THE BEST AND WORST OF MY MOTHER’S LEGACY RECOGNIZING NATIONAL OSTEOPOROSIS MONTH AND MOTHER’S DAY

*This post is part of a paid collaboration between myself and Amgen. The content reﬂects my own personal opinions.

It wasn’t until quite recently, while writing my memoirs, that I suddenly realized how much I’ve inherited from my mother. My love of fashion, the way I walk, my disdain for the color green, and my ability to live life very much in the moment, are all things that were gifted to me as her daughter. While we grew up to be vastly diﬀerent women, there is no mistaking the genetic link that connects us in so many obvious, yet subtle ways.

My mother was beautiful and adventurous. She commanded attention whenever she walked into a room. There was just an aura about her that people found intoxicating and mysterious. She was always in motion and larger than life. As she aged, her ability to live in the moment never faded. It was one of her most interesting qualities, but it also meant that she was always on the go and rarely thought about her health or took notice of the small physical changes that should have been early warning signs to other people. She rarely exercised, yet she seemed strong, agile and ageless, until she wasn’t. All it took was an unexpected twist of an ankle for her entire life to change. When she lost her balance, her sudden fall left her with a fractured hip. While she eventually recovered, she was never truly the same again. It only took one moment for her sense of invincibility to be shattered. It was a lesson that stayed with me. I was wary of repeating her mistake, so I committed myself to exercise. I knew weight training was part of maintaining bone density, so I went all in.¹ I thought solid lifestyle choices would protect me from following in my mother’s footsteps, but I was wrong. I severely underestimated the role that genetics play in our lives. I failed to realize the physical predispositions mothers often pass down to their daughters.

When I was in my mid-forties, my general practitioner sent me for a DXA scan, leading to a diagnosis of osteoporosis. The news came as quite a shock to me because I felt great and was physically active. Although I was going through menopause at the time, I hadn’t experienced any symptoms, so the diagnosis was completely unexpected. What I didn’t realize was that osteoporosis is commonly referred to as a ‘silent disease’ because you can’t feel your bones weakening.² In fact, 80% of people go undiagnosed and untreated even after breaking a bone, and after a fracture, postmenopausal women are ﬁve times more likely to break another bone within a year.^3,4

My doctor later explained to me that I was at high-risk for fracture for a number of reasons. Not only are postmenopausal women at a greater risk for osteoporosis, other risk factors can include low body weight, low calcium intake, vitamin D deﬁciency, excessive alcohol intake (>3 drinks/day), and having a parent who has had a hip fracture.^5,6 Unfortunately I ticked a lot of those boxes, so the numbers were not in my favor from the get-go.

Sadly, the statistics show that approximately one in two women over the age of 50 in the U.S. will break a bone because of osteoporosis.⁷ I’ve been very fortunate because I haven’t broken any bones, but ever since my diagnosis I’ve been more cautious with certain activities. While I’ve made minor adjustments to the way I do a few things, I attribute my good health to the speciﬁc lifestyle choices I have made in order to keep this disease under control.

I’ve previously shared my osteoporosis journey in a few of my other blog posts that describe how I’ve managed my osteoporosis care during the pandemic, and the way that nutrition has played a signiﬁcant role in my ability to manage my condition. You can also watch my Facebook Live discussion here, where I discuss my osteoporosis journey and my path to treatment with an every 6-month injection of Prolia® (denosumab), which is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture. Do not take Prolia® if you have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®. Please see additional Prolia® Important Safety Information below.

My journey with osteoporosis has been a long one that has spanned over 40 years. After trying numerous other medications over the years, Prolia® worked for me and has not only managed to control my bone density loss but has actually improved it. While Prolia® worked for me, it’s important to talk to your doctor about what treatment may be best for you.

Thankfully, my condition was detected early on which has allowed me to manage it successfully. If I hadn’t caught it early, I think it would probably have been a vastly diﬀerent story. Which is why I’m partnering with Amgen to share information about getting a bone density test (DXA scan) and the process for doing so. I want to encourage postmenopausal women to ask their doctors about their osteoporosis risk factors and request a DXA scan.

