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Senior Services

Osteoporosis: “The most important factor is prevention”

May is Women’s Health Month, a great time to celebrate and promote stronger health and a perfect time to discuss the latest information about preventing and treating health challenges like osteoporosis.

More than 44 million American women experience the debilitating effects of the bone disease, and many women fear aching joints and brittle bones are an inevitable part of aging. It is important to know the risks, and engage opportunities to maintain optimum bone-health.

Dr. Lawrence R. Housman is an orthopaedic surgeon who specializes in musculoskeletal disease at Tucson Orthopaedic Institute. He sat down with us to discuss the best ways to prevent and treat osteoporosis.

osteoporosis, know your risksWhy are women at greater risk for osteoporosis?  

Women start with a lower bone density than men. They also lose bone mass more quickly as they age. Between ages 20-80, women will lose about 1/3 of her bone density compared to men who lose only 1/4 of their bone density in that time frame. Estrogen levels also affect bone density, and women lose bone mass more quickly in the years immediately following menopause than at any other time of their lives.

What can accentuate this risk?

Alcohol in moderation is not a risk factor, however more than four drinks per day results in a twice the risk of hip fracture. Steroids can also increase this risk. Long term use of steroids will double the risk of fracture in women.

It should be noted that proton pump inhibitors (e.g. Nexium/Protonix used for stomach disorders such as acid reflux) decrease the absorption of calcium from the stomach.

While increasing fiber, phylates (beans, wheat bran), oxalates (spinach, beet greens, rhubarb) and phosphorus (colas) can provide other health benefits they can also interfere with calcium metabolism.

What are the most effective means of preventing osteoporosis?

Regular exercise is one of the most effective means of preventing osteoporosis. Thirty minutes per day – walking is excellent, and Tai Chi reportedly decreases falls by 47 percent and hip fracture by 25 percent.

Nutrition is another import part of maintaining healthy bones. Fruits and vegetables are important. Women ages 19-50 should take in 1000 mg of calcium daily and women older than 50 should get 1200 mg per day.

Vitamin D is another vital nutrient the body needs to prevent osteoporosis. An individual can get their vitamin D through measured exposure to sunlight or through supplements. A diet with dairy, protein or calcium fortified foods (e.g. orange juice), fish (salmon/sardines) and yogurt (6 ounces has 300 mg of calcium) will go a long way in getting vitamin d to the bones.

What are the warning signs of the disease – and when is it time to see a doctor?

There are usually no warning signs before a fracture occurs; therefore, the most important factor is prevention.

A primary care provider (PCP) is the best person to monitor bone health. Most physicians recommend a DEXA (bone density test) after the age of 50.

The DEXA scan is the bone density test done most frequently and is predictive of fracture risk. The scan will also show whether you have normal bone density, osteopenia (bone is becoming weaker) or osteoporosis (bone is at high risk for fracture).

If a fracture occurs, then an orthopaedist would enter the picture to advise on treatment concerning the spine or extremity fracture.

If diagnosed with osteopenia or osteoporosis – what’s next?

With treatment patients can live normal, active and happy lives.

There are many types of medications that are now available – which work to reverse and then rebuild the bone loss. With treatment, the risk of a vertebral fracture drops from between 30-70 percent and the risk of a hip fracture drops by up to 40 percent.

Dr. Housman is an orthopaedic surgeon who practices at the Tucson Orthopaedic Institute. He earned a medical degree from the University of Alberta in Edmonton, Canada and completed an orthopaedic surgery residency at the Montreal General Hospital and McGill University. Dr. Housman is fellowship trained in several orthopaedic pursuits and is a past chief of staff at Tucson Medical Center. He has also served as president of the Western Orthopaedic Association and Arizona Orthopaedic Society.


Soothing complementary therapies made possible through TMC Mega Raffle

Meaningful and compassionate hospice care is more than meeting complex medical needs. 

Thanks to the support from the TMC Mega Raffle, Tucson Medical Center offers soothing therapies that provide comfort, joy and peace for hospice patients – from the calming melodies of a harp, to the therapeutic knead of massage, the ease of a paintbrush stroke, and  the warm friendliness of a pet. 

