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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.

 

Exercise & Back Pain – Mary’s Promise

Hello Readers,
Have you ever had pain in your back or spine area? An injury or back surgery? Does the pain make it difficult to walk, do your everyday duties or even allow you to exercise?

Earlier I shared my health report with you regarding the cracks in my spine and being monitored for spinal fusion surgery if or when needed.  While the primary motivation for my weight loss is my promise to my Mom, being told by one of my doctors that I was morbidly obese and that would put me at risk if I were to have  back surgery was another reason to be motivated to lose weight.

There is always a risk associated with being put under anesthesia for any amount of time, but in the proposed surgery on my spine, surgery would be six to eight hours and I’d have to hope for no complications during that time.  The increased risk due to my weight was a rude awakening. With my promise to my mom on my mind daily and now knowing I may not survive surgery I knew a change was necessary. I also realized that I needed not only immediate weight loss, but to do it in the proper way.

The TMC wellness programs offered a weekly one hour exercise class which I took and started out slowly. I was given the green light by my doctors to do the light exercises which included walking and stretches. After two months my results not only included weight loss, but my endurance was better and my back pain wasn’t as severe due to exercise.

As I continued the classes and exercising, at the beginning for only for five minutes a day,  my health improved and my back and spine has remained stable without any surgery.  I make sure to find 30 minutes to walk, to exercycle and to stretch. The back pain is no longer constant and unbearable. If you have pain in your back and spine consult with your doctors about the appropriate exercise for you, and get started on  an exercise routine right for you. In the end, as a result of my weight loss I have not needed to have the surgery, my symptoms are so relieved. If in the future I need surgery, my weight will not be a complicating factor or added risk.

Mary Kmak,
Health Warrior

Mike Urquhart – TMC Wellness Instructor shares this fitness tip:
Don’t Forget Balance & Flexibility!

As we progress in age, we tend to lose our agility. Being agile is based on several factors. Probably the two most important are balance and flexibility.

Mike Urquhart, TMC Wellness Instructor demonstrates a pose for balance

Mike Urquhart, TMC Wellness Instructor demonstrates a pose for balance

Balance is our perception of our spatial awareness. We have several different receptors in our body that receive information about our movement. Due to different factors, these receptors may lose some of their function with age. With balance training we can improve our balance.

Flexibility is range of motion (ROM) around a joint. The more flexible you are, the less prone you are to injury due to stresses placed on the joint. A regular stretching program can increase your ROM thereby reducing injury. When stretching, target the major muscle groups of the body.

Mike Urquhart, TMC Wellness Instructor demonstrates a stretch for your back

Mike Urquhart, TMC Wellness Instructor demonstrates a stretch for your back

Celebrate and Educate – Joel M. Childers M.D. Women’s Surgical Center

Women’s health needs and responses are beginning to garner more mainstream attention. Recognition that we are not simply small men with added mammary tissue and different plumbing is garnering more attention from medical researchers and the media. The differences between women’s physiology and men’s, our health needs and responses to care, are significant. At TMC recognition of these needs has a long history. This year we celebrate the 25th anniversary of the dedicated women-only surgery unit, The Joel M. Childers M.D. Women’s Surgical Center.

The center is focused on providing women with a gentle, responsive environment for a whole host of surgical procedures including tubal ligations, breast biopsies, mastectomies, hysterectomies, diagnostic as well as operative laparoscopies, and simple, general and plastic surgeries. These procedures, often only discussed in whispers, address aspects that many of us consider central to our womanhood: our fertility and our sexuality. The center provides an intimate, private and safe environment where you are surrounded by female staff who can sympathize with the complex feelings associated with these surgeries. Positioned in close proximity to Labor and Delivery, the center also provides support to the obstetrics staff when a broader team approach is desired for complex deliveries.

As we celebrate 25 years of a dedicated women’s surgical center at Tucson Medical Center we invite you to join us at Celebrate and EducateCelebrate and Educate will provide insights into the latest technology used in several of our common procedures, the da Vinci robotic surgical system. This technique allows doctors to perform precise, complex surgeries using only a small incision into the body. This technique reduces recovery time, blood loss and scarring meaning a faster return back to life for patients. Get up close and view the robot from the doctor’s perspective. Hear from and talk with patients and doctors about an approach that is revolutionizing how we think about recovery time from surgery. Join us to celebrate 25 years of listening to, involving and encouraging women patients’ voices in their own health care.

Celebrate and Educate
April 21
9am-1pm
Marshall Conference Room
Tucson Medical Center