I know we’re all busier than ever before, and there never seem to be enough hours in the day, but we have to make the time to maintain our health. As we celebrate Mother’s Day and recognize National Osteoporosis Month in the month of May, now is a great time to commit to self-care. Wellness isn’t something that just happens to us, it’s something that we have to work on and make a priority. That means making the time for a DXA scan to check bone density levels. Yes, I know that sounds scary, especially given all of the uncomfortable healthcare tests we women have to endure. However, let me put your fears to rest. I was surprised to ﬁnd that the DXA scan was a much easier process than I had expected. It is a non-invasive, painless test that only takes about 15 minutes.⁸You can even wear athleisure wear to the test, since you don’t have to remove your clothes during the scan. Just avoid pants with zippers.⁸

As someone who suﬀers from anxiety, I can assure you that getting a DXA scan is an absolute breeze. Taking care of your bones is such a beautiful gift to give to yourself, as well as your family. So this Mother’s Day, please share this information with the wonderful women in your life.

ABOUT PROLIA®

The medication, Prolia®, also known as denosumab, was discovered and developed by Amgen. Prolia® was approved 10 years ago by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal women with osteoporosis at high risk for fracture.^9,10
Prolia® is given as one shot every six months by a healthcare professional, taken along with calcium and vitamin D.⁹
Prolia® is proven to reduce the risk of fractures and help strengthen bones in postmenopausal women with osteoporosis.⁹

After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Do not stop, skip or delay taking Prolia® without ﬁrst talking with your doctor.

For more information go to: prolia.com

PROLIA® INDICATION AND IMPORTANT SAFETY INFORMATION

Indication

Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines did not work well.

Important Safety Information

Do not take Prolia® if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®.

What is the most important information I should know about Prolia®?

If you receive Prolia®, you should not receive XGEVA®. Prolia® contains the same medicine as XGEVA® (denosumab).

Prolia® can cause serious side eﬀects:

Serious allergic reactions have happened in people who take Prolia®. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of your face, lips, or tongue; rash; itching; or hives.

Low blood calcium (hypocalcemia). Prolia® may lower the calcium levels in your blood. If you have low blood calcium, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia®.

Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.

Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia® and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia®.

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Increased risk of broken bones, including broken bones in the spine, after stopping, skipping or delaying Prolia®. Talk with your doctor before starting Prolia® treatment. After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip or delay taking Prolia® without ﬁrst talking with your doctor. If your Prolia® treatment is stopped, talk to your doctor about other medicine that you can take.

Serious infections in your skin, lower stomach area (abdomen), bladder, or ear may happen. Inﬂammation of the inner lining of the heart (endocarditis) due to an infection may also happen more often in people who take Prolia®. You may need to go to the hospital for treatment.

Prolia® is a medicine that may aﬀect the ability of your body to ﬁght infections. People who have weakened immune systems or take medicines that aﬀect the immune system may have an increased risk for developing serious infections.

Skin problems such as inﬂammation of your skin (dermatitis), rash, and eczema have been reported.

Bone, joint, or muscle pain. Some people who take Prolia® develop severe bone, joint, or muscle pain.

Before taking Prolia®, tell your doctor about all of your medical conditions, including if you:

Take the medicine XGEVA® (denosumab)
Have low blood calcium
Cannot take daily calcium and vitamin D
Had parathyroid or thyroid surgery (glands located in your neck)
Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)
Have kidney problems or are on kidney dialysis
Are taking medicine that can lower your blood calcium levels
Plan to have dental surgery or teeth removed
Are pregnant or plan to become pregnant

Females who are able to become pregnant:

Your healthcare provider should do a pregnancy test before you start treatment with Prolia®.
You should use an eﬀective method of birth control (contraception) during treatment with Prolia® and for at least 5 months after your last dose of Prolia®.
Tell your doctor right away if you become pregnant while taking Prolia®.
Are breast-feeding or plan to breast-feed

What are the possible side eﬀects of Prolia®?

It is not known if the use of Prolia® over a long period of time may cause slow healing of broken bones. The most common side eﬀects of Prolia® are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side eﬀects of Prolia®. Call your doctor for medical advice about side eﬀects.

You are encouraged to report negative side eﬀects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see accompanying Prolia® full Prescribing Information, including Medication Guide.

REFERENCES:

1. National Osteoporosis Foundation. Osteoporosis Exercise for Strong Bones. https://www.nof.org/patients/treatment/exercisesafe-movement/osteoporosis-exercise-for-strong-bones/. Accessed March 16, 2021.

2. National Osteoporosis Foundation. What is Osteoporosis and What Causes It? https://nof.org/patients/what-is-osteoporosis. Accessed March 16, 2021.

3. Nguyen TV, Center JR, Eisman JA. Osteoporosis: underrated, underdiagnosed and undertreated. Med J Aust. 2004;180:S18-S22.

