Staying Strong, Sitting Pretty
In the prime of her life, Sally Field has learned the importance of being aggressive about her health.
Written by Chris Mann
Turning the tide on her own bone loss Sally Field has learned the importance of being aggressive about her health. Her message to women: Take control, and “treat yourself with value.”
As the sands sift unfailingly through the hourglass, the eternally buoyant Sally Field has
succeeded at accomplishing something even her iconic Flying Nun and crest-riding Gidget couldn’t: slowing and reversing the ravages of time. Not thanks to the Hollywood-prescribed cocktail of Botox injections and facelifts that have befallen too many of her seasoned contemporaries. Instead, the Oscar- and Emmy-winning actress, gracefully aging at 62, has discovered that the key to maintaining her stature in her all-too-human struggle to slow the effects of time is, well, literally maintaining her stature.
The star of the hit ABC drama “Brothers and Sisters” discovered she was a prime candidate for bone loss months shy of her 50th birthday. Her doctor ordered bone-density tests during her annual physicals. After being diagnosed with osteoporosis 10 years later, Field began taking the prescription pill Boniva once a month. Today the vigorous mother of three grown sons juggles double duties as a bone-health advocate and “Brothers and Sisters” family matriarch, Nora Walker. Here, Field begins a long day on the set by telling Great Health readers about her osteoporosis journey, and an active and emotionally enriched life lived with the zest of that beach-bound teenager who first connected with TV audiences more than 43 years ago.
GH: For more than four decades you’ve been the face of the all-American modern girl and liberated woman. Now, you’re the face of bone health and living an active life after 60.
Sally Field: I was diagnosed a number of years ago with osteoporosis, and I didn’t really know what it was, but I have a really good doctor who kept me informed in my late 40s and into my 50s that I was a prime candidate to get osteoporosis. When I did, I was contacted by Roche and GSK to bring about an awareness campaign for women about the dangers of osteoporosis and the epidemic level it’s on.
One out of two women over 50 will experience an osteoporosis-related fracture sometime in their lives. It’s kind of staggeringly dangerous. I’ve been so enriched to travel with this program—I’ve traveled all over the country speaking to large groups of women. It’s been a remarkable opportunity for me.
GH: You also offer health tips on the community-oriented “Rally with Sally” Web site BoneHealth.com. What does it mean to you to pass on your advice and knowledge?
SF: I feel good about it, because I know when I was entering this part of my life, I just felt there wasn’t enough information for me to understand what was happening, and how I should stay healthy and take care of myself.
Our baby boomer generation is different from the generation before us, not only because the whole world has changed and health care has changed, but I don’t think we want to just stand by and be patted on the head and told, “That’s what it’s like when you get older, honey.” You don’t have to be that little bent-over woman. You don’t have to experience a hip fracture or, God forbid, a fracture of the spine. This is one of the things you can actually treat successfully and stay upright the rest of your life.
Older women have so much important information to give to their children, their grandchildren, their communities and the world. It’s so incredibly important that they stay healthy and positive in themselves to do that.
GH: I understand your mom, who’s in her 80s, moved into your home recently. How is she doing?
SF: She’s really doing great. But, again, hers is the generation that just sort of takes whatever they are told and wants to be a good patient and really not question anything. I think that’s the behavior that is changing. I think that all people—men and women, young and old—have to go to their health-care provider armed with information. Until we get a health-care system that works better than the one that we have now, you really can’t put your life or your destiny in anybody else’s hands.
GH: What proactive and/or preventive measures do you encourage women to take in securing bone health as they hit middle age?
SF: Our Web site tries to provide information for women about what they’re looking for—what osteoporosis is, how you might take care of yourself. It’s really encouraging women to ask for and demand bone-density tests. It’s infuriating to many people that a lot of health-care plans don’t include bone-density tests. Insurance companies won’t pay to give these tests to women under the age of 50. Well, I needed those bone-density tests even before age 50. I was such a prime candidate, and my doctor needed to have a baseline understanding of where my bones were and to watch where they were going to end up. I feel strongly that coming in and being armed with information is just essential today.
We still live in an environment that doesn’t pay as much attention to prevention as it does to caring for you after it’s too late. For instance, $18 billion in this country is spent in osteoporosis-related expenses. In other words, once you get a fracture, the cost of taking care of that fracture—for nursing care, hospital care, whatever it might be—is $18 billion of unnecessary expenses. The cost of getting bone-density tests and being treated is so much less.
GH: You were diagnosed first with osteopenia?
SF: Yes, osteopenia is the condition right before osteoporosis. That’s when the patient or the health-care provider would know to be watching out for you and looking out for other things. For instance, are you getting enough calcium? Is your body absorbing vitamin D? Are you getting exercise? Are you eating right? Do you smoke—and if you do, you should stop for many reasons, certainly for bone health. Before you progress to osteoporosis, you should look at all of these things.
If you’re being treated for anything, a pharmaceutical should be the last resort. All of these other things should first be tried. But with osteoporosis, even if you eat right all of your life, even if you take calcium, and you exercise and do all of these things right, chances are if it’s in your genetic makeup, you might hold it off for awhile, but eventually you are probably going to get it. But if you are diagnosed with it, it can be very, very effectively treated. You have to take that treatment seriously, and you have to take it for the rest of your life.
GH: How does osteoporosis connect with menopause?
SF: It goes hand-in-hand with premenopause, postmenopause—all of that goes together. It connects very closely with a lot of health issues for women. The loss of hormones in your body quite obviously affects bone turnover. Bone is a living thing, like tissue, in that it keeps itself healthy by replenishing itself. Your body sheds bone and rebuilds bone. When you reach a certain age, your hormone levels, including estrogen, change, and you begin to lose more bone than your body can build. Depending on how much bone you’re losing and how dense your bones are to begin with, your bones can get to such dangerously thin levels that they’re like wet chalk. And you could experience a fracture of your hip or your thigh just by sitting back on a park bench or picking up a bag of groceries.
