Larry Funnell used to call himself a klutz. Friends joked that he couldn't fall without breaking a bone. Despite his desk-bound job as a federal bureaucrat, by the age of 47, he had fractured both wrists, his upper arm and clavicle, several ribs and his spine.
In all, he suffered eight fractures before a doctor suspected that Mr. Funnell's injuries might be due to weak bones. A bone-mineral-density test revealed osteoporosis.
Mr. Funnell, now 59, says the diagnosis blindsided him. "I thought osteoporosis is a disease that little old women get - not men."
The notion is one of many misconceptions Osteoporosis Canada is determined to change. One in eight men over the age of 50 has osteoporosis, compared with one in four women of the same age group, according to the non-profit organization. New guidelines released last week advise that anyone over 50 who sustains a fracture should be assessed for the disease.
"Quite frankly, you should not break a bone if you fall from standing height," says Famida Jiwa, acting president of Osteoporosis Canada.
Identifying fractures as a major risk factor for osteoporosis marks a radical shift from previous guidelines, which focused on testing levels of minerals such as calcium in patients' bones as they age.
Bone-mineral-density testing remains an important diagnostic tool, Dr. Jiwa says. But she adds that too many Canadians with small fractures of the spine, hips and wrists are left untreated because doctors and patients are unaware that osteoporosis may be the culprit.
A hunched back, loss of height and aches and pains in the spine are not normal signs of aging, Dr. Jiwa says. Rather, they are indications of tiny breaks known as fragility fractures that result from brittle bones. Without treatment, Canadians who suffer hip or spinal fractures face an increased risk of subsequent breaks, deformity and death, she says.
Osteoporosis Canada estimates that the cost of treating fractures adds up to an annual burden of $1.9-billion to the health-care system.
But only 20 per cent of women and 10 per cent of men who suffer a significant fragility fracture are assessed and treated for osteoporosis, according to Suzanne Morin, an associate professor of medicine at McGill University and co-author of the new guidelines.
"A lot of people disregard the fracture, saying it's an accident," she explains.
Mr. Funnell says his disease might have been caught earlier if the link between broken bones and osteoporosis was better known. "I could have avoided some of those fractures."
According to Osteoporosis Canada, patients with risk factors for the disease - including a fracture, a family member who broke a hip, a history of taking corticosteroids and a low result from a bone-mineral-density test - should consult a doctor who can assess the need for drug treatment and recommend an exercise program suitable for the patient's skeletal health.
For patients who have already suffered a fracture, the guidelines recommend a vitamin D intake of 2,000 international units per day, plus 1,200 milligrams a day of calcium from a combination of dietary sources and supplements.
In addition to taking calcium and vitamin D supplements, Mr. Funnell receives an annual infusion of medication to stimulate new bone formation. He estimates that he walks 14 kilometres a day in his current job at a Home Depot in Cloverdale, B.C.
Mr. Funnell credits his treatment regimen for preventing fractures after his diagnosis, and adds that the Canadian Osteoporosis Patient Network, an arm of Osteoporosis Canada, taught him the mantra "always know where your feet are."
But he admits that it took him years to reach out to the support group. When he first learned he had osteoporosis, Mr. Funnell hid the disease from everyone except a few close family members and friends. "I was embarrassed," he recalls.
The stigma of having osteoporosis is especially strong for men, says Mr. Funnell, who now chairs the national patient network and gives public talks about his experience with the disease.
His next talk is scheduled for Oct. 26 at the Kerrisdale Community Centre in Vancouver. But he says he won't be surprised if he is greeted by a sea of women. "Men just aren't ready to talk about it."