4. van Geel TA, van Helden S, Geusens PP, Winkens B, Dinant GJ. Clinical subsequent fractures cluster in time after ﬁrst fractures. Ann Rheum Dis. 2009;68:99-102.

5. Camacho PM, Petak SM, Binkley N, et al. American Association Of Clinical Endocrinologists/American College Of Endocrinology Clinical Practice Guidelines For The Diagnosis And Treatment Of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46.

6. Cosman F, de Beur SJ, LeBoﬀ MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis [published correction appears in Osteoporos Int. 2015 Jul;26(7):2045-7]. Osteoporos Int. 2014;25(10):2359-2381.

7. U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Oﬃce of the Surgeon General, 2004.

8. National Osteoporosis Foundation. Bone Density Exam Testing.

https://www.nof.org/patients/diagnosisinformation/bone-density-examtesting. Accessed March 16, 2021.

9. Prolia® (denosumab) prescribing information, Amgen.

10. Prolia® (denosumab) FDA approval letter. June 1, 2010.

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OSTEOPOROSIS, DIET AND NUTRITION: HOW I MAKE HEALTHY CHOICES DURING A PANDEMIC

This post is part of a paid collaboration between myself and Amgen. The content reflects my own personal opinions.

It seems as though everyone is comfort eating these days. Clearly the pandemic has changed us, especially our relationship to food. Even those of us who were committed to healthy eating during normal times seem to have fallen off the wagon into an abyss of ice cream and chocolate-covered donuts. Comfort eating hasn’t just taken a physical toll, but a psychological one as well. When we eat poorly, we often spend an inordinate amount of time afterwards silently berating ourselves for not taking better care of our bodies. For some of us, it’s a daily struggle to find a delicate balance between eating what we love and eating well.

Let’s face it, many women have a complicated relationship with food. We view it as friend and foe. We recognize that eating a well-balanced diet is essential to maintaining good health, yet we often fail to nourish our bodies properly, especially in times of stress. Instead, we turn to unhealthy food for comfort, then to trendy, fad diets to take off the unwanted pounds. It’s an endless cycle that, for many of us, lasts a lifetime. For many women, our complicated relationship with food really seems to be rearing its ugly head right now.

As a professional model, I have gone through endless periods of binge eating and excessive dieting. I spent decades eating poorly in an effort to maintain a slim figure. The end result was that I was excessively thin, starving my body of nutrients my bones needed, which is one of the risk factors I had for osteoporosis.^1,2 I’ve previously shared my osteoporosis journey on my blog, as well as how I’ve been managing it during the pandemic. During National Nutrition Month that has taken place throughout March, I want to shed extra light on how important nutrition is to maintaining strong bones.³

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both.4 An unhealthy diet can lead to deficiencies in calcium and vitamin D which are risk factors for osteoporosis.^1,2While we all know that good nutrition is key to maintaining our health and an ideal weight, there are many reasons that women fail to nurture their bodies and remain in a cycle of unhealthy eating. It’s not just what we eat, but how we are being taught to interact with food on a daily basis.

I’ve found that these days, it’s difficult to flip through a magazine or log onto social media without seeing the latest celebrity weight loss story and the extreme diet she used to achieve those impressive results. There are also a myriad of trendy diets circulating through the media at any given time that aim to convince us that limiting certain food groups is the solution to all of our health challenges.

So, who do we listen to? Celebrities? The health and fitness “experts” on social media? The answer is your doctor. At the end of the day, medical professionals are the best source of health and wellness information, rather than the trendy health and fitness gurus we see in the media.

Most importantly, we need to recognize that these are challenging times, so I hope you continue to be kind to yourself and set realistic goals by adopting sustainable habits that support your general well-being. Broken bones from osteoporosis can have a devastating impact.5 Our bones give our bodies shape and support and protect our internal organs – so we must protect our bones, too.6 It’s essential that we make a concentrated effort to keep our bones strong and minimize the risk factors of osteoporosis by eating a well-balanced diet rich in calcium and vitamin D.³

While very few of us have a lot of excess time or energy to food prep right now, here’s the good news: it’s not complicated or time consuming to choose nutrient-dense foods like dairy, fruits and vegetables that support bone health.³ As a matter of fact, what could be simpler than whipping up a delicious cheese board or a quick tuna niçoise salad? I try to incorporate good-for-your-bones foods such as salmon, tuna, mushrooms, cheese, and Vitamin D-fortified foods like milk and cereal into my daily diet.³ These foods are not only good for my bones, but they also help me maintain a healthy weight. You can find a list of calcium-rich foods here.

