Renee Yacoub Kawas

Age 83 • Palestine

Patient story

Now 83 years of age, Renee Yacoub Kawas was once a much taller woman.

She is now a petite 147 cm (4 ft 8 in) tall, at least 11 cm (4.3 in) shorter than she used to be!

Height loss is one of the few visible signs of osteoporosis, a disease which progresses silently and without any apparent symptoms until a bone breaks. In Mrs. Kawas’ case, osteoporosis caused multiple vertebrae to compress or collapse, leading to height loss, pain and a stooped back.  

It has been more than 10 years since Renee was diagnosed with severe osteoporosis and prescribed alendronate (a bisphosphonate) treatment together with calcium and vitamin D supplements. In 2015, her DXA exam revealed T-scores of -4 at the spine and -2,8 at the hip. Her doctors decided to stop treatment for a while, but continued to follow up on her regularly. 

Anyone with severe osteoporosis is extremely ‘breakable’ - even after a minor fall from standing height. Unfortunately, Renee experienced just such a fall in June 2017. 

The result was devastating: a fractured shoulder, and a broken hip which required surgical treatment. A DXA exam revealed that her T-score at the spine and hip at that time were -4,4 and -3,4, respectively. She was consequently started on Denosumab injections, once every six months, and continued with calcium and vitamin D supplements. A further setback has been the development of Polymyalgia Rheumatica which is treated with prednisone (a glucocorticoid). Given that glucocorticoid medication causes bone loss, her doctors have gradually reduced the amount she takes. 

With such severe osteoporosis and history of multiple fractures, Renee is wise to continue her medical care and adhering to treatment as recommended. She realizes that this will help protect her from more fractures, so that she can maintain her quality of life as much as possible. 

Her doctor carefully monitors her bone health, and a new DXA scan is planned in the near future.