck the makers of Fosamax, that there had been previous reports of such horrifying effects that could do this permanent damage to my bones. Furthermore, nothing can remove it from the bones and it stays there for a decade or longer, after discontinuing usage (which I did immediately in March)! It was the first orthopaedic surgeon who told me about the Fosamax connection. Imagine my shock when he told me what he thought had caused my fracture! I am part of a support group of 38 such victims who have been trying to spread the word so other women and men will not have to endure what we have gone through!
If you are wondering if you have Osteoporosis or Osteopenia, it is good to remember that Osteoporosis doesn't refer to any specific bone, but rather to a system-wide problem. This means that someone might have a T score of -2.5 in the spine and -1.0 in the femur, but for medical reference, they would still be considered as having Osteoporosis.
One of the fallacies of the bone density scans (DEXA Scans) is that they show if there is an increase (or decrease) in bone mass, but what it does not show, is the quality of the bone. My bone density tests showed that I had an increase in bone mass, so as far as my doctor was concerned staying on Fosomax or it’s generic form known as Alendronate, was what I should do. It wasn’t until after my first femur fracture that it became obvious how porous and brittle my bones really were!
Does this mean you should still get your bone density test? “Yes,” says Dr. Jennifer Schneider (also a victim of a Fosamax femur fracture). “I do believe they are valuable. They are useful especially as a screening test. If nothing else, a low T score will mobilize its owner to take some action. This would certainly include taking calcium and vitamin D and doing weight-bearing exercise (e.g. walking), and if the T score shows osteoporosis (i.e. -2.5 or worse), then I think taking a medication is a good idea. There are several choices. Bisphosphonates help the majority of users. I hope that research will identify who should not be on bisphosphonates, perhaps by getting a urinary T-telopeptide level before starting a drug like Fosamax.”
Dr. Schneider formed the support group that I participate in and can be contacted at: http://www.jenniferschneider.com
MailTo:jennifer@jenniferschneider.com
There are many useful articles available on the Internet now regarding these fractures. The FDA said it will investigate the connection, but in a past survey done in 2008, they did not find a link. I think that observation will change with the new data available to them now. The numbers are increasing in the fractures that are identical in patients taking the bisphosphonate drugs.
Another starting-point with plenty of informational links is the web site for Dr. Jeffery Dach MD. His web page regarding Fosamax and the other bisphosphonates is:
http://jeffreydach.com/2010/03/14/fosamax-induced-fractures-more-bad-new...
Also, if you are experiencing thigh, leg or hip pain, you should get a nuclear bone scan to find out if you have stress fractures lurking in the dark that could break at any time. After they had already experienced one femur fracture and did have positive bone scans showing a stress fracture in the other femur, the men and women in our support group have had preventive rodding in that leg as well. No one wants a repeat performance of that! I did have surgery to do just that scheduled when my second femur broke, so waiting is not a good thing!
By all means, if you are taking one of the bisphosphonate drugs, this includes all of the drugs for osteoporosis such as Boniva, Actonel, Reclast, Fosamax, etc., you should talk to your doctor as soon as possible about your situation.
Good luck!
Vicki
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Add a Comment14 Comments
Hi Vicki - It's been my experience that people dealing with serious medical conditions often get the best information from fellow patients - those special people who think beyond their own personal situation and reach out to help others. You are one of those special people, and your many comments on this site to help other women dealing with fractures and other issues is invaluable.
To be honest, it's painful to read your personal story. I just can't imagine what it must have been like for you to have these experiences. The physical pain, the mental pain, the medical bills and more. You've had to work extremely hard to recover, and you've also clearly worked hard to educate yourself. Thank you so much for your generosity in sharing what you know to help others. Like the sunflower you use for your EmpowHER profile, you clearly try to find the bright side of any situation. I'm looking forward to hearing more from you! Take care, Pat
March 16, 2010 - 6:12pmThis Comment
Hi Vicki,
Thanks you for sharing your story with others in this forum. I have been writing about the adverse effects of bisphosphonates for years. Finally we are seeing more media attention now that larger numbers of women are going public with the stories. Hopefully, the nation will wake up and force the FDA to take action on this issue. If the FDA drags their feet, our last defense is drug litigation court where 900 cases are awaiting for their turn.
jeffrey dach md
March 16, 2010 - 8:00pmLet me preface these comments by saying I'm not a doctor, but I deal with interpreting statistics in my financial job. My wife, age 42, suffered a broken femur while walking and hasbeen taking Fosamax since 1997.