After many years of fad dieting that wrecked my health and may have even contributed to my bone loss, I have finally found a way to eat that keeps my bones strong and also keeps my weight in check. While I still indulge in donuts now and again, I have now stopped the never-ending cycle of extreme dieting that undermined my health and deprived me of essential vitamins and nutrients.

I’ve previously mentioned that in addition to taking care of my bones with exercise and nutrition, I’ve been taking Prolia® (denosumab) since 2019. Prolia® is a prescription medicine used to treat osteoporosis in women after menopause who are a high risk for fracture.

Do not take Prolia® if you have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®. Please see additional Prolia® Important Safety Information below.

To read more about my osteoporosis journey and experience with Prolia®, click here.

ABOUT PROLIA®

• The medication, Prolia®, also known as denosumab, was discovered and developed by Amgen. Prolia® was approved 10 years ago by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal women with osteoporosis at high risk for fracture.^7,8

• Prolia® is given as one shot every six months by a healthcare professional, taken along with calcium an vitamin D.⁷

• Prolia® is proven to reduce the risk of fractures and help strengthen bones in postmenopausal women with osteoporosis.⁷
For more information go to: prolia.com

PROLIA® INDICATION AND IMPORTANT SAFETY INFORMATION

Indication

Important Safety Information

What is the most important information I should know about Prolia®?

If you receive Prolia®, you should not receive XGEVA®. Prolia® contains the same medicine as XGEVA® (denosumab).

Prolia® can cause serious side effects:

Low blood calcium (hypocalcemia). Prolia® may lower the calcium levels in your blood. If you have low blood calcium, it ma y get worse during treatment. Your low blood calcium must be treated before you receive Prolia®.

Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bones. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Increased risk of broken bones, including broken bones in the spine, after stopping, skipping or delaying Prolia®. Talk with your doctor before starting Prolia® treatment. After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip or delay taking Prolia® without first talking with your doctor. If your Prolia® treatment is stopped, talk to your doctor about other medicine that you can take.

Serious infections in your skin, lower stomach area (abdomen), bladder, or ear may happen. Inflammation of the inner lining of the heart (endocarditis) due to an infection may also happen more often in people who take Prolia®. You may need to go to the hospital for treatment. Prolia® is a medicine that may affect the ability of your body to fight infections. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk of developing serious infections.

Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported. Bone, joint, or muscle pain. Some people who take Prolia® develop severe bone, joint, or muscle pain.

Before taking Prolia®, tell your doctor about all of your medical conditions, including if you:

Take the medicine XGEVA® (denosumab)
Have low blood calcium
Cannot take daily calcium and vitamin D
Had parathyroid or thyroid surgery (glands located in your neck)
Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption
syndrome)
Have kidney problems or are on kidney dialysis
Are taking medicine that can lower your blood calcium levels
Plan to have dental surgery or teeth removed
Are pregnant or plan to become pregnant

Females who are able to become pregnant:

Your healthcare provider should do a pregnancy test before you start treatment with Prolia®.
You should use an effective method of birth control (contraception) during treatment with
Prolia® and for at least 5 months after your last dose of Prolia®.
Tell your doctor right away if you become pregnant while taking Prolia®.
Are breast-feeding or plan to breast-feed

What are the possible side effects of Prolia®?

It is not known if the use of Prolia® over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia® are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side effects of Prolia®. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see accompanying Prolia® full Prescribing Information, including Medication Guide.

REFERENCES:

Camacho PM, Petak SM, Binkley N, et al. American Association Of Clinical Endocrinologists/American College Of Endocrinology Clinical Practice Guidelines For The Diagnosis And Treatment Of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46.
Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis [published correction appears in Osteoporos Int. 2015 Jul;26(7):2045-7 Osteoporos Int. 2014;25(10):2359-2381.
National Osteoporosis Foundation. Nutrition. https://www.nof.org/patients/treatment/nutrition. Accessed February 19, 2021.
National Osteoporosis Foundation. What is Osteoporosis and What Causes it? https://nof.org/patients/what-is-osteoporosis. Accessed February 19, 2021.
National Osteoporosis Foundation. General Facts. https://www.nof.org/preventing-fractures/general-facts/. Accessed February 22, 2021.
National Osteoporosis Foundation. Overall Health. https://www.nof.org/patients/treatment/overall-health/. Accessed February 22, 2021.
Amgen. Prolia® (denosumab) prescribing information, Amgen. pi.amgen.com. Accessed March 10,2021.
Amgen Prolia® FDA Approval Letter. June 2010.

