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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.


Outpatient lactation services receiving support from TMC Mega Raffle

Little Kailey Nowak decided to enter the world five weeks ahead of her due date. Her mom, Kelly, experienced difficulties with breastfeeding almost immediately. “She wouldn’t latch on, or if she did, it would only be for a few seconds,” she said. “It was awful. I cried every single day for six weeks as I pumped and fed my baby through a bottle. My plan was to breastfeed, and when I couldn’t, it truly felt like I was failing as a mother. People were

The family lives in Sierra Vista and with few lactation support services available there, Nowak’s pediatrician suggested she seek expert advice from the lactation specialists at TMC, where she had previously rented her hospital-grade breast pump. “I didn’t know what to expect, but the lactation specialists solved my problems and had Kailey successfully breastfeeding just two minutes into my session. It was the most magical moment of being a mom. I finally felt like I was doing a good job for her, and I wish I would have pursued this help sooner.”

The Mega Raffle provides funding for new moms to visit the outpatient breastfeeding clinic even if the service is not covered by their insurance or if they cannot otherwise afford it.




This is the fifth of our six-part series of blogs that show how the TMC Mega Raffle is making a difference for patients and the community.


“I’ve got things to do and places to go” Breast cancer survivor Izora Earl

Breast Cancer Survivor Izora Earl Izora Earl had every right to be anxious when she found out in spring 2014 that she had an aggressive form of breast cancer.

Breast cancer had claimed her mother and her grandmother.

But Izora wasn’t anxious.

A woman of faith, Izora instead settled into a place of determination. “I was like, ‘OK, Lord, I know you’ve got this. I’m going to break the chain. I’m going to get over this.”

Then it was her doctor’s turn for her faith. “I remember the last thing I said before I went into surgery: I’ve got this. Do you?” Surgeon Kelly Favre looked at her and said, ‘I’ve got this.” Izora closed her eyes and embraced the chance for healing.

Izora, who had a successful lumpectomy at Tucson Medical Center in May, jokes that she just has too much to do to let cancer sideline her. An image consultant who, at 73, is retiring for the third time, she quips she’s planning on being at the mall – or better yet – traveling to some fantastic locale like Costa Rica.

“But in all seriousness, I wish more women would be more aware and take care of themselves,” said Izora, who gets an annual mammogram and credits the technology with catching the disease early, when it is more easily treated. “Women are always so busy taking care of everybody else, whether it’s their kids or their parents or their husband, that they don’t always take the time to do what they need to do for their own health.”

Karen Narum, the women’s health care nurse practitioner at the TMC for Women Breast Screening Clinic, said what many women may not know is that only 5 percent of women have a genetic predisposition to breast cancer. The Clinic does a statistical model with screenings, taking history into account, but for Narum, the bottom line is that preventive care is important. “Really, we’re all at risk for breast cancer. You shouldn’t feel secure just because it doesn’t run in the family, because the vast majority of women with cancer don’t have that family history at all.”

Breast Cancer survivor Izora Earl with dog MistyIzora’s own strength has been tested a number of times. Her father died before she was born. When she was born, doctors didn’t think they could save her – but had underestimated her will to live. She survived four heart attacks in the eight years preceding 2011. She nursed her mother through her illness and then honored her wishes when she finally had to be hospitalized to not be resuscitated – which she describes as the hardest thing she’s ever done. And in 2013, she lost all three of her older brothers in a matter of months to either cancer or heart attacks.

“I’ve always been a glass-is-half-full kind of person,” she said.

Any given day might find the Southeast Side resident working out at a gym or walking on a treadmill to stay in shape.

She has a number of reasons to value her health, with three adult kids who keep her faithful to that treadmill and just gave her a new cell phone to master, not to mention eight grandchildren and one great grand-child. “I just knew then, and I know now, that I’m going to be OK. I’ve got things to do and places to go.”


Eat Right…Your Way, Every Day – Mary’s Words of Wellness

Mary Atkinson is the Director of Wellness at TMC, she’s also part of the team organizing the TMC for Women Bootcamp. In Mary’s Words of Wellness we share her updates as we make 2013 the year we take care of our health.