I read an article about a study in Denmark stating that There is no link between Fosamax and increased risk of Femur fracture because of the thousands of femur fracture cases they looked at, there were relatively few femur fractures and just as many non fosamax users as fosamax users experienced femur fractures. Then they suggest that most women on Fosamax have not had a femur fracture, implying that Fosamax therefore plays no role in femur fractures.
I just want to say that this is a complete junk science reading of statistics. They start with a huge number and whittle away at the underlying question. The relevant question is "Did Fosamax play a role in the fractures of the women who DID take Fosamax? It is likely that a biopsy examination of the bone tissue in all fracture victims (Fosamax and non Fosamax) may have completely different characteristics of bone matrix. The Fosamax patients may all exhibit high mass, high density readings, but essentially dead bone matrix.....consistent with the mechanism of action in bisphosphonates. My point is that this psuedo scientific study out of Denmark being floated around now is crap and any freshman stats student can see how they are playing with the bigger patient numbers to dilute the importance of the relevant group and relevant questions.
The number of atypical femur fractures in patients taking bisphosphonates longer than 5 years is rising. The mechanism of action in the drug clearly supresses bone cell metabolism and regeneration. That is what they were made to do. The drug company didn't bother to worry about the long term effect of suppressing natural bone function because the short term and mid term effect was big $$$$$$$.
March 25, 2010 - 12:35pmIt would actually be more suprising if these drugs DIDN'T cause more dead bones and femur fractures over time. Frankly,my guess is they know darn good and well that this drug is causing an increase in fractures, but they figure that even if the science makes a causal link, it will be a small enough group that they can handle the financial hit.
My thoughts on the pending litigation. The current 900 cases are related to osteonecrotic jaw (ONJ). From a purely strategic standpoint, Merck will stand behind the claim that ONJ can be caused by many things and is most often precipitated by Oral surgery and dental work. This will probably be enough plausible deniability for them to fend off the mass tort. I have read a blog written by one of their defense lawyers already making fun of the poor dental hygiene of one of the plaintiffs whose case was dismissed. Keep snickeringJames Beck at Medical Device and Drug Law blog. Pretty immature and imprudent for a Princeton educated lawyer. Here's why: Atypical Femur fractures in women taking Fosamax have fewer alternative explanations than the ONJ cases. Furthermore, what I've read indicates that these Fosamax fractures are amazingly consistent. They may be able to create plausible deniability when its only X-rays and retrospective medical records....but how about if/when doctors start doing tissue biopsies on the bones? That will be a tougher spot to squirm out of. If that ever happens, the specter of hundreds or thousands of women in front of juries detailing the excrutiating pain and the expert witnesses detailing the tell tale signs of dead bone will make their defense lawyers pull out their calculators in earnest. Those X-rays and the stories of spontaneous fracture and pain will RESONATE hard with a jury, and they know it.
March 25, 2010 - 12:52pmThank you all for your comments and support of what I know is right. The New England Journal of Medicine offered an article yesterday, which when one knows who the people are behind the study, is pure balderdash! The study was done by those who have direct ties to the drug companies making bisphosphonates! Depressing isn't it? Such highly publicized articles certainly brings down the reputation of this prestigious medical journal! I am glad to say that those who are in my support group, though initially felt like they had been slapped (hard) in the face, and once again knocked to the ground, bounced up again and wrote letters to the author. After all, you can not survive broken femurs and not have some "bounce" left in your attitude!! I hope anyone and everyone who might read this, will pass along the word, that these drugs are bad news, yesterday, today and tomorrow! Vicki
March 26, 2010 - 6:27amVicki,
September 29, 2011 - 5:45pmMy mom has also suffered from 2 femur fractures due to Fosamax. The first in 2005 and the second in November 2010. Unfortunitely, instead of putting a rod in in November they put a plate in. The plate snapped in half in April of this year and she rebroke it again. When undergoing surgery this time they put a rod in. It has been a terrbile, long journey for her. She has chronic pain and still is forced to walk with a cain. Her walk is very wobbley. She went back to the doctor yesterday (she goes every 6 weeks) and there is no indication of healing on one side of the bone. The doctor is sending her for a cat scan next week. He is saying she may need to AGAIN undergo surgery and have another rod put in. She is really having a rough time with all of this and of course doen't want to go thriugh yet another surgery. She has been looking for a support group, but can't find one. I told her I would do some research and see if I can't help locate one for her. I saw the email addess jennifer@jenniferschneider.com. I was wondering if this is an online support group or locally where you live. We live near Dayton, Ohio. If you could email me some information I would greatly appreciate it! mkecken@yahoo.com
Thanks!