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MANAGING OSTEOPOROSIS DURING A PANDEMIC: GET THE CARE YOU NEED FOR YOUR BONES

This post is part of a paid collaboration between myself and Amgen. The content reflects my own personal opinions.

My approach to my health and wellness has always been a proactive one. While so much emphasis is usually placed on the way we look on the outside, I have always been more obsessed with the way I feel. Do I feel well? Am I treating my body with the respect that it deserves? Because no matter how health conscious we may be, we are all guilty of neglecting ourselves, especially when life becomes hectic and stressful. Women are often juggling a hundred and one different responsibilities at the same time, so often our health ends up taking a back seat to everything else. We are the caretakers that often fail to take care of ourselves.

In the midst of this global pandemic, the world seems like it has turned upside down, and as a result, our daily routines have probably changed a lot. For most of us, it’s a real challenge to stay motivated when our stress levels may be higher than usual. Eating well and exercising might be the last things on our minds. I know, I hear you and I am right there with you. However, I cannot emphasize enough how important self-care is in times of crisis.

While it may seem counterintuitive, the last thing you need right now is to let any chronic diseases or issues go untreated. An example for me is osteoporosis. I was diagnosed with the disease 38 years ago and have made it a point to work with my doctor on managing my condition in order to prevent the disease from negatively impacting my life.

Our bones support us, protect our organs, and allow us to move, but when they become weak, they are more likely to break.^1,2 Osteoporosis is often called a silent disease because you can’t feel bones weakening.² Some people don’t even know they have this disease until after they break a bone.² Breaking a bone is not something we tend to think about when we are stuck indoors, but the reality is that falls resulting in broken bones can still happen inside the home.³ From 2000-2011, hospitalization due to osteoporotic fractures affected more women age 55 years and older in the US than heart attacks, strokes or breast cancer.⁴ I have only had to go to the hospital once in my life, for the birth of my daughter, and I don’t want a fall to bring me there a second time.

Right now, many older women who are social distancing may be hesitant to keep their regularly scheduled doctor’s appointments, or visit their doctor’s office, due to health and safety concerns. But it is so important to continue managing chronic diseases like osteoporosis. Osteoporosis is more prevalent in older women,⁵ who happen to also be in the same age group that according to the CDC seem to be at higher risk for developing more serious complications due to COVID-19. I get it. I have limited my time out in public spaces since the pandemic began, yet I knew it was really important to continue my osteoporosis treatment and see my doctor for my bi-annual Prolia® (denosumab) injection, which is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture. As my doctor has told me, Prolia® only works while I’m taking it. And if my Prolia® is stopped, skipped, or delayed, my risk for breaking bones, including bones in my spine, is actually increased. Do not stop, skip or delay taking Prolia® without first talking with your doctor.

Please see additional Prolia® Important Safety Information below.

I knew it was really important and something that I needed to do in order to keep my osteoporosis under control, but I had concerns about being in a public space during the pandemic. After much consideration, I called my doctor to discuss my concerns, which included being in a crowded waiting room and confined or small spaces with people outside of my household. We came up with a plan that I felt comfortable with. They kindly arranged for me to be seen at another location that had access to their offices on the first floor and arranged for me to wait in my car until I received a text that the doctor was ready to see me. We also talked through their protocols for wearing a mask, taking temperatures, and using hand sanitation at the doctor’s office.

When it was time for my appointment, I was met at the front door of the medical facility by a staff member who escorted me into a separate waiting area within my doctor’s office where I was able to wait alone, thereby avoiding any interaction with the other patients. That alone relieved a lot of my anxiety. A few minutes later I was escorted into the examination room, where my doctor promptly gave me the injection. From beginning to the end, my appointment only took 15 minutes.

My doctors have been incredibly supportive about accommodating my needs and patiently addressing my concerns so that my visits are well planned out, with minimal interaction with others. Their support has alleviated my fears and has inspired me to share my experience with other women. Now, more than ever, don’t let fear prevent you from taking steps to treat your chronic diseases. Hopefully, my experience can help inspire you to discuss a plan with your doctor to enable you to continue to get the care you need.

For more resources and tips or Prolia® specific questions, visit the Prolia® COVID-19 Resource Center
For more information on osteoporosis, National Osteoporosis Foundation

While social distancing will be approached differently depending on where you live and what your individual circumstances are, I would like to encourage you to find a way to stay connected to your healthcare providers. Aging well begins with a commitment to self-care. So please take care and stay safe!

