How A Bone Disease Grew To Fit The Prescription : NPR

Katie Benghauser had no concept of all the forces that combined to bring the box of pills to the bottom shelf of her medicine cabinet. All she knew was that three years ago she went in for a routine checkup and her doctor told her it was time for her to take a test.

Not that there was anything in particular about Benghauser that suggested sickness. At 54 she exercised every day and could outrun most 20-year-olds. She was a model of health.

Still, because Benghauser was thin, white, female, in her 50s and had a sister who had some bone problems, she says the doctor told her that she was concerned. "She felt like because my frame is slight and I'm female, that I was at risk for developing osteoporosis."

Osteoporosis is a disease that causes bones to become thinner, more porous and break more easily. It mostly affects elderly women, who can be devastated by a fall that breaks their hip. One in five elderly women who break a hip will die within a year. Still, just to make sure, Benghauser went in for a test that measured the density of her bones. Two weeks later a letter came in the mail with an unsettling message: Benghauser had a condition called osteopenia, and her doctor recommended medication.

Osteopenia is different from osteoporosis. In fact, though Benghauser is extremely health conscious, she wasn't familiar with it. "I'd heard of osteoporosis before, but I'd never heard of osteopenia," she says.

Osteopenia, it turns out, is a slight thinning of the bones that occurs naturally as women get older and typically doesn't result in disabling bone breaks. Still, Benghauser's doctor recommended that she go on treatment. As Benghauser asked around, it turned out that many of her peers were taking the pills. For example, she works in an office in Richmond, Va., with seven other women.

"Half the staff is younger, in their 20s and 30s, and then there are four of us that are over 50," she said. "Three of those four are on some kind of medication for osteopenia."

This is the story of how pills for osteopenia ended up in Benghauser's medicine cabinet, and in the medicine cabinets of millions of women like her all over the United States. But more broadly, it's the story of how the definition of what constitutes a disease evolves, and the role that drug companies can play in that evolution.

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Matt Birk and other NFL players accept pain as part of the game - ESPN

There is no way to write this without some collective eye rolls from the lower tax brackets of the world. Sure, fellas, tell us about your aches and pains and your multimillion-dollar bank accounts.

Most players won't even talk about it, the price they pay, because in a league full of tough guys and a country with a 10 percent unemployment rate, it just comes across as whining. The game flashes over the TV for three hours on Sunday afternoons, and the average fan heads to work Monday without much thought as to what happens next. But when the camera lights dim, the next 48 hours reveal the true toll on an NFL player's body and how everyday life can be difficult to navigate.

Throughout three separate conversations in which Birk reconstructed for ESPN.com what a typical Monday and Tuesday feel like for a veteran, he wanted to make a few things clear: That he willingly signed up for this 12 years ago and has no complaints or regrets. That he feels lucky to play the game he loves, make a great living and be surrounded by teammates who ultimately become close friends.

Their bond, in large part, is forged from the fact that they're the only ones who know what they go through.

It's a fraternity of long-term pain and lifelong consequences that are suppressed in a 17-week, suck-it-up-and-play vacuum. Pittsburgh Steelers receiverHines Ward reflected that culture earlier this month when he initially questionedBen Roethlisberger sitting in the thick of the playoff hunt while the quarterback was still suffering lingering effects of another concussion.

Birk, who once donated $50,000 from one of his game checks to assist retired NFL veterans, is keenly aware of what might lie ahead for his body 10 years from now. He just can't think about it. In December, all a veteran thinks about is survival. Can his body hold out for a few more weeks? Can he play the way he did in September?

"Guys play the game for different reasons," Birk says. "One of them is the challenge, the physical challenge, the mental challenge, to see how much you can take. How much you can withstand. And it's about developing that perseverance every week. Getting your body and your mind ready to go.

"I mean, everybody's sore. Everyone who played yesterday is sore today. That's just part of the game, and you're not going to last if you can't deal with it."

Birk settles in with a cup of coffee on the Monday after the Lions game earlier this month, Victory Monday, which means the Ravens get the day off. But it's never really a day to relax. His ankles, knees and fingers are sore. His shoulder hurts. That popped this morning, too.

When he got into his truck, he had to lower his head, which triggered a fairly constant pain in his neck. Birk has spent various parts of the season on the injury report because of his neck but hasn't missed a game in three seasons. On Sundays, he says, the adrenaline is flowing and the pain disappears. Mondays are the proverbial hangover, a time to assess the damage. On this particular day, Birk says all is good. He escaped the game with just a few cuts on his hand and a gash above his nose from his helmet. That might affect his modeling career, he jokes. Nothing will change his status for the next game.

Some weeks are worse than others. When Birk goes up against Casey Hampton, the Steelers' massive nose tackle, he always seems to feel a little worse on Monday. One thing is certain: The second half of the season seems to grind at a much slower and harsher pace. If you're lucky, you have a perfectly placed bye week at midseason.

If you're smart, you don't spend Monday in bed. Birk always has been proactive when it comes to his body. The day after a game, he heads into the Ravens' facility to lift weights and "flush out" the toxins and soreness. He stretches. The Ravens have team chiropractors, and Birk takes advantage of the perk and usually sees them on Mondays.

"There's a joke that somebody, some jackass -- usually me -- always says when you're putting pads on that first day of training camp," Birk says. "They say, 'Remember how good you feel right now? It's as good as you're going to feel for seven months.'"

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