Megan
A recent NEJM article by Dennis Black MD denying a link between Fosamax and spontaneous mid-femur fractures has many doctors raising their eyebrows. Firstly, there is the problem of conflict of interest. The study was funded by Fosamax maker, Merck, and the authors are all on Merck's payroll. Secondly, the results of Dr Dennis Black contrast with the many reported case series on Fosamax induced spontaneous femur fractures from Joseph Lane, Odvina and Goh (and many others). Dr Black's results run counter to the experience of the medical community. Physicans are seeing and reporting more cases of atypical femur fractures on Fosamax. We never saw these before the fosamax era.
Why do the results of Dr Dennis Black contrast with bone histology studies that show abnormal bone formation on Fosamax, reporting "microdamage accumulation and reduced some mechanical properties of bone".
Why are these spontaneous mid-femur fractures happening at all ? Doesn't this indicate a severe problem with the underlying bone physiology? The bisphosphonate drug is producing abnormal, pathological bone demonstrated on histology slides. Dr Black's report does not address this question.
What about reports of a link with Osteonecrosis of the Jaw, another example of fosamax disturbing bone physiology, making the bones weaker, not stronger. Dr Black's report does not address this issue.
For More:
http://jeffreydach.com/2010/03/25/fosamax-whitewash-unconvincing-by-jeff...
jeffrey dach md
March 25, 2010 - 2:33pmAs this plays out, I think it will behoove people to consider things carefully from a business and strategic perspective as well as a medical perspective. I have no idea what the scientists at Merck know or believe in their hearts, but I have a pretty good feel for what their executives and defense council know and feel in their bonus checks. Their position on Fosamax will not change slowly, if it changes at all. It will change in one fell swoop when the economics of standing foursquare behind it and propping up ther science are no longer feasible or financially more profitable than a more legal approach to dealing with the issue.
In other words, they could be very well aware that their drug sucks and can cause catastrophic damage to a few unlucky people, and simply not care as long as there is plausible deniability or small potential legal exposure relative to the revenue it produces. I'm a cynic, but my experience has been that morality and ethics are things executives can afford to be concerned with AFTER they hit their numbers.
As long as they can muddy the waters amongst prescribing physicians, even a few percentage points in market share is more than the entire 40 million set aside for defense. Understanding their economics will be key to making sense of any actions or science that doesn't seem to be completely logical or credible.
March 25, 2010 - 3:13pmLike Vicki, I am waiting surgery for rods to be inserted. Unlike her, I have only the stress fractures in both legs, not the complete break. A 63 year old, I have had thigh pain for over a year, and have been to 5 doctors (4 orthopedists, my PCP and an oncologist). After a nuclear bone scan, I spent anxious weeks thinking cancer had returned, since I am a17 yr. cancer survivor. I estimate that my insurance and I have spent $40,000 so far trying to uncover the cause of my pain. Two weeks before the ABC Frontline segment, I did a Google search, discovering the link betweem Fosamax and femur fracture. My doctors didn't believe me. Thank goodness for the support group, and ABC for sticking with the story. My last orthopedist is one who treated one of my "femur sisters", in a nearby town. And, my PCP has allowed me to take a Fosomax "holiday". I will make sure that a sample of my bone will studied, as this seems to be the "evidence" we need. BTW, I have been taking the drug for 7 years--for osteopenia, created artificially at 47 with a hysteroctomy.
March 26, 2010 - 5:35amI broke my Femurs three time and a shadert ankle. I take Fosomax since 1991. And I fal on the ground like you. Thank you, know I now
May 11, 2010 - 6:49pmI am not the only one.The doctors gave me tat feeling!! (sorry my English is poor)