ABOUT PROLIA®

The medication, Prolia^®, also known as denosumab, was discovered and developed by Amgen. Prolia^®was approved 10 years ago by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal women with osteoporosis at high risk for fracture.^6,7
Prolia^®is given as one shot every six months by a healthcare professional, taken along with calcium and vitamin D.⁶
Prolia^®is proven to reduce the risk of fractures and help strengthen bones in postmenopausal women with osteoporosis.⁶

For more information go to prolia.com

PROLIA® INDICATION AND IMPORTANT SAFETY INFORMATION

Indication

Prolia^® is a prescription medicine used to treat osteoporosis in women after menopause who are at high risk for fracture or cannot use another osteoporosis medicine or other osteoporosis medicines that did not work well.

Important Safety Information

Do not take Prolia^® if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia^® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia^®.

What is the most important information I should know about Prolia^®?

If you receive Prolia^®, you should not receive XGEVA^®. Prolia^® contains the same medicine as XGEVA^® (denosumab).

Prolia^® can cause serious side effects:

Serious allergic reactions have happened in people who take Prolia^®. Call your doctor or go to your nearest emergency room right away if you have any symptoms of a serious allergic reaction, including low blood pressure (hypotension); trouble breathing; throat tightness; swelling of your face, lips, or tongue; rash; itching; or hives.

Low blood calcium (hypocalcemia). Prolia^® may lower the calcium levels in your blood. If you have low blood calcium, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia^®.

Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.

Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia^® and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia^®.

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bones. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Increased risk of broken bones, including broken bones in the spine, after stopping, skipping or delaying Prolia^®. Talk with your doctor before starting Prolia^® treatment. After your treatment with Prolia^® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip or delay taking Prolia^® without first talking with your doctor. If your Prolia^® treatment is stopped, talk to your doctor about other medicine that you can take.

Prolia^® is a medicine that may affect the ability of your body to fight infections. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk of developing serious infections.

Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported.

Bone, joint, or muscle pain. Some people who take Prolia^® develop severe bone, joint, or muscle pain.

Before taking Prolia^®, tell your doctor about all of your medical conditions, including if you:

Take the medicine XGEVA^® (denosumab)
Have low blood calcium
Cannot take daily calcium and vitamin D
Had parathyroid or thyroid surgery (glands located in your neck)
Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)
Have kidney problems or are on kidney dialysis
Are taking medicine that can lower your blood calcium levels
Plan to have dental surgery or teeth removed
Are pregnant or plan to become pregnant

Females who are able to become pregnant:

Your healthcare provider should do a pregnancy test before you start treatment with Prolia®.
You should use an effective method of birth control (contraception) during treatment with Prolia® and for at least 5 months after your last dose of Prolia®.
Tell your doctor right away if you become pregnant while taking Prolia®.
Are breast-feeding or plan to breast-feed

What are the possible side effects of Prolia^®?

It is not known if the use of Prolia^® over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia^® are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side effects of Prolia^®. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see accompanying Prolia^® full Prescribing Information, including Medication Guide.

References:

National Institutes of Health. Bone Health for Life: Health Information Basics for You and Your Family. https://www.bones.nih.gov/health-info/bone/bone-health/bone-health-life-health-information-basics-you-and-your-family. Accessed December 16, 2020
National Osteoporosis Foundation. What is Osteoporosis and What Causes It? https://nof.org/patients/what-is-osteoporosis. Accessed November 23, 2020.
World Health Organization. A Global Report on Falls Prevention Epidemiology of Falls. https://www.who.int/ageing/projects/1.Epidemiology%20of%20falls%20in%20older%20age.pdf. Accessed November 23, 2020.
Singer A, Exuzides A, Spangler L, et al. Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc. 2015;90(1):53-62
National Osteoporosis Foundation. What Women Need to Know. https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/. Accessed November 23, 2020.
Amgen. Prolia® (denosumab) prescribing information, Amgen.
Amgen Prolia® FDA Approval Letter. June 2010.

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MY PERSONAL JOURNEY WITH OSTEOPOROSIS

At the age of 86, I have only stayed overnight in a hospital once, to give birth to my daughter. So I guess it’s not surprising that I’ve always considered myself a very healthy person. Working as a model meant that being physically fit was part of my job. I exercised daily, kept my weight in a healthy range for me, and made sure to get regular medical checkups, but in my 40s I received a surprising diagnosis: I had osteoporosis.