Music, massage, art and pet therapies are only a few of the meaningful complimentary services offered at Peppi’s House, TMC’s inpatient hospice program.  

“It made a noticeable difference,” said Krista Durocher, the volunteer services coordinator at Peppi’s House. Massage therapy made a significant difference for Durocher’s grandmother, a hospice patient who struggled with pain and discomfort. “She was so relaxed after her massage. It was so wonderful to see her more comfortable and calm.”

The complimentary services at Peppi’s are carefully and thoughtfully chosen, from reflexology and aromatherapy to reiki and craniosacral therapy. 

“Each service has supportive data and is evidence- based,” said Director of Hospice and Palliative Care Alicia Ferguson. “We care very deeply for the patients and we provide the most effective complimentary services, assured to make a positive difference in a patient’s comfort and quality of life.”

Peppi’s House is a special place for many reasons, and one of them is the pediatric inpatient program. The complimentary therapies have an even stronger impact on children and their families. 

“It is simply wonderful to see a child’s face light-up when a pony walks in; the child and their family are all smiles – forgetting the seriousness surrounding them,” said Ferguson. Plans are in the works to grow children’s hospice services, and the Mega Raffle will be an important part of making the expanded services a reality.

Each TMC Mega Raffle ticket sold is helping hospice patients when they need it most.



This is the last in our six-part series of blogs to show the meaningful impact the TMC Mega Raffle funding has for patients and the community.

Finding what works – An Action Plan for Health

… I sneak out of the house before the children and my husband wake. The dog pulls on the leash urging me forward – today I’m part way to succeeding on my four times to get moving this week. Yesterday, I didn’t track my food, but the previous two days I did. I’m feeling successful. I haven’t given up. This isn’t futile. I have a plan. I have a goal….

We often highlight women within our community who have taken charge of their health and the message is clear, make time, find support within your friends and family, get moving, and get moving early in the morning. Yet, some of us (me) still struggle to take care of ourselves despite all the reasons to move our bodies, to eat right and to prioritize our health. Sometimes, despite knowing what we should be doing, we seem to sabotage ourselves at every turn. I sat down with Karen Ring, one of TMC’s fabulous Senior Services health coaches to seek some insights. While I might not be a senior, Karen’s advice is not bound to a particular age.

What is a health coach?

Karen and her fellow coaches provide one-on-one support to peer seniors within the community to help them attain their health goals. A free program offered by TMC Senior Services, the Health Coach program emphasizes discussing positive ways to manage health, and motivates and supports participants to move beyond a prescription for healthy living to making daily healthy choices. You can find out more information here.

Karen’s Advice

Many self-improvement plans involve some sort of action plan or goal settings. There is something about the verbalization of our intentions, especially in the written form that often makes us more accountable. I used to tell my middle school students, when they asked why science class required them to write, that the process of articulation in the written form and explaining our reasoning to another forced us to face whether we truly understood. Karen explains that for a health coach and peer, after reviewing the peer’s medical and nutritional history, the action plan is a central part of coaching. It is within the goal setting, the development of an action plan, execution and follow-up that the coach finds the place to act as a resource, an educator, an advocate, a sounding board and a cheerleader to their peers.

As we begin to discuss the action plan I start to see just how powerful this tool can be, especially in concert with the support of a health coach. This is more than a mere list of intentions for the week or the month of the sort I’ve engaged in years gone by; this is truly a tool for reflection.

The basic components of the action plan:

1. Establish your short-term and long-term goals so that they have a tangible reward as well as the loftier health goals and write those on the top of your action plan. Karen shares that while the participants are usually motivated to join by a recent medical diagnosis, like high cholesterol, the actual goals often tap into emotional and spiritual health. Her role as a health coach is to consider whole body wellness, not just physical wellness, and to consider barriers to achieving those wellness goals.

2. Make an appointment with your health and keep it.

If your plan states that you’re going to go to the gym or take the dog for a walk don’t cancel that appointment for another function because it seems less important. You have an appointment with your health, and that IS important.

The action plan asks you to identify when and how much of something you plan to do. Are you more likely to get up in the morning and walk? If you put off the exercise until the evening will it never happen?