I got my first bone-density test in my late 40s—primarily because I was such a prime candidate: I was small, Caucasian, I have it in my family history. But it is a silent disease. Even though you may not be small and Caucasian, you may very well still have osteoporosis. And 20% of the diagnosed cases are men.
GH: Who is at risk for osteoporosis?
SF: You can be at risk if you take certain medications that can lead to calcium and mineral depletion. If you are taking a treatment for a cancer, for instance, no matter what age you are, you could lose bone density.
GH: How can children help their older moms maintain bone health?
SF: The greatest thing you can do as a loving child of an older woman is to urge her to get a bone-density test. Urge her to know what’s happening and, when she chooses a treatment, to stick with it.
GH: Does the “Brothers and Sisters” production schedule make you an early riser?
SF: I’m always up in the morning and moving. I’m not at the set right now, but I will be later.
GH: So you’re used to being active from the early morning till you go to bed?
SF: Yes, that’s pretty much my life. One of my problems is I don’t know how to sit still. (Laughs.)
GH: What are some more ways that children help their older mom’s bone health?
SF: Help them be sure that their calcium level is what it should be, they’re getting vitamin C, and even be getting a little bit of sun. Get a little bit of unprotected sun exposure, like 10 minutes a couple of times a week, perhaps on your legs. We’re so worried about skin cancer—we have hats and long-sleeved shirts, we’re slathered with sunscreen—that we’re not getting enough healthy sun to absorb calcium and vitamin C. We should eat right—and that means a lot of dark, leafy greens. We have recipes on the Web site for calcium-rich meals. You should also be exercising. But you should be doing all of these things anyway. All of these things affect your blood pressure, your cholesterol and your heart health.
If you smoke, stop right this second; as hard as it is, you have to. And don’t drink to excess. Those are the things before you are diagnosed with osteoporosis that you might do to stave it off.
But once you’re diagnosed, there’s no amount of calcium you could take that would bring the bones back to a healthy state. Only with some sort of treatment can you bring your bones back to a healthy condition.
GH: Many people are struck by how you’ve aged so gracefully in Hollywood’s plastic-surgery-obsessed culture. What does that say to other women about being comfortable in your skin at any age?
SF: I’m just trying to live my life in a way that feels respectful to myself. I’m not thinking about what I may be teaching anyone; I’m just trying to make it through myself. (Laughs.)
GH: Why is it vital for a mature woman, especially a family caregiver, to be in touch with and tend to her emotional health?
SF: It’s always important to stay in contact with what’s going on with yourself emotionally. That can make you as sick as if you’re in a room full of contagious children. You have to always ask yourself, “What’s happening to me now? What am I feeling about myself and my life right now?” There are bazillions of books and things you can pick up to understand more about your emotional life.
GH: Would you like to see your character of Nora Walker deal with any of the health challenges you and other 60-plus women have conquered?
SF: Not right now. Too many times Hollywood portrays older women or women in their 60s as frail and sick and falling down. And I just don’t think that’s true. I think our generation of women is just as vigorous and robust as their children in a lot of ways. I just think you have to be aggressive to stay that way.
Suzy Cohen, P.Ph
Bone Building Drugs: Bisphosphonates
Examples: Fosamax, Fosavance, Aclasta, Boniva, Didronel and Actonel
These extremely popular medications belong to a class of drugs known collectively as “bisphosphonates.” They are approved for use in the United States, Canada and more than 60 other countries to prevent or treat osteoporosis, the loss of bone density, or simply put, the crumbling of bones that leads to kyphosis, fractures of the spine, broken bones and hip fractures. You see these medications prescribed primarily to post-menopausal women who are at higher risk for bone loss (due to waning estrogen levels). On occasion, these drugs are given to men. They are also prescribed to people who take steroid meds, which cause bone brittleness. Guess why? Because steroids are drug muggers of your minerals, especially calcium and magnesium. See Chapter 16 & 17.
Nevertheless, bisphosphonates work by taking up residence right on the surface of your bones. They sit in the doorway of your bone cells and slow down the process of bone erosion. The mechanism is complicated, but essentially their presence allows bone-building cells (osteoblasts) to work more effectively.
You must take these drugs on an empty stomach, first thing in the morning with plenty of water because they’re really hard on the gut and can damage or create an ulcer in the delicate lining of the esophagus. Don’t even lie down after you take the medicine for at least 30 minutes, or the drug could harm your esophagus.
There is some research that suggests these medications may cause bone death in the jaw (termed osternecrosis), however, drug makers say that it’s too early to conclude this is related to their medicine. The possibility of severe musculoskeletal pain is well-documented. Drug makers got their hands slapped by the FDA in 2004 and were made to update their product labeling to make known this painful and serious side effect. But the problem is that people don't often make the connection of muscle pain to their bone-building drug. Bone-builders ironically mug the body's bloodstream of calcium and this deficiency causes muscle pain and cramping. And, doctors may overlook the drug mugging effect too. What does this mean? It means that many caring physicians will simply give you a new medication to relieve the leg cramps or muscle pain because the underlying cause of the discomfort gets overlooked. Here’s what you need to know if you must take these medications:
Iron supplements: Another type of “cation” which grabs hold of your medicine, reducing drug levels, just like calcium above. Take 2 hours away from your medicine.
Antacids: Because they often contain calcium or magnesium which affects absorption of the medication. Separate by at least 2 hours prior to, or after taking the bone drug.