MISCONCEPTIONS ABOUT OSTEOPOROSIS

While many people think that osteoporosis only affects older people, it can actually occur earlier. In fact, I was diagnosed 38 years ago. At the time I was going through menopause, but I hardly noticed any symptoms – I was young and healthy, or at least I thought so. Osteoporosis is often referred to as a “silent disease” because bone loss can occur without symptoms.¹ In the U.S., one in two women over the age of 50 will experience an osteoporosis-related fracture in her lifetime.²

WHAT IS OSTEOPOROSIS?

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both.¹ As a result, bones become weak and more likely to break from a minor fall or, in serious cases, even a strong sneeze.¹ According to the National Osteoporosis Foundation, approximately 10 million Americans have been diagnosed with the disease placing them at increased risk for breaking a bone.³

OSTEOPOROSIS RISK FACTORS

There are many factors that put someone at greater risk for osteoporosis, including being postmenopausal, being 65 years of age or older, having a parent who had a hip fracture, cigarette smoking, Vitamin D deficiency, excessive alcohol intake (defined as more than 3 drinks/day) and low calcium intake.^4,5 In addition to being postmenopausal, my life as a model revolved around avoiding food, and like many young women, I was at times obsessed with keeping my weight down. Unfortunately, low body weight can lead to vitamin deficiencies that cause bone health issues.

GETTING THE RIGHT TREATMENT FOR ME

There is no cure for osteoporosis, but it can be treated with diet, exercise and medication, when appropriate.² After talking with my doctor and getting a DXA (bone) scan, I made some major lifestyle changes. For the last nearly 40 years I have been committed to successfully managing my condition in order to prevent the disease from negatively impacting my life. At this point, it has become second nature. That has meant eating a well-balanced diet, taking vitamin D and calcium supplements recommended by my doctor and doing low weight-bearing exercise. Unfortunately, diet and exercise were not enough on their own to improve my bone density, and I required medication as well. Throughout the years I have been prescribed a few different medications, but the one that has been most effective has been Prolia® (denosumab).

APPROVED USE:

IMPORTANT SAFETY INFORMATION:

Do not take Prolia® if you: have low blood calcium; or are pregnant or plan to become pregnant, as Prolia® may harm your unborn baby; or are allergic to denosumab or any ingredients in Prolia®.

For me Prolia® has been a real game-changer because it has not only managed to control my bone density loss, it has actually improved my bone density. People may react to medications differently and should discuss their options and medical history with their doctor in order to make the best decision for themselves. Looking back on my osteoporosis journey I’m really glad I discussed my concerns with my doctor as getting diagnosed and on a plan early may be why I have been so lucky and haven’t broken any bones.

October 20th is World Osteoporosis Day and the perfect moment to take the time to educate yourself and talk to your doctor about a bone health plan, including possible treatments that could be available to you. Here are some helpful resources:

– Prolia

– National Osteoporosis Foundation

– American Bone Health

– World Osteoporosis Day

You can also join me on Tuesday, Oct. 20 at 10:00 am PT / 12:00 pm CT / 1:00 pm ET for a panel discussion with Amgen, who is sponsoring this post and giving me the opportunity to talk more about my osteoporosis diagnosis and treatment experience. Click here for more information.

*This post is part of a paid collaboration between myself and Amgen. The content reflects my own personal opinions.

ABOUT PROLIA®

• The medication, Prolia®, also known as denosumab, was discovered and developed by Amgen. Prolia® was approved 10 years ago by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal women with osteoporosis at high risk for fracture.6

• Prolia® is given as one shot every six months by a healthcare professional, taken along with calcium and vitamin D.6

• Prolia® is proven to reduce the risk of fractures and help strengthen bones in postmenopausal women with osteoporosis.6

For more information go to prolia.com

PROLIA INDICATION AND IMPORTANT SAFETY INFORMATION

Indication

Important Safety Information

What is the most important information I should know about Prolia^®?

If you receive Prolia^®, you should not receive XGEVA^®. Prolia^® contains the same medicine as XGEVA^® (denosumab).

Prolia^® can cause serious side effects:

Low blood calcium (hypocalcemia). Prolia^®may lower the calcium levels in your blood. If you have low blood calcium, it may get worse during treatment. Your low blood calcium must be treated before you receive Prolia^®.

Take calcium and vitamin D as your doctor tells you to help prevent low blood calcium.

