And in my bones a typhoon coming.

( Multiple Myeloma is one of the many causes of bone pain)

SHE SAYS her fatigue and achy bones led her to the doctor's clinic.

Canadian- Indian film star Lisa Ray, whose latest role is in Dilip and Deepa Mehta's film Cooking with Stella ( which got a Gala Red Carpet Premiere at the Toronto International Film Festival) has gone public recently about the fact that she is suffering from a disease called Multiple Myeloma.

Lisa's experience is a wakeup call for us to pay attention to the body's signals: Those of us who experience bouts of bone pain shouldn't ignore them.

This pain is not the same as joint pain or muscle pain and can be caused by injuries, arthritic conditions or for other more serious reasons like multiple myeloma. Here we tell you more about this cancer, also called myeloma bone disease, and also other causes of bone pain.

MANY RISK FACTORS MULTIPLE

myeloma is a relatively rare kind of cancer of the bone marrow, and generally occurs in people above the age of 65. Many different factors may increase a person's susceptibility to this condition. These include a family history, exposure to petroleum and other chemicals, and high amounts of radiation. " The cancer generally occurs in old people but now more and more youngsters are being diagnosed with it. There has not been any concrete evidence but exposure to chemicals in food and stressful lifestyle are reasons for this," says Dr Amit Bhargava,

consultant oncologist, Max Healthcare. Obesity is a risk factor for many cancers too, including this myeloma bone disease. Those exposed to heavy metals, some hair dyes, plastics, various dusts including wood dust, asbestos, herbicides, insecticides, petroleum products also run a higher risk of developing multiple myeloma. Autoimmune diseases such as rheumatoid arthritis and others such as HIV/ AIDS compromise the immunity and consequently up the risk.

SYMPTOMS & TREATMENT SYMPTOMS

include a persistent and unexplained tiredness, bone pain, weight loss, numbing or weakness in the legs, excessive thirst and urination.

While these may signal something else, a checkup is advisable. When this cancer occurs, the body overpro-

duces certain white blood cells called plasma cells. These become abnormal and are referred to as myeloma cells.

They collect in the bone marrow and outer layer of the bone, thus affecting the bones. While the disease is incurable, treatment can prolong life by 7- 10 years and is chosen based on the stage at which the disease is diagnosed.

The treatment of multiple myeloma is complex because of rapid advances in stem cell transplantation, medications, and better supportive care, which have led to improved survival for patients with multiple myeloma over the past thirty years. Chemotherapy, Immune modulating treatments such as thalidomide, stem cell ( bone marrow) transplantation, and corticosteroid therapy are the protocols adopted by oncologists.

Injections of zoledronic acid that increase bone strength and a high protein diet are generally recommended. " A bone marrow transplant is recomdiarrhoea, ( mended for patients under 65 who show good success with chemotherapy. Some medications are very successful but there is no perfect cure yet," says Dr Bharagava.

OTHER CAUSES OF BONE PAIN

IT'S A good idea to seek out prompt medical attention for correct diagnosis and proper treatment whenever you experience bone pain and tenderness.

Bone pain may be the result of several health conditions, ranging from arthritis, tuberculosis to cancers and even sickle cell anaemia. Doctors suggest that you rule out the commonest causes firstosteoporosis, osteomalacia, and malabsorption syndrome. Malabsorption is a broad term used to describe the inability to absorb nutrients through the gut lining into the bloodstream.

The most common symptoms of malabsorption syndrome are

diarrhoea, bloating, flatulence, cramping and weight loss. This is not a disease by itself, but rather the result of some other existent condition, such as some defect or damage to the mucosal lining of the small intestine where most of our nutrient absorption takes place. Malabsorption may affect one or more of the nutrients present in the diet, including protein, fat, carbohydrate, vitamins, and minerals. Over time, a person may become deficient in iron, proteins, various vitamins and minerals, leading to degrees of malnutrition and a variety of anaemias.

Protein depletion can lead to impaired bone formation and osteoporosis, and calcium deficiency leads to weakening and demineralization of the bone, causing a condition called osteomalacia. Once this happens, the bones gradually soften and bend due to poor calcification stemming from a lack or impaired metabolism of vitamin D or calcium. The most common symptoms of osteomalacia are bone pain and muscle weakness.

When it occurs in children it is commonly referred to as rickets.

The bone loss caused by osteoporosis also causes bone pain. Also referred to as brittle bones, the average bone loss experienced by a woman in the first five years of menopause is upto 10 per cent of her bone mass. As we age, bone mass loses density, and menopause can accelerate this process due to the depletion in oestrogen levels.

Oestrogen plays two important roles in bone metabolism: it facilitates the absorption of calcium from the blood into the bone and inhibits the loss of calcium from bone. Low estrogen slows down calcium absorption speeds up calcium loss. Research suggests that about half of all women over 60 will have at least one fracture due to osteoporosis.

This is also dubbed the " silent disease" as it can go undetected for years, until weakened bones cause painful fractures in the back or hips.

While investigations and tests to diagnose these conditions vary, consult a doctor if you feel any kind of symptoms, including pain, in your bones.

ritu.bhatia@ mailtoday.in

KITCHEN REMEDY

Green tea improves bone health. According to research, this tea contains a group of chemicals that can stimulate bone formation and help halt its breakdown.

The researchers exposed a group of cultured bone- forming cells to three major green tea components. These components boosted bone growth, levels of bone mineralisation and blocked the activity of a cell that weakens bones.

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