3. Be specific about how much time and energy will go into meeting your weekly goal. A concrete example – you set a goal to eat a more balanced diet, but then don’t actual turn that intention into action. Karen suggests being very detailed in the action plan. Write into the plan a dedicated time to plan meals and snacks, to shop for fresh produce and to prepare the produce in one sitting so that you can use it for those planned healthy meals.

I think about the fruit salad in a little lemon juice my own mother always seems to have in the fridge ready to go, or my friend Trish who keeps salad fixings chopped and cleaned ready in separate clear storage containers to be tossed together at a moment’s notice for a healthy meal. Karen points out that addressing what will appeal or work for the individual is key. For me, those fresh veggies and fruits already prepared and ready to eat means they’re less likely to end up rotting in the veggie draw and then making their way to the compost.

4. Be realistic and flexible about your action plan. Allow wriggle room to be successful.

A crucial part of the action plan is reflecting on the steps you plan to take and being realistic about whether you’re going to attain that. I know that week after week I say I’m going to track what and how much I eat. I know this is a successful strategy for many, yet week after week I fail. Karen suggests I reassess my action plan.

What is my confidence level that I could track for one day out of seven on a scale of one to 10?

Ten, I respond. I know I can do that.

Good. What about two days?

An eight or nine.

What about three days of tracking?

ActionPlan1I have a confidence level of between seven or eight.

Right there at a confidence level of no less than seven, Karen suggests, that is your goal.

“Once your confidence level dips below a seven rethink your goals.”

The emphasis is on being successful and that success breeds success. If I can be successful for three days this week maybe next week or the week after my confidence will be higher so that I can accomplish four days of tracking.

This morning I remember Lorraine’s dedication, Mary’s insistence that we can all find 30 minutes in the day, Rachel’s passion for renewal, Patty’s commitment and Jessie’s energy. I sneak out of the house before the children and my husband wake. The dog pulls on the leash urging me forward – today I’m part way to succeeding on my four times to get moving this week. Yesterday, I didn’t track my food, but the previous two days I did. I’m feeling successful. I haven’t given up. This isn’t futile. I have a plan. I have a goal.

Your TMC for Women Action Plan for Health template is here.

It’s Your Time – A Role Model Jessie Pergrin

Every week is women’s health week at TMC for Women, but nationally the week of May 13 is a dedicated National Women’s Health Week. We’re recognizing National Women’s Health Week by sharing the stories of some of our TMC community – women who have taken the message of National Women’s Health Week to heart with impressive results.

This year National Women’s Health Week’s theme is ‘It’s Your Time’. Many of us struggle with finding time to make our health our priority, the women in these stories are making it happen. Meet Jessie Pergrin

“I’ve been active all my life,” Jessie  shares. “I’ve hiked and backpacked all over the world – the Inca Trail, Chile, Argentina and Alaska.”

Jessie’s voice is strong, vibrant. Over the phone it is impossible to gauge just what age Jessie is.  A participant in Senior Services’s Health Coach program she must be of retirement age, but she also leads multiple support groups for patients with Alzheimer’s and their caregivers. Her voice and her energy belies her age. Jessie is 86 years old.

Jessie joined the Health Coach program at its inception several years ago- the purpose of the program is to help participants set and keep health goals. For Jessie who does not have specific health concerns, her goal was to lose 10 pounds. Jessie’s health coach, Judy, meets with her on a monthly basis providing encouragement, checking up on her progress based upon the goals and needs they have established and spurring her to make time for her health and to stick with it. At 86 years old Jessie rises early, walks 30-40 minutes every day, returns home for breakfast, and heads back out for a 30-45 minute bike ride. She credits her robust health to being active, genetics, never smoking or drinking and never being overweight. Jessie laughs and adds, “and that I never married.”

Jessie met her goal of 10 pounds, but continues to check in with her health coach Judy finding that the accountability helps her stick with it. When asked what her advice is to other women that they might enjoy such ruddy good health Jessie encourages eating well, getting a good night’s sleep, being physically active at least three times a week and emphasizes being socially active for mental health. “For Heaven’s sake cut out the cigarettes.” Jessie pleads.

As each of us assess what our goals are perhaps taking a moment to listen to the strong, vivacious voice of a lively 86-year-old is a good place to start.