Severe jaw bone problems (osteonecrosis) may occur. Your doctor should examine your mouth before you start Prolia^®and may tell you to see your dentist. It is important for you to practice good mouth care during treatment with Prolia^®.

Unusual thigh bone fractures. Some people have developed unusual fractures in their thigh bone. Symptoms of a fracture include new or unusual pain in your hip, groin, or thigh.

Increased risk of broken bones, including broken bones in the spine, after stopping, skipping, or delaying Prolia^®. Talk with your doctor before starting Prolia^® treatment. After your treatment with Prolia^® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine. Do not stop, skip, or delay taking Prolia^® without first talking with your doctor. If your Prolia^® treatment is stopped, talk to your doctor about other medicine that you can take.

Prolia^®is a medicine that may affect the ability of your body to fight infections. People who have weakened immune systems or take medicines that affect the immune system may have an increased risk of developing serious infections.

Skin problems such as inflammation of your skin (dermatitis), rash, and eczema have been reported.

Bone, joint, or muscle pain. Some people who take Prolia^® develop severe bone, joint, or muscle pain.

Before taking Prolia^®, tell your doctor about all of your medical conditions, including if you:

• Take the medicine XGEVA^® (denosumab)

• Have low blood calcium

• Cannot take daily calcium and vitamin D

• Had parathyroid or thyroid surgery (glands located in your neck)

• Have been told you have trouble absorbing minerals in your stomach or intestines (malabsorption syndrome)

• Have kidney problems or are on kidney dialysis

• Are taking medications that can lower your blood calcium levels

• Plan to have dental surgery or teeth removed

• Are pregnant or plan to become pregnant

Females who are able to become pregnant:

• Your healthcare provider should do a pregnancy test before you start treatment with Prolia^®.

• You should use an effective method of birth control (contraception) during treatment with Prolia^® and for at least 5 months after your last dose of Prolia^®.

• Tell your doctor right away if you become pregnant while taking Prolia^®.

• Are breastfeeding or plan to breast-feed.

What are the possible side effects of Prolia^®?

It is not known if the use of Prolia^®over a long period of time may cause slow healing of broken bones. The most common side effects of Prolia^® are back pain, pain in your arms and legs, high cholesterol, muscle pain, and bladder infection.

These are not all the possible side effects of Prolia^®. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see accompanying Prolia^® full Prescribing Information, including Medication Guide.

References:

• National Osteoporosis Foundation. What is Osteoporosis and What Causes It? https://nof.org/patients/what-is- osteoporosis. Accessed September 28, 2020.

• U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.

• National Osteoporosis Foundation. Fast Facts. https://cdn.nof.org/wp-content/uploads/2015/12/Osteoporosis-Fast-Facts.pdf. Accessed September 28, 2020.

• Camacho PM, Petak SM, Binkley N, et al. American Association Of Clinical Endocrinologists/American College Of Endocrinology Clinical Practice Guidelines For The Diagnosis And Treatment Of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(Suppl 1):1-46.

• Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis [published correction appears in Osteoporos Int. 2015 Jul;26(7):2045-7]. Osteoporos Int. 2014;25(10):2359-2381.

• Amgen. Prolia® (denosumab) prescribing information, Amgen.

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AGELESS FASHION

The notion that women need to dress in an “age appropriate” way has always seemed utterly absurd to me. Did you ever wonder where this concept comes from? I’d love to know. Is there some sort of secret committee that gets together every few years to decide what women over 40 can, and cannot wear?

I don’t particularly like the idea that our membership cards to the “fashionista club” expire when we hit a certain age. Women don’t have a “sell by” date, and it really rubs me the wrong way when the media treats us as if we do. So….let’s talk fashion. Should older women be conscious of their age when deciding what styles to wear? In my opinion, no they shouldn’t. Age has very little to do with personal style. Who cares what the fashion police think? What really matters is what you think about what you wear. Does the piece of clothing flatter your figure and your coloring? Does it reflect your personality and make you feel pretty and powerful when you wear it? If the answer is yes, then it’s appropriate for you.

I borrowed this dress and motorcycle jacket from daughter’s closet. Even though there is 32 years between us, we often share clothes, and a lot of what she owns could be worn by her millennial friends. Fashion is about expressing your individuality, so don’t let your inner critic tell you that you are too old to wear a style if you truly love it. Clothing can be worn a million different ways, so there’s always a way to style a piece to make it work for you regardless of how old you are. The rules are changing, and the days when a twenty-something at Vogue had the power to dictate what we wear and how we wear it, are officially over. Long live ageless fashion!