Mary Atkinson, RD, Director of Wellness,

Mary Atkinson, RD, Director of Wellness,

March is National Nutrition Month, so let’s talk FOOD!  Food is a very personal and individual thing.  What satisfies and makes one person feel wonderful, may make another feel awful and cause their blood sugar to soar.  That is why I really like the theme for this year’s National Nutrition Month…”Eat Right…Your Way, Every Day” implying that our preferences, lifestyles, cultural and health concerns impact our individual food choices.  While there are some general guidelines that can be applied broadly such as choosing lower fat foods, increasing our intake of fruits and vegetables, or choosing whole grains, specific food recommendations must be tailored to the individual.

This is why so many diets don’t work long term.  They make sweeping generalizations that either don’t work for an individual’s lifestyle, or so restrictive that it is near impossible to maintain.  Diets by nature aren’t ever going to work because they are always “started” which implies we will end them at some point.  When we do stop dieting or slip up, the weight returns with our previous unhealthy eating habits. Why then do we tend to fall prey to the diet that proclaims things we logically know can’t be true….because regardless of how intelligent we are, it is impossible not to get sucked into the idea of getting something for nothing!  Who wouldn’t want to “eat whatever you want” and still lose weight?!   SIGN ME UP!  But alas, it never works, so we must rely on the tried and proven method:  Consistently make the healthiest food choices you can that fit with your lifestyle.  The Academy of Nutrition and Dietetics website, Eat Right, contains some of the top fad diets that have popped up over the past century.  It is interesting to see how many show up repeated, just re-named.

How do we make healthy food choices when there seems to be so much conflicting information?  Carbs are bad, carbs provide energy…Meat causes cancer, choose lean meats….have three servings of dairy, dairy is bad for you!  If you buy into everything you read, you will think that nutrition professionals are crazy, or perhaps you will realize that all sources aren’t necessarily reporting information accurately.  Here are a few suggestions from TMC’s Medical Librarian, Marni Dittmar, about how to find and recognize legitimate health information:

  •  Look for sites that end in ‘.org’ or ‘.gov’
  • Avoid any site that demands your personal information before giving YOU information or one that charges money
  • Avoid sites that tells you, in any form, that your doctor is wrong and that only that site can help you
  • Avoid sites that states “limited time to take advantage of this special offer..”

These three sites that contain GOOD information on nutrition and consumer issues.  All of these are government sites, all FREE to access, with full text to download:

National Institute of Health 

 Medline plus

and the FDA home page (here is the consumer site within FDA)

Have a healthy week!


Hello, It’s Nice to Meet You – Denise Navarrete

Denise Navarrete is part of the wonderful team at TMC for Women Breast Center. Denise and the team at the Center use full-field digital mammography system as well as ultrasound and minimally invasive stereotactic biopsies. There are even on-site pathologists ensure quick delivery of test results. Meet Denise.

Where are you from? Tucson native or not? How long have you been in Tucson?
I was born in Fort Wayne, Indiana and I’ve lived in Tucson since 1972

What do you love about Tucson?
I love the weather, October and March are my favorite months, also the small town feel that Tucson still has.

What do you do for fun?
I like walk, read, and go to yard sales.

What do you love about your job?
The best part of my job, is my patients. I enjoy meeting them, and helping them get an important screening exam. We also have a great group here at the clinic, and we all work well as a team.

What do you want all women to know about breast health? About the TMC Breast Center?
All women should be screened age 40 and on. The two most important risk factors are being a woman, and age. As we get older, our risk for breast cancer increase.
Our breast center is comprehensive and we have experienced and knowledgeable technologists, radiologist and a nurse practitioner who also acts as our navigator.

What would you tell your 18 year old self, 25 year old self, 35 year old self?
18 year old self: -slow down, enjoy life.
25 year old self: -my parents actually gave me good advice
35 year old self: -take care of your health, watch what you eat and exercise

Check out our recent blog posts on mammograms, breast self-examinations and our Women’s Voices.

Welcome to TMC for Women

From heart disease to stress response we hope this space can be an informal gateway to learning more about women’s health issues, your community hospital and what we have to offer you and your family. Here we plan to tell you of upcoming events and classes, share stories and introduce our staff and resources.

Why a social media space specifically for women’s health? For years medical research was predominately focused on men. The impact and understanding of a disease, of its treatment, of how we might respond was mainly based on how men reacted. We now know that women’s responses and health needs, be they physiological, social or emotional, are not always the same as a man’s.

As the body of research grows that includes studies with women, not solely men, we want to address women’s health concerns, share this new information and dispel myths.  If there is some aspect of TMC for Women that you would like to learn more about please contact us at