Some may notice a slight loss of height. Often a broken or fractured bone is the first sign that there may be a problem with bone mass. This is why bone density scans are recommended for people as they age, the first around age 50 to get a baseline reading and another after 1 to 2 years to assess the rate of bone loss. Ivy, being a 60-year-old Asian-American woman, has several additional possible risk factors for osteoporosis. Up to 90% of Asians are lactose intolerant (WebMD, n.d.), which could lead to a reduced dietary intake of calcium, which is necessary for bone development. Many Asians also have a slim build, so they have less bone mass to begin with. Ivy was also diagnosed with rheumatoid arthritis several years ago. Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks its own cells, especially around the joints. It causes pain, inflammation and stiffness in the affected joints, especially those of the hands and feet. Some drugs given for rheumatoid arthritis, called glucocorticoids, can trigger greater bone loss, and this loss is greatest near joints that show symptoms of rheumatoid arthritis. Ivy suffered a broken ankle, where rheumatoid arthritis tends to be